The following investigations are performed on every new patient prior to giving an opinion, quote or treatment plan: 

• Panoramic X-ray: This Xray gives us an overview of jaws & teeth. 

• Lateral Ceph X-ray: This Xray illustrates the upper and lower teeth, jaw & soft tissue relationships. 

• 8 photographs: Description below. 

You will receive a link to access your digital records. To Login to your patient portal: Use your Username and use the “forget password” option to reset your password if necessary. 

PLEASE NOTE 

• Records are charged with your consultation fee & treatment plan on the day of service. 

• Dr Zieg Weber and/or Dr Jacques Ferreira will evaluate the records to design a specific treatment plan for each patient. 

• Dr Zieg Weber and/or Dr Jacques Ferreira will provide the accounts department with a treatment code to prepare the necessary quotation for you: 

• The treatment plan and quotation may be discussed on the same day; but for more complex cases patients will be advised to return for a Case Discussion appointment. 

• If the patient or parent has any specific questions about the proposed treatment and would like to receive a detailed reply from either Dr Zieg Weber and/or Dr Jacques Ferreira, they may send an e-mail to hello@concelobraces.com; 

• If the patient or parent feels that the answering of the questions in the e-mail was unsuccessful, a Case Discussion appointment may be booked (please check online for available slots for Case Discussion appointments). Take note that a sub-consultation fee in these cases (please see website for cost) will be charged. 

• The records (photos & X-rays) and treatment plan are only valid for 6 months. Records 6-8 months old will be retaken and not charged, however records older than 8 months will be charged for again. 

• The quote is valid for the financial year. 

Photographs 

Both intra-oral (inside the mouth) and extra-oral (of the face and smile) photographs will be taken. Photographs form an essential part of the pre-treatment records. 

Pre-treatment photographs can only be taken once and can never be retaken once tooth movement has commenced. These photographs need to be saved and stored electronically for an indefinite period of time. 

Recommendations after Dr Zieg Weber and/or Dr Jacques Ferreira have evaluated the Photographs and 

X-rays 

• Sometimes no immediate intervention is recommended, and the patient is scheduled for recall in 6-12 months’ time (= Returning patient/To Come Back). 

The following Orthodontic Treatments may be recommended: 

• Retainer wear to protect the teeth. 

• First Stage orthodontic treatment. 

• Full Fixed orthodontic treatment. 

• Invisalign/Tube Align orthodontic treatment. 

• Combined orthodontics and jaw surgery. 

First Stage Treatment (also called early treatment) 

• First stage orthodontic treatment is sometimes recommended while primary (baby) teeth are still present (usually age 8-11 years). 

• Due to the effectiveness of modern orthodontics, early treatment is less frequently recommended. Patients are requested to wait until the eruption of their upper canines, typically around the ages of 12-13 before full orthodontic treatment commences. 

However, early treatment can still be indicated in the following types of cases: 

• For psychological or social reasons. Young patients who are self-conscious or are being teased about their teeth. 

• Edge-to-edge occlusions or anterior cross-bites (especially pseudo class IIIs), where the possibility exists for permanent damage to the incisal edges. 

The First stage appliance: 

• Usually, brackets are only placed on the permanent front and molar teeth with compulsory elastics to be worn as prescribed. 

• Elastics are used between the upper and lower partial fixed appliances to correct the relationships between the jaws. 

• With sufficient cooperation, first stage treatment lasts only 4-6 months, and full treatment will definitely be indicated once the upper canines (cuspids) have erupted. 

Full Fixed Orthodontic Treatment 

• Once the upper eye teeth (cuspids) have erupted, full fixed appliances are placed to align the teeth to their ideal positions in the bone. 

• At Concelo Orthodontics we use our own unique attachments (brackets) and philosophy called 

• P R O P L U S. It relies on only extremely light forces which generally results in less discomfort during the initial stages of treatment. 

• The teeth also tend to align more rapidly resulting in an overall treatment time of around 14-16 months.

• In some cases, the treatment will take longer and in others the teeth align more rapidly. It is generally advised not to remove braces before 14 months. Please note that your payment plan is unrelated to your treatment time.

• The active treatment time will be followed by the retention phase.

• Retainer wear and maintenance as described below. 

Clear Aligners 

• The latest generation of clear aligners are extremely effective in selected cases if worn between 20-22 hours per day. 

• The laboratory fee is due on the day impressions are taken. 

• Slight reshaping of some of the teeth may be necessary before impressions are done. 

• The only time aligners are removed is during eating, brushing and flossing. 

• You should ideally only drink water while wearing aligners. 

• It usually takes 18-24 months to level and align the teeth. 

• Each set of aligners is to be worn for one week before progressing to the next set. 

• When progressing to a new set of aligners this should be done at night after brushing and flossing. 

• Only progress to a new set if the previous set fits perfectly and there are no gaps between the aligner and your teeth. 

Surgical Orthodontics 

• When the discrepancy between the jaws exceeds about 4 mm, a combined orthodontic and jaw surgery (orthognathic surgery) approach sometimes is recommended. 

• The orthodontist first aligns the teeth, and the Maxillo Facial and Oral Surgeon (MFOS) then surgically places the jaws in the correct position for an improved bite and facial balance. 

• Jaw surgery is usually only recommended at the end of general body growth. 

• People with big lower jaws usually need to wait till 2 years after general growth is complete because a late mandibular growth spurt often occurs in these patients. 

• Many patients opt not to undergo these procedures and prefer to accept imperfect bites, profiles and facial proportions. 

Surgery of the Chin (Genioplasty) 

• The chin may be made more or less prominent thereby creating a more pleasing profile and Lip-Chin-Throat angle. 

• A genioplasty can also make the chin vertically shorter or increase the height of the chin depending on the aesthetic requirements of the face. 

• The genioplasty is often performed simultaneously with the surgical removal of impacted wisdom teeth. 

What to expect after your “Fitment of Braces” appointment 

• Braces are uncomfortable initially, and it is difficult to predict which patients will tolerate the braces well and which will suffer discomfort more than others. 

• We estimate that about 1 in 20 patients have significant discomfort requiring one or more additional visits during their treatment. 

• Additional visits for discomfort are done during normal working hours – never at night. 

• If you need advice after hours Whatsapp the Oral Hygienist on 083 456 0465. 

• In some patients the braces irritate the lips, cheeks and tongue – rinse with salt water or apply chewed sugar-free gum or wax to the sharp areas. 

• In other patients the teeth become tender - chewing sugar-free gum immediately after the appointment helps prevent this. 

• The initial archwires are usually quite thin and flexible and they may move in an unfavorable way causing some pain and discomfort. An example of this is where the archwire might be poking into the gum or scratching your cheek due to chewing. 

• The ends of the archwires are difficult areas and can be ended in a number of different ways depending on the case and each method has pros and cons. 

• These archwire ends can be bent away from the cheek or up or down towards the gum - these bends are called cinches. 

• Cinches sometimes must be long cinches if the teeth need to slide backwards along the archwire. 

• The cinches will be short and tight against the last tooth if we don’t want spaces to open. 

The end of the archwire can also be cut flush with the end of the tube on the last tooth: 

• It may become quite scratchy depending on the proximity of the cheeks or if the tongue is too inquisitive. 

• Cut flush may also allow the archwire to pull out of the tube and be really irritating. 

• It also doesn’t prevent spaces opening which have been closed. 

• These problems can sometimes be helped by cutting the archwire 2 mm longer and crimping a stop on the end of the archwire. 

• Depending on the proximity of the cheeks we can also put a small, rounded blob of composite over the top to make it smooth. 

Removal of Braces 

Removal due to arrear accounts – braces will be removed in cases where a patient’s account is not paid up to date or who have failed to pay in terms of the agreement. Treatment can continue later when the medical aid or finances are favourable again. 

You and your parents are aware that: 

• It is a good idea to have retainers made so that we can preserve the progress made to date. 

• When we start again a new quote will be given based on the estimated duration of treatment remaining. 

Retention 

Retention is essential after all the different types of orthodontic treatment discussed above. 

Retention appliances should be worn as follows: 

• Permanent/Fixed retention wires (splints) are routinely placed behind the upper and lower teeth. 

• In addition to the Permanent/Fixed retention wires, removable invisible retainers are to be worn as described below to prevent definite relapse:

• For the first 4 weeks: 4 hours during the day except when eating or drinking and while sleeping.

• Thereafter for the next 6 months: only at night.

• thereafter: every second night indefinitely.

• IMPORTANT: If the retainer starts feeling tight, wear them as much as possible as prescribed above. Take note that it is advisable to wear retainers for the rest of your life.

• Should your retainer break, it gets lost or if they start feeling tight, it is important to contact us to arrange for a new one to be made. 

Cleaning of Retainers: 

• Clean your retainers with a toothbrush & cold water with diluted Sunlight liquid. 

• Sterident like Milton can also be used but only with cold water and not for longer than 30 minutes. 

Post-treatment visits 

• Usually, the first visit will be 4 months after the removal appointment at which time the retainers will be checked. 

• The next post-treatment visit will be after 6 months. 

• Thereafter post-treatment visits will be at 6–12-month intervals depending on the nature of the case. 

• If the patient had a first stage of orthodontics, they will usually be monitored every 6 months until they are ready to start the next stage of treatment. 

• Almost certainly on the eruption of the upper eye teeth a second stage of treatment will be necessary, and a full fixed appliance will need to be placed to co-ordinate and align the arches. 

• It is extremely important that the patient brings the retainers to each visit. 

Policy on Breakages during Treatment 

• Please note that your quote specifically states that excessive breakages will be charged for (code 8848), regardless of the perceived cause of the breakage. This charge applies to each bracket and/or arch-wire which is broken. 

• Breakages will be charged for based on the discretionary decision of the Oral Hygienist. 

• When the braces are placed, the patient is instructed about what food should not be eaten. 

• Any hard food should be made soft or small. Certain “foods” like toffees or fizzers cannot be made soft enough and should not be eaten at all – Please consult your bookmark and the Concelo Orthodontics booklet for additional guidelines, if you are unsure about what you should eat with your braces. 

• We use the best quality braces and composite adhesives (glues). If the brackets can withstand the forces involved in placing the arch-wire, they will withstand careful chewing of the correct foods. 

• It is true that some patients do tend to break braces often and others go the entire treatment without breakages. 

• It is also true that some people who have deep bites also tend to more commonly have grinding or clenching (bruxing) habits and are more prone to breaking their braces – this is a factor beyond our control. 

Payment Of Account 

The responsibility for settling all account balances rests with the patient or, if applicable, their parent or guardian. While we are happy to assist with submitting claims to your medical aid provider, please note that it is ultimately the patient’s responsibility to coordinate with their medical aid provider and understand their specific processes. 

By accepting our practice’s terms and conditions upon completing a new patient form, you acknowledge responsibility for the fees associated with the initial appointment. Any subsequent quotes that are agreed upon will also remain the responsibility of the patient for payment. 

Medical and Dental History Disclosure 

For optimal care, patients must disclose a complete medical and dental history, including any known conditions, allergies, and current medications. Any relevant changes to health status during treatment should be promptly communicated to Concelo Orthodontics. 

Emergency Protocols 

In the event of an orthodontic emergency, such as significant pain or appliance damage, please contact Concelo Orthodontics within normal operating hours. After-hours contacts, including WhatsApp and SMS support, are available for urgent inquiries. Additional fees may apply for after-hours assistance or emergency appointments. These fees cannot be claimed from your medical aid and a cash amount (R 600.00) needs to be given to the Oral Hygienist on call. 

Data Sharing with Referrals 

For comprehensive treatment, some patient records may need to be shared with external specialists (e.g., oral surgeons) or general dentists. By agreeing with treatment, you consent to the sharing of relevant information for coordinated care purposes in accordance with privacy regulations. 

Termination of Treatment Clause 

Concelo Orthodontics reserves the right to discontinue treatment due to specific circumstances, including but not limited to non-payment, non-cooperation, or consistent missed appointments. In these cases, patients or guardians will be informed, and treatment discontinuation does not entitle patients to a refund of previously paid fees. 

Patient Commitment to Oral Hygiene 

Maintaining impeccable oral hygiene is essential for successful orthodontic treatment. Poor hygiene, such as failure to brush and floss, can result in complications, possibly extending treatment time or incurring additional costs. Patients are advised to follow all hygiene recommendations provided by Concelo Orthodontics. 

Photography and Videography Consent 

As part of treatment planning and monitoring, photographs and videos may be taken. By undergoing treatment, you consent to the use of these records for medical purposes only, stored securely and used solely for patient records and evaluation.