Everything you need between visits. These are the same instruction sheets we hand out in the office — open one to read it here, or download the PDF to keep. Questions we haven't answered? Call us at 337-761-7070. For an after-hours orthodontic emergency, call or text our on-call number: 337-889-6019.
Some soreness in your teeth, gums, tongue, lips and cheeks is normal during treatment and usually fades a few days after an appointment. Soft-tissue irritation can last about a week while your mouth toughens up. Most issues can be handled at home.
General tooth soreness
Acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) as needed, following the label. Continuous long-term use during treatment is not necessary or recommended.
Loose appliances
Appliances shouldn't loosen if you follow our eating and care instructions, but accidents happen. Please call us as soon as something breaks so we can schedule the repair — we'd rather hear from you in advance than at check-in.
- Loose band or bracket: if it's still attached to the wire, leave it in place and cover it with orthodontic wax if it's uncomfortable. If it comes off completely, put it in a plastic bag and bring it to your next appointment.
- Loose or displaced wire: try to seat it back in place with your fingers or tweezers. If you can't, call us before clipping anything. Wax will help with discomfort.
- Poking wire: push it down with the back of a spoon or a pencil eraser. If that doesn't work, cover it with wax and call us.
Ulcers
Three kinds of over-the-counter help — relieve, protect, heal:
- Topical anesthetic: Anbesol, Orajel or Orabase (active ingredient 20% benzocaine) to numb the spot.
- Topical barrier: Orabase Soothe-N-Seal, which coats the ulcer so it stops rubbing.
- Mouthrinse: warm salt water (1 teaspoon of salt in a small glass), swished three times a day for five days — or Peroxyl (Colgate) or Rincinol (GUM) after meals for three to four days per the package.
Call us any time you'd rather not handle something on your own. Outside normal business hours, call or text the Balhoff Ortho On-Call number at 337-889-6019 and you'll reach one of our team members — if it's truly necessary, they'll meet you at the office.
Please note: tooth discomfort or soft-tissue irritation lasting more than two weeks may point to something that needs treatment. Contact our office and/or your general dentist right away if it persists.
A quick reference for the most common issues.
| Problem | What to do |
|---|---|
| Loose bracket | If it's still attached to the wire, leave it in place; cover with wax if uncomfortable. If it comes out completely, bring it to your next appointment. Call us so we can decide when to repair it. Do not connect elastics to a loose bracket. |
| Loose band | If it's still attached to the wire or appliance, leave it in place and call us so we can decide when to repair it. Do not connect elastics to a loose band. |
| Appliance does not fit | Call us so we can schedule a time to evaluate it. |
| Wire out of tube | Try to place the wire back into the tube with tweezers, without tugging or yanking. Cover with wax if uncomfortable and call for an appointment. |
| Poking wire | Bend it back with a spoon or pencil eraser. If that doesn't work, cover it with wax and call for an appointment. |
A healthy diet means a healthy body, healthy teeth and a better orthodontic result. With braces or bonded appliances, two categories of food cause the trouble: hard, crunchy foods (which bend, distort or break appliances) and sticky foods (which pull appliances loose and are hard to clean off). Avoid big bites of anything — cut, tear or break food into smaller pieces, since repeated heavy chewing damages appliances whether the food is hard or soft. Please also skip nail biting and pen or pencil chewing.
Foods to avoid
- Chewing gum (all kinds, including sugar-free and non-stick)
- Hard candies (unless simply sucked on)
- Ice cubes
- Popcorn (large handfuls)
- Hard bread and pizza crusts
- Meat on a bone (chicken, ribs)
- Pretzels
- Carrots, unless cut into bite-sized pieces
- Crunchy snack chips (Fritos, Doritos, Zapps and similar)
- Corn on the cob
- Nuts
- Hard candy, granola or snack bars
- Apples or any fruit that requires a direct bite, unless cut into bite-sized pieces
- Sticky candies (Tootsie Rolls, Now and Laters, Skittles, Laffy Taffy, caramel, Starburst, AirHeads and similar)
Have much less of
- Foods with a lot of sugar — candy, ice cream, cookies, cake, pie
- Soft drinks such as colas, Mountain Dew and Sprite
- Other sugary drinks such as Kool-Aid
- Coffee
- Tea, sweet or unsweetened
This list isn't all-encompassing — use common sense about what you or your child eats during treatment.
Making your aligners
- An impressionless digital scan is taken at your records visit. Your delivery appointment is scheduled about three to four weeks later.
- We submit your scan through an online portal.
- Dr. Balhoff gives instructions to design a digital ClinCheck specific to you.
- Once Dr. Balhoff approves your ClinCheck, your aligners are fabricated and shipped to our office.
Delivering your aligners
- Your first set of aligners is delivered at your first return visit.
- Attachments are bonded to specific teeth to help specific tooth movements.
- We'll show you your digital ClinCheck at progress appointments.
- We'll walk you through placing, removing and wearing your aligners.
What to expect
- Mild tooth discomfort in the first couple of weeks is typical. Advil (ibuprofen) or Tylenol (acetaminophen) can help.
- Change aligners every two weeks at first. Once you've shown you're wearing them properly, we'll move you to weekly changes.
- Wear aligners 20–22 hours a day. This is essential. Less wear means aligners stop fitting and teeth stop moving as planned.
- Start a new aligner at night before bed — less discomfort, better fit, better movement.
- Take aligners out to eat and to brush. Eating with them in causes staining and distortion.
- You can drink water with aligners in. Take them out for hot, sugary or colored drinks.
- Use Chewies or Clenchys every time you put aligners in: bite, squeeze and hold lengthwise for 15–20 seconds on the right, left and front teeth, repeating if needed to seat the aligner fully.
- Check your tracking — the aligner should sit flush against every tooth with no large or growing gaps.
Good Fit |
Poor Fit |
- Keep your previous aligners until we tell you otherwise, and bring the previous set to every appointment.
- Never go more than one day with no aligner in. If one cracks, distorts or goes missing, wear your previous or next aligner to hold your teeth and call our office right away — we can make a replacement if needed.
Additional aligners
- After you finish your initial set, a second set is usually made to finish your treatment. Most patients go through two to four additional sets; the better your wear, the fewer you'll need.
- We'll take updated records — a digital scan, photos and x-rays.
- Keep wearing your current aligner while the new ones are made; they arrive in our office in two to three weeks.
Congratulations — you're starting retention, an important phase of treatment. Your teeth have moved a lot and aren't firmly settled yet, so your retainer is designed to hold them in their new positions until they're stable. A removable retainer is either wire and plastic or plastic only, made on a precise model of your teeth. You may get extra instructions at retention checks based on your own needs.
- For the first six months, wear your retainer 24 hours a day except when eating, brushing or playing sports.
- After the first six months, wear it at night while you sleep.
- You may speak a little differently for a few days while your tongue adapts. That's normal — keep talking and it passes faster.
- Always put your retainer in its case when it isn't in your mouth. Lost your case? We'll give you a new one free of charge.
- Never wrap it in a tissue, napkin or paper towel — it will get thrown away. Never put it in a pocket, where it will break or distort.
- Keep it away from pets. Dogs and cats destroy retainers left out.
- Brush it with a toothbrush and toothpaste every time you brush your teeth, or clean it with soap and water if it's soiled. Never boil or heat it — heat warps it.
- Don't soak it in mouthwash. Alcohol makes the plastic brittle and can discolor it.
- Remove it only the way we showed you. Improper removal distorts the plastic and wires so it stops fitting, which lets teeth shift.
- If it breaks or the fit changes, don't repair or adjust it yourself — that can move your teeth out of alignment. Call us so we can inspect and adjust it.
- Your first set of retainers is included in your treatment fee. Replacing or repairing a lost or damaged retainer costs extra, so please be careful.
Questions about wearing or caring for your retainer? Call us at 337-761-7070.
Congratulations on finishing Phase I treatment! Now we work together through retention to stabilize the result. Your tongue, lips, cheeks and gums need time to adapt to the new position of your teeth, and retainers keep the teeth from drifting back.
Research and clinical experience say about 95% of orthodontic correction can be retained. Like the rest of your body, your teeth change over time and adapt to how your mouth and bite work — that's a natural change, not a failure of treatment.
Retention is the patient's responsibility. To protect your investment, wear and care for your retainers exactly as instructed. We'll see you two months after your braces come off and your retainers go in; your second retention appointment is four months after that, then observation visits every six months. Please bring your retainers to every retention and observation visit.
We'll monitor your retainers for one to three years, until Phase II treatment is needed. Phase II most often happens between ages 12 and 14, depending on growth and development.
At some point your retainer will stop fitting as more permanent teeth erupt — that's expected, and small changes can be addressed in Phase II. Because we see you less often during retention, we rely on you to tell us if something's wrong. If your retainer doesn't fit, breaks or is lost, call us immediately so it can be inspected, adjusted, repaired or replaced before your teeth shift. Waiting too long can mean shifting that's only correctable with braces or aligners again. Retainers are expensive appliances, and there is an additional charge to repair or replace a broken or lost one — so please be careful.
Questions during Phase I retention? Call us at 337-761-7070.
Still have a question?
Call 337-761-7070 or email info@balhofforthodontics.com. After hours, call or text 337-889-6019.