Quality Results and Efficient Treatment Time

Braces are a two-way street. Dr. Stokes will do all she can to create a "superstar" smile but he needs your help. Although we have estimated the treatment time, there are many factors that are out of Dr. Stokes's control. There are five areas where you can help to keep your treatment on schedule and on course for a beautiful result.

1. Compliance - Occasionally Dr. Stokes will ask you to wear auxiliary appliances such as rubber bands. With good wear, as instructed, you will keep your treatment on schedule. With poor wear, your treatment will fall behind and we will not meet the expected completion date. Neither you nor Dr. Stokes would like to see that happen.

2. Come Regularly - Dr. Stokes will let you know when the ideal time for the next visit will be. This could be as short as one week or as long as six months depending upon where we are in treatment and what appliances are being used. Although we try to see people after school or work, these times are limited and there will be some days where school or work must be missed. Study halls or lunch hours can often be efficient times to schedule. Limiting yourself to the convenient hours will likely delay your treatment, so please try to schedule as Dr. Stokes suggests.

3. Broken Appliances - We ask patients to stay away from sticky and hard foods for a reason. Sticky and hard foods pull bands off and break brackets. This breakage often sets us back with treatment and we are forced to take a step backwards to previous wires. Nail biting, pencil chewing and playing sports without proper protection can also cause breakage. The more often you break, the longer you will have the braces. Please notify the office should there be breakage to the appliances as repairs take more clinical time. For the most efficient result, please take great effort to avoid these broken appliances.

4. Poor Oral Hygiene - There are many reasons we do not like to see poor oral hygiene. Perhaps the greatest reason is the possibility of permanent ugly white spots around the brackets after removing the appliances. With braces, it is hard to brush and there are more "nooks and crannies" for plaque to settle. This plaque can cause cavities and also ugly white spots. Plaque can also cause gingivitis with swollen, bleeding gums. Swollen gums can slow tooth movement and lengthen treatment time.

5. Stop the Pop - We strongly recommend cutting back on sugar-filled drinks, especially pop. People who drink pop throughout the day are constantly subjecting their teeth to sugar. The sugar interacts with dental plaque to make an acid. That acid, combined with the acid inherent in pop, does double the damage, causing cavities and white spot lesions. We have even seen good brushers who are heavy pop drinkers get some white spot lesions. If these drinks cannot be eliminated, try to at least limit them to dinner hours and brush your teeth immediately after consumption of these sugared drinks.

How a Tooth Moves

Each tooth is surrounded by a periodontal membrane. This membrane is made up of tiny fibers or ligaments that can be squeezed and stretched with tooth movement. These fibers generally extend from the tooth to the bone surrounding the tooth.

To understand how teeth move, you need to understand how the membrane and bone react to the pressure and tension created with braces.

Dentists use wires and other materials to strategically create areas of pressure and tension. This pressure and tension creates a minor initial movement of the tooth within the tooth socket. With this movement, the periodontal membrane (fibers) get squeezed on the side the tooth is moving towards and stretched on the side in which the tooth is moving from.

Cells called osteoclast come to the areas where there is pressure. In these areas of pressure, the osteoclasts serve to remove bone. This bone removal then eliminates the pressure. On the stretched side, the tension from the periodontal ligament signals osteoblasts to these sites. Osteoblasts are responsible for placing bone. As bone is placed by the osteoblasts, the tension is relieved. During the time when there is pressure and tension, some people will have some minor soreness. This is a result of the inflammatory remodeling of bone which is occurring.

Each appointment this process of creating pressure and tension is repeated. The goal is to create a light continuous force. These light continuous forces create the quickest, most comfortable tooth movements. Heavy forces can cause scarring on the pressure side, making it harder for the osteoblasts to remove bone, hence slowing movement. Forces that are too light will fail to signal the osteoblasts and osteoclasts and the teeth fail to move. For this reason, the dentist will need to periodically adjust the appliances maintaining light continuous forces to create the pressure and tension needed to move the teeth.

Typically, the early movements are the largest and create the most soreness. As treatment continues and the osteoblasts and osteoclasts are doing their thing, discomfort tends to subside. Once your teeth have been placed where we want then, your retainers hold them in their new position allowing the boney support to return to a normal and stable condition. This retainer phase is very important because the periodontal ligaments have not completely reorganized. The most successful treatment outcomes typically involve a substantial retention period.

Parts and Pieces

These are thin bands of metal that are carefully fitted to the 6 yr. Molars (Ist molars) and are cemented in place. They are the anchors for the braces. Each band has two tubes attached for the archwires and other appliances.

Brackets are made of stainless steel (or porcelain for those who wanted clear for aesthetics). They are bonded to the rest of the teeth and act as "handles" for the archwire.

The archwire is what actually moves the teeth. Each bracket has a groove in which the archwire sits in. They are made of stainless steel or nickel titanium and are made in varying sizes. Each size is used to do different things to the teeth and roots. The wires mayor may not be changed every visit.

These are tiny, elastic rings used to hold the wire in the groove of the bracket. These are what we mean by "colors" of braces. Each visit, you get to choose your new colors as these need to be changed every visit. Sometimes we will need to "tie-in" with a stainless steel tie instead of the elastic o-ring.

Rubber Bands (Elastics)
Elastics are used to correct the bite. They are used in many different ways. Some patients may not have to ear elastics during the course of their treatment. For those that do, it is very important that you wear them according to how the doctor says to wear them.

Brushing and Flossing
The biggest enemy of your teeth is plaque and the most common and effective means of removing plaque from your teeth is regular brushing and flossing. Braces trap food, making it more difficult to brush. That's why we recommend brushing the teeth for three minutes, taking time to reach all areas of the brackets and bands. Flossing is now more time consuming as the floss must get under the archwire. We have provided "floss threaders" (also known as "bridge aids") to help get the floss under the archwire.

Glossary of Terms

This is a compellation of terms that you will hear throughout the course of your treatment. You can refer to this list whenever you hear a word and don't quite understand the meaning. If you still don't understand, please feel free to call our office or ask us at your next appointment. Understanding what is happening to you will help you enjoy your final results of orthodontic treatment. Archwire - This is the main wire that fits into the brackets. It is "tied in" to each bracket with tiewires or a-rings. The archwires are what move the teeth. They come in varying degrees of strength and are made of stainless steel as well as nickel titanium (an alloy developed by NASA).

Appliances - This is what we call your braces, expander, retainer, etc.

Bands - The small, thin metal ring that we cement onto your teeth. These are merely "handles" by which we can move or hold your teeth.

Bite - This is another name for the way your teeth fit together when you bring them into a normal chewing relation.

Brackets - Brackets are made of stainless steel (or porcelain for those who wanted clear for aesthetics). - They are bonded to the rest of the teeth and act as "handles" for the archwire.

Crossbite - Nature intended that all of your teeth fit in an orderly manner. That is, all of the upper teeth fitting slightly on the outside of your lower teeth. When a lower tooth slips to the outside of an upper tooth, this is what we call a crossbite.

Elastics - During phases of treatment, we may have you wear rubber bands (elastics) that are hooked from one tooth to another or one jaw to the other. These are used to help correct your bite.

Headgear - Another term for headgear is nightbrace, A nightbrace is used to change the way your face grows as well as moving your teeth in a much easier manner for you.

Impressions - We use a soft gelatin-like material which is placed in a small tray that fits up over your teeth. In a matter of a few moments, your teeth leave a print in this material, similar to your handprint in soft sand on the beach.

Malocclusion - Malocclusion = crooked teeth. Mal = bad; occlusion = relation of teeth. Usually malocclusion means teeth are chewing in a poor relationship with each other. This is the basic reason we have gone into orthodontic care for you.

Models - Models are the white plaster records of your teeth which result from making the impression we have just described, We pour the white Plaster of Paris into your mold, or impression, the plaster sets and now we have a model of your teeth.

O-Rings - These tiny, colored elastics tie the archwire into the brackets. They are changed at every appointment allowing you to change your "colors."

Overbite - This is merely a term to describe the upper teeth biting over the lower teeth. Some overbite is normal. Too much overbite can cause severe problems and facial changes that are not particularly good.

Panoramic and Cephalometric X-Rays - A "Pan" is a full-mouth x-ray used to determine what position the baby and adult teeth are in as well as the presence of the 3rd molars (wisdom teeth). The "Ceph" is taken fr0111 the side and is a picture of the side of the head. This allows the orthodontist to measure the growth of your face.

Separators - These are small elastics placed between your teeth to help make room for the placing of bands. This often feels as if you have a popcorn kernel stuck between your teeth. This feeling will pass quickly as your teeth move apart.

Tubes - These are found on the bands located on the 6 yr. Molars of braces. The tubes are long and rectangular into which the arch wire rests.

Tiewire - These are little wires that fasten your archwire into the brackets. They are twisted, leaving a small "pigtail," or twisted wire which is then tucked under the archwire. Sometimes, in eating or brushing, this may become bent out and poke your cheek. If this happens, push it back towards the tooth so that it won't poke anymore.

Wax - We provided you with wax in your ortho supply kit to help with the discomfort from the braces. From time to time, it may become necessary to use the wax to help your cheeks and lips heal.

Appointment Scheduling

Maximum flexibility in our appointment schedule has been designated so as to minimize patient waiting time and to ensure timely dismissal at each appointment. Please help us by understanding that certain appointments will be required during normal work/school hours to maintain effective results.

All long appointments are scheduled mid-day to allow plenty of time to complete all of the necessary steps for that long appointment. If there is breakage or appliance damage, we will need more time for these procedures; therefore, they must be rescheduled for earlier in the day.

If you are unable to keep your appointment, or if you find you will be late for your appointment, please notify us as soon as possible in advance so that we may reschedule your appointment. Keep in mind that failed and cancelled appointments delay treatment progress significantly.

As always, we are committed to quality orthodontic care, building our patient's self esteem and including you as a partner in the treatment process. Your involvement is important to us. We are always happy to answer your questions.

Tooth Brushing and Braces

You and your orthodontist are now a team. You both want the same thing ... a beautiful smile with healthy, white, straight teeth. We will do our best to straighten your teeth but you are the one who must keep them healthy and white. We all know that brushing is the key. Now that you have braces, proper brushing will take extra time and effort. When your braces come off, you want your teeth to look their best so start today to be your smile's best friend.

Plaque is the problem
Plaque is a sticky, white substance that collects on your teeth. It is made up of bacteria, food and saliva. If plaque and trapped food are left on your teeth and around your braces, they can cause swollen gums, bad breath, marks on your teeth and cavities. Plaque also can discolor your teeth and make them look yellow. Don't let any of these things happen to you. Brush often and properly and visit your dentist for regular checkups.

How and when to brush
You should use the kind of toothbrush and toothpaste Dr.Stokes recommends. Brush after every meal, especially if you have eaten anything sticky or sweet. If you cannot brush right away, be sure to at least rinse well with water until you can brush. It is a good idea to carry a special travel toothbrush when away from home. What is most important is that every day you vigorously brush your teeth and braces until they are spotlessly clean. Approximately three minutes is recommended.

If you use an electric or battery operated toothbrush, you should brush for one extra minute as these are typically set for two minutes. This takes extra time so most patients do it at night before going to bed. Whatever time you choose to do this extra brushing, make absolutely sure your teeth and braces are as clean as you can get them.

Applying pressure
One of the biggest problems people have while brushing teeth is not applying enough pressure with the toothbrush. Just "lightly" brushing your teeth will not remove all plaque and debris. Remove every trace of plaque and trapped food from all the surfaces of your teeth: front, back, top and under your wires (our assistants will show you how to do this). Pay very close attention brushing the gum line because plaque left there will make your gums sore and swollen, which will make brushing even more difficult. This also is the time you should use dental floss, special brushes, mouthwashes and fluoride mouth rinse, if recommended by Dr. Stokes. After brushing, you should rinse thoroughly. Swish the water all round your mouth and teeth. Then, inspect your teeth and braces carefully to make sure they are spotless. Do this by looking closely in a well-lighted mirror. This is very important because you cannot feel plaque but you can usually see it. You may have to brush and rinse two or three times before all the plaque is gone. This may sound difficult but remember, they are your teeth and you want to have them for the rest of your life.

Fluoride Facts

**Information taken from the "Oral Health Fact Sheet" submitted by the Bureau of Oral Health Services in Columbus, OH**

What is Fluoride?
Fluoride comes from minerals in the ground. It is found in water, soil, plants and in many foods and drinks. You need fluoride for good health.

How does fluoride work? Tooth decay can be stopped and even reversed by fluoride. Each time you eat or drink foods that have sugars or starches, the germs in your mouth make acid that cause tooth decay. The acid attacks the teeth and dissolves some of their minerals. This happens many times during the day. Fluoride repairs these small spots of decay by putting new minerals in the teeth to replace those that are lost. This stops the decay before it spreads inside the teeth. The repaired teeth become stronger from fluoride.

Where can I get fluoride? The easiest way to get fluoride is by drinking water. Many people in Indiana drink water that has enough fluoride in it. If you do not know if your water has enough fluoride in it, ask your doctor. They can help you have your water tested. If your water doesn't have enough fluoride, your dentist or doctor may prescribe fluoride tablets or drops for your child.

Using toothpaste is an easy way to get fluoride too. Most toothpaste has fluoride in it. Use toothpaste that has the seal of the American Dental Association on the tube. This means that the toothpaste has been shown to prevent tooth decay. Children under age 6 should use a small dab of toothpaste, about the size of a pea. Make sure your child does not swallow toothpaste or their adult teeth could come in with white spots or stains on them.

You can also get fluoride in mouth rinses and at the dental office. Not all children need the same amount of type of fluoride. Ask your dentist or doctor about the best ways for your child to get fluoride.


Braces are pretty durable but can be damaged. Breaking off brackets can extend the time that you have your braces. Whenever we have to make repairs, it slows down the treatment. Use common sense when eating or chewing things. If you think it could break off a bracket, don't eat it ... and certainly don't chew on pens or pencils.

• #1 MOST IMPORTANT-GUM!... This means ALL gum! Including sugar- free!!! It gets stuck in your brackets, around bands and wires. ABSOULETLY NO GUM!!!!
• ICE ... A thousand times NO. It will totally destroy your braces and your teeth.
• PIZZA CRUST, HARD ROLLS, BAGELS ... The hard crust bends wires and knock off brackets
• DORITOS, TACOS, TOSTITOS, CHEETOS, FRITOS, ETC ... Will cut spacers. Will form a hard ball and break/bend your wires.
• CARAMEL CANDY and STICKY FOODS ... Milk duds, laffy taffy, carmel corn, starbursts…Sticky goo will pull off wires and feeds the bacteria in your mouth.
• BEEF JERKY, SLIM JIM.. Tough as nails
• SUCKERS, HARD CANDY ... Loosens bands and knocks off brackets
• NUTS... No nuts of any kind
• PENS AND PENCILS... Favorite exam time snack .... breaks everything!
• POPCORN... The little shells get between the gums and band and will hurt like crazy.
• RAW FRUITS AND VEGETABLES... Hard as rocks. Will break everything! Biting into foods such as raw carrots, apples or corn-on- the-cob can break off the front brackets. To avoid this, cut these types of foods into bite-size pieces.


Loose bracket:
With a toothpick or tweezers, take off the colored o-ring. Then take the bracket off of the wire and put it in a baggie. Call the office to inform us of the needed repair, noting which tooth it is. It might be necessary to have you come in right away to repair it. Bring the baggie with the bracket with you.

Long, poking wire:
If a wire is too long in back and is causing discomfort, try clipping the wire with (clean) toenail clippers. If you have wire cutters, that will work best. If you cannot clip the wire, place wax over it to relieve the discomfort and then call the office for an emergency visit.

Poking tie wire:
Sometimes steel wires are used instead of a-rings to tie in a wire. If the tail of this wire is poking you in the cheek, simply take a pencil eraser or back of a spoon and push the wire back towards the tooth where it will not cause any more discomfort. If the cheek is sore from the wire, place wax over the whole bracket until the cheek has healed.

Missing O-ring:
It is not necessary for you to call us unless the wire is disengaged from the bracket. Disengaged means that the wire is not seated in the groove of the bracket like the rest of the brackets. This is especially important towards the end of your treatment.

Loose band:
A very rare occurrence but if a band does come loose, place wax over the band to minimize discomfort. Call our office to let us know and to schedule and emergency visit to repair the band.

Tending to Soreness

Your braces may cause some discomfort during the first few days of treatment and after some adjustments.

There are several things you can do to minimize this problem:
1. Eat soft foods for the first few days.
2. Use a warm saltwater rinse as needed.
3. Take a pain reliever such as Motrin, Advil, Tylenol, etc. as needed.
4. Use wax to relieve discomfort from the bands or brackets that are "cutting" into the cheek or lip. To do this, pinch off a small amount of wax, press it between your fingers then mold it to the band or bracket.

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What Are Orthodontic Separators & Why Do I Need Them?

Orthodontic separators are elastic (usually blue, white or gray) separators or spacers that are placed in between the back teeth so that orthodontists can more easily place an orthodontic band (like a ring on a finger) on a tooth or teeth in the following days or week.

How Can I Help Separators Work?

⦁ Do not pick on the separator with your fingers or floss where the separator is placed.
⦁ Do not eat sticky foods like gum or sticky candy. Check our list of foods to avoid for more details.
⦁ Continue your normal diet, except sticky foods.
⦁ Biting on the separator is normal and can feel “bouncy.”
⦁ Regular brushing is recommended where the separator is placed

What Should I Do If My Orthodontic Separator Falls Out?

It’s okay if your separators feel loose or mobile, as long as they stay in between your teeth. If a separator should fall out, please call the office to have it replaced. We need to make sure it is in place at least a day or two before placing your braces.

Will Separators Be Painful?

The separator can feel like a piece of floss or food is left in between the teeth. As the teeth start moving, you can expect some soreness as well as possible headaches.  Over-the-counter pain relievers such as ibuprofen (preferred choice) Motrin or acetaminophen. Be sure to follow the recommended dosages to ease any discomfort, as needed.

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Palatal Expander

Why Do I Need A Palatal Expander?

The expander is used to widen the upper jaw and decrease the amount of time you wear your braces. By widening the palate or roof of the mouth, the dental arch increases to create more space for your teeth to grow and straighten. It can also create a broader, more beautiful smile, limit any tooth extractions needed to make room for new teeth, and improve your breathing.

What Can I Expect From My Orthodontic Expander?

In the beginning, your tongue will have some adjusting to do while speaking and eating. But after a few days of practice, you’ll be an expert! The expander, when activated or turned, can cause some slight discomfort and tenderness near the bridge of the nose and cheekbones. To relieve any discomfort,  over-the-counter pain relievers like ibuprofen (preferred choice) or acetaminophen. Take the dosage as directed on the bottle. Speaking and eating may feel a little different at first. You may experience a sore throat as you get used to using different muscles to swallow (having a water bottle and taking small sips of water can help get use to swallowing and control saliva flow). You may notice more salivary flow increases.

Tip: Read your favorite book, magazine, etc. to yourself in front of the mirror for five minutes a day – your speech will be perfect in no time.

How Do I Use The Orthodontic Expander Key?

The expander is activated by placing the special key into the hole in the center of the expander and gently pushing the key towards the back of the mouth. A turn is completed when you cannot push the key any further backward and you can see a new hole appear in the front.  Remove the key carefully toward the throat and you've completed one turn. Do not turn more than prescribed by Dr. If an unusual amount of discomfort is felt and medication is not relieving the discomfort, skip a day.  Keep track of how many actual turns are completed. It’s important to count the turns. Let Dr. know how many actual turns you made between appointments.

How To Turn Your Expander

Place the key in the center hole and turn in the direction of the arrows on the expander.

    Turn the expander toward the back of the mouth until you can see the next hole.
    Carefully remove the key in a downward direction. Be very careful not to “unturn” the expander when removing the key.

        About The Temporary Space

If space develops between the two front teeth, this is normal. This space will begin to close once the turns have stopped. The bone has widened but the fibers surrounding the teeth will help close the teeth together.

  Your Orthodontic Expander Schedule

You can expect to follow this approximate schedule while undergoing your orthodontic expander treatment:

  First 6 weeks Expander is turned TWICE a week for 4 weeks

**Your dentist may prescribe more frequent turns or turning for a longer duration. If you have already started expansion you will have been given a written instruction form for the specific number of turns you should perform. NEVER turn more often or for a longer duration than the dentist prescribes. If you miss an appointment for monitoring, stop turning the appliance.

Next 6 weeks Stabilized (worn but not turned), similar to a cast on a broken bone Once Stabilized for 6 weeks

Once the teeth are stabilized, the expander may be removed and a smaller, transpalatal (across the roof of the mouth) holding bar carefully placed to stabilize the expansion. Alternatively, the expander will remain but be “locked” so it cannot move.  The remaining appliances (braces or aligners) are placed.

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Orthodontic Facemasks (a.k.a. Headgear)

Headgear is actually really an amazing invention; it uses the shape of your head to gently add specific forces which guide growth. Reverse pull headgear is used to treat patients whose teeth are in an “underbite” with the lower teeth forward of the uppers. The reverse pull headgear gently pulls on your upper teeth and jaw to encourage further forward growth and to bring your upper teeth in front of your lower teeth. Headgear is a very important part of treatment for patients like you. Good headgear wear (12-14 hours per day) reduces treatment time!

Your Cooperation Is The Key To Success!

Forgetting to wear your headgear or not getting enough hours wearing your headgear could result in longer treatment time, changing your treatment plan and may even affect the final results.

Instructions For Wear

Practice placing your headgear in front of a mirror. Soon, with practice, you will be able to place and remove it without a mirror.

Week 1

Start with wearing 2-3 hours prior to bedtime, to get used to placing and wearing it.

After That

Wear it while sleeping (8-10 hours) and at home, ideally 12-14 hours a day total.

What To Expect:

Soreness to the teeth once worn is up to 8-10 hours, probably lasting 2-3 days, but consistency is the key to success and comfort. An over-the-counter pain reliever, like ibuprofen, can help with soreness.

Difficulty sleeping at first. Try placing 2 pillows around your face/headgear to be more comfortable. We suggest starting on a Friday or Saturday night. Discomfort will pass with consistent wear, within the first week.

Headgear Care: Brush the metal piece (facebow) with your toothbrush daily. Keep all the pieces in the headgear case when not in use and away from pets and small children. There could be an additional charge if lost or broken.

Remember Make sure to bring your headgear to each appointment! If at any time your headgear does not fit, please gently remove and call the office for an appointment as soon as possible.

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Guide to your Retainer

Wearing your retainer:

1st month= wear your retainers ALL THE TIME except when eating or brushing your teeth 2nd -5th month= “in the house, in the mouth” Wear your retainers whenever you are home 6 months + = night time wear only

But its been years since I had my braces and my teeth haven’t moved, why do I need to wear my retainers?

Teeth can crowd over time. The shift may not be fast, thus is may not be noticeable until the teeth have moved just enough that your retainer doesn’t fit. If this happens and your retainer doesn’t fit back in, how do you move them back? With braces.

How to clean and store your removable retainers

Remove your retainers and brush them gently with a soft toothbrush. This is best done when you are brushing your teeth, which should be done at LEAST twice a day, in the morning (after breakfast if you eat) and at night (right after dinner). You can use a gel toothpaste to remove plaque from the retainers. Do not use an abrasive toothpaste.

NEVER sterilize your retainers with heat. DO NOT BOIL or MICROWAVE your retainers, this will warp or melt them. You can use a solution of bleach and water or a denture cleaning tablet in water for 15 minutes if you are concerned, but this is not absolutely necessary.

Store your retainers in the case provided to you. Animals LOVE to chew retainers. Please do not leave your retainers out in the open if you have them. Also, do not put your retainers on dinner plates or in napkins. They stand a good chance of being forgotten or thrown away.

If you also have a fixed/cemented metal retainer:

These are NOT “permanent” retainers as they are often called. They CAN last for many years, however they may come off base on eating habits and food choices. To best maintain your fixed retainers, avoid biting items or food with your front teeth. We recommend that food items like apples and corn on the cobb be cut into smaller bites.

These retainers need to be cleaned twice a day, just like your teeth. Items to use to help clean your fixed retainer:

  1. Floss threaders with traditional floss
  2. Super floss
  3. Interdental pick or brush
  4. Water pick/air flosser

If you LOSE or BREAK your retainers, or if you notice it doesn’t fit correctly any more:

CALL US RIGHT AWAY and get scheduled for new retainers to be made.

a. Teeth can move very quickly, especially in the first months after orthodontic treatment is completed. New retainers will be made to keep your teeth where they are when you come back in. If your teeth have moved, that is their new permanent position unless you chose to have orthodontic treatment started again, at the current orthodontic treatment fees.

b. If you break a retainer due to NORMAL use within the first year after debond, our practice will make you a new one for no charge

c. Additional retainers, or retainer repairs, and re-treatment of orthodontics are all discounted for patients who have undergone orthodontic therapy at Michigan City Dental, P.C. as long as you have maintained your regular HYGEINE visits according to the schedule prescribed by the dentist (no longer than 1 month overdue)

Please bring your retainers with you for EVERY dental appointment and let the staff know you have them at the BEGINNING of the appointment!!!! 1. At cleaning appointments, the dentist will check their fit to ensure they are still effective. 2. If you have future dental treatment that changes the shape of your teeth, your retainers may no longer fit!
  • a. If the treating dentist knows that you have retainers, they may be able to plan your treatment in a way that your retainers still fit, and they need to be able to have the retainers to make sure they still fit.
  • b. If you try retainers in after dental work WITHOUT having the dentist check them, you can break the dental work OR your retainers. If that happens and you have done this, having either the dental work or retainers done again will be at additional costs.
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Clear Retainers (a.k.a. Essix) Instructions

What is an Essix Retainer?

Often we use retainers to hold teeth in position after they have been orthodontically straightened. The type of retainers a patient is prescribed depends on the condition of their teeth, their previous dental and orthodontic treatment history, as well as what an dentist recommends as the best course of treatment. The retainers guide and maintain the position and alignment of teeth to create an attractive and beautiful smile, and today there’s wide a range to choose from. Essix retainers, in particular, are clear, slim molds that fit over your teeth. We might recommend an Essix retainer as the final stage in a course of orthodontic treatment, or as a complete alternative to braces.

Different Types of Retainers

Some retainers are fixed (bonded in place) and others are removable and made of wires or plastic. Essix retainers are removable and made entirely of transparent plastic, which makes them less noticeable than traditional wire retainers. Another benefit of Essix retainers is that they encourage good dental hygiene; you can take out your retainer when you brush and floss, and clean the retainer yourself at the same time. Unlike wire retainers, Essix retainers cover the entire arch of the teeth. But like the traditional Hawley Retainer, each one is uniquely molded to the shape of your mouth.

How Essix Retainers Work

Essix retainers are molded to your mouth, making it unique to the shape of your mouth. These retainers cover all of your teeth, guiding them into a position where the upper and lower sets are even and straight and align with each other. Though your teeth may feel firmly set in your mouth, they move when under constant pressure, and can assume new positions in the mouth all on their own due to the forces created by chewing, the tongue and the lips. Essix retainers are aesthetically pleasing because of the clear plastic material they are made of. They are also often referred to as overlay retainers because of the fact that they fully cover your teeth. They have an average lifespan of 18–24 months. This can be decreased for patients who clench or grind their teeth. If you know that you clench or grind, let your dentist know, because a different appliance may suit you best.

Pros and Cons of Essix Retainers

Just like any other type of retainers, Essix retainers also have some advantages and disadvantages.

Advantages of Essix Retainers

Essix retainers have many advantages, including:

  • Removable
  • Can be easily cleaned
  • Transparent
  • Disadvantages of Essix Retainers
  • While comparing with other kinds of retainers here are a few disadvantages associated with wearing an Essix retainer which include:
  • Non-adjustable
  • Plastic may warp if exposed to heat
  • Can interfere with a person’s speech
Essix Retainer Care

Usually an Essix retainer should last the entire length of your orthodontic treatment. When caring for your retainer be sure to:

  • Never bite appliance into place, always place in mouth with fingers
  • Never eat or drink with retainer in place (Only water is allowed)
  • Rinse your Essix retainer in cold water every time you take it out and before you put it back in.
  • Brush your retainer with cool to Luke warm water and a soft toothbrush and gel toothpaste after having each meal.
  • Don’t brush the retainer with gritty or whitening toothpaste, as it can scratch the surface.
  • Store your retainer in a braces plastic case whenever you aren’t wearing it.
  • Keep away from pets, animals will seek out appliances to chew
  • Don’t put the retainer in hot water, which will shrink it. Never use hot or boiling water to clean the retainer or place it in the dishwasher.
  • Wash the retainer with a specialized retainer cleaner once every two to three months.
  • Please bring your retainer to every appointment so Dr. is able to check the fit and make any adjustments.
Life with Essix Retainers

Your life should not change due to retainers, wearing Essix retainers should be trouble-free, and your routine should remain the same. Floss your teeth once a day and brush twice a day, using a soft-bristled toothbrush and fluoride toothpaste. If your retainer begins to feel uncomfortable, it’s a sign your teeth are moving out of position and you might not be wearing the retainer often enough. Wearing your retainer more will reduce this discomfort.

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Baby teeth are supposed to fall out, but sometimes a child may lose a tooth before their adult teeth are ready to grow in. While it might not seem like a big problem at the moment, it can lead to more problems if not maintained properly. Dentists can place devices called space maintainers in your child’s mouth to ensure that their adult teeth will grow in properly.

If your child has lost a tooth prematurely, you should schedule a visit with your child’s pediatric dentist. They can examine your child’s mouth and tooth structure and then tell you if your child needs a space maintainer.

What is a Space Maintainer in Dentistry?

Dental space maintainers are devices used to leave enough space open for permanent teeth to grow in after baby teeth are lost prematurely. While it might not seem like a big problem at first, not taking care of a gap can lead to expensive problems down the road.

There are many reasons that lead to premature loss of baby teeth including, trauma, congenital defects, accidents, or decay. Depending on your child’s situation, your dentist will recommend a different type of space maintainer.

What Are the Different Types of Space Maintainers?

There are two general categories of pediatric space maintainers and within these categories, there are different types of maintainers.

In general, a fixed space maintainer is a semi-permanent tooth fixture that keeps enough space open for the adult tooth to grow in. After the permanent tooth has grown in, the maintainer can be removed.

There are four types of fixed space maintainers that a pediatric dentist can use to care for your child’s teeth. These different types are crown and loop, distal shoe, lingual, and unilateral.

1. Crown and Loop
These devices include a crown placed over one tooth and a stainless steel wire loop. The loop presses against the tooth on the other side of the gap and keeps the gap open. Once the new tooth grows in properly, the crown can be removed.

2. Distal Shoe
This type of maintainer is only used for permanent first molars that have not grown in yet. The drawback is that these maintainers require more care and attention from your child’s dentist.

These maintainers are usually inserted into the gum line after a baby molar falls out prematurely. The device then guides the unerupted adult molar as it grows in. If your child needs this type of maintainer, you will need to schedule periodic check-ups to make sure the treatment is working properly.

3. Bilateral
These maintainers use wire and crowns or bands to maintain spacing across several tooth gaps.

4. Unilateral
This treatment uses a wire to maintain space between two teeth, similar to a crown and loop treatment. However, unilateral maintainers use a wire that is wrapped around the teeth on either side of the gap.

A removable space maintainer can be a good option if your child’s tooth is almost ready to grow in. These devices are similar to ones used in orthodontic treatments and can be customized for your child’s needs.

Usually, these devices are made of acrylic material and can be fitted with a fake tooth. These maintainers also make it easier for your child to keep good oral hygiene habits, such as brushing and flossing.

However, removable devices are usually not as effective at maintaining space as fixed devices.

If you have any questions about which type of maintainer is right for your child, please ask us during your next visit.

Are Space Maintainers Really Necessary?

One important function of a baby tooth is to reserve space for the adult tooth. If a baby tooth falls out prematurely, the empty space may cause adult teeth to become crooked as they grow in.

The body is usually good at maintaining enough space, but every case is different. If your child has lost a tooth prematurely, consult with a pediatric dentist about your child’s needs.


Brush gently with a soft toothbrush. Floss underneath all wires and gears using a floss threader at least daily.

Space maintainers are pretty durable but can be damaged or dislodged. Use common sense when eating or chewing things. If you think it could break or bend a wire, don't eat it ... and certainly don't chew on pens or pencils.

• #1 MOST IMPORTANT-GUM!... This means ALL gum! Including sugar- free!!! It gets stuck in your brackets, around bands and wires. ABSOULETLY NO GUM!!!!
• ICE ... A thousand times NO. It will totally destroy your braces and your teeth.
• PIZZA CRUST, HARD ROLLS, BAGELS ... The hard crust bends wires and knock off brackets
• DORITOS, TACOS, TOSTITOS, CHEETOS, FRITOS, ETC ... Will cut spacers. Will form a hard ball and break/bend your wires.
• CARAMEL CANDY and STICKY FOODS ... Milk duds, laffy taffy, carmel corn, starbursts…Sticky goo will pull off wires and feeds the bacteria in your mouth.
• BEEF JERKY, SLIM JIM.. Tough as nails
• SUCKERS, HARD CANDY ... Loosens bands and knocks off brackets
• NUTS... No nuts of any kind
• PENS AND PENCILS... Favorite exam time snack .... breaks everything!
• POPCORN... The little shells get between the gums and band and will hurt like crazy.
• RAW FRUITS AND VEGETABLES... Hard as rocks. Will break everything! Biting into foods such as raw carrots, apples or corn-on- the-cob can break off the front brackets. To avoid this, cut these types of foods into bite-size pieces.

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