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Los primeros días de un tratamiento de ortodoncia es normal experimentar algunas molestias que irán desapareciendo por sí solas. Durante el llamado "periodo de adaptación" (que suele durar una semana o diez días aproximadamente) puede sentirse un cierto dolor debido a la presión que los brackets, arcos o alineadores realizan sobre los dientes para tratar de moverlos, pero también al hecho de que pueden producirse rozaduras contra las mucosas (el interior del labio y de las mejillas en ortodoncia lingual o invisible). En algunos casos también se pueden tener dificultades para pronunciar ciertos sonidos con normalidad hasta que el paciente se acostumbra a tener "un cuerpo extraño" en la boca.

Es importante resaltar que, al igual que sucede con los brackets, los alineadores transparentes requieren un periodo de adaptación debido a la presión suave, pero constante, que ejercen sobre la dentadura, que puede provocar que los primeros días se tenga dolor al morder (que ira desapareciendo). En algunos casos también pueden aparecer pequeñas heridas y roces debido a que el corte de los moldes se hace por láser y, el borde puede llegar a molestar en algunos cosas, pero se soluciona limando esos bordes hasta que resulten confortables al paciente.

Para aliviar las habituales rozaduras y heridas en las mucosas (en la lengua en el caso de ortodoncia lingual y en la cara interna del labio y mejillas en el caso de los brackets convencionales o vestibulares) que pueden ocasionarse los primeros días con brackets aparezcan roces y heridas en las mucosas, se recomienda el uso de cera especial para ortodoncias que ayudan a evitar el roce.



Alimentación los primeros dias de ortodoncia 

Durante esos primeros días de adaptación conviene realizar una dieta mas blanda de lo habitual para minimizar las posibles molestias al masticar y se tengan que sustituir algunos alimentos por otras opciones mas blandas como sopas, pasta, cremas de verduras (calientes o frías como el gazpacho), pescados a la plancha, tortillas, pan de molde, yogures, flanes, helados... También podemos recurrir a ensaladas (aunque la lechuga y verduras tienden a quedarse enganchados a los brackets, se puede optar por ensaladillas en las que los alimentos están cocidos).

Respecto a las frutas las primeras semanas puede costar trabajo masticar aquellas mas consistentes (manzanas, peras...) por lo que será mas fácil optar por las más blandas, tomarlas muy madurado en compota.

En esos primeros dias también se recomienda tener cuidado con los alimentos ácidos (vinagre, cítricos...) para evitar la irritación de las heridas, aftas, o rozaduras que pueden provocar la ortodoncia en los primeros momentos. De igual modo, las comidas picantes tampoco son recomendables mientras existan rozaduras o heridas.

El pollo y el pescado son alimentos de textura más suave y poco fibrosos que pueden ser un aliado durante el periodo de adaptación. Para facilitar la masticación esos primeros días de la carne mas fibrosa como la de ternera o el cerdo, puede consumirse en forma de hamburguesas, albondigas, salchichas, filetes rusos...

También es importante no cortar ni desgarrar los alimentos con los dientes. Puede costar trabajo al principio comer bocadillos con corteza (mejor optar por sandwiches con pan de molde), comer la fruta a mordiscos... En todos los casos es mejor cortar los alimentos en trozos pequeños. Pasando los días las molestias irán desapareciendo y resultara fácil ir introduciendo alientos más consistentes.

De hecho es conveniente masticar lo que se pueda, pues es bueno que los músculos de la mandíbula no dejen de ejercitarse.


Limpieza oral más concienzuda

Lo que también resulta fundamental desde el primer día es extremar la limpieza oral, ya que los aparatos ortodóncicos favorecen que los alimentos se queden atrapados, y, si no se realiza una higiene exhaustiva se aumenta el riesgo de padecer caries durante el tratamiento debido a la acumulación de bacterias y placa.

Cabe señalar que las recomendaciones no son iguales para la ortodoncia removible (de quita y pon) que la fija, ya que la removible se retira para comer y lavarse los dientes, por lo que simplemente hay que recordar que es muy importante no beber líquidos que manchen (como café o vino), ni fumar con los alineadores dentales puestos, ya que se teñirán y dejarán de ser discretos tal y como se pretende.

 Es importante limpiar los alineadores con agua, jabón de manos y un cepillo, y extremar la higiene de los dientes, asegurándose de que no queden restos de alimentos ni de placa antes de volver a colocarse el aparato. 

La ortodoncia fija (brackets metálicos o convencionales, estéticos y linguales) exigirán cuidados más meticulosos, ya que durante todo el tratamiento se comerá y se limpiará la boca con los brackets puestos. Por ello es fundamental limpiarse los dientes correctamente a diario y complementar con ayuda de cepillos interdentales, irrigador oral, seda dental y colutorio específico, para eliminar los restos de comida en las zonas en las que de manera normal el cepillo no llega. 

También es importante hacerse con un kit dental para poder llevar el cepillo y los útiles básicos de ortodoncia a todas partes por si se realizan comidas fuera de casa: cepillo, pasta de dientes, cepillos interdentales, cera de ortodoncia....).

Después de cada comida se debe cepillar cuidadosamente cada uno de los dientes, con especial atención alrededor del bracket y por debajo de los alambres para evitar problemas de caries, sarro e infecciones. 

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