The American Association of Orthodontists recommends that children be seen for an initial orthodontic consultation at seven years of age. At this appointment, we begin to evaluate eruption and development to see if treatment is necessary. Although this may be the recommendation, you can visit the orthodontist at any age!

You do not need a direct referral from you dentist to be seen for an initial consultation at Hallmark Orthodontics. We are more than happy to discuss your dental history with your dentist to help produce the best outcome. However, scheduling an initial consultation is as easy as calling our office or scheduling online!

Absolutely! It is important that your teeth are monitored and regularly cleaned by your general dentist while in active orthodontic treatment.

A virtual consultation provides us with the opportunity to meet you and learn about your concerns and treatment goal without scheduling a visit in the office. We can have a general idea of our treatment goals and we are also able to become acquainted with one another. To initiate active orthodontic treatment, we will require an in-person exam to verify our findings.

Our office offers convenient after school appointments as well as Saturday appointments. We will` always do our best to make sure your appointments work well with your schedule although sometimes your visit may coincide with school or work hours.

The cost of orthodontic treatment varies based on your personal treatment needs as well as insurance benefits. Our office offers flexible down payments as well as payment plans to make sure that the cost of orthodontic treatment is not a barrier. Our financial coordinator will work with you every step of the way!

Prior to initiating orthodontic treatment, we will discuss how long your treatment plan is expected to take. Treatment time will vary based on the complexity or severity of your case.

The process of having braces placed on your teeth does not cause any pain. In fact, it is much easier than you may imagine! Some patients may experience some mild soreness or tenderness in the teeth approximately 24-48 hours after their initial visit. If the pain is bothersome, an aspirin or ibuprofen should take care of the concern. Many patients do not require this at all!

Invisalign is a great tool that we love to use! Determining whether your case can be treated with Invisalign requires our doctors to evaluate your photographs and x-rays. At your initial consultation, we can discuss your treatment options and review the pros and cons of each approach!

Orthodontists may recommend extractions for a variety of reasons including, but not limited to: crowding, decay, bite discrepancies, dental impactions, and many more. We typically recommend extractions when it is necessary and will create an improved esthetic and stable outcome.

Retainers are an important part of your overall treatment. Many of our patients have both permanent and removable retainers. Permanent retainers will be bonded to the backside of your teeth. You will want to be sure you do not bite into anything hard or crunchy with your front teeth and that you are brushing and flossing the retainers twice per day. Removable retainers must be kept in a case away from pets and heat when not in your mouth. If you lose your removable retainer, be sure to call our office right away to ensure that your teeth do not shift!

Poking Wire

Use a Q-Tip or Pencil Eraser to push the wire into a comfortable position. If you can not do this, you can place wax over the wire or attempt to cut the end of the wire with fingernail clippers.

Loose Bracket, Band, or Wire

If a bracket is loose but still tied to the wire with the color tie you can choose to rotate it flat onto the tooth until you are seen in the office or cut the color tie with fingernail clippers and remove the bracket from the wire.

If a wire is loose you may utilize wax or fingernail clippers to alleviate the pain.

Loose Appliance

Do not try to adjust the appliance on your own. Please contact our office and we will walk you through steps of managing your specific appliance at home.

If your forsus springs arms have separated, you should be able to open and reinsert the rod and spring components into one another.

General Soreness/Tenderness/Irritation

Your lips, cheeks, tongue, and other tissues may become irritated when first getting appliances. Utilizing wax in soft spots is the best way to allow your mouth time to adjust.  If you have sensitive spots, be sure to rinse with salt water to alleviate any tenderness.

You may take aspirin or ibuprofen if you have general soreness, however many patients do not require this.

All orthodontists and dentists attend dental school after their general undergraduate educations. Orthodontists complete a residency program after dental school focused on orthodontics alone which makes them specialists in aligning your teeth!

It is usually recommended to wait until the completion of your treatment to whiten your teeth. Patients who are being treated with removable orthodontic appliances may be able to whiten their teeth while they are in treatment. Feel free to ask our office about your specific appliances at your next visit!

It may be possible to initiate treatment while you are pregnant, but it will be important to discuss this with both your orthodontist and OBGYN. Pregnancy can bring changes that may affect your mouth, schedule, and ability to take x-rays.

You can still participate in your extracurricular activities with braces on your teeth! There may be an adjustment period associated with your new appliances however they will not prevent you from participating. Remember to ask our office for a mouthguard to protect your lips and teeth from being injured if you participate in a sport where this would be beneficial!

Care of Appliances

To successfully complete your treatment on time you must work together with our office by caring for your appliances. Damaged appliances can increase treatment time.

Hygiene

It is extremely important to brush and floss regularly when you are in orthodontic treatment. You can brush with a regular toothbrush or electric toothbrush. We recommend a water flosser for hard to reach spaces between the appliances. Patients who do not keep their teeth clean may require more visits to their dentist and are at increased risk for decay around the brackets. We will notify you if we are concerned about your hygiene at your visits.

Foods to Avoid
Generally avoid anything hard, crunchy, sticky or chewy. Some examples of items that may break your appliances include:
• Ice
• Bubblegum, Starburst, Taffy
• Nuts, Popcorn, Chips
• Hard bread crusts or rolls
• Carrots, apples, hard vegetables that are not cut up into small pieces
• Chewing on Pens, Pencils, Hard Objects

What to Expect

When you get your braces or appliances your teeth may be sore or tender to biting pressure for a few days. You may take Tylenol or Ibuprofen as needed during this time.

Your lips, cheeks, and tongue may become irritated as they become adjusted to the surfaces of the braces. This can be alleviated by rinsing with salt water. You may also place wax on any surfaces to soften these spots. We will provide you with wax at your appointments!

Orthodontic Emergencies

Many orthodontic problems such as broken brackets and poking wires are not true emergencies. It is important for you to notify our office of these types of problems prior to your next visit so we can adjust your appointment time to correct them or bring you in at an earlier date.

Please call our office if you have lost or broken your retainer. We do not want your teeth to shift. For your convenience, we do have an emergency line in case you are ever concerned or worried about your treatment. Feel free to contact our office and we will return your call.

How to Wear Your Aligners

Invisalign is most effective when worn approximately 22 hours per day.  Each tray should be worn for 1-2 weeks dependent on the prescribed duration by your orthodontist.  At the end of the selected timeframe you are to move to the next tray in your series.

Your trays must be removed to eat and drink anything other than water.  When removing to eat or drink, make sure to place your aligners in a case to decrease your risk of loss of aligners.  After eating and drinking you should clean your aligners, wash your hands, and place your aligners onto your teeth and continue wearing!

Please keep all old aligner trays after removal and place them in the bag associated with that tray.

 Aligner Insertion

• Make sure you have the proper aligner for the upper and lower
  • You may insert the upper or lower first
• Apply equal pressure to the front and back of the trays until the tray snaps into place. Do not bite the trays into place.  You may utilize a chewie if you need more help in applying pressure to the trays.

 Aligner Removal

• Use your hand on the inside of your back molar to pull downwards or upwards to release your tray. Repeat on the opposite side prior to removing fully.
• Work your way forward before removing fully.
• Do not use any sharp objects to remove your aligners from your mouth.

Cleaning Your Aligners

 Cleaning your Invisalign aligners is an extremely important part of your Invisalign treatment.  You can clean your aligners by any of the following methods:

• Brush with a toothbrush and toothpaste
• Soak in retainer cleaner provided by our office or bought at a drugstore

Invisalign Attachments

Invisalign attachments are tooth-colored pieces of composite that are positioned on your teeth to better assist with your dental movements.  Attachments are individualized shapes and sizes and are important in order to achieve an ideal final outcome.  Attachments should not be removed by your general dentist.

We ask that if an attachment were to become loose or not stay attached on to a tooth that you contact our office to have it replaced immediately!

Interproximal Reduction

Interproximal reduction is commonly utilized with Invisalign.  Your orthodontist will utilize a disc or strip between closely touching teeth in order to create space for movement within your trays.  Interproximal reduction is measured specifically for each patient and for each contact.  It does not place you at higher risk for decay nor should it be a painful experience.

Storage

Store your trays in a cool, dry place that is out of reach of animals.

Common Invisalign Questions

• What do I do if I lose an aligner?
  • If you lose your aligner contact our office immediately. Your orthodontist will make a decision as to having you wear your next aligner or your last aligner based on your treatment progress.  We may have new aligners ordered for you dependent on your status of treatment.
• I have a spot that is rubbing me, how can I manage this?
  • If an aligner is irritating your tissue please be sure to contact our office and make us aware of the issue. We are usually able to teach you how to use a nail file to soften sore spots however we would like to be certain we teach you how to manage these.

Congratulations!  You have received separators and are on your way to tooth movement!  

Separators are placed between the teeth so that your orthodontist can more easily fit an orthodontic band around your tooth at your next visit (like a ring on a finger). Separators gently push the teeth apart so that your next visit is more comfortable and quick!  

Taking Care of Separators:

1. Avoid picking at the separators with your fingers or floss, you should still brush your teeth as normal
2. Avoid sticky foods like gum or candy
3. Biting on the separator is normal, it may feel “bouncy” to your teeth
4. Check your separators to be sure they have not fallen out

Will separators hurt?

Separators will feel as if there is a piece of food or floss stuck between your teeth.  As your teeth start to move, you can expect them to be mildly sore and tender.  Our office recommends over-the-counter pain relievers such as ibuprofen.  The pain should subside in approximately 24-48 hours after placement.

What should I do if my separators fall out?

If a separator has fallen out please call our office to let us know.  You may discard the separator that has fallen out, we will not reuse it!  Sometimes, it will be necessary for you to return to have the separator replaced.  If your appointment is soon enough, we may not replace them.

We are so excited for your brand-new beautiful smile!  Now that your braces have come off you are entering the phase of orthodontics called retention.  

Although you do not have braces, you now have retainers bonded to the back side of your top, bottom, or both arches.  It is important that you take care of these retainers so that they stay fixed to your teeth properly and do not come loose.  Bonded retainers are fantastic retainers as they are always working when attached appropriately to your teeth.  

How to Care for Bonded Retainers:

Hygiene

1. It is important to brush and floss around the wires every day.  Food and plaque buildup around the wire can lead to decay or gum irritation.  We will show you in the office how to floss with your retainer.  You can also use a waterpik to remove buildup without string floss at home!
2. You should spend extra time when brushing focusing on your bonded retainers.
3. Continue to see your dentist for regular visits and cleanings!

Foods  

1. Do not bite into hard, sticky, or tough foods with your front teeth.  The retainers are bonded to your teeth in a similar manner as braces and can come detached.  
2. Do not pick at the retainers with your hands or any objects.  

When to Call our Office:

If you feel as if glue has come off of your retainers, the wire is broken, or the wire is loose please contact our office.  Your wire could bend and your teeth could shift into an improper position.  Sometimes, glue may come detached from a single tooth.  This can be hard to notice.  

If you feel as if your teeth are shifting, please contact our office.  

We will schedule you for an evaluation and a possible repair or replacement of your bonded retainer.  There may be a fee associated with retainer correction dependent on the reason for breakage.

Bonded Retainers with Removable Retainers:

You should still wear your removable retainer as prescribed by our office on top of your bonded retainers.  Your bonded retainers do not maintain the back teeth in their position.  We will keep you scheduled for regular retainer checks in order to monitor your stability!

Wearing retainers is an extremely important step in maintaining your beautiful result. Please be sure to follow the instructions below and keep all your scheduled retainer check appointments with our office!

Wearing Your Retainer

• Wear your retainer as often as prescribed by your orthodontist.
  • You will typically wear your retainers full time after initial appliance removal.
  • We will eventually decrease your retainer wear to nights only after a predetermined amount of time based on your individual occlusion.

Taking Care of Your Retainer

• Always keep your retainer in your case when outside of your mouth.
• Brush your teeth prior to placing your retainer into your mouth.
• To clean your retainer brush it gently with a soft toothbrush and small amount of toothpaste daily. Periodically you may soak your retainer in Retainer-Brite or a mixture of mouthwash and water.  Vinegar is a great cleaning agent for heavy plaque buildup.
• Do not allow your retainers to sit near heat or stay inside the car on a hot day.
• Keep your retainers out of reach of your pets!

Please call our office immediately if you notice tightness that does not subside with consistent wear, movement of your teeth, or your retainers are lost or broken.

Remember, maintaining your beautiful smile is up to you!

Congratulations on being done with your braces! Wearing retainers is an extremely important step in maintaining your beautiful result.

Please be sure to follow the instructions below and keep all your scheduled retainer check appointments with our office!

Wearing Your Retainer

• Wear your retainer as often as prescribed by your orthodontist.
  • You will typically wear your retainers full time after initial appliance removal.
  • We will eventually decrease your retainer wear to nights only after a predetermined amount of time based on your individual occlusion.
• Take your retainer in and out of your mouth by pulling on clasps or hooks towards the back of your mouth unless otherwise instructed by your doctor. Do not pull on the wire that runs across your front teeth unless necessary.

Taking Care of Your Retainer

• Always keep your retainer in your case when outside of your mouth.
• Brush your teeth prior to placing your retainer into your mouth.
• To clean your retainer brush it gently with a soft toothbrush and small amount of toothpaste daily. Periodically you may soak your retainer in Retainer-Brite or a mixture of mouthwash and water.  Vinegar is a great cleaning agent for heavy plaque buildup.
• Do not allow your retainers to sit near heat or stay inside the car on a hot day.
• Keep your retainers out of reach of your pets!

Please call our office immediately if you notice tightness that does not subside with consistent wear, movement of your teeth, or your retainers are lost or broken.

Remember, maintaining your beautiful smile is up to you!

A forsus appliance, or forsus spring, is designed to reposition the teeth and correct your front to back positioning of the bite (overjet).  Sometimes the springs may be used to only hold your teeth and you may not feel a pushing force.  This appliance is custom measured to your mouth and should be taken care of so your treatment can finish efficiently!

 Forsus Placement

• The forsus is a fixed appliance that is placed in office by your doctor and staff
• It is attached to both your upper and lower braces and wires
• We will measure the distance between your teeth and choose a spring that best fts you

 What to Expect

• Clean the forsus spring with water, toothpaste, and a toothbrush. Please pay special attention to the bands on your upper arch to which the forsus is hooked.
• Some mild discomfort may be experienced in the initial following days of placement. Take Tylenol or Ibuprofen as needed.
• You may want to place wax where the forsus springs touch your cheeks. Feel free to ask for wax at any of your orthodontic appointments.
• The forsus spring may come apart if you open very far as in a yawning action. You should be able to interlock the two pieces but please inform us at your next visit if this has occurred.

Please call our office immediately if your spring becomes loose or broken.  We will schedule an appointment to fix your forsus.  Please save all pieces or parts that have broken and bring them with you to your following appointment. 

Congratulations, your orthodontic treatment has started! In addition to widening the upper jaw, the palatal expander allows for the creation of more space for the eruption of the permanent teeth and correction of the bite.

This information is provided to give you information on how to activate your expander, what to expect, and hygiene instructions. If you have other questions or problems, please call the office.

Activation

 We recommend activating the appliance at bedtime so that the pressure from the turn is gone by morning.  If you forget one night, you can activate it once the next morning and then again that night. However, do not turn more than twice in one day.

• You will be given a key to activate the RPE.
• Place key in anterior hole of appliance, toward the front teeth.
• Push the key toward the back of the mouth until the next hole is completely visible.
• Remove the key carefully so the new hole for the next activation is completely visible.

Hygiene

Brush the appliance including the metal bars and screw in the same way you brush your teeth. When you are unable to brush after eating, swish water around in your mouth to help dislodge any food particles.

Diet

At first, eating will be more difficult; take small bites and eat soft foods until this is overcome (usually only a few days). After that, you should be able to eat almost everything you did before with some exceptions.

What To Expect

• Speech: Your speech will be affected. This is not permanent, and the best way to get used to this is to speak aloud as much as possible; try reading out loud or singing.
• Soreness: Your teeth may be sore for the first few days. To help with this you may want to take what you would normally take for a headache; however, chewing and talking are the best ways to get your mouth used to this new feeling.
• Pressure or tingling of the mouth, tongue, chees, and nose
• Space between your front teeth: Although this is a good sign from the standpoint of your treatment, it can be disheartening from a cosmetic point of view. By the time you stop turning the screw, the space may look large enough to fit another tooth. This space should close by itself within a short time.

Potential Problems

Please turn appliance as instructed. Do not continue to activate the appliance beyond this time. At your next appointment, you will be told if your expansion is completed or needs to continue.

The most common problem we see with the RPE is an incomplete activation where the key cannot be seated for the next activation. You should see the next hole completely in the RPE when the key is removed. Call us if you have this problem, and we will get you in to correct it.

If one of the arms gets bent or is pinching the gum tissue, please call so we can adjust your RPE.

If the RPE ever feels loose and you notice the bands are not cemented on the teeth, please call to have the appliance re-cemented. You should carefully follow the food list and avoid sticky, hard foods. Yes, that means no gum!

Congratulations!  You are on your way to a straighter smile.  Today you received your new appliance, the carriere.  This appliance is designed to help your front and back teeth fit together more appropriately.  

Recommended Use & Wear:

1. Wear the elastics between 20-22 hours per day.  The elastics should be replaced 3 times per day at a minimum or as prescribed by your orthodontist.
2. Wear the correct size and strength of elastic as prescribed by your orthodontist.  The size of elastic will dictate how the teeth are moved.
3. Do not wear the elastics without your retainer – this can lead to adverse side effects with the alignment of your lower teeth. 
4. All hard or sticky food should be avoided to prevent the appliance from breaking.

Proper Maintenance of Removable Retainers

1. Clean your retainer with a toothbrush and toothpaste, gentle dish soap and water, or retainer cleaner provided by our office.
2. Retainers should always be stored in their case when not inside of your mouth.
3. Brush and rinse after eating prior to replacing your retainers into the mouth.

What You Can Expect From Your Appliance:

1. As the elastics are worn your teeth may become slightly sore or feel loose.  If worn consistently, this will improve with time.  
2. Small spaces may open between your upper front teeth.  This is a desirable change and your orthodontist will correct this with your future treatment!

Common Occurrences:

1. Lost Lower Retainer: Stop wearing the elastics until we can fabricate a new retainer.
2. Loose Metal Arm: Call the Office.  Do not wear your elastics until this is replaced.
3. Poking Lower Bracket: Place wax on the bracket to make it more comfortable.