PATIENT INFORMATION REGARDING BRACES

AFTER READING THE POSTED INFORMATION BELOW, IF YOU STILL HAVE A QUESTION ABOUT YOUR APPLIANCES, PLEASE CALL OR EMAIL OUR OFFICE! DR STUCKEY'S OFFICE

Keeping your teeth and appliances sparkling clean is a must. Brackets, wires, and loose bands can trap food particles and make it difficult to brush away PLAQUE, the layer of harmful bacteria that attack your teeth and gums.

BRUSHING after every meal or snack is the only way to prevent plaque build -up and tooth decay. When you are not at home, you can carry a small kit containing toothpaste and a toothbrush. If you are unable to brush right away because you are at school or elsewhere, then try rinsing with water until you can get home to brush properly.

There are lots of ways to brush teeth, but here is a good method for braces. Using a soft-bristle toothbrush and a fluoride toothpaste, start brushing the outside surface of your teeth with a back-and-forth motion. Try to brush each tooth 10 times. Be sure to tilt the bristles into the area right next to the gums, bacteria love to hide out there! Brush the inside surface of your teeth with the same back-and-forth motion. Now brush near the gums, as well as the gums themselves, this time using circular strokes. Brush the chewing surfaces of your teeth last. Rinse your mouth thoroughly. If you have brushed correctly, your teeth and bands should sparkle!

An ORAL IRRIGATOR, or water pik, shoots a strong stream of warm water between the teeth where a toothbrush can not reach. But even though an oral irrigator helps keep teeth clean, it is never a substitute for brushing or flossing!

Because a toothbrush can not clean between your teeth, brushing alone will not keep your teeth entirely free of plaque. FLOSSING, at least once a day, is the best way to prevent a build-up of plaque between teeth and between teeth and the gums. Dental floss actually polishes your teeth and makes it hard for food to stick to them.

Flossing can be a bit tricky with braces at first, but you will get the hang of it. A floss threader will help to get under the archwire and is available at your pharmacy.

SPACERS SPACERS SPACERS
Spacers are small wires or small elastics placed between your teeth to help make room for the placing of your bands. Spacers will feel as if you have food trapped between your teeth. This sensation will pass as your teeth begin to move apart. Remember not to floss where the spacers have been placed. Do not eat hard or sticky foods or gum. Sometimes, after the spacers have been in for a few days, enough space will have been created and a spacer may fall out. If this happens, call the office and an appointment will be made a day or two before your scheduled banding and a new spacer will be placed.

Elastics, or rubber bands, are often an important part of orthodontic treatment. They supply the pressure needed to move teeth and jaws into their correct position. Therefore, to achieve the desired results, you must carefully follow the instructions you receive regarding their placement and use. Any time missed in wearing your elastics will only make you treatment take longer, so remember these things:

1. You are responsible for placing the elastics on your braces between appointments. Be sure to wear them as instructed. Remove them only when brushing your teeth, gums and braces after meals. Then put them back on immediately.

2. Always carry a few elastics with you, so if one breaks you can replace it right away. If your supply is low, call the office. We can easily mail you some.

3. If you happen to forget to insert your elastics one day, don't double up the next---just follow your regular instructions

4. Elastics get tired. When they lose their stretch, elastics don't provide the proper pressure on your teeth and jaws. So it is very important to change them as directed, even when they are not broken.

Elastics may cause your teeth to hurt a little at first. That's because the teeth are moving, which is our goal. Usually the tenderness lasts only a few days. Not wearing your elastics as instructed will only make the tenderness last longer, and tooth movement will require more time.

If you have any problems-like elastics breaking frequently, a wire or band loosening, or a hook breaking off-call the office immediately. Don't wait until you next scheduled appointment. These problems need to be corrected as soon as possible.

Remember, faithfully wearing your elastics, following all instructions, and keeping appointments is the quickest, easiest way to achieve our goal-a lifetime of healthy, beautiful smiles.

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There are certain types of orthodontic difficulties that are caused by the lack of enough bone growth to accommodate the upper teeth. In other cases there is room for the upper teeth but the palate, or roof of the mouth, is so narrow that speech is impaired or made difficult. In still another type, the palate is so high that it actually cuts down on the amount of air that can pass through the nose, so that deep breathing, without opening the mouth, is almost impossible. In all of these cases, a palatal expansion appliance is most helpful.

Well, if that sounds pretty drastic, it isn't. The maxilla, or upper jaw, is joined in the center by a suture, or joint, which allows it to be painlessly separated and spread. Temporarily you may see a space develop between your upper two front teeth. This will slowly go away in a few days. Once this has occurred, the two halves knit back together and new bone is laid down to make the jaw wider.

So that's how your palatal expansion appliance works. Your teeth will be a bit uncomfortable for a day or two or you may feel a little "itching" in the roof of your mouth. Don't worry, this is normal, because the fibers there stretch and expand.

1. Brush as usual
2. Use a Water-Pik or syringe to flush out between the plastic and the roof of your mouth
3. Use your favorite mouthwash to swish it clean

TURNING INSTRUCTIONS:

This palatal expansion device is cemented in place and the screw must be turned by you or your parents each day. For rapid expansion it is usually turned once in the morning and once at night. YOUR INSTRUCTIONS MAY BE DIFFERENT SO REMEMBER HOW OFTEN DR. STUCKEY TOLD YOU TO TURN IT.
The key is inserted into the hole and then pushed all the way to the back of the throat. This will bring the next hole into view. The string is always looped around the finger or over the wrist, as desired, to prevent the possibility of your swallowing it. Or you may have a key with a blue handle which is even easier to use. You place the key into the hole(slot) and push toward the back of the mouth, then remove without turning the slot back.

The success of orthodontic treatment depends to a large extent upon the cooperation of the patient. The patient must take proper care of his/her appliances and follow the orthodontist's instructions implicitly. The appliances used are made for each individual patient and are made of costly materials. Skill, time, and effort are required for their construction.

The removable appliance used in the treatment of your case is made of precious metals and special plastic. Unless otherwise instructed, the appliance is to be worn continuously, 24 hours a day. It should be removed and rinsed with water, however, after each meal and the teeth should be brushed. In addition, once each day, preferably at night, it should be scrubbed with a toothbrush and toothpaste (or soaked in a denture cleaner such as Efferdent or Retainer-Brite to the directions on the package). The appliance is fragile and may break if dropped. Great care must be taken when removing or inserting the appliance and while cleaning it to prevent distortion of any of its parts or attachments. IT SHOULD NOT BE WORN WHILE SWIMMING. When the appliance is not in the mouth, it should be kept in a safe receptacle to prevent its being crushed or distorted.

The appliance is made to fit the mouth at the time it is inserted. If it is not worn for a period of days, the position of the teeth may change so that the appliance will no longer fit. If, for any reason, it becomes difficult to wear the appliance, it is important to call the office immediately for an appointment. Otherwise, there may be movement of teeth that will make the appliance useless.

CONGRATULATIONS! YOU ARE NOW THE PROUD OWNER OF ME. I'M A FUNCTIONAL APPLIANCE. JUST LIKE REGULAR BRACES, IT WILL TAKE TIME TO ADJUST TO ME, SO PLEASE BE PATIENT - THE END RESULT WILL BE WORTH IT.

FIRST OF ALL, LET ME SAY THAT I AM NOT FOOD! YOU KNOW THAT, BUT YOUR BRAIN DOESN'T. AT FIRST, YOUR MOUTH WILL PRODUCE A LOT OF SALIVA BECAUSE YOUR BRAIN THINKS I AM FOOD IN YOUR MOUTH. IT WILL SOON LEARN THAT I AM NOT FOOD AND YOU WON'T HAVE TO SLURP AS MUCH.

EVEN THOUGH I WAS CUSTOM MADE JUST FOR YOU, THERE MAY BE A SPOT OR TWO THAT CAUSES AN IRRITATION. WHEN YOU COME BACK TO SEE DR. STUCKEY THE NEXT FEW TIMES, SHE WILL TAKE CARE OF THESE AREAS THAT BOTHER YOU. I'M WORKING EVERY TIME YOU SWALLOW OR TALK. WHEN YOU CLEAN YOUR TEETH…. CLEAN ME.

AT FIRST, YOU MAY TALK A LITTLE FUNNY, BUT THIS WILL IMPROVE WITH TIME. WHEN YOU ARE WEARING ME, TRY TO TALK WITH YOUR TEETH TOGETHER. READING OUT LOUD WITH ME IN PLACE WILL HELP YOU TALK CLEARLY IN A VERY SHORT TIME.

DR. STUCKEY MAY HAVE ASKED YOU TO TURN MY HINGES A CERTAIN WAY EVERY FEW DAYS . THESE THINGS ARE IMPORTANT, SO PLEASE REMEMBER TO DO THEM.

I MUST APOLOGIZE FOR ONE THING. I MIGHT MAKE YOUR TEETH A LITTLE TENDER FOR A FEW DAYS BECAUSE THEY ARE STARTING TO MOVE. IF THEY DON'T FEEL BETTER AFTER THREE DAYS, PLEASE LET DR. STUCKEY KNOW.

TREAT ME WELL AND I WILL WORK VERY HARD TO FIX YOUR TEETH AND HELP YOUR JAWS GROW THE WAY THAT THEY SHOULD.

THIS MESSAGE HAS BEEN BROUGHT TO YOU BY YOUR FANTASTIC FUNCTIONAL APPLIANCE!!

The success of your orthodontic treatment depends on you! You have just received your Bite Correctors. You are wearing the Bite Corrector to correct your Class II malocclusion (top molar in front of bottom molar). The wearing of bite correctors usually replaces the wearing of headgear. They distalize or push back the upper molars and advance the mandible until a Class I (ideal) relationship is achieved. There are a few things you should know about the wearing of Bite correctors. It will take time for your mouth to get adjusted to them. Dr. Stuckey uses several different types that are variations of the same thing. Once your Bite Correctors have been placed in your mouth, you may need an adjustment within two or three days to a week. After this initial adjustment, Dr. Stuckey will be able to adjust your Bite Correctors at your regular office visits, which is about every four to six weeks. If your cheeks become sore you may use Brace Relief (a topical anesthetic/antiseptic which came in your banding kit) and wax as necessary to alleviate any discomfort you may have.

Most Bite Correctors do their job in about 2-6 months but in more difficult cases they may be worn up to a year.

HEADGEAR
You have now begun a new phase of your orthodontic treatment. The facebow headgear prescribed by your doctor must be worn according to your doctor's instructions.

The wire facebow and headgear system must be used properly. If the facebow is pulled from the mouth without disconnecting the headgear strap from the wire facebow, the facebow will snap back and cause serious injury.

ALWAYS FOLLOW THESE SAFETY RULES:
DO wear the wire facebow and headgear system as directed by your doctor. This is generally 12-14 hours per day. Your headgear can be worn while sleeping or after school, just as long as it is worn the required numbers of hours.

DO detach the wire facebow from the headgear strap before the wire facebow is placed in or removed from the mouth. If used improperly, the tips of the inner wire bow can cause injury.

DON'T attempt to adjust, put on, or remove the wire facebow with headgear straps still connected.

DON'T allow other people to pull on, play with, or snap the wire facebow while it is in your mouth.

DON'T wear the wire facebow when taking part in any sporting activities unless permission is received from your doctor.

Putting on and taking off your headgear isn't hard after you've practiced a few times in front of a mirror. Your teeth may be a bit sore for the first few days of wear, but the more you wear it the sooner you'll become accustomed to it.

WEAR IT! Steady pressure is the key to successful headgear treatment. That's why you need to wear it at least 14 hours or more every day. (In fact, many people wear their headgear 24 hours a day, except at mealtimes!) The more you wear your headgear, the shorter your treatment time will be. If you forget to wear it for just one day, you may need to wear it many extra days to make up the lost ground. If you do forget to wear your headgear, don't try to catch up with your wearing schedule by tightening the strap or using more elastics. You could damage your teeth.

The purpose of this appliance is to pull the upper jaw forward. Rubber bands are connected from attachments on the upper jaw to the facemask. In most cases it is worn at night and when worn well it is effective in bringing the upper jaw forward.

Your child's teeth have been protected with a Fluoride Sealant called Pro-Seal when they have their braces placed in our office.

Our office uses a Fluoride sealant that is placed on the teeth around the braces and light cured on the tooth to help protect the teeth from decalcification during the orthodontic treatment. The product is by Reliance Orthdontics called PRO-SEAL. It is placed at the gumline and in between the teeth when braces are placed on the teeth. Reapplications during treatment are made as necessary.

1. Brush teeth thoroughly with regular toothpaste for at least two minutes. Tip: watch a clock to make sure. The length of a song is a good gauge of time in many cases, so if your radio is on this may be helpful to you.
2. Swish with *Phos-Flur for no less than one minute. Do not swallow.
3. Spit out the Phos-Flur after one minute. Do not rinse with anything, it is best not to eat or drink anything for at least 30 minutes for the best effect.

1. Brush teeth thoroughly with regular toothpaste.
2. Floss teeth make sure your teeth are clean and plaque- free.
3. Swish with *Phos-Flur(acidulated phosphate fluoride) for one minute spit out, do not rinse with water this will allow the fluoride to have its maximum effect on your enamel.
4. Brush the * Gel-Kam (Stannous Fluoride) on your teeth thoroughly, do not rinse out with water.
5. Do not eat or drink anything before going to bed this will allow the fluoride to soak into your teeth overnight.

Invisible, so no one can tell you're straightening your teeth. So now you can smile more during treatment as well as after.

Removable, so you can eat and drink what you want while in treatment, plus brushing and flossing are no problem.

Comfortable, because it has no metal to cause mouth abrasions during treatment. And no metal and wires usually means you spend less time in your doctor's office getting adjustments.

On the other hand, it is removable and will not be effective unless worn all the time except when eating or cleaning your teeth. Please do not wrap in a napkin and throw them away. Do not boil or allow the appliances to be left in a warm (hot) place as they may distort or melt. They need to be worn 21-23 hours/day. They should be cleaned with a cotton tipped stick (q-tip) with toothpaste and they may be soaked in a bubbly denture cleaner such as Retainer-Brite or Efferdent. Do not rinse or soak in Listerine or Dr. Tichenors (or any other appliance) as it may react with the plastic. Sometimes bonded tooth-colored attachments must be placed on the teeth or specific tooth to allow the appliance to work effectively.

RETENTION (RETAINERS)

Retention refers to that phase of orthodontic treatment following the fully banded period during which major tooth movements were being accomplished. The bands and arch wires are removed and the teeth are held in their positions while nature performs her task of rebuilding bone and readopting the muscles of your cheeks and lips. Although the major tooth corrections are completed, some minor detailed movements may be carried out be the use of retainers.

Removal of the bands and wires from the teeth does not mean that the orthodontic treatment is complete. It must be emphasized that the retention period is just as important as the tooth movement stage of treatment. Cooperation of the patient is just as important as the wearing of the headgear, bands, wires, and elastics during the more active phase treatment.

We use several types of retainers in this office. The type of retainer which you receive will be that which is most appropriate to your case.

The length of time that the retainer is worn depends on Dr. Stuckey’s discretion in meeting the demands of each individual case. This time will vary dependent upon such factors as the degree of difficulty of the original problem, the direction and amount of growth nature provides, the presence or absence of third molars, the progress of the patient during the retention period and other factors.

RETAINER AND RETENTION AFTER BAND REMOVAL

This is an extremely critical time if the long-term benefits of orthodontic correction are to be fully realized.

1. Orthodontics is a field in which improvement, not perfection, is the expected result. In all fields of medicine and dentistry-indeed, any field dealing with improvement in nature’s plan for the individual - cannot yield ideal corrections. There may be some slippage or relapse in spite of all our efforts. This consists typically of slight lower incisor crowding which occurs in a large percentage of both treated and non-treated dentition in the late teens, early adulthood, and throughout life to a degree.

2. Retainers must be worn according to the needs of the individual and these vary tremendously. Some people have short-term retention requirements, while others may require life-time retention. A schedule will be required for each patient’s wearing time for the first year after the removal of orthodontic bands. Thereafter, it becomes entirely your responsibility to wear it as much as your teeth require to hold them in the position that Dr. Stuckey has put them and to hold them straight.

3. If the retainer is not worn correctly and our instructions are not followed, the retainer may not fit or the teeth may slip or relapse. Very comprehensive instructions are given during the retention period and if carelessness or failure to follow instructions for any reason result in the necessity of a new retainer and/or re-treatment, then the appropriate charges shall be made.

4. There are many types of retainers, and the most appropriate for each case is used.

ADDITIONAL CHARGES

Some cases require more supervision than others. Since there must be a limit, we have included 12 months following completion in our orthodontic fee (excluding interceptive cases). Other possible charges could include retainer remakes because of failure to follow instructions, or re-treatment due to patient failure to follow retention instructions.

In future years following active treatment and retention, some relapse of similar problems may arise, necessitating additional treatment. As this is an individual tendency, re-treatment charges do apply.

I hope that our improvement of the problem which was present shall result in a lifetime of benefits. If there are any questions, please ask.

Signature__________________________________ Date_____________________________

SAMPLE SCHEDULE FOR WEARING REMOVABLE RETAINER*

First 6 months---Wear retainer continually.

Next 6 months---Leave off 2 hours each day or more if directed.

Next 6 months---Leave off 6 hours a day.

Next 6 months---Leave off 12 hours a day.

Next 6 months---Leave off 1 night a week or more if so directed.

The fixed retainer is often used for the lower teeth. This is usually worn a minimum of two years and in some cases for many years. This schedule is subject to change, if thought necessary by the orthodontist. Many patients ask for a fixed (glued to the teeth) upper retainer. In most cases the fixed upper retainer does not work well behind the upper front teeth because it interferes with chewing.

You should not experience great change in the teeth if you follow this schedule, but you may have a collapse if you fail to follow the above outline. Some cases are instructed to wear retainers until the wisdom teeth are erupted or removed and others even after that.

If at any time the retainer seems to go on with difficulty or feels tight after leaving it off, increase the wearing time and drop back to the former schedule for a time. After three years of wearing the retainer the teeth are usually as permanent as can be expected. Any relapse after that time is due to natural causes, but minor shifts are expected and occur in patients even without orthodontic treatment. Therefore, slight irregularity, particularly of the lower front teeth may sometimes be accepted as the best for the particular circumstances and for normal development irrespective of orthodontic treatment. IF YOU WANT TO MINIMIZE THIS SHIFTING THEN IT IS IMPORTANT TO WEAR RETAINERS LONG TERM.

This schedule is subject to change if thought necessary by the orthodontist. In case of loss or breakage of the retainer, a charge will be made.

After 12 months following active treatment completion, then a separate per visit charge will be made for visits about 6 months apart to evaluate the third molars, etc.

*This a sample wearing schedule. It is not necessarily your wearing schedule.

RULES FOR WEARING YOUR REMOVABLE RETAINER

1. To assist you in becoming accustomed to your retainer , we recommend that you read aloud to yourself at home for perhaps an hour to allow your tongue to adapt to the retainer while speaking.

2. For a retainer with a wire, when brushing your teeth, remove the retainer, hold it in the palm of your hand and scrub it thoroughly with your toothbrush or preferably a stiffer type brush. Be certain also to brush the roof of your mouth lightly with your toothbrush. About once a week, you should soak your retainer in a bubbly denture cleaner to keep it disinfected. Be sure to keep your case clean also.

3. For a trutain, or clear, wireless retainer, you should soak it in mouthwash for an 1/2 -1 hour per day
to give it a fresh clean taste. It may be soaked in a bubbly denture cleaner to keep it fresh. . You may use a cotton tipped applicator such as "Q-Tips" instead of your toothbrush on this type to prevent small scratches in the retainer which may fill with plaque . You may also soak your retainer in an over the counter 3 % hydrogen peroxide solution. Use about 1/3 hydrogen peroxoide and 2/3 water.

4. Your retainer should be worn at all times except during meals unless specifically directed otherwise by Dr. Stuckey. You have a small retainer case in which your retainer must be kept anytime it is not in your mouth. Be sure to keep the case clean also.

5. Keep your retainer away from any from any heat source (dash of car, top of stove, boiling water, etc.) and do not let your pets or anyone else's animals to get to it.

6. Remember your retainer is an expensive orthodontic appliance. Take good care of it. If it ever gives you any problem or is lost or broken, call the office immediately. If you have a problem with your retainer DO NOT attempt to adjust it on your own. Call our office as soon as possible for an appointment. Otherwise, your teeth may slip back a little and that could mean treatment all over again and money spent for no good reason.

7. There is a charge to replace any lost or broken retainer.

You have been a good patient during your active appliance wearing time or you would not be receiving your retainer today. For Dr. Stuckey to assist you in obtaining the best possible orthodontic treatment, we must have your continued cooperation. Your tooth relationships and frequently your entire facial appearance will continue to improve for the next eighteen months to two years as nature assists us by adjusting to these corrected tooth positions.

Our office has a program to positively reinforce good patient behavior with the Stuckey Bucks Program. When a patient cooperates or has achieved the guidelines listed below, Stuckey Bucks are rewarded. The patient collects Stuckey Bucks for behavior that helps the orthodontic treatment or for good citizenship. The patient may exchange the Bucks for prizes. Some prizes do not require many Bucks and others require quite a few. Check our prize board for what may interest you.

GUIDELINES:
1. Keep your regularly scheduled Appointment…1 Stuckey Buck
2. Arrive on time for your appointment…1 Stuckey Buck
3. Good oral hygiene…1 Stuckey Buck
4. Nothing loose or broken. (This means brackets, bands, removable appliances, etc.)…1 Stuckey Buck
5. Good grades. You must make all A's and B's. Bring in your report card…5 Stuckey Bucks
6. Raise your grades 1 full letter grade. (i.e. C to a B). If any grades go down a letter you will not receive any Stuckey Bucks for "improved grades"…5 Stuckey Bucks
7. Proof of community service or charity work, anything you do to better the community around you. Please write what you did on a piece of paper with your supervisors signature and bring it to your appointment…5 Stuckey Bucks
8. If you refer a patient to Dr. Stuckey, 5 Stuckey Bucks will be awarded after their new patient exam.
9. Visit your general or pediatric dentist for your regular check up and cleaning. (Bring us a note from your dentist)…10 Stuckey Bucks

Who can earn Stuckey Bucks:
Any patient in active treatment (Braces, Lingual arches, Expansion appliances)

YOU CAN EARN ONE STUCKEY BUCK A MONTH FOR: CLEAN TEETH, NOTHING BROKEN, KEEPING YOUR APPOINTMENT, PATIENT REFERRAL, AND BEING ON TIME.

ONCE YOU EARN YOUR STUCKEY BUCK, WRITE YOUR NAME ON THE BACK OF IT AND GIVE IT TO JULIE.

YOUR STUCKEY BUCK WILL BE PLACED INTO A JAR. MONTHLY DRAWINGS THAT WILL GIVE YOU A CHANCE TO WIN PRIZES SUCH AS: GIFT CERTIFICATES FOR DINNER AT LOCAL RESTAURANT, GIFT CERTIFICATES TO SPECIALTY STORES, ETC. WE HOPE YOU WIN!

PLEASE CALL OR EMAIL OUR OFFICE IF YOU HAVE A QUESTION ABOUT YOUR APPLIANCES! DR STUCKEY'S OFFICE

Brush after every meal.

1. Use a toothbrush with a small amount of toothpaste.		2. Use circular, vibrating motions around the gumline for about 10 seconds on each tooth.


3. Brush every tooth slowly.		4. Brush the lower teeth up and the upper teeth down. Also brush your tongue and the roof of your mouth.

Floss nightly after brushing to remove the plaque missed by brushing.

1. Carefully pull waxed floss between wire and braces.		2. Floss carefully around the braces.


3. Floss carefully around the gum area.		4. Floss around each tooth.

Results

Proper Oral Hygiene		Improper Brushing and Flossing