ORTHODONTIC TREATMENT CONTRACT

A lot of work and effort has gone into the construction and placement of your orthodontic appliance. We encourage you to take care of your braces buy keeping them clean and being careful with the types of food you put in your mouth. Breakage of your braces result in extract appointments (usually during school or working hours) for repairs and will lengthen the time of your treatment. The following tips will help you choose food that are easy to eat with braces and avoid food and beverages that can damage them or hurt your mouth.

WATCH OUT FOR HARD FOODS:

Hard food may cause damage by bending the wires, loosening the cement under the bands or breaking the brackets that are bonded to the teeth. Some examples of those food are listed below along the ways that they may be eaten.

• Carrots or celery: grate, cook or cut into pieces
• Apples, cut into bite size pieces
• French bread, hard rolls, avoid hard crust
• Corn, chicken ribs, cut off cub or bone

USE CAUTION WHEN EATING

• Popcorn, nuts, pretzels, hard pizza crust, hard chips or any hard foods/candies

NEVER CHEW ICE CUBES, PENCIL OR ANYTHING NOT EDIBLE

WATCH OUT FOR STICKY FOODS

LIMIT FOODS WITH HIGH SUGAR CONTENT

• Food high in sugar should be limited. The bacteria that causes tooth decay decalcification and gum diseases sugary food on your teeth in order to live
• Brush your teeth immediately after each meal since most of the damage occurs within the first half hour after eating.

TROUBLESHOOTING

• Poking wire or bond - Use the wax we have provided to cover the irritating part and call the clinic for an immediate appointment for wire cutting.
• Loose band or bracket - Do call or message us immediately to set an appointment.
• Broken wires

  - If it is a small wire, you may remove it or call the clinic.
  - If it is the main arch wire (which are connected to the teeth) try to move it so it is comfortable and call the clinic to set an appointment.

• Discomfort - When pressure is applied to the teeth, you may feel some tenderness which usually persist 2-3 days. The intensity and duration of the discomfort will vary with each patient. If you feel unusual amount of pain or discomfort, take Paracetamol as prescribed or please call the clinic immediately.

BROKEN BRACKET POLICY

• Everyone has dental “ACCIDENTS”. We understand that brackets can come or detached. We will replace lost, broken or detached within a month of placement of brackets without charges
• For every lost bracket/buccal tube, you will be charge a fee of 300-500 pesos and for each bracket that needs to be repaired or re-cemented you will be charged a fee of 300 pesos for each bracket and if there’s a broken main arch wire of the patients neglect there will be additional fee of 300-500 pesos for new wire. This fee is due at the time of the service.

Note: prices may change without prior notice

TERMINATION

• If the patient didn’t go back to the clinic for 5 consecutive months without prior notice to the attending dentist. The ortho package will be terminated and 70% of the balance should be settled.

Note: It is the responsibility of the patient to come to our clinic for their monthly adjustment

RETAINERS

• Retainers upper and lower is not included in the package.
• Patient is required to have retainers after braces to prevent relapse of the teeth.

I have read and understand this letter of information and hereby give consent to the orthodontic treatment recommended by my dentist.