ORAL HYGIENE

Bacterial plaque is what causes tooth decay and gum disease. Bacterial plaque needs to be removed completely from the teeth daily to prevent decay and gum disease. Dull, non-shiny braces (due to plaque covering the braces) and gums that are swollen and puffy (or gums that easily bleed) are indications that the teeth are not being properly cleaned and there is an inflammation present. This condition needs to be controlled by proper brushing habits to protect the teeth and supporting structures.

A toothbrush will be provided in the office so that the teeth can be cleaned prior to appointments. If the teeth are not cleaned at regular appointment visits, the assumption has to be made that the teeth and braces are not being properly cleaned.

Brushing instructions will be given at the orientation appointment and at the first appointment after appliances have been placed (if necessary).

If oral hygiene is not acceptable at regular appointment visits, then there will be a referral to your dentist/hygienist for the problem to be corrected. The hygienist will need to be seen until proper brushing habits are developed.

The dental hygienist is the dental health care professional who is best qualified to give oral hygiene instructions.

We have made the decision in our office to handle oral hygiene problems this way so that treatment time is not lost due to poor oral hygiene. Plus we do not want to have to program into our fee structure the cost for oral hygiene instructions for all patients when the problem exists in only a few. As has already been stated, the hygienist is the best qualified person to render oral hygiene instruction.

The dentist will need to charge a fee commensurate with the services rendered by his hygienist.

We are often asked if an electric toothbrush is beneficial for better oral hygiene. Recent tests have indicated this is true, and we routinely recommend its purchase. In cases where hygiene is not adequate, we would recommend the Rotadent electric toothbrush because of recent published research. The need for purchase of an electric toothbrush can be determined as treatment progresses.

TOOTHBRUSHING TECHNIQUE

1. The teeth should be brushed at least twice a day, morning and night (and preferably after every meal).

2. Each patient should have at least two soft bristle toothbrushes. Always use a dry toothbrush when brushing. After brushing, pull the lips apart so you can see that the teeth are absolutely clean. Then you can brush with toothpaste because toothpaste just makes toothbrushing more pleasant - it does not add to the quality of brushing.

3. Strong brushing pressures are necessary to properly clean the teeth. By using a dry toothbrush on braces, you do not wear out the toothbrush quite as fast. By using a soft tooth brush, you do not wear out the gums.

4. It should take at least 3 to 5 minutes to properly clean the teeth and braces.

5. Always start at the upper left and work to the upper right, then lower right to lower left. This is so you do not take a chance of missing any places.

6. Place the bristles above the braces between the tooth and gum, scrub two or three teeth at a time with a scrub brush (back and forth) motion.

7. After cleaning the teeth above the braces, force the bristles between the wire and the braces cleaning two or three teeth at a time working from left to right in a circular motion. At the same brushing, thoroughly brush the chewing surfaces of the teeth, remembering to place pressure while brushing. Also brush the back of the teeth -- tooth and gum at the same time - using the same pressure and brushing action as brushing the front.

8. Rinse mouth thoroughly.

9. Pull cheeks up and out of the way and inspect the braces and teeth again. Everything should be bright and shiny.

IMPORTANT INFORMATION

Keeping your appliances and teeth 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). You are what you eat! Dr. Rider does not restrict what you eat - but please be careful. Brush after every meal if possible. Properly brush all surfaces of every tooth. At the completion of brushing, the lips should be pulled out of the way so the teeth can be inspected.

NO-NOs

Refined sugar can cause cavities very fast if the teeth are not brushed soon after eating - so try to cut down. Do not chew hard candies. DO NOT CHEW ICE! Phew! What a relief - chewing sugarless gum is OK and can sometimes help sore teeth feel better.

We provide a soft wax that can be warmed between the fingers and pressed over an offending bracket or wire that is sticking you. You can get more wax from the office at any time.

If you develop a sore in your mouth, use a little Orabase with benzocaine. It can also be helpful to rinse with some salt water.

Dr. Rider wants each patient to use fluoride daily when undergoing orthodontic treatment. Studies have shown that decay and white marks on the teeth (when brackets are removed at the end of treatment) can be eliminated in almost all cases when fluoride is used on a daily basis. If the fluoride is not used on a daily basis, then its effectiveness decreases.

It makes us very sad to remove braces at the end of treatment and find straight teeth made ugly due to decay or white marks. The chance of decay and white marks at the end of treatment can be eliminated by the proper use of fluoride.

Did you know that you bite with about 300,000 pounds of force per square inch?!!

Braces do require extra care and they can cause minor discomfort but these problems are temporary. Your dental health and appearance are meant to last a life time. It is possible that a brace may come loose during treatment. If this happens, please call and tell us - even if it is only a half-hour before your scheduled appointment. Thank you.

LIP EXERCISES

Dr. Rider wants every patient who is undergoing orthodontic treatment to do lip exercises daily. This is to help strengthen the lips and to insure that you are breathing freely through your nose. If you encounter difficulty doing lip exercises, please let us know.

FLUORIDE TREATMENT

Tests on orthodontic patients have shown the daily use of fluoride prevents white marks or decay on the teeth when the braces are removed. These same tests have shown if the fluoride is not used daily, its effectiveness decreases dramatically. Therefore, daily use of fluoride is extremely important.

PreviDent is a fluoride paste that has been recommended for daily use during orthodontic treatment. A prescription for PreviDent can be obtained from our office.

FLOSSING THE TEETH

Flossing the teeth with bonded brackets can be done by threading the floss between the tooth and wire and flossing in the normal manner. A faster technique, which is not as good as threading the floss between the tooth and wire but can be effective in improving oral hygiene, is to floss between the teeth down to the wire and tip the floss so the area between the teeth can be reached. Flossing teeth with bands around them is usually impossible and is not necessary because the area of the tooth cleaned by flossing is protected from decay by the band and the cement inside the band sealing the band and the tooth.

Because of the additional time involved in brushing the teeth with braces present, we want our patients to demonstrate impeccable tooth brushing before we encourage flossing. Flossing with braces can only improve the total oral health of the mouth, however, in most cases flossing and its time commitment is not encouraged until proper brushing habits are achieved.

LOOSE BANDS OR BONDED BRACKETS

As a patient you are responsible for gently checking each part of your appliance every Sunday to insure that the appliance is properly attached to the teeth. If something is loose the office should be called even if there is an appointment scheduled in the near future. Please call the office. If whatever is loose is still bothering you, then it does not need to be replaced immediately; obviously the loose appliance should not be of f the tooth too long because if an appliance is of f it cannot be working as it should.

In respect for other people's time and to allow the office to stay on schedule, appliances will not be replaced during short appointments unless the office has been called so proper time has been planned in the schedule to fix what is broken.

There is an emergency time available in the schedule each day to make you comfortable and relieve any pain. It is very important that you call and schedule an emergency important. After you are made comfortable, it may be necessary to schedule an appointment to replace and repair broken appliances. When you have an emergency you need to be flexible with time; knowing this is an emergency, we will be squeezing you into an already busy schedule.

REMOVABLE APPLIANCES

Lost or broken retainers or removable appliances will require the replacement of those appliances and there will be an additional cost. The cost to replace that appliance will be what it cost me.

Should you have any questions about this procedure, please ask or call my office. We want to achieve the best orthodontic treatment results possible and that can only be accomplished by proper wearing of retainers and removable appliances.

STERILIZATION

Meeting the challenge of complete and efficient sterilization is a growing concern in today's orthodontic practice. The danger of patient and staff cross-infection is real and facing that reality has been achieved by improved methods of sterilization.

We are achieving this goal by using the dry heat method of sterilization and the chemiclave. You can see these two sterilizing devices operating in the operatory. This sterilization method has demonstrated a capability to kill all living organisms including pathogens, fungi, viruses (HIV) and spores. It is the state-of-the-art sterilization system for today's orthodontic office.

Our commitment is to maintain the highest level of safety and well-being for our patients. To maintain this commitment we keep informed of new technology and continually upgrade our methods.

TOMOGRAM X-RAYS

One of the goals of our office is the treatment of the entire chewing mechanism, not just the teeth but also the muscles and jaws that move the teeth.

Recent published literature indicates that 50% or more of the adult population suffers from temporomandibular joint dysfunction problems. This is the joint that moves the lower jaw.

A recent article also states 30% to 65% of all children examined before orthodontic treatment exhibit either noticeable or subclinical signs of temporomandibular joint dysfunction. As these patients undergo treatment, symptoms such as headaches, pain and clicking may arise or worsen. Also, temporomandibular joint dysfunction problems are often not evident until a patient reaches their 20s or 30s. Tomographic x-rays (special, specific detailed x-rays of the joint itself) can identify potential problems early.

During the initial examination the tomograms can be used to locate the proper position of the jaw. Should the x-rays show any abnormality, the orthodontist can attempt to rehabilitate the joint to the optimal position of health prior to or during the reorganizing of the bite. Sequential tomograms can determine the degree of healing. Tomograms, unlike other films, are repeatable at exact angle and depth so that comparisons can be made over time.

We employ only the latest x-ray equipment, therefore, exposure is minimal. Since we are committed to excellence in your treatment, we feel tomography can be a vital part of that process.

BREATHING TESTS

The relationship of normal development of the face and the ability to breathe through the nose has been shown by worldwide research. Breathing and chewing are biologically inseparable so that full-time nasal breathing is important to normal jaw development and jaw function.

We test the nasal breathing capacity of all our patients from time to time to monitor their breathing health. We refer those with breathing problems to a rhinologist for care and treatment because we do not want unnatural breathing habits to interfere with normal facial development.

HERBST DEVICE

In young children facial development can often be influenced when a constant force is administered to the developing jaws. The Herbst device is a mechanism that applies a continuous force to the upper and lower jaws.