Here are the solutions to some common problems that occur when wearing braces, plates and retainers.
Wax wont stick?
If you are having problems making the wax stick to your brace you are probably not warming the wax enough before moulding it around the brace. White wax should be kneaded between the fingers, and green wax should be run under warm water before applying it. Try and make your mouth as dry as possible by swallowing all the collected saliva just before placing the wax.
It is normal for teeth to become tender and even a little loose after braces have been fitted and sometimes after adjustments have been made also. The time taken for this discomfort to disappear varies from a few hours to more than a week depending upon the severity of the case and the adaptability of the individual. This discomfort can easily be controlled with “over the counter’ remedies such as aspirin and panadeine.
Asthmatics should avoid non-steroidal anti-inflammatory drugs (NSAID’s) such as aspirin, Ibobrufen and Indomethacin/Naproxen (such as Indocid & Naprosyn), all of which can trigger serious attacks in about 3% of sufferer’s. Generally, paracetamol is safer for asthmatics than any NSAID but the results of a study reported in 2000 suggested paracetamol exacerbates asthma symptoms in some patients – a finding yet to be confirmed. If you have any concerns about which drug to take consult your medical practitioner.
If you get ulcers in your mouth, mould a pinch of wax over the brace to reduce friction and cover the ulcer with orobase or wash out your mouth with warm salt-water. We recommend that you rub lip salve, lipstick or vaseline into your lips a few hours before each appointment to reduce the possibility of cracking.
Place a bead of wax on any part of the brace that is poking into your lips or cheeks. Try and drink more fluid than you normally would have and eat soft food such as eggs, yogurt, mince, bananas, ice cream etc.
As your teeth straighten it is not uncommon for individual teeth to become tender for a few days after an appointment and then settle down. Sometimes, discomfort in a single tooth is caused because the glue holding bracket which attaches tooth to arch wire has failed so always check your teeth for loose brackets.
There are two major types of ulcer, isolated mouth ulcers or generalised mouth ulcers. If you have only one or two ulcers, these are called isolated ulcers and are usually caused by rubbing from the brace or they may just be naturally occurring apthous ulcers. In either case, rinse your mouth out with a weak warm saline solution (a teaspoon full of salt to a large tumbler of warm water) every two hours or so and apply white wax to any part of the braces irritating the ulcer. If these isolated ulcers do not heal within 4 days contact our closest surgery.
If you have a mouth full of ulcers you should immediately contact our closest surgery. Generalised mouth ulcers may be caused by auto-immune reactions, bacteria, viruses and allergic reactions to latex (gloves or elastics), starch (used to lubricate the gloves) or nickel (a metal used in the manufacture of braces). These ulcers all look different to an experienced eye and each condition is treated differently.
These are rings of latex about 1/4″ to 1/2″ in diameter that we ask patients to wear from time to time. They are fitted by the patient. Always wear your elastics exactly as prescribed. This will normally be full-time wear which literally means all the time, day and night, except when eating. Remember the “2-hour, 2-day” rule – if you are without your elastics for more than 2 hours, it takes the teeth 2 days to start moving again.
If you are running low on elastics, contact us so we can post you some more to you wherever you may be in the world. Remember, you can leave a message on our answer phone after normal working hours. Speak slowly and clearly and state your first and family names and the address you wish the elastics to be sent to. Never, ever, be without your elastics.
Low on Wax?
If you are running low on wax, contact us so we can post you some more to you wherever you may be in the world. Remember, you can leave a message on our answer phone after normal working hours. Speak slowly and clearly and state your first and family names and the address you wish the wax to be sent to.
Elastic ligatures and elastic chains?
Elastic ligatures are the little “rubber” rings that hold the arch wire onto each bracket. They are fitted by the orthodontist or a member of his staff. Ligatures are individual rings while chains are the same rings joined into a row to form a chain. They come in many different colours including tooth-colour and clear. They can sometimes be “bitten-off” by the upper teeth closing down onto the brackets on the lower teeth.
If a ligature or chain comes off contact our closest surgery as soon as possible (we will try and fit you in within a couple of days).
Wire ligature sticking in or broken?
Wire ligatures are fine soft wires about 0.01″ in diameter that are wound around the front teeth in a “figure-8″ to hold the main arch wire firmly in the brackets. The running wire is tightened by means of a “pig tail” or “Spanish windlass” which is normally tucked in behind the end bracket. Vigorous tooth brushing can sometimes straighten the “pig tail” so that it sticks into the lip or cheek. This can easily be bent out of the way using a match-end.
Occasionally the wires un-ravel. If this happens bend the two ends out of the way and cover with white wax.
If you break a wire ligature that runs from one upper eye tooth all across the front teeth to the upper eye tooth on the other side and you are wearing elastics from the upper eye teeth back and down to the lower molars (class II elastics), you should stop wearing the elastics until the running ligature wire can be prepared. If you continue wearing Cl II elastics with a broken ligature wire, spaces will open up between your upper front teeth which will then have to be re-closed thus adding extra time to your treatment. Contact our closest surgery as soon as possible (we will try and fit you in within a couple of days).
Bracket or band loose?
If you eat the wrong foods or get a knock on your face one of your brackets or bands might become loose. This should be fixed as soon as possible so contact our closest surgery immediately and we will try and fit you in within a couple of days. Sweet eating accounts for about 98% of breakages. Each breakage costs about NZ$50.00 to fix, so avoid sweets at all times.
Arch wire out of tube?
The initial arch wires are usually heat sensitive, being in a soft state at mouth temperature and only becoming springy when your mouth temperature rises about 5 degrees above normal. Sometimes eating food distorts the arch wire sufficiently to allow it to come out of the tubes on the molar bands. This problem can usually be fixed by the patient and parent. First, rinse your mouth out with very cold water to soften the wire completely. Try to insert the end of the wire into the tube using tweezers. Once you have got the end of the wire inserted into the mouth of the tube, rinse your mouth with hot water to straighten and stiffen the wire. If you find this too difficult contact our closest surgery as soon as possible (we will try and fit you in within a couple of days).
Arch wire broken?
This is a very uncommon problem usually caused by eating extremely hard food but you are much more likely to loosen brackets or bands than you are to fracture an arch wire. Contact our closest surgery as soon as possible (we will try and fit you in within a couple of days).
If your removable acrylic appliance or retainer is loose contact our closest surgery as soon as possible (we will try and fit you in within a couple of days). Acrylic appliances must fit very securely while retainers should “cuddle” the teeth rather than gripping them like a vice. Lost plates must be replaced immediately to prevent the possibility of unwanted tooth movements.
Loose bonded lingual retainer?
If the wire glued on behind your lower teeth becomes loose, contact our closest surgery as soon as possible (we will try and fit you in within a couple of days). If it comes right off be sure to save the wire and bring it in with you. This will save you having to have another impression and a further appointment to have a new wire glued in. Lost lingual retainers must be replaced immediately to prevent the possibility of unwanted tooth movements.