Dentistry · Advice letter · Intermediate

Dentistry — Advice Letter to a Patient Starting Fixed Orthodontic Braces

An orthodontist writes an advice letter to a 16-year-old at the start of fixed orthodontic appliance therapy. The intermediate challenge is selecting the hygiene, diet, discomfort, and emergency contact instructions from the notes and presenting them in clear, age-appropriate patient language.

Letter type

Advice

Write to

Patient

Target length

190–210 words

The case notes

Patient: Miss Lily Thornton, 16 years old; upper and lower fixed metal braces bonded today; parent present

Oral hygiene: Brush after every meal (minimum three times daily) using a fluoride toothpaste; use an interdental brush under the wires; plaque disclosure tablet showed significant build-up around brackets today — hygiene quality critical to avoid white spot lesions (decalcification)

Diet restrictions: Avoid hard foods (crusty bread, raw carrots, hard sweets, ice cubes), sticky/chewy foods (toffee, chewing gum, gummy sweets) — these damage brackets and wires; no biting on nails or pencils

Discomfort: Soreness for 3–5 days after each adjustment is normal; paracetamol or ibuprofen (adult dose) for pain relief; wax provided for any wire irritating the cheek

Emergencies: Loose or broken bracket, poking wire — call the clinic for an urgent repair. Swallowed bracket: monitor symptoms; if choking or difficulty breathing, call 999

Reviews: Monthly appointments — do not miss them; treatment progress depends on regular adjustments

Task: Write an advice letter to Miss Thornton (and her parent) explaining how to care for her braces and what to do if something goes wrong.

Writing task

Write an advice letter to Miss Thornton (and her parent) explaining how to care for her braces and what to do if something goes wrong.

What to include, what to cut

The hardest mark to win is selection. The same case notes contain decision-relevant facts and distractors. Here is what an examiner expects to see in a Grade B letter for this scenario, and what should be left out.

Include

  • Brushing after every meal, interdental brushes under wires, and the white spot lesion risk

    White spot lesions are the most common avoidable complication of fixed appliances. The plaque disclosure finding today makes this a personalised, evidence-based instruction.

  • Food restrictions by category, not just a list

    A category approach — 'hard foods such as raw carrots and crusty bread' — is more useful than a specific list, as the patient can generalise to unlisted foods.

  • The emergency protocol: call the clinic for a loose bracket; 999 if swallowed and breathing affected

    Patients frequently delay calling about bracket emergencies. Naming the specific action and when to escalate prevents delay.

Leave out

  • The full orthodontic treatment plan and predicted timeline

    An advice letter is about living with the braces today. 'Your regular monthly adjustments will guide your treatment progress' covers the ongoing commitment.

  • Biomechanical explanation of how fixed braces work

    One sentence of plain-language context is the right level for a patient care letter.

Criterion in focus · Genre & Style

A letter addressed to a 16-year-old (parent copied) requires calibration: formal enough to be professional, accessible enough for a teenager to understand independently. Avoid clinical jargon — 'decalcification' becomes 'permanent white patches on your teeth that are hard to remove'. Use direct address ('you should brush after every meal'). The parent is in the background; the patient is the primary audience.

Now write the letter — and find out what is blocking your Grade B

Write a 190–210 words advice letter from these notes, paste it into the free checker for an instant read, then submit it for a human grade against all six criteria. Dr Mariam's team returns line-by-line feedback, from $12.

Questions about this case note

Who do I address an advice letter to when there is both a patient and a parent?
Address the letter to the patient ('Dear Miss Thornton') and note the parent as an additional recipient: 'cc: Mrs Anne Thornton (parent/guardian)'. Write in second person, addressing the patient directly.
Should I mention the white spot lesion risk in a patient advice letter?
Yes — contextualised as a preventable consequence of poor hygiene: 'If plaque builds up around the brackets, it can cause permanent white marks on your teeth that are difficult to remove later.' Factual, consequence-based, and motivational.

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