After fitting your orthodontic appliance (brace), it is important to follow some simple but important instructions. We have also provided some useful information and advice regarding after care.
 

TOOTHBRUSHING AND ORAL HYGIENE

Oral hygiene is critical to the success of treatment. Please brush normally 2-3 times a day using a manual or electric toothbrush. It will be very difficult to floss your teeth but interdental brushes can still be used, which are very effective. The use of a mouthwash is advised on a regular basis, ideally containing fluoride. The latest developments in interdental hygiene include devices such as the Airfloss by Philips and Waterpik units. These are excellent adjunctive techniques and highly recommended for the hard to reach areas. They use a combination of pressure, air and water (or mouthwash) to flush debris away from the contact areas of the teeth.
 

PREVENTING TOOTH DECAY

Adhering to a sound oral hygiene regime coupled with the use of fluoride toothpaste and mouthwash will generally prevent any decay around the brace. However, you should also carefully monitor sugar intake throughout the day. High frequency of sugar throughout the day will increase the risk of tooth decay considerably especially when wearing braces. Now is the time to really cut down on those sugary snacks and drinks! We strongly advise using MI plus paste by GC. This is excellent at reversing early decay within the tooth enamel and will help to prevent decay or dimineralisation around the orthodontic brackets. Simply rub a small amount of the paste around the brace with your finger and tongue and discard the excess. Then leave overnight, do NOT rinse with water or mouthwash afterwards.
 

EATING 

It is important to adopt a soft diet for the first few weeks. This is especially important with lingual braces. Foods to avoid are:
 

• Hard crunchy foods such as crusty bread
• Sticky foods such as toffees
• Chewy meats
• Unpitted olives and stone fruits

If you have a tooth coloured brace, please avoid staining foods which could discolour the temporary elastics. These include:
 

• Curries
• Rich tomato based sauces with oil
• Beetroot
• Effervescent table drinks such as vitamin supplements and Berroca

LIP OR TONGUE IRRITATION

Braces can cause irritation to the tongue or lip after fitting. This will settle once you have become accustomed to the appliance. In the meantime, orthodontic wax or putty placed over the brackets can help to provide some temporary relief. We will provide this for you.
 

PAIN RELIEF

Due to the modern technology, there is much reduced pain compared to systems of the past. However, there may be some intermittent pain. Regular pain relief such as paracetamol, ibuprofen or a combination of both should be effective. If there is prolonged severe pain, please contact us. Of course, the most important aspect is that dental braces are temporary! Time will fly by and your teeth will be straight before you know it!

What is dental dam? Dental dam is essentially a drape for your teeth. It provides total isolation for the tooth or teeth in question. Thus it will keep the lip, cheeks, tongue and saliva away from the working field. This is vital in modern day dentistry where most treatment relies on adhesive bonding of some form. A dry field is crucial.

Dental dam is also essential for root canal treatment. Powerful irrigants are used to clean the canal which contain sodium hypochoride and EDTA. It is not pleasant if these are accidentally swallowed! Dental dam will protect the oral cavity from these substances and prevent the ingress of oral fluids into the root canal thus increasing the success rate of the treatment. So if your dentist is not using dental dam, ask them why not. 

For modern day dentistry, it is essential.
 

As we previously mentioned, our dentist Dr Veehar Malde has been shortlisted at the Aesthetic Dentistry Awards for the restorative case - full mouth. The case involved a highly complicated reconstruction of the lower arch in conjunction with restorative treatment on the upper teeth. Just take a look at the photos:
 

We are now well into 2015 and what better way to start the year than taking the first steps to a new smile. Our preferred smile makeover is as simple as ABC: A is for alignment - straighten teeth using discreet or invisible braces B is for bleaching- whiten teeth using or brand new Philips LED whitening system C is for cosmetic bonding- create symmetry by bonding the latest cosmetic composites to uneven edges, short or fractured teeth This technique is totally NON INVASIVE! We do not need to drill your teeth, you will not need injections and the process is virtually pain free. For example, please take a look at our case below:
 

Our case of the month for December involves closing a gap between the front teeth. In the old days of dentistry, this may have involved cutting down teeth for porcelain veneers or having braces for 2 years. However, with modern day cosmetic dentistry and expertise, such cases can be treated in a few months without having to cut teeth. How? Well, it is simple. Careful planning and execution. Here is the case:
 

Our case of the month for November involves cosmetic bonding of a front tooth. The tooth in question was treated after orthodontic teeth straightening. Once the teeth were nice and straight, the smile was significantly enhanced with our minimally invasive technique of cosmetic bonding.

A brief overview of the technique:

1. The tooth is cleaned and polished. Any old composite filling material must be removed and any sharp edges smoothed.

2. Washing and drying with an etching gel.

3. Coating the tooth with a fine bonding layer. This is set with a special light at a certain wavelength.

4. Incremental layers of the composite bonding material are added until the new outline has been achieved.

5. Careful contouring and polishing of the new restoration.

6. Occlusal (bite) analysis and final aesthetic evaluation.

Here are the before and after photos:
 

For those dentists out there who are curious about what is acceptable when fitting your indirect restorations such as crowns, bridges, implant crowns and bridges, inlays and onlays, here are some useful facts on marginal fitting: Quality ratings for marginal fitting:

1. Clinically excellent: no gap; smooth transition between margin and tooth; probe does not catch 
2. Clinically acceptable: space of 150 µm; slight probe catching 
3. Clinically unsatisfactory: space > 150 µm - 250 µm; probe penetrates into the gap, but no dentine exposed.
4. Clinically poor: space > 250 µm; probe penetrates into the gap and dentine exposed. 

It is possible to use probes with a tip size of 250um and therefore check the fitting with accuracy prior to cementation.