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Appliance Care And Wear

Introduction

Orthodontic treatment usually involves the use of either a removable appliance of fixed appliance to correct the malpositioned teeth. Orthodontic fixed appliances are braces that are cemented to the teeth. They cannot be removed from the mouth and should not be detached. They are normally fitted by an Orthodontist on the crooked teeth to straighten them. The average length of treatment with braces is normally about two years. It could be longer depending on types of malocclusion or how crooked the teeth were at the beginning of treatment. Since the patients have to wear the braces for a certain period of time, it is very important for them to look after their braces properly. This can help to prevent unwanted effects to the teeth during or after the braces therapy. As the name suggests, removable appliances can be removed from the mouth. If it is worn properly, it can also produce the desired result. 

Fixed Appliance

Removable Appliance

The Importance Of Having Clean Braces and Removable Appliances.

The components of braces consisted of bands glued to the molar teeth, brackets fitted to the front and back teeth and archwires. Some orthodontists prefer to use brackets on the molar teeth, these are called buccal tubes. The archwires are attached to the bands and the brackets using wire ligatures or colourful elastic bands called modules that the patients can normally choose. The brackets are usually made of stainless steel or ceramic. These braces components are small; they have areas where plaque or food debris can easily stick onto them. The removable appliances are normally consisted of acrylic base plate and wires are attached to them. The acrylic usually covers the palate on the upper arch; on the lower arch it covers the gum tissue near the tongue area. If orthodontic appliances and teeth are not cleaned properly, some unwanted side effects might occur. These include caries or decayed teeth, especially around the brackets and edges of the bands. If caries occurs during orthodontic treatment, it may slow down the overall treatment time, adds extra cost to repair the damage and also it will make the teeth appears unattractive. Another bad side effect is that the patient will have a bad breath known as halitosis. For removable appliances wearers, additional side effect of not cleaning them properly is that there may an inflammation of the gum at the area where the base plate is covering.

Bands
   

Brackets And Archwires

Buccal Tube

Cleaning your teeth and orthodontic appliances

To keep your braces clean, it is very important to have your teeth and braces brushed after every meal. You can use a specially made tooth brush for braces wearers to clean your teeth and braces. Firstly rinse your mouth before brushing; this will help to remove big chunks of food debris that may be stuck between the braces components. Then brush all surfaces of your teeth including your braces. There is an interdental brush that you can use to clean around the edges of the brackets. It looks like a miniature bottle brush and it comes in various shapes and designs depending on the manufacturer. The interdental tooth brush will help to effectively remove the plaque and food debris around the edges of the brackets that cannot be reaching by the normal toothbrush. Your orthodontist should be able to assist you on how to use these correctly and where to get them from. Many orthodontic clinics will have these available in their office where you can easily purchase them. Using a fluoridated toothpaste and mouthwash may also be beneficial to help you clean your teeth and braces.

Make sure that you bring your toothbrush and the tooth paste everywhere you go. Cleaning a removable appliance is easier. Just use an old tooth brush and brush all surfaces under a running tap water. Do not use tooth paste since it can cause the fitting surfaces to be worn off. This will cause loosening of the appliance and will not fit well. Removable appliances are normally worn 24 hours; however some are worn at night only. If this is the case, they should be stored in a tightly closed container filled with water. You can add some retainer cleaning tablets to soak them with. This can help to remove debris and odour.

Flossing

It may be very challenging to keep your teeth and braces clean, especially at the beginning of braces treatment. Sometimes food gets stuck in between the teeth. Should it happen, the use of floss is quite helpful. The regular use of floss is also helpful as it helps to clean the interdental spaces where the interdental brush could not reach. To use floss, take about twenty centimetres of floss and pass it underneath the archwire. Then pass it through the interdental spaces and move it up and down. This will help to remove the food pieces there. For those who wear removable appliances, just remove it before flossing.

Dietary advice

After the braces are fitted, some patients may find it is challenging to finish a meal. It is advisable to take soft diet and avoid hard, sticky and chewy foods. Cut your food into small pieces before chewing them. Avoid biting your food with your front teeth, for example biting an apple. This may cause the front brackets to come off and delaying the treatment. Carbonated drinks have to be avoided as well due to its high content of sugar and acidic condition. Its acidic content may cause the brackets to be dislodged whereas its sugar contents can increase plaque accumulation on the surfaces of the teeth as well as the braces components themselves. As we already know plaque can cause further problems as we have discussed in the previous part. Should you have further questions, please contact your orthodontic clinic and the staff there may assist you.

References

  1. Oral Health Division, Ministry of Health
  2. Malaysian Association of Orthodontists (MAO)
  3. British Orthodontic Society

 

Last Reviewed : 14 March 2017
Writer : Dr. Roslili bt. Mat
Accreditor : Dr. Yatimah bt. Othman