Care During Corona Virus Closure
Given the gravity of this health care crisis and national emergency, the California Dental Association implores dental practices to suspend all dental care with the exception of emergency cases that present as life threatening. The purpose of this recommendation, consistent with the statewide shelter-in-place order, is to minimize the risks of virus exposure to patients and the dental team, and to preserve critical health care workers’ personal protective equipment (PPE), which are currently in extremely short supply.
If this situation changes, we will adapt the recommendations accordingly. In the mean, please refer to the following instructions:
Invisalign Patients: Please continue through the aligners you have, then stay on the last aligner until you are seen again.
Running out of elastics: Email us the address you would like them mailed to and please include a photo of the packet you need refilled.
Wax: Email us if you are out of wax.
Poky wires & discomfort: Please e-mail us with your concerns. Include photos if possible. A team member or doctor will communicate with you directly to send you specific instructions.
Oral hygiene, food & care of your braces: Take extra precautions during these times and remember the importance of brushing after meals and daily flossing. Please stay away from hard and sticky food now more than ever. If something comes loose, we will not be able to see you at this time to fix it. Please avoid popcorn as it can get under the gums and lead to gum irritation and infections.
Broken or lost retainers: If you can trim the sharp part of a chipped retainer, please do so. Please e-mail us if you are in need of a retainer replacement so we can evaluate your individual situation and contact you when it’s possible for us to help.
Future appointments: As soon as the State/Dental Associations permit us to re-open, and we have the proper protective supplies to function at full capacity, we will contact you and schedule you to be seen.
Thank you for your understanding. We truly want to help you as soon as it is possible. We wish you all the best of health.
Be sure to see your general dentist every 3 to 6 months for your general dental needs and cleanings!
Bring your Cleaning Report to your next dental visit. If you return it to the office, you will earn $500 in Carlsbad Cash and an extra $100 in Carlsbad Cash if you are cavity free! Your dentist or hygienist will also be entered in a raffle. We want to reward you for helping us achieve your best smile.
In order to achieve your best smile, we need your help! Your efforts and habits are just as important as what our team does here at CVO.With your cooperation, you will have the beautiful, healthy smile your always wanted.
The Patient Promise
Here is what we ask of you:
Oral Hygiene – this means that you need to keep your teeth clean and healthy. It’s more important than ever to brush and floss regularly when you have braces, so the teeth and gums are healthy after orthodontic treatment. Don’t forget your cleanings with your dentist every 3 – 6 months as directed by your dentist.
Appointments – regularly attending your appointments on time will help keep your treatment on track. Please inform us as soon as possible if you must change an appointment; we request a minimum of 48 hours. Please inform us ahead of time if you have anything loose or broken.
Care of Appliances – please follow all instructions carefully. This means avoiding hard and sticky foods, limiting sugar intake, and not playing with appliances. Avoiding damage and breakage of your braces and appliances will ensure that you will get your braces off on time and that your teeth will be beautiful and healthy when treatment is finished.
Wear of Appliances – we need you to wear your appliances faithfully as directed by the CVO team. The teeth and jaws can only move toward their corrected positions if you consistently wear your rubber bands, headgear or other appliances as prescribed. Less wear or damage of your appliances will lengthen your treatment time.
Retainers– in order to keep your wonderful new teeth straight, you must wear retainers as directed.
Now that you have braces…
Care of Braces
Extra time is needed with toothbrushing to make sure that all areas around the braces have been cleaned properly.
- Specialized brush tips, like interproximal brushes, are available to help get in between the braces and under the wires.
- Floss-threaders are helpful in passing floss under archwires to facilitate flossing of the teeth.
- Oral irrigators, like water tips, are often helpful to dislodge food debris from around the teeth.
- Over-the-counter mouth rinses can be to help reduce the level of bacteria around the teeth.
The goal is to remove plaque from around the teeth and gums. It is the bacteria in plaque that is responsible for causing inflamed gum tissue (gingivitis), permanent scarring of enamel (decalcification), as well as tooth decay. Remember, braces don’t cause these problems, they just make cleaning the teeth more difficult. Avoiding hard, sticky, crunchy and chewy foods will also keep your braces intact and help to make your treatment flow smoothly.
We will do our best to make sure that you are as comfortable as possible. Getting your braces on does not hurt. After you get your braces on, you may feel general soreness in your mouth and teeth may be tender to biting pressures for 3 to 5 days. This sensitivity is completely normal.We encourage soft foods. You may take an over the counter medication that you normally take for headache or similar pain.
Irritation of Lips or Cheeks
The lips, cheeks and tongue may also become irritated for the first week or two as they toughen and become accustomed to the surface of the braces. A small amount of orthodontic wax makes an excellent buffer between the braces and lips, cheek or tongue. Simply pinch off a small piece and roll it into a ball the size of a small pea. Flatten the ball and place it completely over the area of the braces causing irritation. If possible, dry off the area first as the wax will stick better. The patient may then eat more comfortably. If the wax is accidentally swallowed it’s not a problem. The wax is harmless. If you run out of wax, a wet cotton roll may work too.
People who have mouth sores during orthodontic treatment may gain relief by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the sore area using a cotton swab. Reapply as needed.
The slight loosening of your teeth is to be expected throughout treatment. Don’t worry! It’s normal. Teeth must loosen first so they can be moved. The teeth will again become rigidly fixed in their new corrected positions.
Here at CVO, we care about your pearly whites, and we want to help keep you protected from sports injuries that can be damaging to your beautiful smile. If you play sports, it’s important that you consult us for special precautions. A protective mouthguard is always advised for playing any contact sport. We can give you a mouthguard when you first get your braces on. If you buy your own, make sure that it is designed to fit loosely so that it fits over the braces. Remember that your teeth are moving and will not be in the same place next week. In case of any accident involving the face, check your mouth and the appliances immediately. If teeth are loosened or the appliances damaged, phone for an appointment. In the meantime, treat your discomfort as you would treat any general soreness.
Lost Spacer or Separator
Spacers are tiny rubber bands placed in-between your teeth to create a small amount of space. This amount of space is needed to fit your bands or appliance at your next appointment. Biting on them and soreness is normal. Please stay away from sticky foods and flossing where the spacers are. If a spacer falls out, we may need to see you back in our office prior to your next appointment; usually we’ll ask you to come in a day or two before your scheduled appointment to replace the missing spacer. If they fall out the day before your scheduled appointment, you will likely still have enough space and be okay.
Lost Tie (Color or Wire Ligature)
Tiny rubber bands known as elastic ligatures (see diagram), are often used to hold the archwire into the brackets. If a color ligature is lost, contact our office, so we can advise you whether you should be seen. The same holds true for wire ligatures. If your archwire is staying in place and your appointment is not far away, you may be able to wait until your appointment. If you lose a ligature tie shortly after being seen, we will likely recommend that you come in to have the lost tie replaced.
Loose Band / Bracket
Don’t be alarmed if a wire or band comes loose (see diagram below.) This happens occasionally. Call our office so that we can evaluate the urgency of the problem and schedule you to be seen accordingly. If any piece comes off, save it and bring it with you to the office.
A. A loose band can generally be left in place until seen in our office. A band is the ring around the back molar teeth. Call the office as soon as you notice a loose band so we can see you within two weeks if possible.
B. A loose bracket can generally be left in place until seen in our office. Brackets are the parts of braces attached to teeth with a special adhesive. They are generally positioned in the center of each tooth. If the bracket is off center and moves along the wire, the adhesive has likely failed. If the loose bracket has rotated on the wire and is sticking out, attempt to turn it back into its normal position and call us to schedule an appointment to have it reattached. You may wish to put orthodontic wax around the area to minimize the movement of the loose bracket. If you are in pain, please call and inform us of the circumstance. If you are not in pain, this is not an emergency. Please call at your earliest convenience to schedule an appointment to reattach the bracket to the tooth.
The archwire is the wire tied into each bracket (see diagram below.) As the teeth move, the wire may change position. The following are helpful hints to remedy some of the problems you may encounter until you can be seen in our office:
A. If the end of an orthodontic archwire is poking in the back of the mouth, attempt to put wax over the area to protect the cheek. (See “Irritation of Cheeks or Lips” for instructions on applying relief wax.)Please call to be scheduled on the next business day to trim the wire. [In a situation where the wire is extremely bothersome and the patient will not be able to see the orthodontist soon, as a last resort, the wire may be clipped with an instrument such as fingernail clippers. Reduce the possibility of swallowing the snipped piece of wire by using folded tissue or gauze around the area to catch the piece you will remove. Use a pair of sharp clippers and snip off the protruding wire. Relief wax may still be necessary to provide comfort to the irritated area.]
B. If the archwire has slid out of the band in the back, you can attempt to slide it back into the band. Tweezers are helpful for this. If you are unable to get it back into the band, then place a small piece of wax to hold the wire against the band.
C. If a small ligature wire around the bracket protrudes and is irritating(metal ligature similar to the elastic ligature), use a Q-tip or blunt instrument, such as the back of spoon or the eraser end of a pencil, and carefully, gently push the irritating wire under the archwire. Simply get it out of the way. If irritation to the lips or mouth continues, place wax to reduce the annoyance.
D. A broken archwireneeds to be seen in our office so that we may trim or replace it. Please use wax to make you comfortable.
An expander is used to widen the upper jaw and teeth to align them properly with the lower teeth. There are different types of expanders, and your expander was selected specifically to correct your dental problem. If your expander requires turning with a key, you will be given specific instructions the number of your turns to do. But here are a few helpful reminders:
- Brushing your appliance before doing turns will make it easier to find the hold. Waterpiks work well in removing debris caught under the expander.
- Place the key in the front hole. Push the key back until the next hole appears. Remember to remove the key from the back after the turn has been completed. Do not undue your turn by bring the key forward after the turn.
A bent headgear or removable appliance that is not fitting well is not to be worn until it can be properly adjusted in our office. Call the office to schedule an appointment to have the headgear or removable appliance adjusted.
If you have a true orthodontic emergency and need assistance outside of business hours, please call our office. You will receive directions for assistance. All comfort visits are scheduled mid-day (between 9am and 1pm). As a team, we ensure that you and your family will be well cared for during and after office hours.
Parts of Braces
To help you accurately describe what’s going on to the orthodontist, use the diagram below, which illustrates and names each part of a typical set of braces.
A. Ligature or tie: The archwire is held to each bracket with a ligature, which can be either a tiny elastic (the “color” part of the braces) or a twisted wire.
B. Archwire: The archwire is tied to all of the brackets and creates force to move teeth into proper alignment.
C. Brackets: Brackets are directly bonded on the teeth and hold the archwire in place.
D. Band: The band is the cemented ring of metal which wraps around the tooth and is found in the back of the mouth.
E. Rubber Bands: Hooks on the brackets and bands are used for the attachment of rubber bands, which help move teeth toward their final position.
Invisalign and Invisalign Teen
Invisalign is an effective treatment for many adults and teens. Invisaligntherapy is a set of clear aligners that are designed to gently move your teeth to the corrected position.
Wear: The aligners are worn all the time and removed for eating and drinking (except for water) and brushing your teeth. Typically the trays are replaced every 2 weeks.
Oral Hygiene: In addition to esthetics, a significant advantage of Invisalign is that they can be removed to brush and floss. This makes keeping your teeth clean easy aligner therapy. And if you are having trouble keeping your teeth clean, we can show you how. Please brush your teeth after each meal prior to re-inserting the aligners.
Storage: Store your aligners in the colored cases provided. This will protect your aligners. Keep all aligners out of reach of children and pets. If you accidently lose or damage an aligner, please inform us.
Our goal is to get you to a beautiful, healthy smile comfortably and efficiently.
As a general rule, an emergency appointment may be made when there is severe pain, a loose band, a broken wire or something sticking out that you can’t take care of. It is helpful to know the names of the parts of your appliances when you phone the office so you may identify what part is broken or out of place.
Parmis Sionit, DDS, MSD
Kelly Ryan Taylor, DDS, MSD
Board Certified Specialists in Orthodontics for Children & Adults
1291 Carlsbad Village Drive Carlsbad, CA 92008