A braces adjustment is a planned appointment where the orthodontist or their assistant modifies the orthodontic hardware. The purpose of this visit is to maintain the gentle, continuous force required to guide the teeth toward their final, aligned positions. By changing components of the braces, the treatment progresses predictably according to the patient’s personalized plan. These regular adjustments, typically scheduled every four to ten weeks, ensure that the teeth are moving safely and efficiently.
The Procedure: What Happens at the Appointment
The adjustment process begins with an initial assessment of the patient’s progress. The orthodontic staff checks for discomfort, loose brackets, or broken wires, and confirms that the patient has followed care instructions. Next, the small elastic ties, or ligatures, that hold the main wire to the brackets are removed, and the existing archwire is taken out.
With the archwire removed, the team performs a quick cleaning and examines the teeth and gums before new components are placed. The orthodontist evaluates the current tooth movement against the treatment plan to decide on necessary changes. A new or modified archwire is placed back into the brackets, and fresh ligatures secure the new wire in position.
This process usually takes about 20 to 30 minutes, focusing on precise, incremental changes that continually move the teeth. If the patient is using interarch elastics, which connect the upper and lower teeth, instructions for wearing the new bands are reviewed to ensure the bite is corrected as planned. The patient leaves with hardware recalibrated to apply the next stage of controlled pressure.
Key Components Adjusted
The most frequently manipulated component is the archwire, the thin metal wire running through the brackets. As treatment advances, the archwire is often replaced with one that is thicker, stiffer, or made of a different material to exert greater forces. The change in wire diameter or material provides the calibrated tension needed to continue the gradual biological process of tooth movement.
Small elastic ligatures, which secure the archwire into the bracket slots, are always replaced because they lose elasticity over the course of several weeks. They are replaced with new ones to ensure the archwire remains firmly engaged and actively applying force. In some stages, a thin metal wire tie may be used instead of an elastic ligature for greater control over specific teeth.
To achieve more specific movements, the orthodontist may introduce or modify auxiliary components. Power chains, a series of interconnected elastic loops, are often added to apply continuous, stronger force to close spaces between teeth. Similarly, coil springs may be placed onto the archwire between brackets to push teeth apart and create necessary space for crowded teeth. The use of these specialized elastics and springs allows for targeted directional forces to address rotations or root positioning.
Managing Discomfort After an Adjustment
It is normal to experience pressure or mild soreness for the first 24 to 72 hours after an adjustment as the teeth respond to renewed forces. This discomfort occurs because the new tension initiates the biological process of bone remodeling around the teeth. For relief, over-the-counter pain relievers such as ibuprofen or acetaminophen are recommended. Taking a dose shortly before the appointment can help minimize the onset of soreness.
Patients should temporarily switch to a diet of soft foods that require minimal chewing, such as mashed potatoes, yogurt, or soft pasta. Avoiding hard, sticky, or crunchy foods for a few days prevents strain on the newly adjusted teeth and hardware. Applying a cold compress to the outside of the cheek for 10 to 15 minutes at a time can help numb the area and reduce inflammation.
If a new wire end or bracket causes irritation to the soft tissues, a small piece of orthodontic wax should be applied to the offending part of the appliance. Rinsing the mouth several times a day with a warm saltwater solution can soothe tender gums or minor abrasions. These simple measures help make the period of initial tooth movement more manageable.