Orthodontic Patients

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When to See an Orthodontist

If you’ve been thinking about orthodontic treatment for yourself or someone you care about and looking for orthodontics near you, you may be wondering: When is the right time to see an orthodontist? It’s an excellent question, and there are several ways to answer it. The most basic one is this: You should see an orthodontist any time you have a question about the alignment of your teeth or the quality of your bite. Sometimes, a problem in this area is painfully obvious. For example, you may have difficulty biting, chewing or speaking, or some of your teeth may be clearly protruding, crowded or misplaced. If that’s the case, then it’s time to consult with our office —an orthodontist has the special skills and training needed to diagnose and treat the problem.

Other conditions may not be as clear cut. Mouth breathing, clenching or grinding your teeth, and the inability to comfortably close your lips may be signs that orthodontic treatment is needed. Likewise, if your jaws seem to frequently shift in position or make sounds as they move, or if you find you’re unintentionally biting your cheek or the roof of your mouth, you may have an orthodontic issue. Teeth that meet abnormally can even cause a facial imbalance (asymmetry), meaning that some facial features aren’t in proportion with others. This is a problem that can often be corrected by orthodontic treatment.

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What to Expect At Your Initial
Orthodontic Treatment Visit

We are always excited about meeting new patients at their first visit to our office. Your initial appointment will consist of a thorough examination and a discussion of potential treatment options. This important visit will give us insight into your orthodontic needs.

During the initial examination for each patient, we will address the following questions that cover the basics of orthodontic treatment.

We encourage you to ask questions as well.
  • Is there a condition that orthodontics can address?
  • Is treatment needed now or should treatment be delayed until appropriate growth, tooth eruption or other factors have occurred?
  • What treatment procedures will be used to correct the problem?
  • Do any permanent teeth need to be removed?
  • How long will treatment take?
  • How much will it cost?
  • What are my payment options?
Please assist us by providing the following information at the time of your first visit:
  • Is there a condition that orthodontics can address?
  • Is treatment needed now or should treatment be delayed until appropriate growth, tooth eruption or other factors have occurred?
  • What treatment procedures will be used to correct the problem?
  • Do any permanent teeth need to be removed?
  • How long will treatment take?
  • How much will it cost?
  • What are my payment options?

While we can often answer these general questions about treatment during the initial examination, we may recommend scheduling an additional appointment for diagnostic records. We feel it is important to analyze each patient’s specific needs, because in-depth planning leads to superior results and higher patient satisfaction. The records include X-rays, photos and impressions for study models. After careful review and analysis of these records, we can address specific issues and develop an appropriate treatment plan, as well as present treatment options and time frames. Our goal is to have each patient leave our office with a clear understanding of their specific needs, what the treatment will consist of and how long it will take. Also, we will be happy to answer any additional questions. This additional appointment will last approximately one hour.

Open Communication

We believe that good orthodontic care begins with open communication. We promise to speak candidly with you about our diagnosis and recommendations, any alternative treatments and any symptoms present that may require further treatment. We also encourage our patients to be open about any questions or concerns they might have. Working together, we can achieve a true partnership, with one common goal – helping you achieve a beautiful, confident smile!

Orthodontics and Dental Hygiene

You know how important it is to brush and floss properly when you’re wearing braces — but what’s the best way to do that? Let’s start with the basic brushing tools: Either a soft-bristled brush or a bi-level brush (one that has shorter bristles in the middle and longer bristles at the edges) can be effective. Used carefully, an electric toothbrush can work just as well. But be sure the electric brush is set to a moderate power level, and don’t let its vibrations cause the back of the brush to hit the braces!

Our office provides you with a Spin brush and Fluoride gel once your braces are placed. You should brush with a fluoride toothpaste at least two times per day (preferably after meals), for at least two minutes each time. Remember to brush all of the tooth surfaces: the front, the back, and the chewing surfaces as well. Be especially careful to clean the areas between wires and teeth, and between brackets and gums — that’s where food particles can easily become trapped

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Brushing with Braces

Here’s a suggested brushing technique: Beginning at the front surfaces, place the tips of the bristles flat against your teeth, and use small circular motions to gently polish them clean. For areas between braces and gums, tilt the brush toward the gum line (down for the bottom teeth, up for the top) while keeping up the circular motions. Next, move on to the chewing surfaces of upper and lower teeth, using a firm back-and-forth motion. Finally, finish up by carefully brushing the back surfaces of the teeth the same way you did the front surfaces.

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Special Brushing Tools

If you’re having trouble cleaning the areas near brackets and wires, there are some special tools that may help. One is the interdental toothbrush. It has a small tuft of bristles that stick up all around, like a pipe cleaner. Use it gently and carefully to clean the tiny spaces under wires and around bands and brackets.
Another special cleaning tool is the oral irrigator or “water pick.” This device shoots a small stream of pressurized water at your teeth, which can help dislodge bits of food that become trapped in nooks and crannies. While it’s easy to use, an oral irrigator isn’t a substitute for a toothbrush or dental floss — but when used along with proper brushing and flossing techniques, it can be very effective.

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Floss Fundamentals

To keep your teeth and gums clean and healthy, you need to floss at least once per day. But how do you get floss under the archwire of your braces? It’s not so hard with the help of a floss threader. Using this device is somewhat like threading a needle: You pull one end of floss through the threader, and then push the threader — carrying with it the free end of the floss — under the archwire. Now grasp the floss on each end and slide it up and down the sides of both teeth, and all the way under the gums until you hear a squeaky sound. Finally, pull it out and use a new section of floss for the next area.

Professional Care

Even though you’re seeing an orthodontist regularly, that doesn’t mean you don’t need to see your regular dentist — in fact, it’s just as important as ever! While we’re focused on improving your bite and alignment, your dentist will make sure your teeth stay healthy with thorough examinations, cleanings and preventive care.

Your orthodontic treatment is a team effort where everyone — our office, you, and your family dentist — has an important role to play. And the team has just one goal: giving you a winning smile.

Diet and Tooth Decay

Controlling your diet involves avoiding foods that could increase your risk of developing tooth decay. That means cutting down or eliminating foods with an excess of sugar, like soda, sweets, and ice cream. It also means avoiding foods that could easily become stuck in your braces, like toffee, gum, licorice, and caramels. Foods that are very hard or extremely sticky can also cause physical damage to orthodontic appliances. Certainly, braces or retainers with broken wires or loose brackets aren’t working to straighten your teeth! You should avoid foods like hard candies or nuts, beef jerky, and hard pizza crust. Keep eating healthy foods like carrots and apples — but cut them into bite-sized pieces first! And don’t chew on ice, pencils, or your nails: these habits can cause damage to your appliances, and even result in chipped teeth!

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What You Should NOT Eat With Braces

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Popcorn

Popcorn hulls can get stuck under braces, where they are very difficult to remove. They can get wedged between teeth and below the gums, causing them to become inflamed and swollen. If you feel you can’t live without popcorn, “hulless” popcorn is safer for people with braces. Note that “hulless” popcorn still has a hull; it’s just smaller and softer.

Acidic beverages

Acidic beverages like soft drinks — including diet sodas — sports drinks, energy drinks and lemonade are especially hard on teeth with braces. Some people notice white spots on their teeth after their braces have been removed. These spots are where the enamel has been stripped of its important minerals, paving the way for bacteria to create cavities. The resulting white spots are likely to be permanent.

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Ice Cubes

Chewing on ice isn’t good for teeth without braces either, but it can cause particular problems for braces, possibly breaking off a bracket or moving a wire.

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Sticky candy

Caramel, taffy, gummy bears and the like can coat your teeth with sticky sugar and can even pull off your brackets.

Hard candy

Hard candy can pop off brackets and bend wires. Also, the sugar can invite plaque to form under and around the braces, where cleaning is difficult.

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Hard foods and chewy foods

Chewy foods like bagels and hard rolls as well as hard, crunchy foods like pizza crust, hard nuts and thick pretzels may bend wires and pop off brackets. Even healthy fruits and vegetables that require biting with the front teeth can damage braces. These include apples, corn on the cob, carrots and many raw veggies.

All of this is not to say you should forego these fruits and vegetables completely, but you might have to go about eating them differently. Here’s how: Cut or slice raw fruits and vegetables into small pieces and chew carefully, or cook veggies to soften them. You can cut corn off the cob — although it is still likely to get stuck in your braces. If this happens, you can use an interdental toothbrush (the floss picks with bristles) or a water pick to free food particles.

What You CAN Eat With Braces

The good news is that not every yummy food is off-limits for people who wear braces. There are still plenty of food choices that you can safely eat with braces. Among them:
  • Smoothies
  • Soups and chili
  • Yogurt and other dairy products
  • Bananas, strawberries and other soft fruits
  • Applesauce
  • Oatmeal
  • Eggs
  • Tuna, baked fish, meatloaf and tofu
  • Mashed potatoes, baked potatoes and sweet potatoes
  • Peanut butter and jelly sandwiches
  • Mac 'n' cheese, ravioli and other pasta dishes
  • Thin and light crackers or cookies

As a rule of thumb, soft foods are easier on the hardware in your mouth. If you’re not sure about a certain food, ask yourself if it fits into one of the categories of foods to avoid: hard, chewy, sticky, sugary or acidic. And you can always ask us!

Orthodontic Emergencies

At first, having orthodontic treatment may take a little getting used to. It isn’t uncommon to experience a bit of soreness when appliances are first put on, or some minor aches as teeth begin moving into new positions. Yet it’s comforting to know that genuine orthodontic emergencies are rare. If you think you may have an emergency, however, the first step is to determine the severity of the problem: Is it an urgent situation that requires immediate attention, or a minor problem that you can take care of yourself, temporarily, until you can come in to our office?

A Major Emergency

There are only a few true orthodontic (or dental) emergencies. They include:

Trauma or injury

injury to the teeth, face or mouth

Infection or swelling

of the gums, mouth or face

Severe, unmanageable discomfort or pain

in these areas

In any of these situations, you should seek help as soon as possible — go to an emergency room, if that’s your best option. Generally, however, the place to start is with your regular dentist. Remember that he or she is trained to handle a range of dental problems, and can most likely offer the necessary diagnostic tools, anesthetics and treatments you need. If, for example, you have a fractured tooth, your dentist will treat the immediate problem and arrange for the tooth’s restoration; afterwards your orthodontic treatment plan can be adjusted as needed. Likewise, severe pain or swelling could be a sign of infection or disease, which a dentist or periodontist is best able to treat.

Some Minor Troubles

Fortunately, the vast majority of orthodontic problems are minor compared to these situations — but they may still cause discomfort or irritation. In general, it’s best to try and soothe the immediate cause of the discomfort, and then call our office to schedule an appointment; that way, we can allot sufficient time to take care of you. Here are a few of the more common orthodontic problems, along with some tips on what you can do to relieve them at home:

Loose or broken brackets, bands or wires

This problem is often caused by eating hard or sticky candy or food, or playing with the braces. If the band or bracket is still attached to the wire, leave it as is — but don’t connect any elastics to it! You can cover it with orthodontic wax if it’s irritating the inside of your mouth. If it has come off, save it. In either case, call our office to let us know what happened, and we will schedule a visit. Be sure to bring any loose parts with you to the appointment!

Misplaced or poking archwire, bracket or tie

As the teeth start to move, the wire that connects them (archwire) may begin poking near the back of the mouth or irritating the cheeks. You can try moving the wire into a better position with a pencil eraser or a Q-Tip. If the wire won’t move, you may be able to cut the end off with a nail clipper sterilized in alcohol — but before doing so, please call our office for our guidance or instructions. Often, you can also use tweezers to gently move a misplaced wire or a tie that’s causing
problems.

When wires or brackets cause irritation, covering the metal parts with wax will often help ease the discomfort. As with any of these types of problems, call our office and we’ll schedule a time to see you.

General tooth pain or loosening

It’s normal for teeth to become slightly loosened during orthodontic treatment — that shows they’re moving! Sometimes, this movement may be accompanied by tenderness, especially after braces are placed or adjusted. For minor soreness, you can use your regular over-the-counter pain reliever. A twice-a-day salt-water rinse may also help: Mix one teaspoon of salt in an 8-ounce glass of warm water, and rinse for 30 seconds. A warm washcloth or heating pad placed on the outside of the jaw can also offer some relief.

While actual emergencies are rare, at Drs. Cooke & Gutsche Orthodontics, our goal is to make orthodontic treatment as comfortable as possible. If you need additional advice, don’t hesitate to call us!

FAQs about Orthodontics

What do orthodontists do?

Orthodontists are dental specialists who diagnose and treat problems with the position, alignment or spacing of the teeth, and related irregularities in the face and the jaw. We use a number of special treatments, including braces and other oral appliances, to correct these problems.

When should orthodontic treatment be started?

You’re never too old to begin orthodontic treatment — but if you start at an earlier age, your problems may be easier to treat. The American Association of Orthodontists recommends that a child who may need orthodontic treatment should come in for a first visit around age 7.

Does getting braces hurt? What about wearing them?

Having braces put on is generally painless. Some people experience minor aches and pains in the first couple of days or so, as they adjust to wearing their appliances; periodic adjustments may sometimes cause soreness as well, though it typically lasts only a short time. Over-the-counter pain relievers can be used to alleviate any discomfort, but are usually unnecessary.

Does getting braces hurt? What about wearing them?

Having braces put on is generally painless. Some people experience minor aches and pains in the first couple of days or so, as they adjust to wearing their appliances; periodic adjustments may sometimes cause soreness as well, though it typically lasts only a short time. Over-the-counter pain relievers can be used to alleviate any discomfort, but are usually unnecessary.

How often will I come in for an appointment?

It depends on what’s being done, and how often you need to be monitored. During active treatment, you’ll typically come in to our office once every 4 to 10 weeks.

Will I have to watch what I eat?

Yes — you should pass up the types of foods that could damage or become trapped in your braces. Some of these include raw vegetables, hard candy, caramel, taffy and ice cubes (fortunately, ice cream is OK). We will give you a list of foods to avoid.

Is orthodontic care very expensive?

Orthodontic care is a long-term investment in your health and well-being. Yet its cost hasn’t increased as fast as many other consumer prices, and many financing options are available that make orthodontic care affordable. Weighed against the true cost of living with problem teeth, orthodontic treatment can be a wise investment indeed.

Why should I (or my loved ones) get orthodontic treatment?

There are two good reasons: aesthetics and function. Having an attractive smile not only changes the way people see you — it enhances your own self-image as well. Orthodontic treatment also allows your teeth to function better and makes it easier to keep them clean, which can improve your overall health. 

How can I recognize a potential bite problem?

Teeth that are protruding, crowded together or erupting out of position are clear indications that treatment is needed (View Examples). Less obvious signs are mouth breathing, frequent biting of the cheek or palate, speech difficulties, and thumb sucking that goes past 3-4 years of age. If teeth don’t meet properly when the mouth closes, or if jaws make sounds or shift as they move, this may also indicate an orthodontic problem.

How long will treatment take?

It’s different for each person, but generally the active stage of treatment (that is, wearing braces or other appliances) may take from 6-30 months. After that, a retainer is worn.

Will I need to have any teeth extracted?

If your teeth are severely crowded (because your mouth is too small to properly accommodate all of them) — or if you have impacted teeth (teeth that are trapped beneath the gum line by other teeth) — then extraction may be necessary. In the case of younger patients, early treatment may make extraction unnecessary.

Will I be able to play sports/ play my instrument?

In a word: Yes. Of course, whether you wear braces or not, we recommend you wear a mouthguard when playing most sports. Musicians are generally able to play their instruments just as they did before, but they may need a short adjustment period after getting braces.

Will I wear a retainer when my braces come off?

Almost always, the answer is yes: If you don’t wear a retainer, your teeth can rapidly shift out of position — and then all the effort put into your treatment is lost! Your retainer helps you maintain that good-looking smile for a lifetime.