Fixed Lingual Brace

INFORMATION AND CARE ADVICE

You are now wearing a fixed lingual (tongue side) appliance. Treatment with a fixed brace takes an average of 12-24 months from the day the brace is put on. You will need to take great care of the brace as continued breakages of the appliance will prolong treatment. Following the advice below will help you take care of the brace and your teeth during treatment.

Comfort and pain relief

It is normal for you to experience some discomfort during the first week or two after the brace is fitted and after a change of wire. A mild analgesic such as Ibuprofen or Paracetamol is ideal to relieve this discomfort. We recommend that you take Ibuprofen and paracetamol together for best effect, and ideally take this straight after the brace is fitted to stay ahead of the discomfort developing. We also recommend that you take at least 1-2 more doses of both before bedtime. The following day continue with pain relief if needed but follow the instructions on the packaging. Remember to take Ibuprofen AND Paracetamol at the same time. You may find taking Ibuprofen before adjustment appointments also helps you feel more comfortable.

If you find the brace rubbing on the side of your tongue, an ideal way to relieve the soreness is to try a soothing gel on the affected area, or use some comfort wax by placing it over the bracket that is irritating you. Make sure you dry the bracket (square) fully before placing the wax, and crimp it firmly in place to secure. If you find that is not staying on well you can use the putty you have been supplied with – the instructions are below

To Use the Putty (yellow and white tubs):

Take equal small portions of each coloured putty and blend them together. Dry the bracket with a tissue to absorb the moisture and push the putty onto the bracket. Replace daily.

At first you may find your teeth and tongue are a little sore especially when eating. To help you eat well we find it best to follow this simple rule – “if you have to bite it or chew it avoid it”. If you choose softer, easier to eat foods for the first week you should be able to manage fine. If you are at all worried that you are not eating enough then we recommend adding some protein powder or build up powder to a milkshake or soup. This can be purchased at your local health food shop or pharmacy.

Speech

Because this type of brace is fitted behind the teeth and next to the tongue it may initially cause a slight change to your speech. People generally adapt completely to a lingual brace within a month. However about 10% of patients undergoing treatment with this type of brace will have ongoing minor problems with speech or slight discomfort throughout the treatment period. You can help your speech become more like normal by practicing “SAUSAGE” and “THISTLE” going slowly and making the sound as clear as you can.

Cleaning your teeth/braces

Ideally you should clean your teeth and braces after each meal and before going to bed – this will take longer than normal because of the braces. Firstly, make sure when you are using your toothbrush that you concentrate on cleaning one corner of your mouth at a time. Place the brush over the brace so that the bristles can reach either side of the brace. Take particular care in cleaning the gums thoroughly to prevent bleeding and irritation as this may lead to your gums overgrowing. You may find it easier to clean above/below the brace with a single tufted brush – make sure to angle the brush so the bristles go under the edge of the brace (see picture) and around he gums. You may have to do this by “feel” alone.

You have been provided with a selection of smaller brushes to help you clean in between the teeth and under the braces. The TePe style brushes are particularly good for cleaning between the teeth. You may wish to continue flossing your teeth – we can provide you with brace friendly floss to use.

Get into the routine of keeping your appliance clean from the start as it makes the treatment considerably easier for everyone. Never attend the practice without having carefully brushed your teeth

If you have time to clean at lunch times then do so, if not at least try and rinse out your mouth vigorously with water to dislodge any food from the brace. You may like to take a small bottle of mouthwash with you to use afterwards.

We recommend that you carry out a very thoroughly cleaning using all the additional brushes provided just before bed time. After completing this clean use the mouthwash provided but do not rinse with water afterwards or have anything to drink. Ideally you want the fluoride to remain in the mouth to help strengthen the enamel.

Diet during your treatment

Once your teeth have settled and you are more used to your brace, you should be able to return to a normal diet. However there are certain foods that should be avoided such as crusty bread, pizza crusts, un-popped popcorn kernels and hard or chewy sweets. Anything that you would normally bite off with your front teeth or could cause a breakage should be cut or torn into small bite-sized pieces and placed to the back teeth to be chewed. This would include bananas, apples, sandwiches and pizza. Foods like corn on the cob or meat on the bone should be cut off to be eaten. You may find that foods with nuts or seeds in will become lodged in your brace so it may be easier to avoid these foods and eat foods without these.

Avoid sugary foods and fizzy drinks, especially between meals. Sugary foods are usually stick and hard to clean off. Fizzy drinks (including carbonated water) are acidic and this will weaken the enamel of your teeth.

Since it will be necessary to clean your teeth after every meal, you may find it easier to avoid snacks between meals. If you do need a snack then savoury foods are best and cheese is known to be particularly good at neutralising the acid produced by the bacteria in your mouth.

No bad habits!

Avoid chewing nails or plastic items such as pen tops, and do not open things with your teeth (including bottle tops). If you do get something stuck around your brace do not pull it off. Instead try and unravel it gently yourself or ask someone else to help

What to do if you have a problem

It can, understandably be worrying or of a concern if you feel something is loose or has come off. The first thing is not to panic. Quite a lot of the time a few simple measures can be done to get yourself comfortable again. If you have lost a square in the brace but its comfortable then it can be left till your next visit but please call to let us know in case we do need to see you sooner. If the last square at end of you wire comes off then this will potentially lead to discomfort. If you have a thin wire in place it can be easily trimmed with a nail clipper but make sure to do this tight up against the next square on the brace. If you don’t feel comfortable tackling this on your own then contact the practice or the advice number below.

If you feel something is poking out it may be pushed back in to make it more flush using a pencil with a rubber end may be a quick and easy way to do this.

If you cannot make yourself comfortable call the practice on the number below to arrange an appointment or if the practice is closed contact us on the mobile number you were given when you started treatment for advice.