brushing

It is absolutely essential that you keep your teeth, gums, and braces spotlessly clean. If brushing is not adequate, permanent staining (brown or white spots) and cavities could develop. Keep your braces clean by brushing and flossing every day. Please feel free to ask the clinical staff to review brushing techniques with you. It is essential to continue brushing in a gentle circular motion along the gum line. Even though we check your brushing at every appointment, it is still necessary to continue your regular 6-month check up with your family dentist.


Food Rules

Our goal is to provide you with a beautiful smile. This can only be accomplished if the braces stay attached to your teeth. We do not want to interfere with your nutritional intake, but we do ask that you watch the types of foods that you eat. Some types of foods are capable of breaking your bands, brackets, or bending your wires. The foods listed are ones that we have found to be the most common cause of loose bands or brackets and broken appliances.


Hard Foods

  • Ice (no crunching), popcorn, cut corn off the cob
  • Hard pizza edges, carrots/apples, peanuts (all nuts)
  • Hard corn chips, crispy French fries, cut meat of the bone

Sticky & Chewy Foods

  • Caramels/taffy, liquorice
  • Jujubes/gumdrops, candy bars
  • Gum, fruit roll ups

Sweet  Foods

Although they may not cause damage to your appliances, care should be taken to brush teeth immediately after eating very sweet foods, if you cannot brush, at least rinse your mouth with water.

  • Cake/pies, sweet drinks
  • Ice cream, cola / pop
  • Candy

Emergencies
Call our office as soon as possible if you break or loosen any of your appliances. Please do not come directly to the office. By calling us, you will allow us to create a time to see you. Even if you have a regular appointment scheduled, call us immediately to notify us if you need an appliance repaired.

Loose brackets or bands
Call our office immediately for advice if a bracket or wire is loosened. The bracket may need to be re-fitted as soon as possible. You may have a situation that requires cutting a wire or sliding a bracket off a wire at night or over the weekend. If you need to cut a wire in case of emergency, you may use fingernail clippers that have been washed and sterilized in alcohol. Please call our office the next business day, so that we may schedule an appointment for you.

Wire irritations
Sometimes discomfort caused by a wire on your braces can be resolved by moving the wire away from the irritated area with a cotton swab or eraser. If the wire will not move, try covering the end of it with a small piece of cotton or a small amount of wax. If the wire is painful, you can cut it with nail clippers or scissors that have been washed and sterilized in alcohol. If you cannot resolve the wire irritation, call our office for an appointment.

Discomfort with Orthodontic Treatment
During the first week after your braces are in place and routine adjustments are complete, you will likely feel some pain, soreness or discomfort. You may take acetaminophen or other non-aspirin pain relievers while you adjust to your new braces. A warm washcloth or heating pad may reduce the soreness in your jaws.

There is also a lot of useful information on the Canadian Association of Orthodontists’ website.

Sports Mouthguards

Mouthguards are now mandatory for amateur hockey and strongly recommended for many other sports. Please consider having a custom mouthguard made. Research has shown that a custom-fitted mouthguard is far superior to the boil and bite type. However, when orthodontic treatment is being done, a custom mouthguard may not be practical since tooth positions are constantly changing. We will gladly supply our patients with a sports mouthguard if requested.

Elastic Instructions

Today is the beginning of an important new phase in your orthodontic treatment. Elastics (small rubber bands) will be needed and they will help reposition your teeth and jaws if worn as directed!

Here’s what you have to do:

  • Wear the elastics all the time, night and day, unless we tell you otherwise
  • Carry some elastics with you at all times. If one breaks in your mouth, replace it right away
  • You may remove them when you eat. Brush your teeth carefully after every meal and put elastics on immediately. Remember: Change them at least once a day
  • If you run out of elastics, call us and tell us what size you need. We'll get a new supply to you

The elastics may make you teeth tender for the first 2 or 3 days, but, if you continue to wear them, they will become comfortable in a short time.

A Final Word

Teeth have never failed to move when elastics are worn consistently as directed. But, when they are worn one day and left off the next, your treatment slows and may even stop. Why? Because the teeth "jiggle" back and forth and actually sets up a resistance that prevents movement. Your cooperation is most important. If you wear elastics as recommended, you'll be surprised at how quickly your treatment will progress, and your overall time in braces may possibly be less than expected.

facial types

malocclusion classes

Class I
Normal maxilla to mandible skeletal relationship. Patient may have many dental problems such as crowding or excess space, cross bites anterior or posterior, missing teeth or extra teeth.

Class II
There is a difference between the maxilla and the mandible. There are many variations of maxillary and mandibular relationships are classified as class II division I and class II division 2.

The dental structures compensate to the skeletal problem resulting in typical proclined incisors or a deep bite, when the incisors are retroclined.

The same type of dental problems can also be present, i.e., crowding or spaces or missing teeth.

Class III
Skeletal problems can be due to various combinations of maxilla to mandible. For instance, excess mandibular development, either vertical or horizontal can be present with a normal maxilla. Other combinations could be deficient maxilla and normal mandible. Again, various dental problems can be present.

Although we are showing typical profile patterns, it is obvious there are many skeletal variations within each profile type that will require different diagnosis and treatment planning.

An orthodontist has the extra education and training to recognize these variations in skeletal and dental relationships and design appropriate treatment plans.

separators

Orthodontic separators, also known as spacers, are rubber bands that make room for the metal bands we will fit around your teeth at your next appointment. Proper care of your separators:

  • Brush carefully after each meal, including the teeth that have the separators between them
  • Avoid using dental floss between the teeth that have the separators
  • Do not touch, pick or play with the separators
  • Do not chew gum or eat candy or anything sticky that could pull your separators out

Separators may make your teeth sore and tender for the next 24 to 72 hours. This is a normal reaction for teeth that are moving. An over the counter pain reliever such as Tylenol often helps relieve the discomfort.

If a separator comes out and it is not lost or swallowed (they are digestible), rather than coming back to the office, you may wish to try to replace it yourself by using two pieces of dental floss as follows:

Using the dental floss as a handle, gently slip the separator between the teeth until it is in place and then slowly pull the floss out by one end. With young patients sometimes, so much space is created that the separator is difficult to keep in. If this is the case, wait for one day and try to slip it in again. Separators are an important part of your orthodontic treatment. They will make your first banding appointment much more comfortable for you if they are left in place. If one or more falls out and you are unable to guide it back in, please call the office so we can replace them in a timely manner.

sleep apnea

Oral appliance therapy (OAT) is a recognized treatment for snoring and other forms of sleep-disordered breathing (SDB), upper airway resistance syndrome (UARS) and obstructive sleep apnea (OSA). It is recommended that orthodontists who treat any type of SDB should do so in conjunction with the patient’s physician.

While snoring by itself is often the presenting complaint, in a significant percentage of sufferers it is the principal symptom of a more serious condition, obstructive sleep apnea (OSA), which ranges from mild to moderate to severe. OSA left untreated may predispose a patient to cardiovascular complications such as heart attacks and strokes as well as gastro-esophageal reflux disease. OSA may also give rise to daytime drowsiness, leading to an increased risk of work- related and motor vehicle accidents and fatalities. It is therefore important that orthodontists treating snoring ensure that any treatment not only eliminates snoring but also any related OSA, if this condition is shown to exist. This can best be accomplished through the use of a polysomnogram (PSG) both in the diagnostic stage, as well as afterwards to confirm treatment success.

Definitions

  • Apnea: Cessation of airflow for 10 seconds or longer
  • Sa02: Blood oxygen level (given as a percentage)
  • Hypopnea: Decrease in airflow by 50 percent or more for 10 seconds or longer and associated with a decrease in Sa02 by more than four percent and /or arousal
  • Respiratory index (RDI): the total number of apneas and hypopneas per hour
  • Mild OSA: generally an RDI of 10-20, although some clinicians accept slightly different numbers
  • Moderate OSA: RDI of 20-40
  • Severe OSA: RDI greater than 40
  • CPAP: continuous positive airway pressure

Dr. Milne uses an oral appliance to control sleep apnea.

bite turbos

Bite turbos are small acrylic pads that are bonded to the tongue side of the upper front teeth or to the molars. They are a temporary addition to your treatment, and are used to correct excessive overbites. Wearing bite turbos can reduce the amount of time spent in braces by 4-6 months. The rapid increase in the speed of overbite is how they earned their name, "bite turbo"!

When bite turbos are initially placed the back of the teeth will not come completely together when chewing. This is temporary condition, and eating soft foods for the first week will allow you to tolerate this new type of bite. Your speech may be slightly affected, but usually returns to normal within a week.

It is highly unlikely that a bite turbo will break loose. If one bite turbo does come off, it's not a problem. If you lose them both, please give us a call - we will probably replace them for you if the overbite still needs more correction.

Temporary Anchorage Device (T.A.D.)

In traditional orthodontic treatment, a system of anchorage control has always been utilized to prevent any unwanted movement of teeth mostly in the posterior area when forces are applied to anterior teeth. These systems would often involve head gear appliances in various forms, fixed wires on the interior of teeth and plastic appliances. The weakness in these systems has always been patient compliance.

In modern orthodontics, we are now using a system for temporary anchorage device (TAD), we can now use miniature implants using titanium materials which can be inserted into the alveolar bone and these have the benefit of provided fixed anchorage so that forces can be applied in different areas of the mouth without unwanted tooth movement. These implants are simple to insert under a local anesthetic and they can then be removed when that portion of treatment is completed. They are small self-tapping screws which can be inserted or removed quite comfortably.

Information

239B Argyle Avenue

Ottawa, ON K2P 1B8


Phone: 613-232-4266

Email: info@bracesbymilne.com

Hours

Monday & Tuesday: 8am to 4pm
Wednesday: 8am to 12pm
Friday: 8am to 12pm

May to September
Thursday: 8am to 2pm

September to May
Thursday: 8am to 4pm

Emergency appointments available

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