Complimentary Exam and FREE whitening kit. Schedule your appointment with Dr. Bagden or Dr. Coffelt today.
Our offices use the latest technology. From the Damon System to Invisalign, we have brought the newest materials and techniques in orthodontics into our practice.
Our patients notice a difference in care that is delivered in an unhurried, individual, doctor directed treatment. Contact us to make a difference in your smile and your confidence.
We are one of the largest INSIGNIA practices in the country. INSIGNIA brings faster treatment times & higher quality results.
Meet Our Doctors
Dr. Bagden brims with energy, enthusiasm and passion, a quality he brings to orthodontics and life. He enjoys dissecting the mechanics of complicated cases and producing transformative results for patients. His can-do spirit is contagious.Dr. Bagden graduated from Lafayette College in 1975 and then attended the prestigious University of Pennsylvania dental school, earning his Doctor of Dental Medicine (DMD) degree. After fulfilling a service obligation as a dentist with the United States Public Health Service, he decided to specialize in orthodontics and studied at the University of Maryland as an orthodontic resident. He joined Dr. William Wallert in practice in 1987, and the two pioneered many efficient practice management techniques.
In 2000, Dr. Bagden performed clinical trials and documented studies on the effects of the Damon System of orthodontic treatment, concluding that its premise of passive self-ligation was more efficient than traditional orthodontics. It was revolutionary! He began working closely with Dr. Dwight Damon of Spokane, WA, developer of this advanced treatment system, to further refine the technique. Dr. Bagden took the Damon message on the road, speaking to doctors around the world on the mechanics and benefits of the Damon system and instructing doctors on how to phase-in the new technology to maximize patient results. He has been a featured speaker at professional meetings in more than 40 countries on six continents!
Dr. Bagden has also been on the forefront of the development and integration of the Insignia System, a computer-based custom designed orthodontic system. He now lectures worldwide on both the Damon and Insignia Systems and is a “Certified Damon Instructor,” an accreditation given to less than 25 orthodontists in the United States.
Dr. Bagden is Board Certified by the American Board of Orthodontics, a distinction attained by only one quarter of all orthodontists in the United States. He has served as President of the Virginia Association of Orthodontists and the Northern Virginia Dental Society. He is a member of the Pierre Fauchard Honorary Dental Society and the American College of Dentists in recognition of his contribution to the orthodontic profession. Dr. Bagden is often a guest lecturer at his orthodontic alma mater, The University of Maryland Orthodontic Residency program, as well as many other specialty programs world-wide.
A dedicated runner, Dr. Bagden has completed many marathon races, most famously the Boston Marathon. He and his wife, Kathy, have proudly raised five children, and are now enjoying their three grandchildren, hoping they are joined by many more. They enjoy their circle of friends and extended family, travel to the far reaches of the globe, and spend beach time in Lewes, DE. They love to cook together and explore new interests from yoga to golf to vegetable gardening and biking.
Dr. Coffelt is the Orthodontist with a gentle touch and a fierce karate kick. After graduating from Randolf-Macon College with a degree in biology, Dr. Coffelt earned her dental degree from the Medical College of Virginia and completed the University of Maryland’s Advanced General Dentistry Residency Program. Dr. Coffelt continued her education at the University of Louisville, where she completed a Masters degree in Oral Biology and an Orthodontic Residency. Dr. Coffelt practiced orthodontics in Northern Virginia for 12 years before joining Dr. Bagden in 2004.
Dr. Coffelt is a certified Damon Instructor. She provides short lectures and workshops with doctors both nationally at the Damon Forum and Gorman Institute and in locations around the world. Dr. Coffelt loves working with the new INSIGNIA treatment technology to produce technically excellent results for patients in less time than ever. She enjoys working with patients of all ages, and her philosophy is to treat each patient like family. Her inviting personality, combined with a wealth of orthodontic expertise, lends to an exceptional patient experience.
Outside of the office, Dr. Coffelt is an avid tennis player, and has a black belt in karate. She is a self-acclaimed ‘gym rat’ and shares her love of sports in summer volunteer trips to Poland where she teaches children everything from soccer to lacrosse. She enjoys playing the piano and clarinet and would escape to Yosemite National Park for R&R if only she were closer!
Everything we do centers around making your teeth and face look better and all physical structures from teeth to gums and jaws perform better functionally because of our treatment. While traditional orthodontics often required the removal of up to eight teeth to create space and remedy overcrowding, new technologies require tooth extraction far less often. As a result, patients enjoy a beautiful final result along with the facial support that comes with maintaining more teeth for a lifetime. We do still extract teeth when it is apparent that facial aesthetics will benefit from their removal. However, this decision is made only after exhaustively reviewing the diagnostic records and reviewing non-extraction treatment choices. Our ultimate goal is for our patients to be thrilled with their final result now and in the future.
We are committed to providing patient care as efficiently as possible, performing as many procedures as we comfortably can at each visit as well as scheduling as much time as practical between visits. Our goal is to finish your care with as little disruption of your daily life as possible. The new Damon/Insignia wire and bracket technology we work with helps us minimize treatment time and maximize results.
Read Dr. Bagden’s most recent article about The Phenomenon of Low Friction Techniques: State of the Art.
The goal of First Phase Treatment is to develop well-oriented jaws, healthy bones and gums and adequate room for permanent teeth in the patient. Children sometimes exhibit early signs of jaw problems as they grow and develop. An upper or lower jaw that is growing too much or not enough can benefit from early orthodontic treatment. Severely crowded jaws can also benefit from early observation and treatment. This early correction can prevent the removal of permanent teeth due to excessive overbite or overcrowding. If you believe a problem exists, you are most likely correct in your assessment.
Generally we use a growth-modifying appliance for skeletal problems and only limited braces to create necessary space for patients between 8 and 12 years of age. In our practice, approximately 25% of patients evaluated between these ages undergo early treatment.
First Phase Treatment Goals:
The goal of Second Phase Treatment is to position all the permanent teeth to maximize their appearance and improve their functional integrity. This is best accomplished by placing braces on all the upper and lower teeth. Second Phase treatment is generally 18-20 months long.
To paraphrase photographer James Colton, “A wow smile must not only be effective they also have to be affective.” We want our smiles to invoke a reaction…so that our patients exude confidence, beauty, accomplishment and charisma.
Treatment is individually designed to maximize cosmetic and mechanical improvement. We use state-of-the-art hardware and the absolute latest, least invasive techniques to modify the shape of your jaw and comfortably accommodate your teeth. A detailed and comprehensive assessment of facial features, personal needs and existing condition is made to determine a strategic treatment plan to enhance facial structure, balance, alignment, and aesthetics.
Confident, poised, satisfied patients eager to express themselves with a beautiful smile who refer their family and friends to Dr. Bagden.
Orthodontic treatment is good for your health and your looks. When jaw discrepancies such as overbites and underbites are corrected, you’ll find it more comfortable to chew, talk, and even breathe! When the bones and tissue that support your teeth experience less stress, the risk of gum and bone deterioration-the leading cause of adult tooth loss-is minimized.
Orthodontic treatment can resolve cosmetic, functional, and physiological issues such as:
Dr. Bagden’s orthodontic practice is unique because:
Experienced office staff with more than a collective 200 years of orthodontic service among professional staff. They are always learning, innovating, and most importantly, caring deeply about their patients. Dr. Bagden’s office telephone is also answered by an experienced staff professional who is immediately available to help schedule an appointment or help you resolve a question you may have about your treatment.
Dr. Bagden treats children at their individual optimal starting point from a growth and development perspective not from a pre-determined chronological age criteria.
Using the new Damon treatment system, number of office visits discomfort, and overall treatment time can be reduced significantly, offering patients flexibility, convenience, and hassle-free treatment involving less pain and use of light active forces.
Dr. Bagden is known for preserving the integrity of each smile through a concerted effort to retain all teeth. He has had great success in producing full smiles and profiles through non-extraction.
Dr. Bagden is one of the most experienced practitioners in the mid-Atlantic region in handling pre-prosthetic and adult treatment, resolving periodontal issues, and integrating surgical solutions to ideal finished smiles.
Because of Dr. Bagden’s consulting relationship with the leading orthodontic suppliers, Ormco and Allesee Orthodontic Appliances, he uses the very latest in treatment appliances to offer the most minimally invasive treatment possible to patients.
Expedites delivery of retainers and other appliances. If an appliance is lost a new one can be made quickly and easily so as not to delay treatment.
Dr. Bagden and Dr. Coffelt work collaboratively in one office to provide concentrated, high-focus service.
To accommodate working patients and parents, Dr. Bagden maintains early morning and late evening office hours and is open on most major holidays.
Dr. Bagden’s office accepts assignment of benefit from most major insurance carriers. Patients are not required to continually fill out reimbursement forms.
In 1997 and again in 2003 Drs Bagden and Wallert were listed in the elite group of “Top Orthodontists” in the DC Metro area by Washingtonian Magazine. In addition Dr. Bagden was named a top orthodontist in America by the Consumer Research Council of America in 1998.
Initial assessment exams are performed at no charge. During this visit Dr. Bagden will discuss probable length of treatment, types of treatment options that may be feasible, possible appliances that may be used to achieve the desired result, and probable fees.
If treatment is indicated, diagnostic records to be evaluated during treatment planning are gathered. These include: facial and dental photographs, x-rays of the teeth, bite registration, and impressions of the teeth for study models. Dr. Bagden evaluates each case and structures a treatment plan to achieve maximum result in minimal time. There is a charge for these diagnostic records.
Fill out this health questionaire and bring it with you on your first visit to help expedite the evaluation process.
Orthodontic separators, also known as spacers, are rubber bands that make room for the metal bands we will fit around your teeth at your next appointment.
Separators may make your teeth sore and tender for the next 24 to 72 hours. This is a normal reaction for teeth that are moving. An over the counter pain reliever such as Tylenol often helps relieve the discomfort.
If a separator comes out and it is not lost or swallowed (they are digestible), rather than coming back to the office, you may wish to try to replace it yourself by using two pieces of dental floss as follows:
Using the dental floss as a handle, gently slip the separator between the teeth until it is in place and then slowly pull the floss out by one end. With young patients sometimes, so much space is created that the separator is difficult to keep in. If this is the case, wait for one day and try to slip it in again. Separators are an important part of your orthodontic treatment. They will make your first banding appointment much more comfortable for you if they are left in place. If one or more falls out and you are unable to guide it back in, please call the office so we can replace them in a timely manner.
The Damon philosophy recognizes that to limit diagnosis exclusively to hard-tissue cephalometric criteria ignores soft-tissue symmetry. Of course, achieving the best facial balance possible must be done in conjunction with conventional treatment goals. The Damon System offers a unique mechanical system a passive conduit that permits low forces to work in conjunction with the muscles of the face, tongue, bone and tissue. Low forces minimize discomfort and greatly increase the types of cases that can be treated to a symmetrical facial result without high-force expansion or extractions.
Actually it is a revolutionary approach to orthodontic treatment due to a unique orthodontic bracket which is attached to the teeth. Traditional braces used wires or elastics to hold the wire in the bracket.
The Damon bracket utilizes a sliding mechanism ( not unlike a trap door) over the bracket which allows the wire to be secured to the bracket without the need for ties and the added friction and forces they require.
Dr. Bagden’s treatments now require far less extraction of teeth to achieve beautiful results because the Damon brackets allow him to work within the normal biological range of forces rather than overpowering the body’s biology. Damon brackets are beneficial for patients of all ages. Adult patients benefit from them because of the low forces and can now enjoy faster treatment than ever before. Damon brackets are also indicated for patients with periodontal (gum) problems due to the light forces they deliver. As a result all of our patients’ treatments can now be finished in less time, with fewer visits and far less discomfort than ever before. Dr. Bagden continues to improve the technique, and being recognized for it, publishes many articles and book chapters on the technique. In addition he conducts many seminars world wide concerning the Damon Technique. Feel free to ask him or one of the staff about the Damon System. Ask one of them to show you the difference between the traditional method of tying braces and the Damon method of passive self-ligation.
Damon Clear is HERE-We’re excited to offer the first COMPLETELY CLEAR passive self-litigating orthodontic bracket (Damon Clear) to our patients.
Treatment forces should be just high enough to stimeulate healthy tooth movemnet without occluding the blood vessels of the ligament which surrounds the tooth. By applying light continuous forces throughout every phase of treatment, we’re able to achieve healthy, comfortable and efficient tooth movement.
“What is so striking about the Damon System is that I can start my cases with a .014 Ni-Ti and the teeth will level and align far quicker than what I had ever seen with conventional braces and with much less patient discomfort. I am amazed to see how by using Passive Self-Ligation combined with light, constant forces at the beginning of treatment, we are able to work with the muscles of the face to poduce a lip bumpering effect on the upper and lower incisors. Instead of incisors dumping labially a posterior expansion is produced.”
This is a non-removable orthodontic appliance that is used for the treatment of an overbite. The Herbst appliance, developed by Dr. Herbst, holds the lower jaw forward in a normal biting position by means of telescoping metal rods. The appliance creates a desirable facial change immediately and, even though the muscles of the face may appear tense at first, these muscles will soon relax.
Typically, the rods are worn for 12 – 18 months with adjustments every six to eight weeks to accomplish the forward movement of the jaw. The last two months can actually create an underbite as the teeth may be overcorrected in anticipation of some relapse when the rods are removed.
At first, the lips, cheeks and teeth may become sore. An over-the-counter pain reliever such as Tylenol will help to relieve this discomfort. Since the upper and lower teeth do not usually fit together for the first two to four weeks, a softer diet is recommended for the adjustment period. Wax may be placed over any part that is irritating the cheeks. Attempt to dry off the area thoroughly with tissue before applying the wax. If the wax does not stay on, consider trying some moldable silicone ear plugs available at any drug store. The silicone can be used in the place of the wax and is much more tenacious.
Please avoid hard, sweet and sticky foods. Brush your teeth and gums, the appliance and the areas around the appliance carefully an often. It is possible in some cases for the rods to disengage by opening the mouth too wide. This can be corrected by opening wide again and reinserting the rods in the sheaths which we have demonstrated for you.
We truly appreciate and understand the difficulty you might have adjusting to the Herbst and the rods. Once you have become accustomed to the appliance, we feel you will be very pleased with the rapid results. If you have any questions, please do not hesitate to call us.
The purpose of your new headgear is to help correct the overbite (protrusion) between your upper and lower teeth. Headgear uses the top of your head or the back of your neck as an anchor. By faithfully wearing your headgear, you are playing a big part in straightening your own teeth.
It will take several days for you to get used to your new headgear. Practice putting it on and taking it off in front of a mirror to begin with. This will be difficult at first but will soon take little effort. During the first week patients work up to the desired number of hours. Typically, the headgear must be worn a minimum of 10 hours per 24 hour day, unless we indicate otherwise. We suggest wearing it after school until dinner time, after dinner until bedtime and all night while you sleep. You have the option of wearing it to school or the workplace.
The more you wear your headgear, the better and faster your teeth will move. You cannot wear your headgear for too many hours. You can try snacking or drinking through a straw with your headgear on, but it is best not to wear it when you are eating, playing an active sport, horsing around, or swimming. Please keep track of the total daily hours on the calendar we give you. Please bring the headgear and calendar with you to all appointments.
If any part of your headgear breaks or gets bent so that it fits improperly, or just does not seem to fit correctly, please call the office for an appointment to have it adjusted or repaired. If you lose your headgear, there is a replacement charge.
We want your treatment with us to progress as quickly and successfully as you do. The more you wear your headgear now, the sooner your daily hours will be reduced and the sooner your treatment will be completed.
The purpose of your new facemask is to help correct the underbite between your upper and lower teeth. It does this by using the front of your head as an anchor to move the upper teeth and jaw forward.
By wearing your facemask, you are playing a big part in straightening your own teeth. You must wear it faithfully for successful results. It will take several days for you to get used to it. Practice putting it on and taking it off in front of a mirror to begin with. This will be difficult at first but with practice it will soon become much easier. During the first week you will work up to the desired number of hours. The facemask must be worn a minimum of 10 hours per 24 hour day unless we indicate otherwise. The more you wear your facemask, the faster your teeth will move. You cannot wear it too many hours. We suggest wearing it after school until dinner time, after dinner until bedtime and all night while you sleep. You may also wear it to school or work. You can try snacking or drinking with a straw with your facemask on, but it is best not to wear it when you are eating, playing an active sport, horsing around or swimming. Please keep track of the total daily hours on the calendar we give you and please remember to bring the facemask and calendar with you to all appointments.
The chin can sometimes become irritated and chafed from the facemask. Try using only the plastic piece to begin or put moleskin (replace it regularly) or pads to protect your skin. Use any moisturizing cream a couple of times a day on any dry skin. If the skin gets too uncomfortable, discontinue the facemask for a few days. If this irritation returns again upon wearing the facemask, please call the office. We do have a silicon putty that can be applied to the chin piece at your next appointment.
If the jaw joint next to the ear becomes sore or it is difficult to open or close your mouth, please stop wearing the facemask and call the office. You may need a differently designed facemask. If any part of your facemask breaks or gets bent so that it fits improperly, or just does not seem to fit correctly, please call the office for an appointment to have it adjusted or repaired. If you lose your facemask, there is a replacement charge.
We want your treatment with us to progress as quickly and successfully as you do. The more you wear your facemask, the sooner your daily hours will be reduced and the sooner your treatment will be completed.
The Lip Bumper is a wire and tube that is placed between your lower teeth and lower lip. It changes unfavorable muscle imbalances of your lip and cheeks. It moves teeth into a more favorable position, creating additional space for crooked and crowded teeth to align.
You may experience one or two days of soreness in your lower back teeth which have bands on them and are used to anchor the Lip Bumper. We recommend that you eat soft foods that do not require a lot of chewing and take Tylenol if the soreness bothers you. The soreness will gradually go away in two to three days. After several days, you may notice redness or a slight groove in your cheek or lip in the area of the lip bumper. This is normal and is not a cause for concern. If the area becomes extremely irritated, please call the office so we can make the proper adjustments.
We will show you how to brush your teeth around the Lip Bumper. This is very important as the Lip Bumper acts as a shield and you must angle your toothbrush to remove all the plaque from your teeth (and from the Lip Bumper).
You will probably be wearing the Lip Bumper for 12-18 months so we want to make sure it is very comfortable. The Lip Bumper significantly reduces the possibility of extracting teeth, reduces the amount of time for braces on all your teeth, and will give you the healthy teeth and beautiful smile that is our goal.
Elastics are very important to the progress of your treatment. They provide the force or “pull” needed to move your teeth into a proper alignment to achieve a good bite. Before you leave the office, make sure that you understand where to place your elastics. You may need to use a mirror at first, but you will soon be able to change them without a mirror and with very little effort.
For elastics to be effective, they must be worn as close to 24 hours per day as possible,every day. Constant wear of your elastics is essential. If you forget to wear them for one day,the progress that you achieved for the last two days may be lost. NIGHT TIME ELASTIC WEAR ALONE WILL NOT MOVE YOUR TEETH. You should take your elastics off only to eat and to brush your teeth. When you remove them, put them on your little finger, this is so you remember to put them back on. Some patients choose to eat with their elastics on and are rewarded with getting their braces off sooner.
For the first few days of using the elastics your teeth will probably be sore. This is normal. As soon as the teeth get used to the new pressure, the soreness will disappear. A pain reliever such as Tylenol might be helpful. As long as you continue to wear your elastics, the teeth will not be sore again. However, if you take a long break from the elastics, you may need to go through the one to two days of soreness again.
Make you have enough elastics before you leave the office – take as many packs as you need. If you run out or lose them, come in and pick some up or call our office and we will mail some to you.
If you follow the basic instructions that we have given you and wear your elastics all day and all night, your treatment will progress as planned and you will be on your way to a beautiful, healthy smile!
We’re excited to offer the first COMPLETELY CLEAR passive self-litigating orthodontic bracket (Damon Clear) to our patients. Specifically designed for those patients who desire traditional orthodontic treatment with the least noticeable braces, these brackets are manufactured from a crystalline material which is clear, durable and comfortable…and they won’t stain with food or beverages! We’re thrilled that the Damon System has chosen our office to present this bracket to our Northern Virginia, Washington DC and Southern Maryland patients. Ask us about them…we think the choice is clear…DAMON CLEAR.
The Damon hybrid bracket (D3 brackets) were developed as an option for those patients who want the treatment efficiency of the Damon System as well as the cosmetic benefit of a clear bracket. 60% of the bracket is clear, making them virtually undetectable, while the remaining 40% is metal which allows the metal wire to easily slide through the metal slot without introducing excessive friction and resistance. There is no additional charge for this feature.
The smallest Damon metal bracket in use. Created for maximum efficiency, maximum strength, maximal comfort and minimal visibility. The standard bracket in use in our office. Again, no additional charge for our patients for this new, high-technology bracket.
Eating Habits and Orthodontics: Much work and effort has gone into the construction and placement of your orthodontic appliances. We encourage you to take care of your braces by keeping them clean and being very careful with the types of foods you put in your mouth. Breakage of your braces results in extra appointments (usually during school hours) for repairs and will lengthen the total time of your treatment. Please refer to the following recommendations on eating.
Hard foods may cause damage by bending the wires, loosening the cement under the bands or breaking the brackets that are bonded to the teeth. Examples of those foods are listed below along with the ways that they may be eaten:
Please do not eat nuts, hard pretzels, hard pizza crust or chips. The top half of the popcorn bowl is fine to munch on, but stay away from the nuggets in the bottom. CHEWING ICE CUBES IS STRICTLY FORBIDDEN!!!
Sticky foods can damage the appliances by bending wires and loosening the cement, actually pulling them off the teeth. Please do not eat Taffy, sugar daddies, peanut brittle, caramels, candy apples, licorice or any of the currently popular types of sticky candies such as Starbursts, Skittles or Now and Laters.
No gum of any kind, please.
Foods and drinks high in sugar content should be limited. The germs (bacteria) that cause tooth decay, decalcification and gum disease need sugary food on your teeth in order to live. Sweets provide an excessive food source for these germs to produce their bad effects. Please brush your teeth immediately after each meal, since most of the damage occurs within the first half hour after eating. Be especially careful that the area between the bands and the gums is shiny and clean.
Plaque and food debris accumulate on the surfaces of the teeth, especially around brackets, bands, and wires, and can cause tooth decay and gum disease. It is important to clean your teeth and brackets to prevent this from happening. You may need to use more than one cleaning device. When you begin to floss and brush properly, gums that have not been kept clean may become sore and bleed. After a few days of proper care, the gums should stop bleeding and heal. Remember that extra time and care should be given to oral hygiene during orthodontic treatment.
You should ordinarily brush with a soft toothbrush and use moderate force. Place the toothbrush at an angle so that you feel the bristles under the gum line, and move the brush back and forth in short strokes. Work your way systematically from one side of the mouth to the other. Make certain you brush all surfaces of all teeth. Spend enough time to make sure you clean your teeth properly (at least 3-4 minutes). You should brush your teeth after every meal and before going to bed. Remember that a toothbrush cannot reach areas between the teeth, so for a proper cleaning you should also use dental floss.
An interdental toothbrush is designed to clean areas that a regular toothbrush cannot reach. Using an interdental toothbrush, clean around the bonded appliance and under the wires with slow, repetitive movements. Work systematically and make sure you clean all parts of the appliance.
Many patients achieve good oral hygiene with electric toothbrushes. Dr. Bagden recommends them as hygiene results are so superior. Consider the Sonicare, Braun, or Rotodent brands.
Dental floss is a nylon thread that is used to remove dental plaque and food debris that accumulate between the teeth. Start flossing on one side of the mouth, and systematically work your way to the opposite side. To begin, cut off a piece of dental floss that is long enough to wrap around the middle finger of each hand. Guiding the floss with your thumbs and index fingers, insert it between the teeth by gently moving it back and forth. Don’t snap the floss, as this can hurt your gums. Scrape the surface of the tooth clean by moving the floss up and down. Then clean the adjacent tooth in the same way, and move on to the next interdental space.
Change the position of your hands to maintain a convenient grip on the floss. Do not forget to floss all your teeth, including those in the back. Also remember not to snap the floss when inserting it and to use gentle movements when you scrape the side of the tooth under the gum line. Flossing can injure your gums if done improperly.
Flossing is more difficult when you have orthodontic gear bonded to your teeth. You may find it necessary to insert the floss under the wire with a device called a floss threader and then slide the floss gently between your teeth. Be careful not to apply too strong a force on the wire. Superfloss, a special kind of thick, fluffy floss may be helpful for cleaning under the wires. Remember to use gentle movements when you scrape the side of the tooth under the gum line and not to snap the floss. Flossing can injure your gums if done improperly. Do not forget to floss all your teeth, including those in the back.
An appliance tends to accumulate plaque and food debris just the way teeth do. It should be cleaned daily with a toothbrush. You should also soak your appliance several times a week in a glass of lukewarm tap water with one or two denture-cleaning tablets. Whenever you’re not using the appliance, keep it in water. You may add a little mouthwash to keep it fresh. Do not use hot water, which could damage the appliance. Appliances are breakable. If they become damaged, they must be replaced. BE CAREFUL!
Brackets tend to irritate the lips in the first few weeks. Lips get drier and sometimes start to bleed. Apply a lubricant such as Vaseline or Chap Stick to the lips, and place wax on the orthodontic devices to protect the lips from sharp edges. If soreness lasts more than a few days and wax does not help, call our office and ask whether an early appointment should be scheduled.
When pressure is applied to the teeth, you may feel some tenderness which usually persists for 2-3 days. The intensity and duration of the discomfort will vary with each patient. If you feel an unusual amount of pain or discomfort, please call the office immediately at
If your headgear tends to fall off at night or cause any other problems, call your orthodontist for advice. Important: If a loose bonded appliance injures your soft tissue, try to put some wax on the part of the appliance that is irritating you. Call our office to make an earlier appointment. The appliance should be rebonded as soon as possible but does not usually require emergency attention.
Although uncommon, allergies to brackets or other metal appliances and sometimes even to latex gloves do occur. If allergic symptoms such as inflammation and skin rashes appear, you should call contact our office as soon as possible.
Orthodontic appliances are designed to move teeth in all directions. Sometimes teeth will move in a direction that seems to be wrong. Be patient. Usually this happens when tooth movement has just begun and only one direction of movement can be seen. Undesired tooth movement can occur also when brackets come off, when the force being applied is too strong, or when wires are bent and damaged. Call for us to check whether an earlier appointment is needed.
If a broken appliance can be easily removed, take it out. If not, cover the sharp, irritating parts with wax or chewing gum. However, when a wire is sticking out and wax does not help, you should call the office. If professional assistance is not available, the wire can be cut with a small wire cutter. A broken appliance that does not cause any irritation does not usually require emergency attention.
If oral hygiene is not properly maintained during orthodontic treatment, the gums may become swollen and start to bleed. Special care, including brushing the gums gently and rinsing with mouthwash or warm saltwater, usually helps return the gums to a healthy condition. Use dental floss to check whether food is stuck between your teeth. Sometimes swollen gums are caused by the orthodontic movement of the teeth. See the section on oral hygiene, and call to check whether an earlier appointment is needed.
Loose metal parts of a removable appliance may no longer hold it in the mouth and should be tightened. Erupting teeth may result in an improper fit of the appliance. Remove the appliance and call to make an earlier appointment.
It will usually pass through your digestive system and out of your body. However, if you have difficulties in breathing, you should seek immediate medical help.
PLEASE DO NOT WAIT UNTIL YOUR NEXT SCHEDULED APPOINTMENT. CALL US IMMEDIATELY AT (703) 451-3900 EVEN IF YOU HAVE AN APPOINTMENT THAT DAY, SO WE CAN SET ASIDE THE NECESSARY TIME FOR THE REPAIR.
Decay can develop under a loose band if left unrepaired for too long.
If it is a small tie wire, you may remove it and call the office. If it is the main arch wire (which connects all the teeth), try to move it so it is comfortable and phone the office for an appointment. If it is not possible to make it comfortable place and you are unable to come to the office immediately, please cut the wire as close as possible to the nearest bracket it is still secured to (use a small wire cutter or fingernail clipper). To prevent irritation, use wax. Open the wax container, take out a small piece of wax, and apply it directly to the irritating part of the appliance. Press gently and smooth it out with your finger. You should continue brushing your teeth and brackets even when you have wax in your mouth. Remember, wax is harmless and can be applied as often as necessary. Do not worry if you swallow it.
Use the wax we have provided to cover the irritating part and call the office for an immediate appointment. Please remember to dry off the area first so the wax will stick better. If you do not have wax with you, use cotton, tissue, or gauze until we can take care of the problem. Moldable silicon ear plugs, available at any pharmacy, work very well. Sometimes the eraser end of a pencil can be used to push a small poking wire back into place.