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No matter how careful you are, accidents can happen. Perhaps it’s a slice of apple that was a little bit larger than it should have been. Or you were chewing on your pencil while you were trying to work out an algebra problem. Or you tried a piece of candy that your friend really, truly thought didn’t have a caramel center.

No matter the cause, when something‘s wrong with your braces, you know it. And you want to fix it as soon as possible. What can you do to make yourself more comfortable? And which repairs are best left to orthodontic professionals?

First things first. If you have been injured, and suffered a trauma to your mouth or jaw that has damaged your braces, we want to make sure that you get any medical attention you might need before we worry about your appliance. Call Dr. Donald Neely, and your doctor, immediately if you have suffered a medical or dental injury.

Even if your braces are the only injured party, you might need a special appointment if the damage is something that shouldn’t wait and can delay your orthodontic progress. Broken wires, brackets that have fallen off, and loose orthodontic bands, for example, need to be replaced in our office.

But what about minor problems? First, call us to see if it’s something that really is minor, and whether you can do some home repairs to keep you going until your next regular visit.

• Wayward Wires

One of the most common—and most annoying—problems is a broken or out-of-place wire. If a wire end is poking you, dental wax can be applied to the loose end to protect your cheeks and gums. If that doesn’t work, we can let you know how to apply gentle pressure to move the wire away from delicate tissue. Don’t try to cut a broken wire or remove it without talking to us—small pieces can be swallowed accidentally. We’ll give you suggestions for how to handle a broken or loose wire and protect your mouth until you can see us.

• Breakaway Brackets

If your bracket becomes loose, this is another good reason to give us a call. Brackets are specifically placed to let your archwire guide your teeth where they need to be. Without a firmly bonded bracket, the wire isn’t doing you much good! If a loose bracket is irritating your cheeks or gums, you can try a bit of dental wax to stick it in place and cover hard edges until we can re-bond it. If the bracket comes off all together, bring it with you to your next appointment.

• Balky Bands

Spacers are little rubber bands we put between your teeth if we need to create some room between your molars before you get your braces. They have a tendency to fall out after several days. We’ll let you know if their work is done, and you’re ready to start your orthodontic treatment. If you lose one of your ligatures, those colorful bands around your brackets, give us a call and we’ll let you know if replacement can wait.

We’re happy to help you with any braces problems, large or small. It’s best to check with us for even small fixes to make sure you avoid injury. Larger repairs can be handled in our Hanover, NH office—and we can give you tips on how to prevent future ones. Accidents happen, but they don’t need to delay your progress toward a beautiful, healthy smile.

It’s normal to be a little self-conscious when you first get your braces. Even though you really want to straighten any crooked teeth, or correct a bad bite, you might still be a bit hesitant about sharing your new orthodontic work with the world. What are some ways to get over those under-confident feelings?

• Keep It Clean

Make sure you brush after every meal to reduce the chance of food particles and plaque sticking to your enamel and brackets. Brushing and flossing is particularly important now, not only to prevent cavities, but because nobody wants to see food stuck in your braces—especially you! If you absolutely can’t brush, rinse with water right after eating.

And carry a small bag filled with all the essentials for gleaming braces: a travel toothbrush, floss, a small tube of toothpaste, an interproximal brush, and a handy mirror to make sure you’re good to go. When you know your teeth and braces are their cleanest, you can’t help but feel more confident.

• Express Yourself

Braces are no longer the one-style-fits-all appliances of the past. Traditional metal braces at our Hanover, NH office are more compact, and now come in different colors and shapes. Metal brackets are typical, but ceramic brackets are an option for an almost unnoticeable look. And don’t forget to accessorize!

You can choose from a rainbow of band colors to make a fashion statement that’s uniquely you. Show your spirit with school colors, celebrate the holidays with festive tones, or choose shades that do wonders for your coloring. Whether you go for bold contrast, mono-chromatic subtlety, or “just because I’m in the mood” quirky combinations, let your braces showcase your style. And remember—you can change that style with every adjustment!

• Smile with Confidence

Nothing looks better on you than a confident smile. If you’re a little unsure, practice! Some mirror or selfie time will get you used to seeing yourself in braces. Break them in with friends and family before you go public. Remember that any difficulties with talking or eating should only last a little while.

Above all, you’re still your unique and valued self. You can wear braces and be a good friend, a student, an athlete, a lovestruck Juliet on the theater balcony, a star at your after-school job. Don’t let wearing braces hold you back from the activities you love.  Act like your old self, and you’ll soon feel like your old self!

It’s normal to feel a little self-conscious when you first get your braces. But when you care for yourself and your braces, good things happen! If you’re having difficulty adjusting, talk to Dr. Donald Neely. We want to help make sure your journey to a beautiful, healthy smile is as rewarding and as positive as it can be.

If your pre-teen or teenager is home for the summer, it’s easy to provide braces-friendly lunch options. The school lunchroom, though, presents another challenge altogether. What menu selections are most compatible with braces? And what can you put in that lunch box or brown bag to provide a tempting, healthy lunch during school hours? Let’s look at some options!

From the Cafeteria

Encourage your student to stick with soft foods that don’t require biting into. Some good choices include:

• Soup, either creamy or with soft vegetables
• Salads without crunchy vegetables or croutons
• Soft, shredded chicken or beef
• Egg or tuna salad
• Tofu
• Pasta
• Meatloaf
• Macaroni and cheese
• Soft casseroles
• Steamed vegetables
• Mashed potatoes
• Soft breads or tortillas

Bringing a Lunch?

There are many great options for packing a lunch bag! Just remember to keep foods at the proper temperature, with insulated containers for hot foods and two cold sources, such as two frozen gel packs, for cold foods.

• Sandwiches with soft filling (no chunky peanut butter!) on soft bread. Thinly sliced, easy to chew cold cuts will work, but cold cuts like salami are too chewy. Cut the crusts off if necessary. Cutting sandwich wedges into smaller portions will also make them easier to eat.
• Hard boiled eggs
• Hummus and soft pita wedges
• String cheese and soft crackers
• Applesauce
• Yogurt
• Soft fruits such as berries or bananas
• Jell-O or other gelatin dessert cups
• Pudding cups

When to Say “No, Thank You”

If you have to bite into it, if it’s chewy, or if it’s crunchy, it’s best to choose something else! Here are some common culprits when it comes to broken brackets and wires:

• Caramel
• Hard candy
• Popcorn
• Whole carrots
• Whole apples
• Hard rolls
• Pizza
• Corn on the cob

And remember to send your child to school with a brush and floss to clean teeth and braces after lunch. Dental hygiene is very important now, because brackets and wires can both trap food particles and make brushing them away more difficult. This can lead to increased plaque, cavities, and staining around the area of the braces. If it’s impossible to brush, be sure to remind your student to rinse thoroughly with water after eating.

Lunch hour should be a time to relax, get together with friends, and recharge for the rest of the school day. Talk to us about the most (and least) braces-friendly foods and recipes. By learning what foods to avoid and adjusting some old favorites, your school-age child can continue to enjoy healthy, tasty lunches. Most important, visiting Dr. Donald Neely at our Hanover, NH office for an emergency repair will not be on anyone’s list of afterschool activities!

When does an underbite need surgery? The short answer is: when Dr. Donald Neely and our team recommend surgery as the best way to give you a healthy, functional bite. But let’s take a longer look, and see just why your doctors might come to that conclusion.

• First, what exactly is an underbite?

In a perfect bite, the upper and lower jaws align, well, perfectly. Upper teeth overlap lower teeth very slightly, upper and lower teeth meet comfortably, and jawbones and joints function smoothly. When the alignment is off, it causes a malocclusion, or “bad bite.”

When we talk about an underbite, or Class 3 malocclusion, it means that the lower jaw protrudes further than the upper jaw. This protrusion causes the bottom teeth and jaw to overlap the upper teeth and jaw.

• What causes an underbite?

Sometimes an underbite is caused by childhood behaviors while the teeth and jaw are developing, including tongue thrusting or prolonged thumb-sucking and pacifier use. (Working to stop these behaviors before they affect tooth and jaw formation is one of the many good reasons children should have regular visits with their dentists and pediatricians.)

Most underbites are genetic, however, and tend to run in families. It’s estimated that from five to ten percent of the population has some form of underbite. The lower jawbone (mandible) might be overdeveloped, the upper jawbone (maxilla) might be underdeveloped, both bones could be affected, or, sometimes, tooth size and placement might cause an underbite. These irregularities in jaw shape and size and/or tooth crowding are not something that can be prevented, and require professional treatment.

• Why? What’s the problem with an underbite?

Even a minor underbite can cause difficulties with biting and chewing. A more severe underbite can lead to speech problems, decay and loss of enamel where the teeth overlap, mouth breathing and sleep apnea, persistent jaw and temporomandibular joint pain, and self-confidence issues.

• Can’t my dentist treat my underbite?

Most probably not. A very mild underbite can be camouflaged cosmetically with veneers, but this does not address the cause of the underbite, and will not work for moderate or severe underbites.

• Can my orthodontist treat my underbite?

Dr. Donald Neely will create an underbite treatment plan after a detailed study of each patient’s individual dental and skeletal structure. Treatment options will vary depending on the cause of the underbite, its severity, and even the patient’s age.

Early intervention is especially important for children who show signs of an underbite. That’s why we recommend that children visit our Hanover, NH office by the age of seven.

If an underbite is caused by tooth misalignment or crowding, braces can reposition the lower teeth. Sometimes extractions are necessary to make room for proper alignment.

If the cause is due to jaw structure, children’s bones are still forming, so treatment can actually help correct bone development. Palatal expanders, headgear, and other appliances are various methods of encouraging and guiding bone development.

But braces and appliances aren’t effective for every patient with an underbite, and especially in patients (usually those in their late teens and older) when the jawbones are already fully formed. In this case, we might suggest coordinating treatment with an oral and maxillofacial surgeon.

• What does an oral and maxillofacial surgeon do?

An oral surgeon has the training, experience, and skill to help correct an underbite by surgically reshaping and repositioning the jawbone. This corrective jaw surgery is called orthognathic surgery.

• What will happen during orthognathic surgery?

Your treatment will be tailored to your specific needs. Two of the common surgical procedures for treating an underbite involve repositioning the upper jaw to lengthen it and/or reshaping the lower jaw to shorten it.

Bone is sometimes removed or added, small bone plates or screws are sometimes used to stabilize the bone after surgery—your surgeon will let you know exactly which procedures will give you a healthy, functional bite. The surgery itself is most often performed under general anesthesia and requires a brief stay in the hospital.

• How will my orthodontist and oral surgeon coordinate my treatment?

Correcting a Class 3 malocclusion can take time. Your oral surgeon will work together with Dr. Donald Neely to analyze the interrelationship of teeth, bones, and joints to determine dental and skeletal problems, and will develop the best treatment plan possible to create a healthy alignment.

• So, when does an underbite need surgery?

Sometimes, a minor underbite can be corrected with braces and appliances alone. A serious underbite, however, will often require the specialized skills of both Dr. Donald Neely and an oral surgeon.

And, while it’s not the primary purpose of surgery, corrective jaw surgery and orthodontics can also make you happier with your appearance and boost your self-confidence. Achieving a lifetime of beautiful, comfortable, and healthy smiles—that’s the answer to your question.