Care and cleaning of fixed braces

Care of fixed braces (train tracks)

Discomfort

Your mouth will feel strange as you have something new fitted in your mouth called braces. It is unusual, but you may speak a bit funny for a few days. First of all, your teeth are going to ache as they loosen in preparation for straightening. This can happen in a few hours from fitting the braces and up to 24 hours afterwards. Do not be alarmed by loose teeth as it is a natural process to allow the teeth to move. The pain can take anything from one day to 14 days before it starts reducing. Everybody’s pain goes away eventually. The severity of pain usually relates to your level of pain threshold. The lower it is, the more pain you experience. This kind of pain is reduced or goes away with painkillers, whatever you might use for a headache for example. Paracetamol is usually used safely. It can also be combined with Ibuprofen if you have used it before safely. Do consult your pharmacist before using any over the counter medication.
Your tongue and your cheeks are not going to like this newcomer for the first few days. During this period your cheeks and your tongue are going to be irritated and cause soreness and ulcers due to the rubbing of the brace. The irritation will eventually go away as the cheeks and the tongue get used to the brace. “Perseverance” is the key important factor to go through the first few weeks. We will also give you some wax. Roll a pea size of the wax and stick it over the area that is sharp in your mouth making sure the area is completely dry first. Wax acts like a cushion, at least temporarily. You can dry the area with a piece of thick tissue, like kitchen towel, or cotton wool. You can also use a bit of chewing gum if you do not have wax. Ask your pharmacist for anything they can offer you to ease the mouth ulcers with the braces in the mouth. Please note that the use of Bonjela has been stopped in the UK.
Is there any pain afterwards? Occasionally yes when your brace is tightened. Your teeth may feel tender after tightening your brace, but the soreness is a lot less than when you first got your braces fitted.

Cleaning

It is more difficult to brush your teeth with fixed braces. You need to use a special brace toothbrush only. Please do not use your normal tooth brush on the teeth that you have braces on, whether it is manual or electric. The normal toothbrushes as well as electric toothbrushes may cause damage to your brace and lengthen your treatment time. We will show you how to use the brace tooth brushes when we fit your fixed braces. You can buy the brace toothbrushes from big pharmacists or from the reception. They need to be changed once every 3 months. With fixed braces you need to brush longer, more thoroughly and more frequently. If you don’t, the braces will cause damage to your teeth. You need to brush after each meal. Many people have their lunch out of home; hence the need to carry a toothbrush to brush your teeth after lunch. You might want to consider getting a brace toothbrush to carry with you when you are not at home. You can use any fluoride toothpaste that you would like. You also need to use a fluoride mouthwash at least once a day.

Diet

The fixed braces are glued on to your teeth. The glue is deliberately designed not to be strong so the braces can be removed without causing damage to your teeth. The downside is that your braces can come away from your teeth if you eat anything hard. When the brace breaks off a tooth or any teeth, your brace may not function as it should do. This will increase your treatment time; hence you need to wear your braces for longer than you need to.

Anything chewy can damage your brace. Use your common sense! The usual suspects are biting into apple, raw carrot and toffee. Also crusty bread and pizza crust should be avoided. Chewing gums of any kind are an absolute no no! DO NOT HAVE CHEWING GUM! The other things that can break your braces are lollipops, ice-lollies and popcorn. If you fancy an apple or carrot, cut them into thin slices before eating.
Acidic juices can dissolve the enamel of your teeth. With fixed braces on, these juices damage the enamel a lot quicker as the brace acts as a reservoir to keep the juice in contact with the enamel for a longer period of time. Acidic drinks include fizzy juices, diluted squash juices, most fruit juices and flavoured water. If you have to drink any of those, limit them to your meal times, use a straw and try to rinse your mouth after drinking. The best drinks are plain water and milk. Remember, any drink that has a taste, it is probably due to it being acidic!

Breakages

If your brace breaks or something comes off, contact the practice and see if you can get an extra appointment to have it fixed. The extra appointments are very limited and there is no guarantee that you can get one. If your brace becomes jaggy due to the breakage, use some wax in the area (see the discomfort section). If you do not have wax, you can use some chewing gum (ideally sugar free) to stick onto the sharp bit of the broken brace. Alternatively, if you have had your fixed braces fitted recently, the sharp bit is likely to be from the end of the wire fitted onto your brace. You can get a pair of scissors or nail clippers and clip the sharp end of the wire in the mouth. If all these fail, you can phone your orthodontic practice and get advice. There is an emergency telephone number on the answer phone for out of working hour’s emergencies. This number is ONLY for emergencies and for advice. You can call that number up to 8 pm at night. If you cannot get hold of the emergency orthodontist, you need to contact an emergency dentist through your own general dentist telephone number; or your local A&E department.

Appointments

Your braces need to be adjusted once every 3-12 weeks. You need to arrange your next appointment every time you see your orthodontist. Your brace is adjusted to do a certain amount of movement to your teeth over a certain period of time. If you miss your appointment, the movement can exceed its required amount and either cause damage to your teeth or delay your treatment. We will not contact you if you miss your appointment to make a new one. Please kindly note that you are responsible to keep your appointments. There might be a penalty charge if you fail your appointments, and if this happens frequently we may discontinue your treatment.

Other

Do I still need to see my dentist when I am having treatment with my orthodontist? Yes! Your orthodontist is only responsible for you brace treatment and your general dental health still needs to be checked up by your own general dentist on a regular basis.
How long do I need to wear my braces? Ask your orthodontist as it varies. It is not always possible to give you an exact time as the speed of tooth movement varies from individual to individual. Breakages and poor brushing prolong your treatment.
I play a woodwind instrument. Is the brace going to affect it? Generally speaking no. It depends on how much you practice. With enough practice you should be able to play as normal, however, initially it might be slightly difficult to get the notes right. If you feel discomfort to your lips and cheeks because of the brace, try to break down your practice time to shorter periods. You can also ask for Bracemate ® or similar products from the reception, which can be worn over the braces and can reduce the discomfort in some cases.