Frequently Asked Questions: Teenage Orthodontic Patients (tm) Part 8
- Brushing My Teeth with Braces.
- All About Rubber Bands
- Ligating Modules
- Lingual Braces
- Dangers In Orthodontics: Facebows Snapping
- Allergic Reactions
- Improper Sterilization
This FAQ has been divided into several sections to make it load faster
Teeth with Braces.
All About Rubber Bands,
Dangers In Orthodontics: Facebows Snapping
- How often should I brush my teeth when I
Brushing and flossing is really important when you have braces because food can get caught in the braces and cause cavities. Also you will have terribly bad breath so no one will want to talk to you.
You should brush and floss your teeth after every meal and before you go to bed. You may want to brush with a special fluoride jell to make sure that you do not get any cavities.
- Will it hurt to brush my teeth with braces?
Brushing might hurt the first week after you get braces but then everything might hurt your first week in braces. Fortunately, you can get through it.
After the first week, brushing should be fine. Flossing is a little harder. However, a waterpic works great. There are also special brushes and floss designed to clean around your braces. Be sure to ask your orthodonists for some. Also, please ask your orthodontist's assistant for help flossing every time you get your braces tightened. The orthodontist's assistant can do a great job cleaning your teeth.
- What happens if I skip brushing with braces?
Your breath will smell terrible and you will get cavities. Cool dude makes sure to brush his teeth after every meal, so that he does not have bad breath. Bad breath is very uncool.
- What happens if I get a cavity with braces?
It is hard to say. If it is a normal cavity, your regular dentist will just fill it. If the cavity is underneath your braces, your orthodontist will have to remove your braces first.
- I have noticed that some of my friends
have rubber bands
in their braces. What do the rubber bands do?
The rubber bands are used to move teeth forward or back in your mouth. For example, they could be used to move your lower teeth forward or back, to move a tooth that is in the wrong place, or to close a gap between your teeth.
- Will I get rubber bands too?
Most people get rubber bands.
- How often should I change rubber bands?
Orthodontic rubber bands break after they have been chewed a few times. Usually, the rubber bands will snap suddenly when you open your mouth wide. The rubber bands will hurt your jaw. The only way to avoid the pain is to change your rubber bands frequently. Take off your rubber bands before each meal and put in new ones when you are done eating. Change your rubber bands before you go to bed to make sure that the rubber bands do not snap when you are snoring in the middle of the night.
- Do rubber bands ever hurt?
If you leave the rubber bands in too long, they will snap and hurt you. Be sure to change your rubber bands before every meal, and before you go to bed.
- What happens if I leave off my rubber bands?
Your braces will need to stay on for up to a year longer and your teeth will hurt more.
Changing rubber bands is not hard, so there is no reason not to change them. Old fashioned rubber bands used to taste awful, but people now make flavored rubber bands which taste like candy breathmints. With flavored rubber bands, changing your rubber bands after every meal is like eating a piece of candy after every meal, but using a flavored rubber band does not cause cavities.
- What happens if accidentally I swallow a rubber band?
Nothing; the rubber band is safe unless you are allergic to it. The rubber band just passes through yur dijestive system, and comes our in your feces. Just do not swallow a whole pack of rubber bands. They will give you indigestion and you might have a bad allergic reaction.
- What does a retainer do?
The retainer keeps your teeth in perfect alignment after braces are removed so you keep an excellent smile as your mouth grows?
- Why do I need the retainer?
Usually, when braces are first removed, your teeth will all be in perfect alignment, and your smile is excellent. However, your gums, bones, etc will not have completely shifted into their new positions. The retainer holds your teeth in position until your gums, bones etc settle in to their new positions. At the end of your orthodontic treatment, your smile will be wonderful and your will look excellent. You need to wear your retainer to keep yourself looking excellent.
Also, you are still growing after your braces are removed. Sometimes, your mouth will grow unevenly. If so a retainer can be used to make sure your teeth stay perfect as you grow. Cool dudes all have perfect teeth.
- What happens if I do not wear the retainer?
Your gums and bones will not settle into their new positions so your teeth will move part way back to their old positions. Your fabulous smile will dwindle. You may even need to get your braces put on again. Don't let that happen! Be just like cool dude. Wear your retainer.
- Does the retainer hurt?
It should not. If your retainer hurts after the first week, it means that the retainer was fitted wrong. Go back to your orthodontist and ask him to give you a new retainer.
- How long should I use a retainer?
You need to wear your retainer 24 hours a day for at least a year after your braces are removed. Then continue to wear the retainer a few nights a week until you are 24 and stop growing.
- What happens if I break the retainer?
Ask your orthodontist for a new one.
- Won't the retainer wear out after a while?
A well made retainer should last for years. If your retainer breaks ask your orthodontist for a new one.
- What happens if I swallow a part of the retainer.
Nothing. The part will just pass through your digestive system.
- Tell me about fixed retainers
Fixed retainers are an alternative that is sometimes used when you keep "forgetting" to wear your retainer. The orthodontist cements a retainer in your mouth and you cannot take the retainer off for a year.
If this happens, be sure to clean the retainer every night or else your breath will smell awful.
- I notice that some braces have little colored
rings around the brackets. What do the colored rings do?
The colored rings are called ligating modules. They hold the wires into the brackets.
Ligating modules can be fun. You can get them in 24 colors! There are orange and black ligating modules for Halloween, red and green for Christmas and red or pink for Valentines day. Red, white and blue for the fourth of july. You can get ligating modules in your favorite colors, your school colors, your favorite teams colors or even your mom's least favorite colors. Ligating modules allow you to make your braces match your personality. Enjoy!
- What happens if I swallow a ligating module?
I know it is scary, but orthodontic ligating modules are safe. Orthodontic ligating modules are made of a medical grade polyurethane which is similar to the grade of polyurethane used for medical implants. The polyurethane is safe to eat. If you swallow a ligating module, the ligating using just passes through your digestive system.
- What are lingual braces, and what are their
advantages and disadvantages?
Lingual braces are an old technique where braces are mounted behind a patients teeth. They were used years ago, before the advent of stylish or orthocosmetic(tm) braces. Now lingual braces are rarely used.
Occasionally an orthodontist can be convinced to use lingual braces when the patient insists that the braces absolutely cannot show. Generally, lingual braces are much more uncomfortable than standard braces. The orthodontic treatment is much more painful, and the treatment takes almost twice as long as with standard braces. Also the patient often has trouble talking with lingual braces.
Today, most orthodontists refuse to put on lingual braces. However, there are a few orthodontist who still use the procedure if the patient is very insistent.
- What is the purpose of a facebow?
A facebow is designed to push your rear teeth back so that there is space for the teeth in the front of your mouth.
- What Happens If I "Forget" to wear my facebow?
If you do not wear your facebow, your orthodontist will not be able to stretch your mouth so all of your teeth fit. Usually, the orthodontist will try another alternative. He may wire in the facebow, so you cannot take it out! He may try a more painful appliance. You need to wear your facebow! Your braces will not work unless you wear them.
- How do I use a facebow?
Generally, you should wear the facebow for about 12 hours a day. The facebow should be inserted into the two holes on the buccal tubes at the back of your mouth. The facebow should then be connected to the breakaways, and on to the neckpad or other headgear. A facebow should never be worn without a safety strap or breakaway.
- Are there any dangers with a facebow?
A facebow uses headgear to provide the force needed to move your jaw. There is so called "high pull" headgear, which has straps over the top of your head, and around your neck, and "cervical headgear" which only have straps around your neck.
Many manufacturers do not sell high pull headgear because we consider high pull headgear risky. High pull headgear has been known to snap a facebow. In rare cases, the parts from the facebow have been known to go into a person's eye. Sometimes, high pull headgear is the only alternative to surgery, and so an orthodontist will prescribe it. Still, we recommend that parents and children be very cautious around high pull facebows.
Be sure that the facebow is inserted properly. Be sure you wear a safety strap. Be very cautious to make sure that the facebow does not come loose and hurt you.
If you find your facebow coming loose at night be sure to tell your orthodontist about it immediately. If the facebow comes loose, it could hurt you or even poke you in the eye. If the facebow comes loose, ask the orthodontist to adjust your safety strap. The safety strap needs to be tight enough that the facebow cannot come out of your buccal tubes. Use the tightest hole possible. Try out the facebow to make sure that it cannot come loose and hurt you.
Cervical headgear is less risky than high pull headgear but still not 100% safe. Some kids try to bend their facebows to make them more comfortable. They can weaken the facebow as they bend it which can cause the facebow to snap. DO NOT BEND YOUR FACEBOW - IT COULD SNAP AND HURT YOU. Insist that the orthodontist give you a facebow with breakaway modules and/or a safety strap. Ask the orthodontist's assistant to carefully instruct you on the use of the facebow. Make sure that you do not bend the facebow, and uses the break away modules or safety strap whenever you are wearing the facebow.
- What causes the facebow to snap?
Something called "metal fatigue". When you bend a wire enough times, the wire will break. You can see this with a solid copper wire like the wires in the wall in your house. If you take a piece of solid (unstranded) copper wire and bend it several times, the wire will break. Facebows are made of a special stainless steel wire which is resistant to breakage. However, all wire will break if the wire is bent enough times.
- Are there any other dangers in orthodontics? There are some concerns about sterilization of orthodontic materials, taking orthodontic materials out of one patients mouth and "recycling" them to a second patient's mouth, and allergic reactions to orthodontic materials. These issues are discussed in the next section.
- I have lots of allergies. Are there any
special concerns when I comes in for orthodontic treatment?
There are always special concerns with an allergic patient, so your parents will need to discuss your allergies with your orthodontist. You can be allergic to something in the orthodontist's office, or allergic to the orthodontic materials.
There are two kinds of allergies to orthodontic materials: allergies to nickel chrome and copper and allergies to latex. Allergies to nickel, chromium, or copper happen a lot, but are not very dangerous. Latex allergy is very rare but can be life threatening. Further details about latex allergy, and nickel, chrome and copper allergy are given later in this document. If you are worried about allergic reactions your orthodontist can provide you with latex, nickel, chrome and copper free orthodontic materials.
- I have Spina Bifida. Is there anything to fear?
About 40% of spina bifida patients can develop class I latex allergy. Class I latex allergy is very dangerous. People occasionally die from it. Be sure to inform your orthodontist that you have spina bifida before you start orthodontic treatment and make sure that he uses latex free products. Also ask the orthodontist to make your appointment the first appointment of the day so there is no latex dust in the air when you are treated. For further information about latex allergy and Spina Bifida, consult the Spina Bifida Association Of America Home Page
- I have heard that some orthodontists take
orthodontic materials out of one patients mouth and then "recycle"
the orthodontic materials to another patient's mouth.
Is this true?
Unfortunately, yes. As disgusting as this sounds, it has been estimated that as many as one US orthodontist in three "recycles" some of their materials from one patients mouth to the next patients mouth.
- What can I do to prevent me from getting orthodontic
materials which have been previously in someone elses mouth?
Talk to your orthodontist about it. Most orthodontists will not use "recycled" materials (materials that have already been used in a previous patient's mouth) without your consent or your parent's consent.
Look what the orthodontist does when the orthodontist takes off a wire. Does the orthodontist throw out the used wire or does the orthodontist save the wire that has been in your mouth and "recycle" it to another patient. Does the orthodontist throw out the bands and brackets he has removed from your mouth, or does he save them for "recycling".
If the orthodontist is saving materials from you, think about what he is using in your mouth. Tell the orthodontist that you only want materials that have never been in someone elses mouth. Be sure to tell all of your friends so they know to ask him too.
- I have heard about allergies to nickel,
chromium and copper? How common are these allergies, what are the
symptoms, and how serious are they?
Nickel, copper and chromium allergy occur in 30% of orthodontic patients with peirced ears, 1-3% of all other orthodontic patients. The symptoms are generally an inflammation of the mouth, and possibly inflammation at points where metal such as a watchband comes in contact with your skin. If you mouth stays sore for more than 2 weeks after you get braces, or if you notice stuffy ears, you probably have an allergy to the metals in your braces.
It has been found that patients sometimes develop sensitivity to nickel, chrome or copper during the orthodontic treatments. Fortunately, a recent article in a fancy allergy magazine Contact Dermatitis 30(1994) 210. suggests that the allergic reaction will go away when your orthodontist switches to nickel, copper or chrome free materials.
If you are concerned about nickel, chrome or copper allergies, talk to your orthodontist.
- I have heard about latex allergy? How common
is it, and do I have anything to fear?
There are two kinds of latex allergies, a so called class IV allergy, which is not very serious, and a so called class I allergy, which can be life threatening. The class VI allergy causes a slight inflammation of the patients mouth, but it goes away after the latex is removed. Class IV latex allergy is fairly common, affecting perhaps 1% of the orthodontic patients.
The Class I allergy is much more insidious. Class I latex allergy is quite similar to penicillin allergy. You get the allergy from continued exposure to natural latex rubber. You usually do not have any symptoms when you are first exposed to latex. After you are exposed to latex for a long time, you get sensitized to it. First break out in a rash. Then you become very sensitive to latex. You might break into hives when exposed to a rubber glove or a condom. We have even heard of a case where a dentist became so sensitive to latex that she cannot be in the same room as a rubber glove. When she walks into a hospital or doctors office or airplane which contained a rubber glove an hour earlier, she goes into shock.
Further information about latex allergy can be found at the University of Chicago medical information site.
The estimates of how common Class I latex allergies are varies considerably. The US Food and Drug Administration (FDA) estimates that approximately 14% of dentists, 6% of physicians and 2% of other health workers will eventually get latex allergy. Latex allergy is said to be less prevalent in orthodontic patients. Still the FDA estimates that 1% of the general population eventually gets latex allergy.
Orthodontic rubber bands can contribute to your developing latex allergy, although class I latex allergy will normally take many years to develop. If you are worried about this, insist that your orthodontist use all latex free materials.
- What are the symptoms of Class I latex allergy
There can be several different symptoms. Some patients with class I latex allergy develop hives and/or swelling in their face and hands perhaps 20 to 50 minutes after being exposed to latex. Other patients have difficulty breathing. Occasionally, there are no visible symptoms. IF YOU BREAK OUT INTO HIVES SOON AFTER CHANGING YOUR ORTHODONTIC RUBBER BANDS, OR IF YOUR HANDS OR FACE SWELL UP, OR IF YOU HAVE DIFFICULTY BREATHING, GO IMMEDIATELY TO AN URGENT CARE FACILITY OR A HOSPITAL EMERGENCY ROOM. DO NOT WAIT HOPING THAT THE SYMPTOMS WILL GO AWAY.
- What can I do to avoid latex allergy?
Ask your orthodontist to use only Latex free materials.
- Are there any concerns about
sterilization of orthodontic materials?
Orthodontic materials can be sterilized in dry heat sterilizers, autoclaves, or a solution called "glutaraldehyde". A recent study shows that when used properly, dry heat sterilizers and autoclaves kill all known infectious agents. However, the glutaraldehyde solution does not always kill the Aids virus. The chances of you catching AIDS in the orthodontist's office are slim. Still, we recommend that you make sure that your orthodontist is using a dry heat sterilizer or autoclave on all of the orthodontist's instruments and orthodontic materials.
You probably should also make sure that your orthodontist changes his or her gloves after each patient.
Whoa, we are up to 100 questions. I guess that I better stop at 101.
- What is the world's record for length of time someone had braces?
I do not know. I have heard of a case of SOMEONE NEEDING BRACES FOR 9 YEARS STRAIGHT. I wonder if that is a world record. It sure sounds like it.
OOPs. Not even close. In the December 1995 issue of the AJO there was an article about a guy who HAD BRACES FOR 20 YEARS. It seems that he started orthodontic treatment and stopped after his orthodontist had put the braces on. He did not see a Dentist for the next 20 years, and kept the braces on. He finally came in to see a dentist and the braces were removed.
How would you like to have braces for 20 years?
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