Orthodontic braces are specialized appliances designed to straighten teeth and align the bite for improved function and appearance. The process of getting braces involves careful preparation steps to ensure the brackets adhere securely to the tooth surface. Understanding this preparation can help demystify the procedure and ease any anxiety about the initial appointment.
Preparation Before Bonding
The teeth are cleaned before braces are applied, but the process is specific to bonding, not a standard dental cleaning. Before the orthodontist attaches the brackets, the tooth surfaces must be completely free of plaque and residual films. The success of the adhesive bond relies on direct contact with clean enamel.
The clinician performs a specialized, quick polish, often using a non-fluoride pumice paste. Standard dental cleaning pastes containing fluoride or flavoring oils are avoided as they can leave a residue that interferes with the adhesive’s ability to stick. This polishing step removes microscopic contaminants that could weaken the bond. The orthodontist also checks for any existing decay or large restorations.
The Step-by-Step Bonding Process
The process of securely affixing the brackets, called bonding, begins with isolating the teeth to maintain a dry field. The clinician uses cheek retractors and cotton rolls to keep the lips, cheeks, and saliva away from the tooth surface. Isolation is important because moisture contamination is a leading cause of bond failure.
Next, the enamel surface is prepared using an etching solution, typically a phosphoric acid gel. This gel is applied for 15 to 30 seconds to microscopically roughen the enamel surface. This process creates tiny, porous channels in the enamel, allowing the liquid adhesive to penetrate and form a strong mechanical lock. The acid gel is then thoroughly rinsed off, and the tooth surface is dried until it appears frosty white, indicating a properly etched surface.
A thin layer of bonding agent, or primer, is then applied to the conditioned enamel. This liquid resin flows into the microscopic pores and acts as a bridge between the tooth and the bracket adhesive. The orthodontic bracket is coated with a dental cement or adhesive paste and carefully positioned on the tooth. Finally, a specialized high-intensity light is shined on the bracket for several seconds to cure or harden the adhesive material. This light-curing process rapidly sets the cement, securing the bracket firmly to the tooth for the duration of treatment.
Immediate Care Instructions
Patients should expect general soreness for the first three to five days as the teeth begin to respond to the initial pressure. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, can be effective in managing this initial discomfort. Rinsing the mouth several times a day with a warm saltwater solution can also help soothe any irritated gum tissue.
The soft tissues of the mouth, including the cheeks and lips, will need time to adapt to the new metal surfaces. Orthodontic wax is provided to cover any brackets or wires that feel sharp or are causing irritation, creating a smooth barrier. Immediately following the application, a soft-food diet is necessary to prevent damage to the new hardware and minimize tenderness. Hard, crunchy, or sticky foods like nuts, hard candy, and caramel must be avoided entirely to prevent the brackets from detaching or the wires from bending.