Sometimes, dramatic improvements can be achieved in the face, lips and jaws, by orthodontic treatment alone, without jaw surgery. However, considerable effort is required, in terms of compliance with the instructions of the orthodontist. Elastics have to be worn almost all day, in order to move the teeth properly. Eating hard bulky foods can sometimes deform the wires, or break the brackets, so careful chewing is required. Regular attendance at the clinic is needed to monitor the progress as the teeth move into place. Appliances have to kept clean to prevent clogging, and prevent tooth decay. Sometimes, temporary mini-screw implants need to be inserted into the jaw bone to help attain stunning results, as though jaw surgery had been preformed.