This office need to re visit patient teaching as part of healthcare profession especially considering the age of your clients. Explanation,demonstration and teach back should be employed. The other area that needs improvement will be customer relations. This will help with referals and client retention.I would also suggest that children be asked to brush or at least rinse their mouth after the removal of the old wires before putting a new one. It is easier to avoid complications using this method than taking out a wire and replacing it irrespective of possibilities of having left over food. This could be up to a 50/50 chance.