Note to our orthodontic patients

I hope you and your family are staying healthy during these unprecedented times.  As you have already heard, our office has suspended all non-emergency care in accordance with the guidelines released by the American Dental Association and California Dental Association. 

If you had an appointment in our office scheduled that was supposed to occur during this time of closure, our office staff will be calling you to reschedule your appointment as soon as we receive guidance from the health authorities that it is safe to proceed.  

I understand that some patients may be anxious that you can not come in for your regular orthodontic appointments during this time. However, our staff and I will work hard to get your orthodontic care back on track soon, when we can do so without exposing you or your loved ones to unnecessary risk.   Many orthodontic procedures, including simply replacing broken or loose brackets, require the use of compressed air to dry tooth surfaces before adhesive is applied.  This can aerosolize oral secretions, and place patients and staff at risk of exposure to the coronavirus if there is a patient who is an asymptomatic carrier. 

If you have any urgent needs during this time (for example a loose appliance), I will certainly be available for emergency troubleshooting (via phone or FaceTime) or appointments if necessary. In the meantime, I have listed some common questions (and their answers) below:

  1. What constitutes an orthodontic emergency? Normally we are pretty lenient with this definition, and if you break a bracket we see you in to get it repaired fairly quickly. But, at this time we will be limiting emergencies to true dental & orthodontic emergencies. This means facial trauma (for which you would call an oral surgeon) or if you have an appliance that is loose (we will remove it for you and replace it at a later date). 
  2. What if you have a broken bracket or a poking wire?  In most cases, this will not constitute as an orthodontic emergency.  Many if these instances can be managed at home with wax (and in some cases, tweezers and nail clippers!). We have uploaded several videos on our website to help troubleshoot some of your questions including: 
    • What happens if a bracket pops off? 
    • What do I do with a poking wire (how to cut & remove wire if needed)? Please remember to hold the free end of the long wire prior to cutting it!
    • How do I get wax to stay on better?

If you have concerns after reviewing these videos, please give me a call and I will be happy to give you instructions and guide you thru the process.

3. What happens if I lose or break a retainer? While this does not constitute a dental emergency, I really don’t want your teeth to move! If you do lose or break your retainer, please call me and I will help troubleshoot the situation. If your retainer is not in wearable condition, the most likely next best TEMPORARY option at this time to minimize relapse is use of a boil and bite mouth guard which can be purchased at most drugstores. Please make sure that the temporary appliance covers all the teeth in the arch that is being retained (including in the very far back). 

4. When can I reschedule my appointment? If your appointment was previously scheduled to occur during this time of closure due to COVID-19, please do not cancel it thru our reminder system. We will be calling you as soon as possible to reschedule it. Leaving your appointment will keep you in our list for appointment priority. We are also in the process of trying to set up tele-visits for select types of appointments. 

5. How can I make sure my treatment continues to progress during the office closure?  Keep your teeth clean and stay away from problem foods. These things are always critical factors in making progress in your orthodontic treatment, but especially important at this time. 

  • Take time to thoroughly brush around your braces, at the gum line, and under wires. Flossing can be challenging, but is worth the trouble to keep your gums healthy. If you experience bleeding with brushing or flossing, it often means that you have a gum infection. Rather than avoiding the gums to stop the bleeding, it is increasingly important to clean this area to decrease the bleeding (in a few days to a week you will see the bleeding stop). 
  • Be cautious of what you are eating! Since we are not able to make repairs of broken brackets at this time, it is critical to minimize risk of bracket/appliance breakage. Please stay away from sticky/gooey foods (ex. caramels, gummies) and very hard foods (ex. unpopped popcorn kernels, chewing hard candies or ice, biting into apples or very hard pizza crust). 
  • Wear your rubber bands/appliances as directed. You will not make progress in bite correction if you are not wearing your recommended rubber bands (or appliances). If you are wearing rubber bands, please take a look inside your mouth every night when you brush and make sure all the color (or metal) ties are present on the individual brackets. If you run out of rubber bands, please give us a call and we can mail more to you. 

Our office’s top priority is the health and well-being of our patients, families, staff and community.   We will continue to evaluate the situation as it evolves and determine on a weekly basis when it is appropriate for us to return to our normal business hours.

Our entire office sends out love and well-wishes for everyone to stay healthy and strong.  We miss our patients & look forward to seeing everyone again when it is safe!


Elana Norman, DDS, MS

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