Patient Site

All you need to know

Your First visit

The Free Ortho Consultation

In your first visit You would be advised whether you would benefit from orthodontic treatment. An orthodontic treatment usually involves the wearing of braces (removable or fixed) and often the extraction of teeth. The reasons why you might need treatment are:

• To improve the appearance of the teeth.

• To improve function (to make eating easier).

• To improve the health of the teeth and gums.

In your First visit We will take a look at your mouth and teeth using only a small mirror and a ruler. All the information taken will help decide which is the best treatment for you. There are likely to be 4 possible outcomes:

• You are not ready for treatment, you might need to be reassessed when you are older

• Your Oral Hygiene  is not good enough. This might be due the presence of decayed teeth  or/and gums problems. In this case you will be referred back to the dentist or to the periodontist and you will be seem again once the situation has improved.

• You don't need treatment because the position of your teeth is perfectly acceptable, or expected to be.

• You are ready for treatment and need to decide whether to go ahead.  

If You are ready to start,  You will be  informed about:

• The option for treatment and which is the best for you

• Pros and cons of treatment, Risks and limitations

• The possible length of time the treatment will take

• The commitment needed on your part for the treatment to be successful.

You will be given the chance to ask any question and  brochure with further information will be given to you to read at home before your next appointment to take yours record.

Records Appointment 

In the Records appointment Impressions (moulds), photos and X-rays may be taken and assessed.

Using this complementary information, We will reassure the right treatment option is taken.

If everything is agreed, and understood, You will be asked to sign a written consent. Next time We will see each other will depend on:

• How many of your adult teeth have come through.

• Caries or Gums Problems.

• Extraction of the permanent teeth (if indicated) 

• The length of any waiting list involved

• Your Growing stage/Age 

In case You need to go back to your dentist to treat the decayed teeth, Gum problems or to carry out the extractions. A referral form will be given to you.

Keeping your Teeth and Gums Healthy

When you eat or drink something, the bacterias in your mouth produce acids. These acids may damage your teeth giving you Caries (tooth decay). The acid attacks can last fr up an hour after eating or drinking. The more often you eat/drink (specially sugary thing), the more likely you are to cause tooth decay. At the same time, the bacterias sticked to your teeth when you don't clean them properly may lead to gum disease. This layer of bacterias on your teeth surface is called plaque. If you leave the plaque, your gums will become red, swollen, sore and may bleed when you brush them. You may have bad breath. If gum disease is not treated the teeth will become loose and may eventually fall out.

To keep your mouth healthy, you should:

• Keep your teeth and gums clean. Good brushing is very important

• Avoid Sugary foods and drinks in between meals

• Cut down on fizzy and acidic drinks.

To Keep your teeth and gums clean, you should:

• Brush your teeth for at least two minutes in the morning and at bedtime

• Use a toothpaste containing fluoride

• Choose a manual or electric toothbrush with a small head. Electric toothbrush only work well if you uses it properly.

• Brush every surface of every tooth

• Make sure the bristles reach the part of the tooth where it joins the gum

• Move the toothbrush in smalls gentle circular movements.

• Dental Floss or inter proximal brushes may be helpful to clean in between your teeth

• Try to cut downtime number of times you have sugary foods or drink by keeping these to mealtimes.

• Avoid sugary snacks like cakes, sweets and bitscuits between meals.

• Avoid sugary drinks like fruit squashes, natural fruit juices and milk shakes  between meals.

• Reduce the intake of fizzy and acidic drinks (even sugar free ones)

• Try to stick to still water or mild between meals.

• Avoid large amounts of acidic fruit such orange and lemons.

• If you want to have a snack between meals, go for a sugar free or low sugar food such as: cheese, bread, vegetables

• Use Fluoride mouth rinse  before go to bed.

• Visit your dentist regularly to check your teeth and gums. REMEMBER: is patient's responsibility to keep visiting the dentist along the orthodontic treatment. 

• Stop Smoking

• Replace your toothbrush regularly 

• Use disclosing tablets which contain a harmless dye to stain plaque, making it easier to see for removal.

Teeth and Brace-Friendly Food and Drink

Now that you are wearing braces your diet needs to change so you don't damage your teeth or braces. Food and plaque that are not cleaned off your teeth may lead to permanent  marks or/and tooth decay.

Softer foods and a good balanced diet are advised  for a  successful orthodontic treatment. Braces and wires are fragile and easting the wrong food can break your brace and damage tour teeth. Broken or loose braces will lengthen your treatment as your teeth will not move correctly.

Soon after you get your braces fitted and sometimes when they are adjusted you may want food the need little or no chewing such as soups, pasta, yogurt and cheese. Remember to cut up sandwiches, fruits and vegetables tater than biting into them.

Try to stick to the 3 meals a day instead of snacking, but if you eat between meals select healthy food like: wholemeal bread, plain cheese, dry crackers, breadsticks, fruits and vegetables. if you ar thirsty drink still water or milk between meals. Fruit juices should be be kept to mealtimes only.

Avoid hard, sticky or crunchy food. Chewing gum, toffee, caramel should be avoided.  Apples, raw carrots, pizza crust, nuts, biscuits, celery, chicken wings or ribs are best eaten by cutting them into small pieces and chewing with the back teeth.

Chocolates, sweets, fizzy and acidic drinks should be kept to minimum and only eaten at meal times.

Orthodontic Treatment

Orthodontic treatment usually involves wearing braces, It may involve the extraction of teeth too, but only when is necessary. There are many reasons (benefits)  for having orthodontic treatment like:

• To improve the appearance of the teeth and face. Teeth become crowded with age (Age is not a limiting factor to have braces) or they start to drift following gum disease (If you are having an active gum disease, it is important this is brought under control before having braces).

• To move teeth prior to crown, bridges  or implants.

• To improve the health of the teeth and gums 

• To improve the bite and make it easier to eat.

There are many types of braces. To simplify we can divide them in: Removable and Fixed.  Invisalign is an example of removable braces.  The clear trays have to be worm 22 hours a day and you can remove them to eat and clean.

The fixed braces can be in the labial  (outer) or in the lingual (inner) surface. Harmony, Incognito and Win Braces are Lingual braces. They are bonded in the inner surface and they are virtually invisible. The Labial braces are the normal traditional braces, also known as "train tracks". You also have the discreet version known as ceramic, clear or cosmetic braces. In this case, the brackets are tooth colored making them  less visible, although  the wires are still metallic.

When you get a fixed braces, you would need to attend to yours appointments every 4-6 weeks for the brace to be adjusted. It is likely  to be sore 3-5 days each time. If necessary, simply take painkillers like Paracetamol ( if you are not allergic to) If the brace rubs your lips or cheeks, you can use wax to help.

An average orthodontic treatment  vary from 12 to 24 months but this will vary according to how severe your tooth problem is. Missed appointments or repeated breakages of the brace will add to your overall treatment time.

As part of your brace, it might be necessary  for you to wear elastics at some stage during your treatment, do stripping or use TAD or another auxiliary appliance. 

You still need to visit your dentist through the treatment. This check ups are vary important and they are patient responsibility

It is recommended to wear a gumshield if you play contact sports. A fixed brace may make it more difficult for you to play a musical instrument like wind or brass. Once your treatment is done, you will need to wear retainers. This can be Fixed or removable.

Retainers 

A retainer is an orthodontic appliance that must be worn after braces.  All patients need to wear retainers after treatment. The aim of retainers is to keep your teeth straight. 

Your speech will be different at first. Practice speaking with the retainer in place, read out loud at home on your own. Your speech should return to normal within a few days.  You might produce more saliva as well  and you should have to swallow more than usual, but this should pass after a few days too.

There are two types of reteiners: fixed and removable. Once we remove your braces, your teeth will want to shift naturally due to muscle preasure. It is crucial that you wear your retainer to prevent your teeth from moving. 

Wearing your retainer is a very important phase of the total treatment process. When your braces come off, the teeth are mildly loose. They need time to settle down in the bone until they become stable.

Following our protocol, a fixed 3-3 retainer will be placed in the bottom arch and an Essix (Clear removable retainer) in both arches. 

The fit and wear of your retainers will be checked for the next 12 months after the brackets removal. Please wear your removable retainers as described:

For the first 3 months: Wear your retainers all the time 24/7. Take it out only to eat and brush

• At the 3 months mark: Wear your retainers every other day and every night. Take it out to eat and brush.

• At the 6 months mark: You have to wear your retainer at bedtime, every night.

• At the 1 year mark: You have to keep wearing your retainer every night, but, as long your retainer inserts smoothly, you can switch to wearing your retainer every other night. However if it feels tight or has resistance, you must wear it several nights per week.  It is advisable to keep your lower fixed retainer for at least 5 years and If you decide to remove it, you still need to keep wearing  the removable one. You should expect your teeth to move a little once you stop wearing retainers. Changes in position of your teeth continue through out life and are a normal part of aging. Keeping this in mind, you must wear your retainer for the rest of your life, if you don’t, your teeth will shift back to their original position over time. 

THE ONLY WAY TO HAVE PERMANENT STRAIGHT TEETH IS TO WEAR A RETAINER ON A PART-TIME BASIS FOR LIFE

Clean your Removable (essix)retainers at least once a day to keep them fresh and free from bacteria and tartar build up. Brush your retainer with a different brush than the one you use to brush your teeth using cold water and  washing up liquid. Do not use hot water or place it in the dishwasher. Always store your retainers in its case. You can use once a week cleaning tablets or sterilising fluid to soak your retainers to get better results. Regarding to your Fixed/bonded retainers, as long you brush with a good technique, use fluoride mouthwash and use floss and superfloss to clean in between your teeth is unlikely to have a problem. It Is always advisable to visit the hygienist twice a year to remove tartar. 

Remember:

• Always bring your retainers with you to your retainer check appointments 

• Retainer use is your personal responsibility

• Contact your orthodontist  immediately if you damage or lose your retainers

• Brush your teeth for about 2 minutes, 3 times a day

• Avoid sugary snacks and drinks between meals and bedtime

• Its advisable to wear retainer for life, It’s the only way to keep your teeth straight

• After 6 months of retention, you are likely to have to pay for any repair or replacement

Microscrews (TAD)

It's a small screw inserted into the jaw bone to be used as an anchor. It can be called as well as Temporary anchorage devices (TAD)

The microscrews will be usually placed when the other surrounding teeth can not provide the necessary anchorage needed in order to move one or a group of teeth.  The microscrews can be placed at any time during the brace treatment under local anaesthetic in the area. It will be gently inserted directly on the bone although some patients will feel an odd pressure sensation while the screw is inserted. The screw insertion itself is not painful, but some patients will have mild ache in the area for 24 hours after the anaesthetic wears off.  If necessary, simply take painkillers like Paracetamol ( if you are not allergic to) The brace can be engaged to the screw immediately or in a latter appointment.

Once is in place and working, gently brush around it twice daily using a fluoride toothpaste. Avoid using an electric toothbrush and don't play with it with your fingers. Use chloehexidine mouthwash to rinse twice a day for the first week. If you screw become really loose or detached contact the dental practice immediately.  The screws will usually stay in for several months  and once the tooth movement is complete or they are not longer needed, the screws are taken out.

Risks: 

• The screw may touch a tooth root during placement. The root should heal with no problems

• The screw become loose, it can usually be replaced in the same position at  later visit or in a different position. 

• 5% of the screws break during insertion. If this happens, the end of the screw may be left in the bone. This won't cause any further problems.

• 15-20% of the screws fail early and need to be removed

• Infection is very unlikely if you keep the area clean.