Patient Resources - Emerick Orthodontics

Your Orthodontic Roadmap

Our Emerick Orthodontics team in Carmel is here to support you through your orthodontic treatment. Here, you'll find all the key information and instructions you need to stay on track.

From tips on caring for your appliances to troubleshooting common issues, consider this your go-to resource for an easy, successful treatment.

How Does My Insurance Work?

These are some of the most common questions about insurance we get at Emerick Orthodontics.

Will my orthodontic insurance pay all at once?

The short answer is “no.” Orthodontic benefits are paid over the course of the entire treatment time.

Insurance plans usually do not pay their amount in full as they know most treatment plans may take anywhere from 9 to 12 months (Phase 1) or 18 to 24 months (Comprehensive Treatment).

Most orthodontic plans usually pay a percentage at the beginning and then make monthly or quarterly payments throughout the course of your treatment. This is because there are multiple adjustment visits, and they are not all performed at once.

What happens if I change employers?

If you change employers, your benefit from the first employer will be stopped automatically and they will not pay any more at that point.

Your new insurance information will need to be entered and a new claim will be submitted to your new insurance company from your new employer and location.

Additionally since insurance companies do not pay their portion of your benefit in full, if you drop or lose your orthodontic coverage before treatment is finished, they will stop payments at that time and you will not receive the full benefit.

This means at that point you will be responsible for the remaining balance.

How can Emerick Orthodontics help me with my payment & insurance coverage?

Orthodontic Care 101

Need to know what do do to keep up with your current appliance or treatment plan? Look no further.

Clear Aligners

Congratulations on beginning your clear aligner treatment! We are so excited to watch your smile transform! Your aligner delivery appointment is an exciting day, so sometimes patients forget the instructions explained at this appointment.

For your convenience, we have outlined our aligner instructions below. As always, please call us at (463) 266-4656 or email us at [email protected] if you have any questions.

Attachments

Aligner Insertion

Aligner Removal

Aligner Numbers

24/7 Wear

Food & Drinks

Do not eat or drink anything except plain water with your aligners in place. Sugary/acidic food and beverages can become trapped under your aligners and cause tooth damage. Colored beverages can stain your aligners. Drinking water with your aligners in is perfectly safe!

After you eat or drink, we recommend brushing your teeth before replacing your aligners. If you do not have time or access to brush, please rinse your mouth with water to remove food debris then brush when you get home.

When eating or drinking, please store your aligners safely in your aligner case.

Tracking

Tracking means that your teeth are fitting perfectly into your aligners. Do not change your aligners until all teeth are tracking perfectly. There should be zero “air space” between the edges of your teeth and the aligner.

If there is an air space, please wear the aligner for a more extended period until it fits. We do not recommend progressing into new aligners unless you are tracking perfectly.

If you have worn an aligner for 2 weeks and it still does not track, please call our office to schedule an appointment.

If you experience tracking problems, we recommend using a chewy or bite stick to help the aligner track. Please bite into your chewy or bite stick in 15-second increments for 15 minutes a day to help the aligners track.

Changing Your Trays

Please wear each aligner set for a minimum of 1 week. You will change into a new aligner set on the same day each week. If you experience tracking issues, please stay in your current aligners until they fit perfectly.

Always keep at least your most recent aligner set as a backup. Ideally, you would keep all of them just in case adjustments are needed.

Your teeth will be sore 24-48 hours after progressing to the next aligner because they are moving! You should feel free to take an over-the-counter pain reliever (whatever you typically take for a headache) to make yourself more comfortable during this period.

Cleaning Your Aligners

What If I Lose an Aligner?

Lost an aligner? Life happens… no worries! Please move forward to your next aligner set. You may need to wear this set longer (2 weeks) in order for it to track correctly.

If you do not have any future aligners, please go back to wearing your most recent aligner set and call our office. For example, if we give you aligners #1-12 and you lose #12, please go back to wearing #11.

If you did not save a backup set, please get in touch with our office immediately, as this is an emergency.

What Are Bite Turbos?

A Bite Turbo, bite ramp, or bite block is used to help with misaligned bites. These are used simultaneously with braces. They are bonded to the back of the teeth or on a biting surface. Their purpose is to prop your bite open, which will keep you from biting off any bracket.

Remember! What we do to one side, we do to the other side! The reason is to keep the bite as even as possible. Therefore, you will have two, one on each side. Dr. Emerick will determine whether or not you will need bite turbos.

What Are the Different Types of Bite Turbos?

L-shaped bite turbos are bonded behind your front teeth; these can also be metal. At Emerick Orthodontics, we prefer to use the adhesive material over the metal ones.

Bite props, or bite pads, are bonded to the back of the teeth. This could vary as to what teeth they will go on, depending on each individual’s bite. They can, at times, be bonded to the biting surface of the upper or lower first molars.

At times, they may be bonded onto the canines or even onto the premolars.

How Do Bite Turbos Help With My Bite?

What Can I Eat With Bite Turbos?

Be patient! It will be challenging adjusting to having braces with Bite Turbos! Chewing can become tricky. When Bite Turbos are placed in the front, your back teeth will not touch, and when the Bite Turbos are placed in the back, your front teeth will not touch.

Stock up on soft, easier-to-chew meals, such as mashed potatoes, mac and cheese, soups, apple sauce, smoothies, ice cream, yogurt, etc. You will slowly start adapting to your new way of biting.

Talking With Bite Turbos

How Long Do Bite Turbos Stay On?

What Do I Do If My Bite Turbo Comes Off?

Our Bite Turbos are pretty strong, so damaging them will take a lot. If one or both come off, please call, text, or email the office. We will schedule you a comfort visit. If a Bite Turbo comes off and you bite off any lower bracket, please let us know!

While we offer extended hours for wire clips and comfort visits, when repairing anything that must be bonded, Dr. Emerick HAS to be in the office.

Please be gentle with your braces and refer back to our diet list, where we go over all the sticky, hard, and chewy things we suggest you stay away from.

What Is a Carriere Motion Appliance?

The Motion is a bite correction appliance used before braces are placed on the teeth. It focuses on correcting the way the back teeth bite together. This is often the most time-consuming stage of treatment when done with braces alone.

With a Motion appliance, bite correction is completed faster and more comfortably, which ultimately decreases the total time in treatment.

How Does It Work?

Each Motion arm (right and left) has pads that get glued onto the upper canine tooth and the corresponding upper first molar tooth. Two hooks (one on each side) are cemented to the lower first molars.

Elastics (orthodontic rubber bands) are worn from the Motion arm on the upper canine to the brace on the lower first molar, which, over a period usually spanning 4-6 months, corrects the patient’s bite.

It is incredibly important that a lower clear retainer or a lower lingual holding arch is worn whenever elastics (rubber bands) are worn with the Motion appliance. Doing so would cause lower teeth to shift unfavorably and extend treatment time.

Elastics and the retainer need to be worn for 22 hours per day to be effective. You should change your elastics 2-3 times a day. After the bite is corrected, the Motion appliance is removed, and braces (or Invisalign) are placed on all teeth to continue treatment.

What Can You Expect?

Caring for Your Carriere

With the Motion appliance, you can brush normally. Floss will have to be threaded through the Motion to reach those teeth. To clean your lower retainer, use a separate toothbrush and antibacterial hand soap, and brush it thoroughly two times per day.

This is the most effective way to keep it clean. When the lower retainer is in, you cannot eat or drink anything except water. Any other food or liquid can seep in between the retainer and your teeth, which can cause staining and cavities.

Make sure to brush your teeth after eating/drinking, and place the retainer back in. When the retainer is not in your mouth, please make sure to store it in its case. If you have a lower holding arch appliance, make sure to brush around the bands and wire.

What Do I Do in an Emergency?

If a bracket becomes dislodged (or falls off), please stop wearing your elastics and contact us ASAP. We will get you in for repair within the week. If any piece of appliance comes off, please bring it to the office with you to your appointment.

Pain or poking? Use your wax for temporary relief. Call us, and we will schedule an adjustment. If you have a question, please feel free to text, email, or call the office at (317) 660-5552.

Hold On to Your Herbst

The Herbst appliance that has been placed in your mouth is a growth appliance. It is designed to assist you in changing the way your jaws line up with each other. With its use, we are attempting to change your skeletal pattern through growth.

As with any orthodontic appliance, you have to be very careful with it. If you eat things that are too hard or tough, or if you bite on things that are hard, you risk damaging the appliance.

Maintaining Your Herbst

Chew Carefully

Leave Your Appliance Alone

Sleep Habits

Patients Need Patience

Restricting Your Jaw Movement

With your appliance in place, you can open and close normally. However, do not try to move your lower jaw sideways very much at all. If you force your jaw sideways, you risk breaking the screw head off the top or bottom part of the appliance.

Avoid excessively opening your mouth. If you open too wide, the shafts on the Herbst appliance may come apart. If this does happen, just open widely again and attempt to put the two ends back together, then close.

You will have to work a little to make ends meet. When you try to close with the ends aligned, you may have to wiggle your jaw a little bit as you close to get the shafts to slide together.

Explaining Elastics

Elastics or rubber bands provide the connective forces needed to move your jaws and teeth into proper alignment. In other words, improve your bite.

It is important to wear them all the time; this will speed up the time spent not having to wear them.

How to Put Your Elastics On

Do's

Dont's

Take your elastics off if your teeth are sore. Every time you remove them for an extended period and put them back on, you're starting the adjustment period and any related discomfort over again. You'll get used to wearing them quickly, and the soreness will go away.

Double up on rubber bands or try to modify them in any way in an attempt to get them to work faster. Use any rubber bands other than the ones you were given.

Introducing Palatal Expanders

We use palatal expanders to:

Widen the upper jaw to create room for erupting permanent teeth in growing patients
Improve upper and lower jaw alignment due to a constricted upper arch
To enhance the esthetics of the smile.

What Happens After I Get an Expander?

When you first have the expander placed, your mouth may produce more saliva.

If this occurs, make a conscious effort to swallow normally by closing your lips and pushing your tongue up against the roof of your mouth. This will go away as your brain gets used to the expander – typically after a couple of days.

You may speak a little funny for a day or two until your tongue gets used to sharing space with the expander – but in no time, you will speak normally!

How Many Times Do I Turn the Expander?

How Do We Do the Turns?

In a well-lit area, firmly grip the blue key. Insert the key carefully into the hole in the middle front part of the expander. Push the key gently and steadily from the front toward the back of the mouth.

You should feel some resistance while turning it. You will notice that the next hole will rotate in position as you complete your turn. Remove the key by pushing it toward the throat out of the hole.

What Does It Feel Like When It Is Turned?

The expander, when activated or turned, can cause some slight discomfort and tenderness near the bridge of the nose and cheekbones. To relieve any discomfort, Dr. Emerick recommends over-the-counter pain relievers like ibuprofen or acetaminophen.

Take the dosage as directed on the bottle. It should not hurt at all to have your expander turned. If you feel any discomfort, please call our office to discuss. A tingling sensation may occur on the bridge of your nose.

Over time, you may develop space open between your two front teeth, but don't worry; it is only temporary.

How Do I Clean My Expander?

How Long Will My Expander Be in My Mouth?

Additional Expander Information

Attached to the upper molars through bonding or by cemented bands, the Rapid Palatal Expander is an orthodontic device used to create a wider space in the upper jaw.

It is typically used when the upper jaw is too narrow for the lower jaw or when the upper teeth are crowded or blocked out of the dental arch.

When patients are still growing, the connective tissue between the left and right halves of their upper jaw is very responsive to expansion.

By simply activating the expander by turning a screw in the center with a special key we provide, gradual outward pressure is placed on the left and right halves of the upper jaw.

This pressure causes an increased amount of bone to grow between the right and left halves of the jaw, ultimately resulting in an increased width.

Working With Removable Expanders

The Removable Palatal Expander is an appliance worn in the mouth to expand the upper jaw, which creates more space for the teeth and allows a better fit with the lower jaw.

Ground Rules

To be effective, your expander must be worn and taken care of as directed by our office. Below is some important information to help you achieve the best results.

The expander will remain in your mouth for up to 6 months. To activate the expander, turn the key once every 4 days until you are instructed to stop.

Activate the expander at the same time each day (most commonly before bedtime.)

Activating Your Expander

What Happens When You Turn the Key

Things to Keep In Mind

It is important to do everything with your mouth slowly. Eat, talk, and swallow very slowly for the first few days. After three days, you will feel better, and after 7 days, you will be fully adjusted to your new appliance. Some patients might notice an increase in salivation because the mouth thinks that the expander is food. This will also decrease with time.

Removable expanders require regular cleaning. They can be cleaned with dish or hand soap and cool water and gently scrubbed with a toothbrush. Toothpaste can be used but is abrasive and will cause the expander to appear cloudy over time. Avoid hot water when cleaning your expander since heat can alter the shape and fit.

Beware of your pets. Cats hide them, and dogs like to eat them. Protect your expander by keeping it in the case.

Remember: If it's not in your face, it's in your case!

Important Note: If you miss the next scheduled appointment, do not turn the expander for more than 24 turns. Contact our office at 317-660-5552 if you have any questions about your Removable Palatal Expander.

Tips for a Healthier Smile with Braces

Congratulations on starting your braces treatment. Here are some tips to help you make the most of it.

How to Clean Your Teeth With Braces

It is very important to keep your teeth and gums clean throughout your orthodontic treatment. Poor oral hygiene while in braces WILL result in decalcification, cavities, swollen tender gums, and permanent staining of your teeth.

Brushing With Braces

Flossing With Braces

Flossing with braces is especially important. They tend to trap more food between your teeth. They also make it more difficult to remove food particles by brushing alone. If you don't floss while wearing braces, cavities can be more likely to happen.

A few ways you can floss your teeth include:

Floss threader with regular floss.
Proxy brushes are useful for getting food out from behind the wire and are easy to carry with you.
A Waterpik is a great product to help wash out the food from brackets.

Decalcification & Inflammation

Bacteria in your mouth are irritants, and they create acids that can break down the enamel of your teeth. This can create areas of demineralization (often around a bracket), which shows up as white areas on the teeth.

This is called decalcification. Plaque and bacteria cause gingival inflammation. When bacteria remain on your teeth for too long, your gums become irritated, red, and swollen.

Troubleshooting Braces Issues

While you should do everything you can to avoid certain situations, sometimes things just happen. Here is a list of potential issues that can occur during your orthodontic treatment and how to fix them at home.

Remember, there are no real emergencies with braces. If an issue comes up, give us a call, and we will schedule your next available appointment!

Broken Bracket

If a bracket comes off, it still may be attached to the wire from the band around it. The result of this may be the bracket sliding around on the wire or causing discomfort.

What can you do? Pull a piece of wax about the size of the bracket and roll it in a ball, then gently push the ball of wax onto the bracket. This will make the bracket more comfortable and stick to the tooth until you can come back into the office.

Wire Woes

If the wire has come out of the last bracket, you can try to put it back into the tube by directing it with a clean tweezer plier. If the wire just seems to be long, first try to apply some orthodontic wax wherever the wire is poking.

If that doesn't help, you or a parent can cut the wire with a clean nail clipper or cuticle cutter at home. Cut the wire as far back as you can. If you can't reach all the way to the back, cut between two other brackets and pull the end piece of the wire out.

We will fix your wire at your next appointment. Is the smaller wire around the bracket poking you? Push the end of the wire toward your teeth with a pencil eraser. You can also gently push it in with your nail or apply orthodontic wax.

Braces FAQs

Got questions about your braces? Great! We’ve got answers.

How can I get my braces off sooner?

There are four main ways to help get your orthodontic treatment completed as efficiently as possible:

Keeping your appointments and being on time.
Do not break any brackets, and make sure you are following all of Dr. Emerick’s recommendations on foods to avoid and care for your teeth.
Wear your elastics as instructed.
Keeping your teeth and braces clean and healthy and visiting your general dentist for regular cleaning.

What happens if I break something?

Always call our office and keep us informed on how you and your braces are doing. We will let you know if you can wait until your next appointment or if you should come in sooner to have an adjustment made.

Always place any pieces in an envelope or plastic bag and bring them with you. Use this diagram to help you know the names of the appliances in your mouth. This will help you better explain to us when you call.

If the white spots are on my teeth after braces are off, will they ever go away?

Will my braces hurt?

Do I get to pick new colors?

What food do I have to avoid while I have braces?

Eating with braces is more about HOW you eat rather than WHAT you eat. Remember to take smaller bites and chew a bit softer. Hard food like apples, soft carrots, pizza crust, and bagels should be cut up or sliced and eaten on the back teeth.

Avoid extremely hard things like nuts, hard candies, chewing on ice, or pen caps. You should stay away from sticky food like taffy and caramels. You can continue to eat most of the foods you love, including soft gummies and sugar-free gum!

What to Eat (and Not to Eat) With Braces

Here are Dr. Emerick’s guidelines for what to eat with braces or a palatal expander.

Foods to Avoid (Hard, Sticky & Chewy)

Foods to Enjoy (Soft & Small Portions)

Post-Treatment Care

Now you know what happens before and during treatment. But what about after treatment? That’s where retainers come in!

The Purpose of a Retainer

Retention, or wearing a retainer, is very important in order to maintain your beautiful new smile and protect your investment in orthodontic treatment.

Teeth Will Shift

Types of Retainers

Dr. Emerick will recommend the type of retainer and how much wear is best for your individual needs.

An Essix (Invisible) retainer is made of clear plastic, very similar to the aligners worn during Invisalign treatment. This retainer fits snugly against your teeth and isn't noticeable to other people.
A Hawley retainer is made of acrylic and a metal wire to keep your teeth in place. This retainer is very durable because the patient does not bite on any plastic. This can also be worn during the day and transition into nighttime only.
A bonded retainer adheres to the back of the teeth; this is the only type of retainer that isn't removable. This is extra retention for lower incisors to help resist relapse. However, a lower removable retainer is always needed in addition to the bonded retainer.

Taking Care of Your Retainers

Removable retainers require regular cleaning. Both Hawley and Invisible retainers should be cleaned with dish or hand soap and cool water and gently scrubbed with a toothbrush. Toothpaste can be used but is abrasive and will cause the retainer to appear cloudy.

Avoid hot water when cleaning or storing your retainers since heat can also alter the shape and fit of your retainers. Also, beware of your pets. Cats hide them, and dogs like to eat them! Dr. Emerick reminds all patients that ‘if it’s not in your face, it’s in your case!’

Retainer Reminders

Essix and Hawley Retainers:

Do not wear your retainer (Essix or Hawley) while participating in sports or swimming.
Never eat anything while wearing your retainer. It is okay to drink PLAIN water while wearing the retainer, but remove them for anything else.
If you forget to wear your retainer, wear the retainer full-time for a few days to re-align your teeth. Your teeth may be sore while they re-align.
If you lost your retainer, cannot push the retainer in place, or do not fit it, contact our office AS SOON AS POSSIBLE! There will be a charge to replace lost or broken retainers.

Bonded Retainers:

It is very important to brush and floss under the retainer wire EVERY day. Food and plaque build up around the retainer and can cause tooth decay and irritation to the gum tissue.
Do NOT bite hard or sticky foods with your front teeth. This can bend the wire or loosen it from your teeth. Cut foods like apples and carrots into small pieces and chew them on your back teeth.
If your retainer is damaged or becomes loose, contact our office AS SOON AS POSSIBLE. Save the wire and bring it with you to your appointment. Wear your removable retainer full-time until you can be seen.

Nighttime for a Lifetime

At Emerick Orthodontics, we not only want to help you achieve a beautiful smile; we also want to help you maintain it for a lifetime. Retainers are essential to orthodontic treatment to help keep your teeth straight and healthy.

You must wear the removable retainers we give you at night to maintain your dental arch form and protect your bonded retainer. Retainers are nighttime for a lifetime!