
YOU
AND
YOUR
ORTHODONTIC
TREATMENT
Orthodontic Department
Maxillofacial Unit
Queen Alexandra Hospital
Cosham
PO6 3LY
TELEPHONE
NURSE
ORTHODONTIST
CONSULTANT
023 9228
APPLIANCES
There are different types of appliances used by your orthodontist
to treat your malocclusion.
Fixed appliances are those that are glued to the teeth and cannot
be removed except by your orthodontist. They are a delicate
piece of engineering and time should be taken to read the
instructions below to ensure treatment is successful and carried
out within a reasonable amount of time.
Headgear is not required for all patients but occasionally it is of
great benefit to ensure a rapid and successful result. There are
many types of headgear and you will be fitted with the kind your
treatment requires. Regardless of what type of headgear you have
it must be worn for between 14-16 hours every day (or as your
orthodontist instructs you) before it can do any good. It is not
unusual in the USA to wear it for 24 hours - so please co-operate
the best you can. Keep a chart of the hours worn, and bring it
with you to each visit. Headgear potentially can be dangerous it
can cause injury to the mouth, face or eyes. Your headgear
already incorporates important safety features but to ensure safety
at all times, follow the ‘safety code.
treatment is successful and is carried out within a reasonable
amount of time.
Functional Appliances are a special type of orthodontic
appliance that is removable for cleaning purposes, but are
designed to move not only teeth but also have some influence on
facial growth. To be effective it must be worn as much as
possible and your orthodontist will give you special instructions.
At first your mouth will feel unusually full , speaking will be
awkward and you may have more saliva than normal but a little
practise will make you comfortable. A very important thing to
remember during your appliance wear is to keep your lips
together and breathe through your nose, this will help the
treatment and look better.
APPOINTMENTS

DO NOT attempt to remove the facebow without removing or
loosening the headstrap first
In most circumstances we expect your orthodontic treatment to
last 18-24 months. Some more difficult cases, however, take
longer. Time intervals between appointments may vary between 6
– 12 weeks or more in some cases. Most appointments are short
routine adjustments of about 15 minutes. At other times,
however, when bands are being cemented or complex archwires
are being inserted your appointment make take 45-90 minutes.
Since most patients are of school age we cannot guarantee that all
appointments can be made outside normal school hours, though
we will try to arrange them in the most reasonable way. If an
appointment must be cancelled or changed as much notification
as possible would be appreciated. It is not always possible to
reschedule the appointment immediately but every effort will be
made to ensure treatment is not delayed.

DO NOT wear the headgear during rough play or sports
EXTRACTIONS

DO NOT allow the facebow to be pulled/twisted during play
‘The Headgear Safety Code’
 DO NOT continue to wear the headgear if it ever becomes
dislodged during sleep or normal activities. Leave it off and
make an appointment for adjustment as soon as possible
If an EYE INJURY is ever suspected (however small) seek an
immediate opinion at the Accident & Emergency department
It is sometimes necessary to remove certain teeth in order to treat
orthodontic cases. If this is indicated at the start of treatment, or
becomes necessary during treatment, you will be informed and
your dentist will receive a letter notifying him of the extractions
to be carried out.
Removable Appliances are removable for cleaning purposes
only and should be worn at all times (or as directed) to ensure
SEPARATORS
These are small elastic bands placed between your back teeth to
facilitate the placement of a fixed brace. They can be quite
uncomfortable for the first 48 hours as the teeth begin to move
and you may require a mild pain killer to relieve any discomfort.
They will be placed approximately 1-2 weeks before the brace is
fitted.
Diet is an important aspect of appliance care. The amount of
sugar in your diet should be kept to a minimum. In particular
sticky toffees, caramels and chewing gum should be avoided.
Fizzy drinks are an additional source of sugar and should be kept
to a minimum during treatment. Please note ‘diet’ drinks are
very acidic and are equally damaging to the teeth during
treatment. Please avoid excessive consumption.
.
WILL THE BRACE HURT
DAMAGED APPLIANCES
For the first few days after an appliance is fitted it is quite normal
for the brace to rub the inside of the cheeks and lips causing
soreness and occasionally small ulcers to occur. It may be helpful
to use a mild pain-killer to relieve discomfort and to apply the
dental wax provided to smooth the sharpest parts of the brace. As
the teeth start to move after the first visit or when the wires are
changed at follow up appointments additional discomfort may
arise.
Damaged appliances are probably the biggest nuisance in
orthodontic treatment for both the orthodontist and the patient.
They mean extra appointments, inconvenience and extended
treatment time. Even though accidents do happen, almost every
loose band or broken wire can be attributed to patient
carelessness. It is usually due to poor eating habits and we ask
you to follow these guide-lines:

Cut up hard food, such as raw carrots, crusty bread or tough
meat before consumption.

Avoid sticky foods, such as chewing gum or toffees which
put excessive force on to the appliance.

Bad habits like nail biting, picking at the wire with pencils
or other implements can also break the appliance.
DENTAL CARE
Keeping your teeth and appliance clean is important to prevent
damage to your teeth and gums. The teeth and appliance should
be cleaned thoroughly to remove all food and dental plaque using
a toothbrush twice a day and the mouth rinsed effectively after
every meal and snack. You will be shown proper tooth brushing
methods at the start of treatment and it is recommended that in
addition to your normal toothbrush that you obtain an interspace
brush or a brush designed specifically to go in between the wires
and the teeth below. It is also recommended that you use a daily
fluoride mouth rinse whilst you are wearing your appliance. This
helps to strengthen the enamel of your teeth but it should not be
considered a substitute for normal cleaning - it does not clean
your teeth, it merely helps to protect them. Fluoride mouth rinses
can be obtained from your chemist or local supermarket. Please
read the instructions for use carefully and like any other medicine
keep it out of the reach of children. During orthodontic treatment
it is necessary for the patient to be examined on a routine basis by
your regular dentist for fillings etc.
DIET
the only time your teeth will hurt is when the elastics are out.
Elastics are normally attached from a hook in the top arch to a
hook in the bottom arch and you should place them as directed by
your orthodontist. Remember that rubber bands will lose some of
their stretch while they are in the mouth, so it is essential to
change them regularly. You will be given a supply of these
elastics by the orthodontist. It does take some practise to wear
the elastics but you should learn to eat your meals with them in
place.
RETENTION
After active treatment, it is necessary to hold the new position of
the teeth to allow the bone and gum to settle down. This is
usually carried out with the use of removable passive type of
appliances which are worn for a minimum of three months full
time and up to twelve months on a part time or nightly basis.
Patients should be aware that irregularities, deep bites, rotations
or protrusions can return if the retainer is not worn at all times.
THE IMPACTED CANINE
If the appliance becomes damaged , fractured or unduly loose you
should telephone the department immediately and arrange an
appointment for repair . Failure to do so can lead to a delay in
treatment progress.
If your appliance is damaged beyond repair or should be lost
altogether a charge may be made for its replacement.
ELASTICS
Rubber bands or elastics are sometimes needed during
orthodontic treatment to give teeth an extra push. The extra force
of rubber bands will usually cause teeth to be sensitive for a few
days and you will be tempted to leave them off - but don't. This
only slows your treatment. Once you get over this slight soreness
The upper canine teeth can occasionally erupt into the wrong
position. They may impact in the roof of the mouth. In most
circumstances it is possible to bring the errant tooth into
alignment with a brace. The tooth will need to be uncovered
surgically before orthodontic treatment can commence. The
surgical procedure is very straight forward but will normally be
carried out under general anaesthetic. The tooth will then be
allowed to erupt for 3-6 months before active orthodontic
treatment commences. It will be moved into alignment in much
the same way as any other orthodontic treatment is carried out
but will normally take longer and you can expect treatment to
take from 24-30 months to complete.