What does the pandemic mean for your treatment?

2020.03.26

Dear Patient/Parent,

As the news about the Covid-19 pandemic are moving very fast, this can be a challenging time for you or a member of your family who are in the middle of orthodontic treatment. They may feel anxious that the treatment is not progressing or worried that things could go wrong because your next appointment got cancelled due to the practice closure. It is a fact that within the current regulations orthodontic practices have to remain closed and can only see extreme emergencies, which are described as “associated with trauma or injury, extreme and unmanageable pain, ulcerations, infection or swelling”. On this basis, for the time-being, we are not allowed to operate any regular procedures such as fitting, adjusting or removing braces.

Please note that in these challenging times the Team of the London Orthodontic Group are still here and always available to provide advice and answer questions. Please email us at hello@londonlovesbraces.com if you require any help and keep an eye on our website as we will be placing an update as soon as possible with our return news. In the meantime, it is very important to follow the instructions we gave on brushing and caring for the braces as usual and follow the necessary dietary restrictions. For any other instance, please take the time to read the advice below on how to deal with issues with your braces at home.

Please also note that we are already planning our return clinics and we are maximizing capacity as we are committed to get patients back on track as soon as we are allowed to do so. We will work on full steam to ensure your treatment plan remains unchanged and the treatment outcome is something to smile about.

We wish everyone in our small community good health for you and your family. This interruption to our normal life, it seems to us, already gave rise to an even deeper feeling of community and togetherness amongst us.

With kind regards and warm wishes,

Richard and Vivi Hennebry and Associates

 

Orthodontic Advice during Covid-19 Practice Closure

If you are receiving orthodontic treatment, it is unlikely you will experience an orthodontic emergency, as genuine orthodontic emergencies are rare, but it is better to know what to do just in case.

If you think you may have an emergency, the first step is to determine the severity of the problem: Is it an urgent situation that requires immediate attention, or a minor problem that you can take care of yourself, temporarily, until you can come in to our office? Please note that during an emergency visit, we will only make your brace comfortable. The broken brace may not be repaired until a later visit.

 

A Major Emergency

There are only a few true orthodontic (or dental) emergencies. They include: • Trauma or injury
• Infection or severe swelling
• Severe, unmanageable discomfort or pain
In any of these situations, you should seek help as soon as possible, for the time being please do not go to any emergency room as at these times Hospital are inundated.

 

Some Minor Troubles

Fortunately, the vast majority of orthodontic problems are minor compared to these situations — but they may still cause discomfort or irritation. In general, it’s best to try and soothe the immediate cause of the discomfort, and then contact us if that worsens.

Here are a few of the more common orthodontic problems, along with some tips on what you can do to relieve them at home:

• Loose or broken brackets, bands or wires

This problem is often caused by eating hard or sticky candy or food, or playing with the braces. If the band or bracket is still attached to the wire, leave it as is — but don’t connect any elastics to it! You can cover it with orthodontic wax if it’s irritating the inside of your mouth. If it has come off, leave it. In either case, as soon as we are allowed to see you for your next appointment, we will repair the broken part.

• Misplaced or poking wire, bracket or tie

As the teeth start to move, the wire that connects them (archwire) may begin poking near the back of the mouth or irritating the cheeks. You can try moving the wire into a better position with a pencil eraser or a Q-Tip. If the wire won’t move, you may be able to cut the end off with a nail clipper sterilized in alcohol or boiling water— but before doing so, please call us for guidance or instructions. Often, you can also use tweezers to gently move a misplaced wire or a tie that’s causing problems.
When wires or brackets cause irritation, covering the metal parts with wax will often help ease the discomfort. As with any of these types of problems, as soon as we are allowed to see you for your next appointment, we will replace that part of your brace.

• General tooth pain or loosening

It’s normal for teeth to become slightly loosened during orthodontic treatment — that shows they’re moving! Sometimes, this movement may be accompanied by tenderness, especially after braces are placed or adjusted. For minor soreness, you can use your regular over-the-counter pain killer, please avoid ibuprofen and take paracetamol instead if needed. A twice-a-day salt-water rinse may also help: Mix one teaspoon of salt in an 8-ounce glass of warm water, and rinse for 30 seconds. A warm washcloth or heating pad placed on the outside of the jaw can also offer some relief.

• Removable brace

If your removable brace looks broken or causes a lot of pain, do not wear it if it is uncomfortable or if is at risk of being dislodged.
If you completed a prescribed number of activations (turns) please pause. Further activations may be required after your next regular appointment.

• Invisalign treatment

You can continue to wear your next aligners as normal, even if more attachments or elastics were originally planned. These will eventually be incorporated in your next scan/clincheck. If you are on your last aligners, please continue to wear those at night only and contact us.

• Elastics

You can continue to wear your elastics at night only during this time.

• Fixed Expanders (Hyrax) or Fixed functional appliances (MARA, AdvanSync)

If you completed a prescribed number of activations (turns) please pause. Further activations may be required after your next regular appointment.
If the appliance is very loose and coming out completely, please carefully remove the appliance or the offending part and keep it safe. If it is not coming out completely and is causing severe discomfort please get in touch.

While actual emergencies are rare, if you need additional advice or any issues seem to worsen significantly, please don’t hesitate to email us at hello@londonlovesbraces.com.

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