In light of the current coronavirus pandemic and guidance from national authorities, we have taken the decision to fully suspend activity to protect the general wellbeing of our patients, our staff and the community by limiting travel to and from the practice.
We are experiencing a very challenging time and as you can imagine, the Corona Virus represents a very unique challenge to us as a dental practice. We understand the anxiety from all the uncertainty that many of our patients are living through. This is a completely new ground for all of us too.
We have to balance first and foremost your general health, the timing of your dental treatment and our professional responsibility towards helping stop the spread of the virus by limiting movement of people to and from work or to our practice and person to person contact.
In line with National Guidelines we have temporarily suspended all activity to protect our patients, staff and the local community from becoming infected and spreading the new COVID19 virus. All routine appointments booked until end of April 2020 have now been postponed until further notice in all of our practices.
EMERGENCY PATIENTS ARE ADVISED TO CONTACT NHS 111 BUT PLEASE APPRECIATE THE PRESSURE OUR NHS IS GOING THROUGH WHEN DECIDING IF YOIUR PROBLEM IS URGENT OR CAN WAIT.
Currently there is planning underway to establish urgent NHS dental care centres. As soon as we have information as to where these will be located, we shall update this section on our website. We are still able to provide advice and recommend you to e-mail us with your query. We will aim to get back to you as soon as possible.
Please follow the recommended emergency orthodontic protocols created by the British Orthodontic Society. Most orthodontic appliances can be left in situ for some months without detriment to the patient if the patient continues with the usual after care instructions. Common ‘emergency’ brace problems and solutions: If you are an orthodontic patient following the advice contained here PLEASE where possible contact your orthodontic HCP first to ensure that you are carrying out procedures safely and not producing other aspects of your orthodontic appliance.
WIRES DIGGING IN:
- If a thin wire, it may be possible for the patient or family member to use tweezers to replace wire in the tube or band. Or use tweezer and nail clipper/scissors to shorten the long end.
- It may be that a thin wire is the correct size but may have rotated round the teeth so that it is short on one side and long on the other. Using tweezers a pencil with a rubber on the end or a teaspoon, it may be possible to push the wire back round to prevent the long end digging in.
- If the wire is very thick and stiff, discuss with your Health Care Professional (HCP) it may not be possible to cut the wire with home care instruments. If this is the case it may be necessary to cover the wire to prevent it being sharp. Relief wax/silicone may be sent to you or you can buy it online (Orthodontic Wax) Failing that using a wax covering from hard cheese or sugar free chewing gum may help.
BROKEN BONDED RETAINERS:
- Push back wire down towards the tooth as much as possible (Fingers or tweezers)
- Cover with best medium available (Orthodontic wax, Cheese wax or Sugar free chewing gum)
- Cut the exposed unbonded wire using tweezers and nail clippers/scissors
- Gently pull the wire to remove the whole retainer
- Advise greater use of removable retainers if present (If not please seek advise from our HCP)
- Contact HCP – it may be that your unit has access to your final moulds and can make a new retainer remotely which can be posted out to you
- If it not possible to get a replacement retainer you could consider ordering online a “boil in the bag” (heat mouldable) gumshield to use and wear at night to reduce the risk of relapse (unwanted tooth movement). It should be noted that these appliances aren’t specifically designed to hold teeth in position so the manufacturer cannot be held responsible for any relapse. Please contact your HCP before investing in this strategy to ensure all aspects of this compromise for retention are understood.
- If the gold chain was recently place and is now dangling down, it may be possible to cut it short. Gold is quite a soft metal and it may be possible to cut the chain using some nail scissors or nail clippers. Always hold the loose end with tweezers or similar item. If possible leave at least 5 links through the gum so it can used later by your orthodontic team.
- If you have a none dissolvable coloured stitch discuss with your HPC about the feasibility of removing it at home using nail scissors to prevent a minor infection in the gum.
- Discuss with your local hospital team your specific concern/problems for the best advice
- Consult yourjawsrugery.com for general post op advice (https://www.bos.org.uk/Portals/0/Public/docs/Your%20Jaw%20Surgery/After_Surgery_Advice_%20Final-V2.pdf)
- Stop or reduce post-surgery elastic wear as advised by your HPC.
- If your current aligner is in good order keep wearing it as much as possible
- If your current aligner is broken or ill fitting, step back to your previous aligner
- If neither option is open to you, ring you HPC for advice. It may be possible to have a new aligner at the correct stage made for you and sent out to you, or with advice from your HPC a ‘boil in the bag’ (heat mouldable) gum shield to use and wear at night to reduce the risk of relapse (unwanted tooth movement). It should be noted that these appliances aren’t specifically designed to hold teeth in position so the manufacturer cannot be held responsible for any relapse. Please contact your HCP before investing in this strategy to ensure all aspects of this compromise for retention are understood
(This is not urgent unless it is causing trauma to the soft tissues)
- It may be possible your HPC can guide you on how to remove the bracket from the wire via video if it is causing trauma.
- It may be the possible to leave the bracket if it is not causing any problems at present. Consider contacting your HPC for advice.
- At this time if you run low or out of elastics your HPC may either send you some more out via the post or advice cessation of wear.
MOLAR BAND OFF:
- If band is very loose your HPC may be able to talk you through removal of the band and trimming of the wire depending upon your stage of treatment.
- It may also be also be the case your HPC advises you to leave the band in place. If this occurs please ensure you adhere to good oral hygiene and a low sugar diet to prevent decay under the band and around your tooth.
BAND OFF QUADHELIXES, RME, TPA +/- NANCE:
- Discuss with your HPC about the nature of the looseness and take advice accordingly.
- Push band back onto tooth if it will locate and ensure you adhere to good oral hygiene and a low sugar diet to prevent decay under the band and around your tooth.
- Check for comfort and retention
- If unsure about how much to continue to wear the appliance discuss with your HPC
- If fractured or ill-fitting do not wear the appliance
- These should be removed at the earliest opportunity – Attempt removal with end of safety pin, small paper clip or wooden tooth pick
- No action required – try and make wire where the module has been lost secure with orthodontic wax, cheese wax or sugar free chewing gum
TEMPORARY ANCHORAGE DEVICES TADS:
- HPC may assist you in removing and springs or elastic chain moving the teeth.
- Stop wearing
- No treatment required
FRACTURED/FRAYED POWER CHAIN:
- Accept situation– most powerchain will denature in 4-6 weeks and become passive
- Remove powerchain with tweezers if necessary
- Cut frayed end as short as possible to improve comfort
EXPOSED END OF WIRE TIE – LONG LIGATURE OR SHORT LIGATURE:
- Re-tuck sharp end under wire/bracket using tea spoon or tweezers
- Remove wire if broken with tweezers if possible
- Cut fayed end as short as possible to improve comfort with nail cutters or scissors
- Cover for comfort using Ortho wax, Cheese wax, Sugar free chewing gum
We would suggest that you maintain an optimal level of oral hygiene, use your interdental brushes/floss and continue to brush your teeth after meals, to prevent any gum inflammation. We would also suggest that you avoid foods that may cause your braces, removable appliances, aligners, retainers and all other orthodontic appliances to break. We realise that this for many of you will be an inconvenience and as such we apologise, but at this stage of the COVID19 outbreak our emphasis has to be on keeping you and your loved ones safe, keeping our team healthy and doing our best to reduce person to person contact and travel.
We are available to answer any questions you can still contact us by email as these is monitored regularly. We aim to respond within 24hrs to all emails. Below are suggested protocols to follow when you attend an acute orthodontic emergency appointment at your local dental urgent care units:
- When entering the practice, please use the hand sanitisers provided and if required, allow our team to take your temperature. If your temperature is over 37.5, we will not be able to see you and will advise you to follow NHS self-isolation advice of minimum 7 days.
- Remain 2 meters away from ALL other persons where possible and at least 1 meter away from reception desk.
- Avoid touching unnecessary surfaces, your eyes, nose or mouth if your hands have not been cleaned.
Please do not attend if you or someone in your household has:
- Been recommended to self-isolate
- A high temperature
- A new persistent cough
- Been in contact with a confirmed or suspected carrier of COVID19.
We would like to again send our apologies for the inconvenience but we need to work together so that we overcome this difficult time in humanity.