Life with Braces

Carefully follow the instructions provided by our office regarding your orthodontic care. Specific steps may vary depending on the type of braces you have.

Brushing

• Always use a soft rounded-bristle toothbrush that is in good condition. When wearing braces, toothbrushes will wear out faster and must be replaced more often.
• Be sure to brush your teeth thoroughly after any meal or snack. It is important to keep your teeth and braces as clean as possible to avoid potential problems.
• Remember to brush your tongue and rinse your mouth thoroughly after brushing.
• We recommend carrying a travel toothbrush when you are away from home. Before going to bed at night, brush thoroughly and floss carefully.

Flossing

• While flossing may take a little more time and practice, it is a vital part of good oral hygiene during orthodontic treatment.
• You may need a floss threader to pull the floss under the archwire.
• You should always clean along and under the gum lines with floss each night before going to bed.

After you have brushed and flossed, your braces should look clean and shiny, making it easy to see the edges of the braces.
Please let us know at your next appointment if you have tips or tricks to make brushing or flossing easier.

• Try to choose softer foods and cut larger foods into smaller pieces rather than trying to bite through them, especially at the beginning of your orthodontic treatment.
• Always chop whole fruits such as apples or pears into bite-sized pieces before eating
• Always avoid chewing on ice.
• Avoid any particularly hard, chewy, crunchy, or sticky food. These foods can loosen, bend, or even break your brackets or appliances.
• After eating, check your braces for any loose or broken appliances. If you find any problems, please give our office a call so that we can make any needed adjustments.

• Bread: Bread, Pancakes, Muffins (no nuts), Soft Tortillas
• Grains: Rice and Pasta
• Fruits: Applesauce and Bananas
• Vegetables: Mashed Potatoes, Beans, and other Steamed Veggies
• Meats and Seafood
• Dairy: Yogurt and Soft Cheeses
• Treats: Ice Cream, Cake, Soft Cookies, and Pudding

• Whole Foods such as Apples, Pears, Celery
• Chewy Foods such as Bagels, Granola Bars, Gummy Candies
• Hard Foods such as Nuts, Hard Candies
• Crunchy Foods such as Tortilla Chips, Pretzels, Cheetos

Wearing Your Aligners

• Wear each set of upper and lower aligners for two weeks unless otherwise instructed by Dr. Palermo.
• Be sure to wear your aligners in the correct numerical order. (Each aligner is labeled by number and with a U or an L to designate upper or lower.)
• Use your fingers to put your aligners in place. First, place the aligners over your front teeth and use your fingers to push the aligner down over your molars gently. If your aligner is correctly inserted,  there will be no space left in the aligner.
• Aligners will fit tightly on your teeth at first but should fit comfortably when it is time to switch to the next set of aligners.
• To remove the clear aligner, simultaneously lift the aligner from both sides of your back teeth and then remove it from your front teeth.
• Wear your aligners continuously,  except when flossing, brushing, or eating. We also recommend removing the aligners when drinking warm beverages such as coffee or tea.

Caring for Your Aligners

• Always place your aligners in their provided case any time they are not being worn. Many aligners have been accidentally thrown out when placed in or on a napkin or tissue.
• If you have pets, be careful not to place your aligners anywhere your pets can reach them. Aligners can easily become very expensive chew toys!
• Clean your aligners using a soft toothbrush and toothpaste. You should avoid using denture cleaner, alcohol, or bleach to clean your aligners.
• Please do not chew gum or smoke while wearing your aligners. Both habits can damage the aligners.
• Be sure to keep all of your old aligners and bring them to your orthodontic appointments.

Just in Case

• If you lose the tab attached to your tooth that helps the aligner snap in place, please call our office to determine if you need to come in before your next appointment.
• If you lose one of your aligner trays, it is imperative to continue to wear a tray to prevent teeth from shifting.
• If you have the next tray available, go ahead and wear it. If not, please wear the previous tray to prevent shifting.
• If you lose a tray, please call our office and let us know to determine if a replacement tray is needed or if treatment can continue with the next tray. If another tray is required, there may be a replacement fee.

During your orthodontic treatment, Dr. Palermo may have you wear elastics, aka "rubber bands," to adjust your overall bite pattern and arch development. Typically attached from brackets on the upper arch to the lower arch, elastics use tension to create subtle changes in the teeth and bite. When you start wearing elastics, you may experience some tenderness, but the tenderness should subside after a few days. Over-the-counter medications like Ibuprofen should help, but if the soreness continues for more than a week, please give our office a call. You must always wear your elastics as directed. Wearing your elastics only occasionally will prolong your overall orthodontic treatment and cause you to experience persistent tenderness.

Wearing Elastics (Rubber Bands):

• Remove elastics when eating and brushing your teeth.
• Always replace your elastics after brushing your teeth.
• If a rubber band breaks, please replace the broken one and the elastic in the exact location on the other side to ensure the same amount of force is applied on each side.
• Always have extra elastics on hand in case one should break.
• If you think you might run out of elastics, please call us, and we can mail extras to you.

Dental wax can be a very useful tool to keep on hand during orthodontic treatment. Take a small piece of dental wax between your fingertips and roll it into a ball. Gently press the ball over any orthodontic brackets or wires that might be irritating your mouth or gums. At your appointment, please let us know if you have to use wax regularly so that we can make any necessary adjustments.

Keep these materials on hand to help with the most common orthodontic maintenance and minor emergencies:

• Interdental or Proxabrushes fit between teeth and help patients to clean around wires without damaging them.
• Non-medicated orthodontic relief wax can be placed over brackets or wires that may be irritating gum tissues. This can be especially helpful at night when sleeping when your mouth may get drier than during the day time when you can regularly hydrate.
• Antibacterial Mouthwash can be used to reduce inflammation and prevent infection. For minor sores in the mouth, Peroxyl, an antiseptic rinse containing hydrogen peroxide may be used up to 4 times per day after brushing. Refer to the product label for specific instructions.
• Dental floss, an interproximal brush or a toothpick can be used for removing food that gets caught between teeth or wires.
• Sterile tweezers can be used to replace orthodontic rubber bands that have come off.
• A Q-tip or pencil eraser can be used to push a wire up against a tooth if it has come loose and is irritating the cheeks or gums. If it is not possible to reposition the wire so it is more comfortable, place wax over the end of the wire and call our office so that we can set a time to have the wire adjusted and put back into place.
• Salt is used for warm salt-water rinses, which help heal sore gums and tissues in the mouth.
• Non-prescription pain relievers, such as acetaminophen or ibuprofen, can help with the temporary discomfort that sometimes occurs for the first day or two after an orthodontic adjustment.
• Topical Anesthetic Treatments, such as Orabase or Ora-Gel, can be applied with with a Q-tip to any abrasions or sores in the mouth should they occur.

• Please be sure to wear your appliance as instructed by our office. Doing so will help reduce your treatment time and ensure that you receive the best possible results from your orthodontic treatment.
• Please place your appliance in the provided case whenever it is not worn. Placing your appliance in or on a napkin increases the likelihood of your appliance being accidentally thrown away!
• Please clean your appliance both morning and night to remove dental plaque. You can clean the appliance with a toothbrush and toothpaste.
• If you have pets, please do not place your appliance anywhere your pet can reach them. Pets have been known to LOVE to chew on orthodontic appliances!
• You may remove your appliance while participating in physical activities, but wear a mouthguard to protect your teeth, gums, and lips. Our office can create a custom mouthguard for you that will protect your teeth and gums.
• Please bring your appliance to every orthodontic appointment so we can check it for fit and wear and tear.

Yes, you can still play your favorite sports while wearing braces! As an athlete receiving orthodontic treatment, you must wear a custom mouthguard to protect your teeth and gums.

Our office can make a custom mouthguard fitted to your mouth for the highest level of comfort and protection. Be sure to bring your mouthguard to your orthodontic appointments so we can check it for wear and tear and ensure it still fits you well.

If you experience an accident while playing sports, check your mouth and your orthodontic appliances for any signs of damage. If any of your teeth feel loose or appliances are broken, please call our office. Gently rinsing your mouth with warm salt water can help alleviate discomfort and expedite healing. You can also apply dental wax to any loose appliances causing discomfort.

You may notice some soreness or discomfort when starting orthodontic treatment or even your braces are adjusted.

Here are some useful items that may help alleviate any discomfort you may experience:

• Non-prescription pain relievers: Acetaminophen or ibuprofen can be effective in treating soreness. Take any medications according to the directions or Dr. Palermo's instructions.
• Topical anesthetic treatments:  Orabase or Ora-Gel can provide pain relief for abrasions or sores.
• Orthodontic Wax: Non-medicated wax can be placed over brackets or wires that may be irritating.
• Soft Diet: A diet of soft foods for a day or two can help reduce soreness while your mouth is adjusting.
• Warm Salt Water Rinses: Rinsing your mouth several times a day with warm salt water (1 tsp. of salt in 8 oz. of warm water) can help with discomfort and also accelerate the healing of any sores or cuts.

There are two types of ligatures that can be used to attach your archwire to the orthodontic brackets on each tooth. These ligatures may be tiny rubber bands or small, thin wires.

• If a rubber band ligature comes off, you can try to put it back into place by using clean tweezers.
• If a wire ligature comes off, you can also use clean tweezers to remove the wire.
• If the wire is poking your mouth but is not coming off, it may be possible to use a Q-tip or clean pencil eraser to bend the ligature down away from the tissue.
• Let our office know about the problem so that we can decide if we need to see you before your next scheduled appointment.

If your archwire is sliding out of place and poking your cheek, use a Q-tip or pencil eraser to try to push the wire against the tooth. If this is not possible or if the wire is still uncomfortable, place some dental wax over the end of the wire and call our office to set up a time to have the wire adjusted and put back into place.

You can use dental floss, an interproximal brush, or a toothpick to remove food that gets caught between teeth or wires. Sometimes tying a knot in the dental floss before threading it through the brackets can help to grab and remove the food.