Brushing

1. Brush along the gum line.	2. Brush with the bristles of the toothbrush directed toward the top of the brackets.	3. Brush with the bristles of the toothbrush directed toward the bottom of the brackets.	4. Brush with the toothbrush by placing the brackets in the groove of the orthodontic brush (the bristles of the toothbrush will be perpendicular to the tooth).

     Interdental brush

	1. Gently insert the brush under orthodontic wire, between the brackets. 2. Using a gentle up and down motion, remove plaque and food particles from around all bands, brackets, and orthodontic wires.	3. Clean under the utility arch wire in the same manner. 4. Rinse interdental brush frequently and replace when bristles are worn.

                     Super Floss

1. Thread the Super Floss under the orthodontic wire.	2. Wrap the Super Floss around your middle fingers. Using your first fingers and thumbs slide the Super Floss between the teeth in a back and forth motion. 3. Hold the floss in a “C” shape against the tooth. Gently move the Super Floss in a back and forth motion while you are sliding the Super Floss along the side of the tooth. Gently slide the floss under the gums to remove plaque and food particles.	4. To remove the Super Floss, slide the floss away from the gums and pull it out from between your teeth. 5. Continue the previous steps for each tooth.

            Floss threaders

1. Floss is threaded through the floss threader.	2. Slide the floss and threader under the orthodontic wire, and remove the floss threader. Wrap the floss around your middle fingers. Using your first finger and/or thumbs, slide the floss between the teeth in a back and forth motion. 3. Hold the floss in a “C” shape against the tooth. Gently move the floss in a back and forth motion while you are sliding the floss along the side of the tooth. Gently slide the floss along the gums to remove plaque and food particles.	4. To remove the floss, slide the floss away from the gums and pull it out from between your teeth. 5. Continue the previous steps for each tooth.

Topical Fluoride

1. AFTER teeth have been brushed, flossed and all the plaque and food particles have been removed; brush the topical fluoride gel on all tooth surfaces or rinse for 60 seconds and then spit out.

2. DO NOT eat, drink, or rinse with water for at least 30 minutes afterward (best to do before bedtime).

Optional oral hygiene products: 1. Waterpik 2. Electric tooth brush Although these two products are not an absolute necessity, they are a big help for good oral hygiene.

Proper brushing, flossing, & topical fluoride can help you in three ways:

1. Prevent tooth decay by removing bacterial plaque which tends to build at the gum line and around your braces.
2. Prevent enamel decalcification (white marks around and under the brackets) by using the topical fluoride to strengthen the enamel..
3. Prevent swollen gums and gingivitis (gum disease) by thoroughly flossing and brushing your teeth.

            Dental concerns while in orthodontic treatment:

	Gum inflammation/gingivitis will happen if plaque and food are allowed to remain near the gums. The gums will bleed and appear red, puffy and swollen. The gums can even cover the bracket. This is NOT HEALTHY.
	Enamel decalcification can happen if the plaque is allowed to remain on the teeth. The tooth’s enamel will begin to break down resulting in permanent white or brown lines or spots on the tooth surfaces. These white or brown lines or spots are not reversible. Enamel decalcification is the first stage of tooth decay (the start of a cavity!).

    Why can’t I eat what I want?

 If you are not careful about the things you eat, you will break off brackets, loosen bands, bend or break wires.

Remember this handy rhyme:
A tiny bite will keep things tight.
A bite that’s GRAND might loosen a band!

Foods to avoid completely:

• Anything sticky, chewy, or gooey Examples: Gum (any kind of gum, including Freedent or Stick Free), caramels, taffy, fruit snacks (Shark Bites, Fruit by the Foot, etc.), Skittles, Now & Laters, candy apples.
• Hard candies, even though you only suck on these, hard candies will bathe your teeth with sugar for a long period of time. Examples: Life Savers, Lollipops, Jolly Ranchers, etc.
• Natural dried fruits (raisins, figs, dried apricots), are very high in sugar and are very sticky making them cariogenic (decay causing).
• All types of nuts.

Please use caution when choosing the food that you eat. Sucking on lemons can dissolve enamel (surface of your teeth). Research has shown that each time you break something (brackets or wires), you add one month additional time to your orthodontics.

Foods to be careful with:

Most of the following foods are to be cut into small pieces before being eaten. If you bite directly into certain foods, with your front teeth, you will weaken the bracket bonding and eventually the bracket will “break” loose from your tooth surface or break a wire.

• Crunchy pizza crust, bagels, hard rolls, and toasted bread. Examples: When eating pizza, eat the center pieces; don’t eat the outer crust around the pizza. When eating bagels, cut them up into smaller pieces so you can chew them with your back teeth. You can have bread, but don’t eat bread that has been really toasted and is hard like a crouton.
• Hard fresh fruits and raw vegetables Examples: Apples or pears can be eaten if they are cut up into wedges or small pieces so that you use your back teeth. Do not bite into a whole apple or pear. Raw vegetables should be treated the same way. Cut them into bite sized pieces, so that you can use your back teeth and do not need to use your front teeth to bite off a portion of the raw vegetable.
• Corn on the cob: remove the corn from the cob before eating.
• Ice chips and cubes: Don’t chew ice cubes or ice chips, but you can use them in your beverage glass.

                               Quick Quiz - Name the numbered items.

1. Bracket 2. Colored elastic 3. Utility arch wire 4. Band

                   Please do not:

              *Pick or play with brackets, wires, and bands.
              *Chew on pencils, pencil erasers, or pens.
              *Chew your fingernails.

^{Something is broken!}

^{When something is broken or poking call our office to schedule a time to come in so we can get you out of discomfort. Your regularly scheduled appointments are made to continue your treatment with the understanding that nothing is broken.}

^{If you break a wire or break off a bracket or have a band loose, you will need a morning appointment, so that we can bend a new arch wire, bond a new bracket, or recement the band. To do any of these procedures we must remove all the colored elastics and arch wire, which takes more time than what is scheduled for the regular orthodontic continuing care appointments. Expect to be in the office for a minimum of one hour when repairs are required.}