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THE FIRST FEW DAYS
Because your mouth thinks that your appliance is something to eat, it will automatically generate excess saliva. This will fade away in a few days, as will the urge for the tongue to constantly explore this new terrain in the mouth. Because of the design of the ALF, obstacles to speaking with it, if any are experienced, are easy to overcome. You may experience biting your cheeks or scraping your tongue, and though frustrating, this is common when adjusting to a new appliance. The key to success is to not take it out, as every time you do, your mouth has to go through the adjustment period again. Within a short period of time you will discover you hardly even notice your ALF appliance.
WHEN TO WEAR YOUR APPLIANCE
ALFs are generally designed to be worn all of the time, being removed only by the doctor during a visit. Some ALF designs are cemented into the mouth so that it is not removed even for adjustments- they are made with the appliance in place.
The doctor and hygienist will help you with how to clean your appliance and maneuver around it to properly clean the teeth. The ALF appliance in particular is a very non-invasive appliance and will seldom conflict with any activities (such as sports or playing musical instruments). Be sure to talk to Dr. Johnson about any times you feel you might need to remove your appliance so he can let you know what to do.
WHEN TO REMOVE YOUR APPLIANCE
The ALF should not be removed unless it breaks or in specific situations as instructed by the doctor. Should you have to remove it because it is broken or hurting you, be sure to call right away for advice from the doctor.
If the appliance breaks: Remove the appliance immediately and place in a case, Tupperware container, etc., to protect it from any further damage. Do not attempt to wear a broken appliance! If possible, we will repair the existing appliance, which is on average about half to 1/3 the cost of a replacement.
If the appliance begins to hurt: Call the office as soon as possible to report the problem and be advised by the doctor. If this is not possible within a couple hours of first noticing an issue, remove the appliance. Do not leave the appliance out without contacting the office.
IMPORTANT: The ALF is an incredibly light-wire appliance and needs to be protected to improve the possibility of repair or adjustment to replace in the mouth. DO NOT put it in a pocket, the bottom of a purse, or anywhere it is likely to incur any sort of force or pressure.
If your appliance becomes loose or falls out when eating, be sure to have Dr. Johnson tighten it at your next appointment. If it is so loose that you can't keep it in, call and make an appointment to come in right away.
HOW TO EAT WITH YOUR APPLIANCE
Eating with your appliance in your mouth is the most important part of the treatment. The teeth will not move properly without doing so. Eating with it seems impossible at first, but once you get used to it, you'll find here, too, you hardly even notice it.
There are very few food restrictions with your appliance, but some common sense will tell you what to do, or not do. You should not eat / chew gum or gummy candies, or hard or sticky candies like taffy and Jolly Ranchers. This is because the candy or gum will stick to the appliance, may pull it out of place, and you can chew on it and break or damage the appliance. (Not to mention the high sugar content.)
Tough meats and stringy foods like celery sticks are better managed if cut up into small pieces. The food does not have to be soft; crackers are hard, but still relatively easy to eat. Of course, during the initial adjustment period and after some routine adjustments, your teeth may be a little sore and sensitive. Here you want to stick to softer foods so as not to place more stress and pressure on your teeth.
If a piece of food is stuck in the appliance or between it and your teeth, first try brushing to remove it. Using a toothbrush and lightly stroking the bristles away from the gums can often dislodge such an annoyance. Flossing can also help, and very careful use with a toothpick can be tried if your toothbrush does not remove the food. Never pull on the wire or try to force it away from the tissue- this can create weak spots and places too much stress on the joints, bends, or loops of the ALF. It is likely to cause breakage, if not immediately, in the near future.
OTHER RESTRICTIONS
Just as your tongue wants to explore the new addition to your mouth, often so do the fingers. But resisting that urge is very important. The fingers can put stress and force on the appliance which can weaken or create unwanted pressure. This can cause breakage (even when other care is properly taken), discomfort, or may dislodge the appliance where "ledges" have been placed. All of these are very unfavorable for treatment!
CLEANING YOUR APPLIANCE
Keeping your appliance and your teeth clean is very important. At no time should food be allowed to accumulate in your appliance. Therefore, it must be cleaned after every meal. Cleaning is usually done by brushing the appliance with your toothbrush and toothpaste just as you do to your teeth. Use floss regularly to remove plaque and food from between your teeth. When you are out where you cannot brush, try to find a drinking fountain or restroom where you can thoroughly rinse your mouth to remove any remaining food debris. To maintain good oral health, it may be necessary or advisable to increase the frequency of professional dental cleanings.
WHAT DR. JOHNSON WILL DO AT YOUR APPOINTMENTS & WHAT YOU NEED
Dr. Johnson will be checking your appliance to be sure that it is moving the teeth correctly and fitting properly. He will make adjustments to your appliance in order to guide the movement and ensure proper and comfortable wear and fit. Be sure to tell him about any problems with it coming loose, hurting your teeth or gums, or anything unusual you experience. Every few visits we will want to take progress photographs as well.
If you have any questions between visits, you may want to write them down to bring with you to your appointment. If you also have a trainer appliance, you should bring that with you and let Dr. Johnson know how you are doing with it.
THE IMPORTANCE OF STAYING ON TRACK
Each patient is a unique individual and therefore has a unique response to treatment. The pace may also vary during treatment; you may progress faster at some points than at others. The pace of progress depends on many factors, some of which are under your control and some of which are not.
To understand why we need to stay on track (meaning you come in for routine visits as instructed), it's important to have a basic understanding of how this type of appliance works. Very simply, this light-wire appliance produces a gentle and gradual but strong force on the structures which create the arch of teeth, including the teeth.
When the appliance is first placed, it is inserted passively into the mouth. This means no forces are yet introduced and provides time to adjust before active force is introduced. Two weeks later, the appliance is activated, which means it is adjusted to begin moving the teeth / structures. This is the time you are most likely to experience soreness. The movement occurs on average for about 2 weeks, at which point the appliance becomes passive again because the movement has been achieved. Another 1-2 weeks are allowed for the mouth to function in the new position before the appliance is adjusted again for more movement. The average regimen varies between 3-6 weeks for routine appliance adjustments.
It is acceptable to delay routine adjustments once in a while due to certain circumstances such as a vacation, but always discuss this with the doctor first. Also, please advise the doctor of unusual schedule conflicts (away at college, vacations) for scheduling appointments. He will then be able to more appropriately address your treatment.
When an appliance needs repair or replacement, these must be properly done by the lab. In most cases this requires 2-4 weeks, the average turnaround time for orthodontic appliances. An appointment for delivery of the repaired or replaced appliance should be scheduled as soon as possible so that schedule restrictions do not further delay the appliance being placed back into the mouth.
Can I come in more frequently for adjustments to speed up treatment time? There are parameters for the appropriate amount of tooth movement within a specified time. Making adjustments too rapidly can be detrimental to the health of a tooth or teeth. If you are interested in accelerating the pace of treatment, you should discuss this with the doctor. He will evaluate your progress, the rate at which your body seems to be responding and several other factors in order to determine the pace at which you may proceed.
What if I don't want to return as often as instructed? If you wish to regularly delay routine adjustments, it's important that you understand that, though the appliance remaining in place will help prevent relapse, there are other factors which impact the mouth, teeth, and supporting structures. The doctor needs to ensure that treatment is proceeding as necessary. You should not go more than two weeks after the instructed return date without coming in for an appointment unless you have previously discussed doing so with the doctor. In many cases, taking a "break" from treatment (extended time out of state or country, etc.) with minimal or no relapse is possible with proper preparation. Doing so may require alternate or additional appliances or treatment methods.
Treatment may be discontinued at the doctor's option if delays in your routine adjustments cause complications in the treatment which he feels are impeding the success of treatment.
SUCCESS!
Treatment moves along quite rapidly if you stick to the schedule and follow the rules. Our goal is to get your treatment done as quickly and efficiently as possible, but this does require teamwork. If you are having any problems, please let us know about it ahead of time so we are prepared to help you. Good Luck!
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