Patient's Role in Orthodontic Treatment

Home Patient’s Role in Orthodontic Treatment

The single most important factor contributing to the success or failure of orthodontic treatment is the cooperation of the patient in caring for the appliances and teeth and following the doctor’s instructions during the treatment period.

Keeping Your Teeth and Braces Clean

  • One of the most important responsibilities of a patient taking orthodontic treatment is to maintain the teeth clean during treatment. The presence of orthodontic appliances makes it easy for food particles and debris to collect around them. This is difficult to remove by casual brushing. However, with a bit more commitment and effort on the part of the patient, excellent oral hygiene can be maintained during orthodontic treatment.
  • Failure to keep teeth clean can lead to decalcification which manifests as unsightly white marks on the tooth surface and ultimately caries (cavities). Consistently poor oral hygiene can also weaken the bone supporting the tooth and cause gum disease. This would ultimately compromise the results of orthodontic treatment. In rare instances, orthodontic treatment may have to be discontinued in patients who are absolutely careless about maintaining oral hygiene.
  • The best way of keeping teeth and appliance clean is proper brushing. The first step is to clean teeth and braces by moving the brush in a gentle circular motion over each group of teeth. This is done all around the mouth. Special care should be taken to ensure that the area where the teeth and gums meet is thoroughly cleaned. Still, food and debris would remain below the wire between adjacent braces. The brush is then held at an angle to the tooth surface and the bristles are pushed below the archwire between the braces. Then the brush is gently vibrated back and forth to dislodge the debris in this area. One such attempt would end up covering 2-3 teeth. Then the brush is shifted to the next group of teeth and the process repeated till all the teeth and braces have been cleaned. Patients should also brush the occlusal (biting) surfaces and inside surfaces of the teeth.
  • The procedure sounds tedious but can be done in 3-4 minutes with some practice. Brushing should be done after every meal. In case children are not able to brush after eating in school, they should rinse thoroughly with water and brush after reaching home. Special orthodontic brushes are available but proper cleaning can be done with regular toothbrushes also (soft bristle brushes are preferred).
  • A similar protocol is followed for patients with lingual braces (braces on the inside surface of teeth). However, as access and visibility are more difficult with inside braces more care and time is needed to be spent in brushing by these patients.
  • Another aid to proper brushing is the use of proxa brushes and unitufted brushes. These are pushed below the wire between two braces and moved back and forth to clean these areas. If spaces exist, these should also be used to clean between the teeth.
  • Some patients may also be advised the use of Oral Irrigation Devices such as Water Pik as an adjunctive aid to toothbrushing.

Diet Modification during Orthodontic Treatment

  • Since braces are stuck to the teeth they can become loose if a force of sufficient magnitude is applied on them. Even if braces don’t break, moderate to heavy forces can distort the wires and braces which can hamper treatment or be detrimental to the teeth. Hence it is extremely important to avoid hard and sticky food during orthodontic treatment. Things like chikki, chakli, hard laadus, toasted bread, nuts, éclairs, hard and nutty chocolates, ice, candy, caramel, etc. have to be totally avoided. Nuts and hard dry fruits should be ground into very small pieces and then eaten. Patients should refrain from biting into whole apples or guavas or carrots; these have to be sliced into very small pieces and then eaten. Nonvegetarian food has to be boneless and well-cooked to make it soft.

Keeping Appointments / Following Instructions

  • It is absolutely important for the patients to be on time for their appointments. If there is some other engagement on a particular day, patients are welcome to reschedule their appointment by calling our clinic at least a day in advance. Appointments missed without prior intimation result in significant wastage of our professional time and must be avoided at all costs. Shifting your routine appointment by 2-3 days normally does not alter your treatment progress. (However, in case of broken or loose appliances or any other emergency, please call our clinic immediately and give top priority to schedule a checkup at the earliest).
  • All the instructions given by the orthodontist should be followed diligently. In addition to avoiding hard/sticky food and proper brushing, it is extremely important to wear removable appliances, elastics etc. as prescribed for treatment to finish satisfactorily and on time. Remember that your orthodontist works on your braces for a short time each month but it is you who has to wear and care for the appliance all the time. Irregularities in maintaining appointments, long absences without checkups or not wearing elastics or other appliances as advised will lead to compromising the results of the treatment.