Braces, Retainers and Dental Health

Straightening teeth is known as orthodontics, and is needed as part of orthognathic treatment before and after surgery.  Orthodontic braces are used to move the teeth into the correct positions so that after the surgery the teeth in the upper and lower jaw meet.  The braces are not only used to move the teeth before surgery but also allow the bite to be finely adjusted afterwards. 

Fixed braces commonly known as 'train-track' braces are typically worn for 18 months to 2 years before the surgery and then kept on up to 4-9 months afterwards.  This time can vary depending on how straight the teeth are beforehand and the amount the jaws need to be moved. 

Above: A patient having their brace adjusted

Treatment is lengthened by missed appointments and any breakages of the brace (see below: Brace Breakages and Emergencies).  If you can't attend an appointment, please contact the department and rearrange your appointment, so not to delay your treatment. 

 

Keeping your brace clean and your teeth and gums healthy

 Interdental  (in between the teeth) brushes are essential to clean in between the teeth, around the brackets and under the wire as shown in the video below.  If you do not brush your teeth, and you eat the wrong diet, your treatment will be abandoned and the braces removed.  This is to prevent damage to the teeth (e.g. marks and decay) or gum disease.

 

 

Above: A large interdental brush used to clean underneath the wire

• Do brush your teeth for 2-3 minutes twice a day with a fluoride tooth paste.
• Do use an electric toothbrush if you like using them.  They will not break your brace.  Ones with a built in timer and small toothbrush head are helpful.
• Do use sugar-free chewing gum after meals to help reduce tooth decay.
• Do cut down or stop fizzy, acidic drinks and sweet sticky foods as this will cause decay and dissolve the enamel around the brackets leading to square marks on the teeth once the brace has been removed.
• Do not bite and chew hard foods e.g. apples or crusty bread as this may break your brace.

 There are leaflets on the clinic which will give you diet and brushing advice.  Please ask your dental nurse and they will give you one.

 

Brace breakages & Emergency appointments

If your brace breaks don't worry.  If it is less than 2 weeks before your next appointment with the orthodontist, and you are not in pain then it is ok to wait for it to be fixed.  If the brace breaks in the weeks following surgery then contact the department as soon as possible.  Emergency appointment slots are available Monday - Friday and are only available by contacting the department to book a slot (Tel: 0117 342 4350 or 0117 342 4338).  If the brace is sharp, use the wax to keep your mouth comfortable.  

 

Elastics

After surgery you will have to wear elastics to settle your new bite and prevent you from over stretching your jaw muscles.  Your surgeon and orthodontist will demonstrate how to put them on and where.  It is important you put them on in the correct place.  If you are not sure ask the orthodontist or surgeon to draw how on the back of the elastics bag.  They should be changed daily. 

How to fit your elastics

A plastic hook (shown below) may be given to you to make placing the elastics easier in the first few days or weeks after surgery when you are swollen and the stiches are sore (see photo below: Patient 1 week after surgery).  Tweezers can also be used.

 Above: A patient fitting their elastics

Retainers 

After the braces are removed all patients will receive clear plastic removable retainers (pictured below left) and in some cases also a fixed retainer (pictured below right).   Retainers are as important as the braces and surgery.  They will keep your teeth straight and if you want to maintain the finished result you should wear them on a part-time basis for life.   Your orthodontist will advise you how often to wear the removable retainer.  

If you lose your retainers inform your dentist or your orthodontist straight away so you can get a new retainer made before the teeth move.  There is a fee for replacement retainers if you lose them or want a new set made, so take care of them.

How to clean your retainer

• Do gently clean your retainer with cold water and liquid soap or mouthwash daily
• Do use a sterilising tablet/liquid occasionally to keep your retainer bacteria free and cleaner for longer
• Do not use tooth paste to clean your retainer
• Do not use hot water as it will melt the plastic.

 

Dental treatment