First Visit

We are always excited about meeting new patients during their first visit to our office. Your initial appointment will consist of a thorough examination and a discussion of potential treatment options. This important 30-minute visit will give us insight into your orthodontic needs. We know your time is valuable, so to expedite treatment, we may also reserve time following the exam for diagnostic records. The records include X-rays, photos and impressions for study models and are necessary for developing the appropriate treatment plan.AAO_William_And_Chris_083 During the initial examination for each patient, we will address the following questions that cover the basics of orthodontic treatment. We encourage you to ask questions as well.

  • Is there a condition that orthodontics can address?
  • Is treatment needed now or should treatment be delayed until appropriate growth, tooth eruption or other factors have occurred?
  • What treatment procedures will be used to correct the problem?
  • Do any permanent teeth need to be removed?
  • How long will treatment take?
  • How much will it cost?
  • What are my payment options?

While we can often answer these general questions about treatment during the initial examination, we will address specific areas after careful analysis of the diagnostic records. We feel it is important to analyze each patient’s specific needs, because in-depth planning leads to superior results and higher patient satisfaction. We will then schedule a consultation visit to discuss treatment options, time frames and financial arrangements. We insist that our patients leave the office with a clear understanding of their specific needs, what the treatment will consist of and how long it will take. Also, we will answer any additional questions. Please assist us by providing the following information at the time of your first visit:

  • Any panoramic X-ray taken within the past six months.
  • If you have orthodontic insurance, bring your insurance card. By providing this information at the first visit, we will be able to give you an estimate of your costs.

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Oral Hygiene

What to Eat When You Have Braces

Brushing and Flossing While Wearing Braces

Common Problems

Dr. Behringer to decide

 

Before and After

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Before

After

Spacing

Non Extraction

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Before

After

Crowding

Non Extraction

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After

Crowding

Extraction

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After

Crowding

Extraction

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Before

After

Non Extraction

Jaw Surgery

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After

Open Bite

Invisalign

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After

Missing Teeth

Cuspid Substitution

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After

Crossbite

Non-Extraction

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After

Crowding

Extraction

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After

Open Bite and Crossbite

Surgery

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After

Crowding

With Restorations

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After

Buck Teeth

Growth Modification

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After

Diastema

Non Extraction

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Missing Teeth

Restore with Bridges

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Crowding

Invisalign

Handling Orthodontic Emergencies

TOOLS & SUPPLIES
• Non-medicated orthodontic relief wax
• Dental floss
• Sterile tweezers
• Small, sharp clipper
• Q-tips
• Salt
• Interproximal brush
• Toothpicks
• Topical Anesthetic
(such as Orabase or
Ora-Gel)
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EMERGENCY TREATMENTS

The following orthodontic emergencies and their treatments are listed in the order of the least severe to the most severe. Only the most severe emergencies may require immediate attention by an orthodontist. The majority of these are easily treated with a follow-up by the patient’s orthodontist. The following information is also available for downloading. (PDF)

Food caught Between Teeth

food_teeth

This is not an emergency, but can be a little uncomfortable or embarrassing for the braceswearing patient. It is easily fixed with a piece of dental floss. Try tying a small knot in the middle of the floss to help remove the food, or use an interproximal brush or toothpick to dislodge food caught between teeth and braces.

Ligatures come Off

Tiny rubber bands or small, fine wires, known as ligatures, holdLigature_Off the wire to the bracket. If a rubber ligature should come off, you may be able to put it back in place using sterile tweezers. If a wire ligature comes loose, simply remove it with sterile tweezers. If the wire ligature is sticking out into the lip but is not loose, it may be bent back down with a Q-tip or pencil eraser to eliminate the irritation. Of course, when one ligature pops off or breaks, others may follow. Be sure to examine all ligatures. Missing or broken ligatures should be brought to the attention of the patient’s parent/guardian, who should then inform the orthodontist. If a rubber or wire ligature is lost, notify the parent/guardian so that the orthodontist may advise whether the patient should be seen.

Discomfort

It’s normal for a patient to have discomfort for a day or two after braces or retainers are adjusted. But it can make eating uncomfortable. Reassure the patient that the discomfort is both normal and temporary. Encourage soft foods. Have the patient rinse the mouth with warm salt water.

Mouth Sores

Some patients are susceptible to episodes of mouth soresOrthoEmergency-FLYER-13-hl. While braces do not cause them, they may be precipitated or exacerbated by an irritation from braces. One or several areas of ulceration of the cheeks, lips or tongue may appear. This is not an emergency, but may be very uncomfortable for the patient. Prompt relief may be achieved by applying a small amount of topical anesthetic (such as Orabase or Ora-Gel) directly to the ulcerated surface using a cotton swab. Instruct the patient to reapply as needed.

Protruding Wire

Occasionally, the end of a wire will work itself out of place and protruding_wireirritate the patient’s mouth. Use a Q-tip or pencil eraser to push the wire so that it is flat against the tooth. If the wire cannot be moved into a comfortable position, cover it with relief wax. (See Irritation of Lips or Cheeks above for instructions on applying relief wax.) The patient’s parent/guardian will need to make the orthodontist aware of the problem. In a situation where the wire is extremely bothersome and the patient will not be able to see the orthodontist anytime soon, you may, as a last resort, clip the wire. Reduce the possibility of the patient swallowing the snipped piece of wire by using folded tissue or gauze around the area. Use a pair of sharp clippers and snip off the protruding wire. Relief wax may still be necessary to provide comfort to the irritated area.

Loose Brackets, Wires or Bands

If the braces have come loose in any way, the parent/OrthoEmergency-FLYER-lglguardian needs to be notified, and they should call the orthodontist to determine appropriate next steps. Brackets are the parts of braces attached to teeth with a special adhesive. They are generally positioned in the center of each tooth. The bracket can be knocked off if the patient has eaten one of those hard or crunchy foods orthodontic patients are instructed to avoid, or if the mouth is struck while at play. (Encourage all patients, especially those with braces, to wear a protective mouth guard while playing sports.) If the bracket is off center, the adhesive may have failed. Call the parent/guardian, and recommend that they immediately notify the orthodontist, who will determine the course of action. If the loose bracket has rotated on the wire and is sticking out and the patient cannot immediately be taken to the orthodontist, you can do a temporary fix to alleviate discomfort and prevent further damage. But take care to prevent swallowing or other injury. To put the bracket back in place, use sterile tweezers to slide the bracket along the wire until it is between two teeth. Rotate the bracket back to the proper position, then slide it back to the center of the tooth.

Piece of appliance is swallowed

This is rare, but when it does happen, it can be fairly alarming to the patient. Encourage your patient to remain calm. If the patient is coughing excessively or having difficulty breathing, the piece could have been aspirated. If you are able to see the piece, you may carefully attempt to remove it. But do not make the attempt if you could cause harm. If appropriate under the circumstances, examine the patient’s braces for problems that may result from the missing piece, such as looseness or irritation, and treat as specified above. If you are unable to see the piece and believe it may be have been aspirated, notify the parent/guardian and the orthodontist immediately.

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