Ask Dr. Orchin: When should my child come in for a visit?

At Orchin Orthodontics, knowing when to treat patients is just as important as knowing how to treat patients.

The American Association of Orthodontists recommends that all children see an orthodontist by age seven. This allows the orthodontist to make an early assessment for possible skeletal problems such as a severe cross-bite (narrow jaw), overjet (protrusive upper teeth), underbite (upper front teeth are behind the lower front teeth), or any other problem that is best treated while the patient is growing. Dr. Orchin uses appliances that are designed to capture growth and correct the malocclusion. Dr. Orchin has the experience to know when it is best to start treatment and when to step back and allow Mother Nature to do her work.

If you or a family member is already in treatment with Dr. Orchin, we are able to schedule a no charge look-see appointment for a younger sibling. This is our way of introducing Dr. Orchin to the patient while he gets a baseline reading on the patient. Please call us at 202-684-9227 for an appointment!

The importance of retainers, from Orchin Orthodontics

OK, you've completed your orthodontic work and you’ve revealed your new smile. You are proud and excited and then Dr. Orchin presents you with a retainer to wear.

What is the deal?

Every orthodontic treatment plan at Orchin Orthodontics includes a retention phase. Dr. Orchin’s years of experience has taught him that retention is one of the most important phases of orthodontic treatment. Orchin Orthodontics has learned that wearing your retainer(s) as directed is the most important factor in maintaining your orthodontic result. Dr. Orchin recommends that all of our patients keep their retainer (forever) and wear it once a week even after they are released from our care. If a removable retainer breaks or needs adjustments, simply give us a call at 202-684-9227.

Most of Dr. Orchin’s patients have a fixed lower lingual retainer (also called a permanent retainer) to maintain the lower teeth. Many patients ask us why we do not remove it. Here is the answer; it is the best insurance plan you can buy. Teeth remain mobile and do tend to drift forward as we age and the lower lingual is a great tool for preventing that. It is important to brush and floss as directed as well as maintain regular hygiene visits with the general dentist. The patient’s general dentist will monitor the lower lingual and advise if it needs to be removed or replaced.

As always, we welcome our patients back anytime to have their retainer(s) adjusted or require a visit for any reason. The best reason to return to Orchin Orthodontics? Simply to say “hello” and share your beautiful smile with us or bring a friend or family member here for treatment.

Ask Orchin Orthodontics: What are SPEED Braces?

SPEED Braces are a miniaturized metal bracket. The reduced size minimizes lip and cheek irritation and is more aesthetic and hygienic than traditional braces. In addition, SPEED Braces are efficient because their springs apply a light continuous force (stored energy) that means less discomfort and pain throughout orthodontic treatment. With patient cooperation, SPEED Braces also reduce time in treatment for patients.

Hygiene: SPEED eliminates the two most common food traps: "tie-wings" and "ligature ties." Additionally, the clean lines of the SPEED design have resulted in a smooth rounded silhouette that is easy for all patients to keep clean.

Aesthetics: SPEED Braces are 1/3 the size of traditional metal braces

Comfort: SPEED improves patient comfort in two ways:
SPEED's smooth rounded design minimizes soft tissue irritation
SPEED permits the use of extremely light forces by eliminating the high frictional resistance caused by ligature ties

The result... more comfortable treatment for patients!



SPEED's Self-Ligating design eliminates the need for tie-wings. This permits significant appliance miniaturization. With all of the benefits to SPEED Braces, it seems an obvious choice for Orchin Orthodontics to use them. Why doesn’t every orthodontist use SPEED Braces?

SPEED Braces require additional training for the orthodontist since they are not routinely used during orthodontic residency. Bracket placement on the tooth is different for SPEED Braces than it is for traditional braces. In addition, since SPEED Braces use stored energy, lighter wires are utilized. All of these factors contribute to a fairly steep learning curve for both the orthodontist and orthodontic assistants. Rest assured that Dr. Orchin and his team have mastered SPEED Braces. In fact, Orchin Orthodontics has been using SPEED Braces for about 20 years.

If you have any questions about SPEED Braces, or about your treatment with Dr. Orchin, please give us a call. We look forward to hearing from you!

A great braces-friendly fall recipe! From Orchin Orthodontics

Fall is here, and sometimes we here at Orchin Orthodontics just feel like a hot delicious meal is in order. Our friends at the American Association of Orthodontists (AAO) made an appetizing (and braces-friendly!) fall dish that is sure to delight. Remember, a healthy diet provides essential nutrients and helps you achieve the best possible result from your orthodontic treatment.

Pasta Pomodorini
Ingredients:
•¾ pound spaghetti or spaghetti
•¼ cup extra-virgin olive oil, plus more for drizzling
•¼ cup sliced garlic
•½ teaspoon finely minced Calabrian chilies, or 1/4 teaspoon red pepper flakes
•1 pint small cherry tomatoes, stems removed, crushed between your thumb and forefinger
•Sea salt, preferably gray salt
•½ cup fresh basil leaves, each torn into 2 or 3 pieces
•Wedge of Parmesan cheese

Directions
Bring a large pot of salted water to a boil over high heat. Add the pasta. While the pasta cooks, heat the 1/4 cup olive oil in a large skillet over moderate heat. Add the garlic and cook until the slivers are golden brown and crisp, then add the chilies and cook for about 30 seconds. Raise the heat to high and add the tomatoes. Simmer briskly to soften the tomatoes and thicken the juices, about 3 minutes. Season with salt. When the pasta is al dente, scoop out about 1/2 cup of the pasta cooking water, then drain the pasta. Return the pasta to the warm pot off the heat. Add the sauce and the basil and mix well. Add some of the reserved cooking water if the pasta seems dry. Transfer to a warmed serving bowl and grate Parmesan over the top to taste. Drizzle with a little more olive oil. Serve immediately. Makes 4 servings.

Enjoy this great fall dish and have a great week!
--From Drs. Orchin and the team at Orchin Orthodontics

What are you up to in November? Orchin Orthodontics want to know!

Believe it or not, we’re almost in full holiday mode! But before you go celebrating, the team at Orchin Orthodontics want to know: What are you doing this month? Anything exciting happening in your life? If so, we'd love to hear all about it!

You can share your stories with us here, on our social networks or by giving us a call!

--The team at Orchin Orthodontics

Preparing for Cold and Flu Season, from Orchin Orthodontics

Traditionally cold and flu season starts in Fall, but this year it seems to have started much earlier and with the number of patients canceling appointments because of flu and H1N1 symptoms Drs. Orchin and Orchin Orthodontics are taking additional precautions to help prevent the spread of germs.

To promote a healthy and clean environment, we give a great deal of attention to sanitation and sterilization in our office at all times as well as following all requirements for sterilizing instruments and work surfaces.

For the protection of other patients and our staff, we always ask that patients reschedule their appointments if they have any type of cold or illness that can infect others.

Maintaining and protecting oral hygiene equipment is also important this flu season. To protect your toothbrush from bacteria follow these steps:

• Wash your hands before and after brushing
• Allow the brush to air dry after each use, harmful bacteria dies after being exposed to oxygen
• Store the toothbrush in an upright position to allow water to drain and dry faster
• Replace toothbrush after every cold or flu or every 3-4 months when bristles appear worn

Hope this helps! Stay healthy!

--The team at Orchin Orthodontics

Write a Review of Orchin Orthodontics!

Whether you have visited Drs. Orchin for a week or for years, we'd love to hear your feedback about Orchin Orthodontics! Now with the Internet, it’s even easier to write your thoughts and share them with the world. We'd want to encourage you to write a review of us. It only takes a moment!

Please submit your reviews here.

Thank you!

--Orchin Orthodontics staff

Everybody in D.C. Benefits from Braces! (Really)

Braces aren’t just for pre-adolescents and teenagers anymore! Anyone, at any age, can benefit from orthodontic care; whether it is correcting a problem not treated in your younger years, or catching a problem early.

To ensure the best overall treatment, the American Association of Orthodontists recommends that children receive an orthodontic consultation as early as age seven. If a problem is evident, taking action early can spare a lot of treatment and expense down the road.

If you never received orthodontic treatment when you were young, don’t worry! You’re never too old for a beautiful smile. Set up an appointment for a consultation and find out how adult orthodontics will transform your smile, and your life!

--Drs. Jeremy and Andrew Orchin

Preventing Gum Disease and Protecting your Teeth!

It is estimated that around 80 percent of American adults are currently diagnosed with some form of gum disease. Also known as, periodontal disease or periodontitis, gum disease starts with gum inflammation and can end with major damage to the bone and tissue holding the teeth in place, resulting in tooth loss and irreversible damage to the gums. Many doctors and researchers have also found gum disease to be the cause of several other health problems, including heart disease, diabetes, and complications for women during pregnancy. Gum disease is a serious dental health condition, and by understanding how gum disease is caused, what symptoms to look for, and how you can prevent it, you will be able to keep your smile healthy for many years to come.

What causes gum disease?

Your mouth is full of bacteria, and when the bacteria are left in your mouth, it can cause a sticky, colorless film over your tooth surface called plaque. Brushing your teeth regularly and flossing can help to remove much of the plaque build-up on your teeth; however, if you do not brush and floss regularly, the plaque on your teeth can harden and turn into tartar. Tartar cannot be removed by a toothbrush, only your dentist has the special tools needed to remove tartar from your tooth’s surface.

Eventually, if left untreated, the tartar and plaque on your teeth will cause gingivitis. Gingivitis is the early stage of gum disease and is usually curable if caught early enough. Signs of gingivitis include:

• Red, swollen gums
• Gums that bleed when you brush and floss
• Gums that pull away from your teeth
• Pockets between your teeth and gums where food gets caught
• Persistent bad breath

If you have gingivitis, and it is left untreated, you may end up with gum disease. Gum disease causes the gums to pull completely away from the teeth and form infected pockets. The bacteria in your mouth and on your teeth will start to break down the tissue and bone that supports your teeth and holds them in place. Gum disease that is left untreated will lead to the extraction or loss of teeth. Most people do not show signs of gingivitis and gum disease until they are in their 30s, 40s, or older. Certain risk factors can increase your chance of getting gum disease, including:

• Smoking
• Diabetes
• Stress
• Certain prescription medications
• Illness
• Genetics

How can I prevent gum disease?

You can help your chances of never getting gingivitis or gum disease simply by taking care of your teeth and gums on a regular basis. Here are some of the ways you can help keep your smile healthy:

• Brush your teeth at least twice a day using fluoride toothpaste approved by the ADA.
• Floss at least once every day to remove food stuck between your teeth and along the gum line.
• Visit your dentist for routine, general checkups and teeth cleaning every six months.
• Eat a well balanced diet, including fruits and vegetables.
• Stay away from using tobacco products of any kind.

Gingivitis and gum disease are both preventable and treatable. If you would like a list of recommended dental health care products, or have any questions about gingivitis, gum disease, and how to keep your teeth and gums healthy, please ask Dr. Orchin at your next appointment. Our practice is happy to answer any questions you may have, and provide you with accurate information to help you maintain the health of your smile in between office visits. If you think you may have any form of gingivitis or gum disease, please contact our practice at 202-609-8948 to schedule an appointment as soon as possible.

National Dental Hygiene Month

Did you know that October is National Dental Hygiene Month? Fall is here, and Halloween is coming soon, but now it is more important than ever to maintain good oral hygiene.

All those sweet, sour and sticky candies may taste great, but these treats can damage your teeth and braces too! Did you know sour candies can be acidic to your teeth, and actually wear down the enamel that protects them? This can cause tooth decay and cavities! After eating these candies, be sure to wash your mouth out with water, drink milk or eat a few slices of cheese. These will help neutralize the acid in your mouth (wait at least one hour before brushing your teeth with toothpaste, as this can actually increase the effects of acid on your teeth)

Besides cavities and tooth decay, many people do not realize that good oral health and hygiene are important to your overall health too! Research is discovering the connection between periodontal disease and other major health concerns, such as heart disease! Therefore, it is important to maintain a good oral hygiene routine: see your dentist every six months, brush and floss daily and use an antibacterial mouthwash.

Make a resolution to improve your oral health for October, the National Dental Hygiene Month!

--Orchin Orthodontics

Answering all your burning questions about mouthwash

While mouthwash is not an alternative to regular brushing and flossing, it can help keep your teeth and gums clean and healthy. There are several different types of mouthwashes available, and all of them will help do different things for your smile. The most common types of mouthwashes are:

• Fluoride - fluoride is the most used type of mouthwash available, and is used to strengthen the enamel of the teeth while preventing cavities and tooth decay.

• Antiseptic - an antiseptic mouthwash is used to kill bacteria and germs in the mouth. Most commonly used before and after a dental surgery, antiseptic mouthwashes can also help to fight gum disease, and halitosis (chronic bad breath). Antiseptic mouthwashes can affect your sense of taste and may stain the teeth, so it is recommended that you consult your dentist before using this type of mouthwash.

• Combination - a combination mouthwash is designed to help prevent tooth decay, freshen the breath, and maintain the health of your smile.

• Prescription - for patients with gum disease, or any signs of gum disease, you may need a prescription mouthwash. Prescription mouthwashes, like Peridex of PerioGard, are used to treat gingivitis, and other forms of decay.

There are also many different brands of mouthwash. Some common brands include:

• Scope
• Listerine
• Act
• Crest
• Tom’s of Maine (all-natural)
• Plax (anti-plaque rinse)
• Breath Rx
• Orajel
• Targon (special mouthwash made for smokers)
• Rembrandt (whitening mouthwash)


If you are curious about which kind of mouthwash would work best for you, be sure to ask Dr. Orchin at your next appointment. If you have a favorite mouthwash, let us know by posting a comment for others to read!

Imagining Your Life With Invisalign

Are you wondering what Invisalign treatment is really like, and what effect it will have on your day-to-day activities? Will it slur your speech? Will people know you're in treatment? You're not alone in your concerns! Following are a list of questions and answers for anyone pondering Invisalign treatment.

How exactly does Invisalign work?

Using 3-D computer imaging technology, Invisalign creates a series of custom-made, clear aligners exclusively for your teeth, based on the treatment plan that we specify for you. Each aligner moves teeth incrementally and is worn for about two weeks, then replaced by the next in the series until the final position is achieved.

Will I experience pain during treatment?

Most people experience temporary discomfort for a few days after a new aligner is placed. This feeling of pressure is normal and is a sign that Invisalign is working by sequentially moving your teeth to their final destination.

Can other people see that I'm in treatment?

One of the benefits of Invisalign is that the aligners are clear. You can straighten your teeth without anyone knowing.

Can I smoke during treatment?

We discourage smoking while wearing the aligners as they may become discolored.

Are there any foods I cannot eat while in treatment?

You can eat normally during the entire course of treatment. One of the advantages of Invisalign is that the aligners are removable. Simply take the aligners out before each meal, brush when you're finished eating, then reinsert the aligners afterward.

What about chewing gum?

We recommend removing your aligners for all meals and snacks, as gum and other chewy substances can stick to the aligners.

How often must I wear my aligners?

Aligners should be worn all day, except when eating, brushing, and flossing.

Will my speech be affected by the aligners?

As with any orthodontic treatment, aligners may temporarily affect your speech. If this does happen, your tongue will adjust within a day or two and your speech should return to normal.

How can I clean my aligners?

The best way to clean your aligners is by brushing and rinsing them in lukewarm water.

How often must I visit your office during treatment?

For most patients, visits every 4-6 weeks are frequent enough for us to determine that your treatment is progressing properly. Dr. Orchin will provide you with a specific schedule that supports your individual treatment plan.

More About Orthodontics From Orchin Orthodontics

There are so many questions about orthodontics that we never ask, so Dr. Orchin took some time to explain the most common concerns.

At what age should orthodontic treatment occur?

Orthodontic treatment can be started at any age. Many orthodontic problems are easier to correct if detected at an early age before jaw growth has slowed. Early treatment may mean that a patient can avoid surgery and more serious complications. The American Association of Orthodontists recommends that every child first visit an orthodontist by age seven or earlier if a problem is detected by parents, the family dentist or the child's physician.

What is Phase I and Phase II treatment?

Phase I, or early interceptive treatment, is limited orthodontic treatment (i.e. expander, Herbst, Facemask, headgear, or partial braces) before all of the permanent teeth have erupted. Such treatment can occur between the ages of six and ten. This treatment is sometimes recommended to make more space for developing teeth, correction of crossbites, overbites, underbites, or harmful oral habits. Phase II treatment is also called comprehensive treatment, because it involves full braces when all of the permanent teeth have erupted, usually between the ages of eleven and thirteen.

Would an adult patient benefit from orthodontics?

Absolutely!! Orthodontic treatment can be successful at any age. Everyone wants a beautiful and healthy smile. Between 30-40% of our patients are adults.

How does orthodontic treatment work?

Braces use steady gentle pressure to gradually move teeth into their proper positions. The brackets that are placed on your teeth and the arch wire that connects them are the main components. When the arch wire is placed into the brackets, it tries to return to its original shape. As it does so, it applies pressure to move your teeth to their new, more ideal positions.

How long does orthodontic treatment take?

Treatment times vary on a case-by-case basis, but the average time is from one to two years. Actual treatment time can be affected by rate of growth and severity of the correction necessary. Treatment length is also dependent upon patient compliance. Maintaining good oral hygiene and keeping regular appointments are important in keeping your treatment time on schedule.

Do braces hurt?

The placement of bands and brackets on your teeth does not hurt. Once your braces are placed and connected with the arch wires, you may feel some soreness of your teeth for one to four days. Your lips and cheeks may need one to two weeks to get used to the braces on your teeth.

Will braces interfere with playing sports?

No. It is recommended, however, that patients protect their smiles by wearing a mouth guard when participating in any sporting activity. Mouth guards are inexpensive, comfortable, and come in a variety of colors and patterns.

Will braces interfere with playing musical instruments?

No. However, there may be an initial period of adjustment. In addition, brace covers or wax can be provided to prevent discomfort.

Should I see my general dentist while I have braces?

Yes, you should continue to see your general dentist every six months for cleaning and dental checkups, or more frequently as recommended.

Got more questions? Give us a call at Orchin Orthodontics. We'd love to hear from you.

The Myths and Facts of Orthodontics

There are quite a few myths about orthodontists circulating around. Before you buy into those myths, you should get the facts! We came across a great site that helps set the record straight. Our friends at the American Association of Orthodontists have some excellent information on the myths and facts of orthodontists, check them out today!

Hope this helps,

--Orchin Orthodontics

Katherine Heigl Struggles with Crooked Teeth

Everyone struggles with little imperfections. Making crooked teeth straight, stained teeth sparkling white and chipped teeth smooth is part of what we do as orthodontists. The sense of renewed self confidence that comes to my patients after having some sort of reconstructive work is what makes our job worthwhile.

Consider Katherine Heigl, award winning actress, and considered by many the Grace Kelly of our day. She describes struggling with crooked teeth her whole life until finally there came a point when she said "enough is enough!" She decided to do something to straighten her teeth.

We think you will enjoy this clip. Please feel free to leave comments, tell me what you think! Have you ever struggled with this same problem? Have you felt the relief of smiling to reveal a straight, bright smile after hiding crooked ones for so long? Contact us so we can hear your story, or help you create a new beautiful smile and a story of your own!



--Orchin Orthodontics

Smoke Screen, From Orchin Orthodontics

Everybody knows that smoking causes lung cancer, but did you also know that smokers and tobacco are susceptible to a variety of oral health problems at a faster rate than non-smokers?

It’s true! Smoking is responsible for almost 75% of gum disease in adults; and, similar to smokers, adults who smoke pipes and cigars, as well as those using smokeless tobacco, are just as susceptible to gum disease and other tobacco related health problems.

As soon as you use tobacco products, you become more likely to experience any of these oral-health problems:

• Oral cancer
• Gum disease
• Tooth loss
• Loss of bone in the jaw
• Gum recession
• Delayed/impaired healing process after oral surgery or any other treatment
• Decreased success rate of dental implant (tooth replacement) procedures
• Mouth sores
• Loss of your sense of taste and smell
• Bad breath
• Tooth and tongue stains

If you are interested in protecting your oral health we strongly recommend you quit using tobacco products! The following steps are recommended by the Surgeon General to help you quit smoking and using tobacco:

• Get ready – set a quitting date and remove all materials from your home, car and office
• Get support
• Learn new skills and behaviors
• Get medication and use it correctly
• Be prepared for relapse or difficult situations

--Orchin Orthodontics

Softly Brushing Your Way to Clean Teeth, From Orchin Orthodontics

Just as there are so many different types of toothbrushes to choose from, each brush also has a different type of bristle! There are generally three different types of bristles; hard, medium, and soft. We always recommend that our patients, especially children and seniors, use a soft bristled toothbrush.

Using a hard and medium bristled brush can actually harm your teeth and gums by stripping the enamel from the teeth and irritating the gums so that they become red and sore, and can even cause gum recession. If you do use a hard or medium bristled brush as a personal preference, we recommend using an electric toothbrush.

Soft bristles are much gentler on your teeth and gums, and while patients of all ages are recommended to use soft bristled brushes, they are particularly great for children, seniors, patients recovering from a dental procedure, and patients wearing braces.

Soft bristles, and even extra-soft bristles are every bit as effective when it comes to cleaning your teeth; in fact, if you currently use a hard or medium bristled brush, try a soft bristled brush next time you buy a toothbrush and we bet you won’t even notice a difference!

--Dr. Orchin

Your Friend – Fluoride, from Orchin Orthodontics

There are so many ways you protect your teeth throughout your orthodontic treatment at Orchin Orthodontics. You brush your teeth twice a day, floss regularly and protect your mouth and appliances from being damaged. But did you know there is another, often forgotten about, way to keep your teeth clean and healthy during your treatment? Fluoride – a mineral that helps prevent cavities and tooth decay – can help keep your teeth strong! Fluoride comes in two varieties, topical and systemic. Topical fluoride is applied directly to the tooth. Topical fluoride includes toothpastes and mouth rinses. Systemic fluorides are swallowed in the form of a dietary supplement. Dentists and orthodontists use in-office fluoride treatments to help protect the oral health of adults and children undergoing dental/orthodontic procedures.

Fluoride used in the dentist/orthodontists office is often times a stronger concentration than in toothpaste or mouthwash, but is available at some drug stores or a pharmacy (ask your doctor how to purchase professional strength fluoride). A fluoride treatment typically takes just a few minutes. After the treatment patients may be asked not to rinse, eat or drink for at least 30 minutes in order to allow the teeth to absorb the fluoride. Depending on your oral health or doctor’s recommendation, you may be required to have a fluoride treatment every three, six or 12 months. Your doctor may also prescribe a fluoride product such as mouthwashes, gels or antibacterial rinses for at-home treatment.

When choosing your own fluoride product be sure to check for the American Dental Association’s (ADA) seal of acceptance. Products marked with the ADA seal of approval have been carefully examined and have met the criteria of the ADA for safety and effectiveness. Take care of your teeth, and smile bright!

From Orchin Orthodontics

Summer Fun with Orchin Orthodontics!

Its summer here at Orchin Orthodontics, a season full of vacations, adventures and great memories. Whether you are headed to a barbeque, a camping trip, or just having fun in the sun, we want to hear about it! Leave a comment on our blog and tell us about your summer!

Happy Travels,

-From Orchin Orthodontics

The Tooth Fairy, From Orchin Orthodontics

Losing your first tooth, or any baby tooth for that matter, can be exciting! Your baby tooth may be gone, but in no time you will have a bigger, “grown-up” tooth in its place. So what do you do with the lost tooth? That’s simple…place it under your pillow at night and when you are fast asleep the tooth fairy will come and whisk your tooth away leaving behind a special gift just for you! Here’s a simple craft project We found at Orchin Orthodontics that will help make the tooth fairy’s job a little easier and give your tooth a special place to stay until it is taken away. Please click on the link for instructions and pictures!

Tooth Fairy “Tooth” Box
(remember to ask your parents for help when using hot glue and scissors)

What you will need
• 1 large empty match box
• Enough felt to wrap the box and inside sliding tray
• Ribbon
• Glue (tacky glue or a hot glue gun)
• Markers
• White, pink and blue (or your favorite color) felt for decorating the matchbox
• Scissors

Step 1: Pull the inner tray out of the box and line the inside with glue and felt as shown. Wrap the outside of the box with felt and glue it in place.

Step 2: Glue ribbon to the outside of the box in a hanging loop shape. Fold another piece of ribbon in half and glue it to the bottom of the inner tray to create a handle for sliding it in and out.

Step 3: Draw a tooth shape on paper, cut it out, and trace it onto the white felt twice. Cut out the teeth and face details.

Step 4: Decorate the teeth with the eyes and cheeks and draw on a mouth. Glue one tooth to the outside of the box.

Step 5: Create a tooth pocket by applying glue to the sides and bottom of the remaining tooth as shown, leaving an opening at the top. Glue the pocket to the inside tray. Once the glue dries, the box is Tooth Fairy-ready. Have your child put the tooth inside the inner pocket and hang it outside their door before your child goes to bed!