Orthodontic (Braces)

HOW DO YOU GET STARTED?


This is an average sequence of events for the early stages of orthodontic treatment with our office. Everybody has a busy schedule and hopefully this will be helpful in explaining and planning for the different appointments. (Please note all banding, delivery and repair appointments must be made prior to 3pm.)



FULL BRACES WITH NO APPLIANCE THERAPY

  • Initially you should schedule a complimentary consultation. At this visit, you will meet Dr. Debra Alavi and she will discuss with you if you need braces, what your choices are and if you will need an appliance first.
  • The orthodontic coordinator will then reserve a time to review. At this review appointment, she will have your insurance information, discuss the fees and set up a convenient payment schedule for you. To help parents provide their children with braces, we accept a down payment and then the balance is divided over the expected duration of the treatment. There is no interest added and we are happy to bill your insurance for you. Your insurance is something you will need to track to ensure you receive optimal benefits.
  • Records are the next step. These involve a series of two different x-rays, impressions for study models, orthodontic photos and Dr. Alavi's examination of these to treatment plan your case.
  • An appointment for spacers will be made approximately 5 days before getting your braces on.
  • At the next appointment, you will have the upper braces placed. Often the bite needs correction before allowing the lower brackets to be placed.
    Once your braces are on, you will return every 4 weeks (one month) for a simple visit to monitor and guide your teeth into position. These are considered your periodic orthodontic visits.
  • Evey case is a little bit different. When lower braces are now ready to be placed, you will again require a spacers appointment 5-7 days prior to the banding of the lower teeth.
  • Today is the day you will now have upper and lower braces working together to give you the smile you have been dreaming of.
  • Periodic orthodontic appointments will continue until the braces are ready to be removed.

APPOINTMENTS FOR THOSE BEGINNING WITH APPLIANCE THERAPY OR PHASE ONE:

The amount of time necessary can vary tremendously. In the majority of the cases, it is the first phase. It can also be started later during braces as occasionally certain teeth will require to be in a different position before the appliance will be able to do its job. (Please note all banding, delivery and repair appointments must be made prior to 3pm.)

  • Appointment with the orthodontic coordinator to review insurance information, necessary appointments and development of a payment schedule.
  • Records appointment consists of impressions of both arches, photographs of the face and teeth, a panoramic x-ray and a cephalometric x-ray. Then Dr. Alavi will evaluate this data and design an individual treatment plan for your teeth.
    Spacer Appointment is where small separators, which look and feel like tiny rubber bands, are placed in between specific teeth. We like to schedule this appointment about one week (5-7days) prior to your next appointment with Dr. Alavi.
  • Impression for the appliance with Dr. Alavi, where she will design the appliance for your needs. At this visit, she will remove the spacers and place bands just as if the braces were going on today. With the bands in place and impression made, the bands are removed and sent with the impression to our lab for the appliance to be constructed per Dr. Alavi's prescription. When you leave today, there will be nothing in your mouth. This will take up to 4 weeks to be constructed.
  • Spacer Appointment is necessary again 5-7 days prior to the delivery of the appliance. The effects fo the spacers are very temporary. The teeth can shift back into place in an afternoon, so at this visit they are placed again.
  • Delivery Appointment is when the appliance is cemented. The appliance is placed into the mouth and secured by the molar bands that will hold it into place.

THIS IS A VERY INVOLVED PROCESS AND REQUIRES SEVERAL APPOINTMENTS TO COMPLETE. WE WILL DO OUR BEST TO MAKE THIS CONVENIENT FOR YOU.

SPACER INFO: Spacers can be somewhat uncomfortable or annoying. We are often told it is similar to having a piece of meat stuck in between the teeth. A pain reliever can help these symptoms, if necessary. The spacers must stay in place until the appointment with our office. Not chewing gum or having hard or sticky foods can help them stay in place. The patient is constantly biting on to them and they can often slip out on their own. If they come out, please call us and we will be happy to replace them. It is important that they are kept in position.

ORTHODONTIC GUIDELINES

  • Be careful not to abuse your appliances/braces. Do not bite on hard objects such as a pencil, ice or finger nails. Bent wires or broken appliances can cause teeth to move to undesirable positions and have a negative effect on treatment progress.
  • Do not eat sticky or hard candy, hard breads, popcorn, tortilla chips, nuts, thick pretzels, corn on the cob, taffy apples or chew gum. Thick crusted pizza may be eaten with a knife or a fork.
  • Raw fruits and vegetables such as celery, carrots, apples may be eaten only if sliced or diced. Cooked fruits and vegetables are fine. Cut the meat from the bone before eating ribs or chicken. Chewing slowly and taking small bites will also help to minimize appliance breakage.
  • Brush your teeth in horizontal motions starting at the gumline after meals. Rinse if you can't brush. Brush thoroughly at bedtime, use floss threader to clean between teeth and check the gum area. Use a fluoride gel nightly.
  • We will supply wax in small packets to cover any part of the appliance that is causing irritation to the lips, cheeks or tongue. Some minor irritation is normal and usually subsides but contact our office if it persists.
  • If any part of the appliance becomes damaged or loose, contact the office for an appointment. The loose portion of the appliance will be removed and you will be rescheduled for a repair appointment, if appropriate. Always bring loose portions of the appliance with you.
  • For discomfort after an adjustment appointment, you may take an over-the-counter pain reliever. Soreness may be experienced at the beginning of treatment and for a few days following each adjustment. Such sensitivity is most apparent when clenching and chewing hard foods.
  • If you have a removable appliance, clean it with a toothbrush and warm water. It may also be soaked occasionally in a commercial denture cleaner. Never use boiling water as it will deform the appliance as will going into the clothes dryer. Do not put it in your pocket.
  • Remember teeth and gums that are not properly cleaned can cause decay, gum disease, mouth odor, permanent "white spots" and an unsightly appearance. Damage to teeth and gums due to poor oral hygiene must be considered your responsiblity.
  • Orthodontic treatment represents an important investment in your oral health. Your cooperation is vital to obtaining a successful result. During braces it is recommended you brush your teeth following evey meal in addition to morning and night. Professional cleanings should be every 3 to 4 months to assist in maintaining optimum oral health. Remember although you may be going into the dental office, you are seeing the orthodontist who is working on tooth movement. You still need dental visits to check for cavities and assist you in keeping your gums healthy. Addtionally, there will be certain foods and oral habits you will need to avoid to keep from breaking the bracket or bending the wire.

Retainers

Retainers are for life. Following the first year of retention, you may chose to wear your retainers once a week at night. You will want a pattern that will be easy for you to follow so you do not go for a prolonged period of time without wearing your retainer. Should this happen, your retainer may or may not fit. If you do not get a new one then you are taking a risk that your teeth will shift or move back into the original position. Once your teeth have shifted a new retainer will retain the new position and keep them from moving more. You will require either an appliance, invisalign or braces again to put them back into a healthy position.

 

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