Traditional braces correct misaligned teeth and bite issues (malocclusion) using a system of components. This orthodontic appliance applies gentle, continuous force to gradually shift teeth into prescribed positions. The system consists primarily of small attachments, called brackets, bonded to the tooth surface, and a flexible metal archwire that connects them. Understanding the installation process, which typically takes an hour or two, is the first step toward achieving a straighter smile.
Preparing the Teeth for Installation
The installation process begins with the orthodontist isolating the teeth to ensure a completely dry working environment. Cheek retractors are placed to hold the lips and cheeks away from the teeth, while a suction device manages saliva flow. Maintaining dryness is necessary because moisture contamination compromises the strength of the adhesive bond.
Next, the tooth surface is cleaned and polished, often using a non-fluoridated pumice paste, to remove plaque or debris that could interfere with adhesion. Following this mechanical cleaning, a slightly acidic etching solution is applied to the front surface of each tooth. This etching step creates microscopic pores in the enamel, establishing a rough, textured surface. The roughened enamel allows the bonding material to physically interlock with the tooth structure, forming a strong mechanical anchor for the brackets.
Securing the Brackets and Adhesive
After the etching solution is rinsed away and the teeth are dried, the process of securing the brackets begins. A specialized dental adhesive, often a composite resin, is applied either directly to the prepared tooth surface or to the back of the bracket base. This material acts as the permanent cement that holds the bracket in place.
The orthodontist positions each bracket onto the exact center of the corresponding tooth, using a gauge to ensure precise placement according to the patient’s treatment plan. Accurate bracket positioning is important because the slot in the bracket dictates the final three-dimensional movement of the tooth. Once the bracket is in the correct location, any excess adhesive around the base is removed.
To finalize the bond, a high-intensity curing light is directed at the adhesive surrounding each bracket. This light triggers a rapid chemical reaction called polymerization, which hardens the composite resin in seconds. The immediate hardening of the adhesive creates a powerful bond between the bracket and the enamel, securing the attachment firmly in place. This application and curing sequence is repeated for every tooth receiving a bracket, establishing the foundational structure of the braces system.
Installing the Archwire and Ligatures
With all the brackets bonded, the orthodontist introduces the archwire, which is the main component responsible for generating the force that moves the teeth. This wire is threaded through the horizontal slot of each bracket, following the curve of the dental arch. Initially, the archwire may be flexible and thin, designed to apply light pressure to misaligned teeth.
The archwire is then secured to each bracket using small elastic rings, known as ligatures, or thin, flexible metal wires called wire ties. Ligatures cinch the archwire into the bracket slot, transmitting the wire’s spring-like force to the tooth. This activates the system, applying the pressure necessary to initiate tooth movement. The orthodontist ensures the ends of the archwire are clipped short and tucked away behind the rearmost bracket or band to prevent irritation to the cheeks.
Immediate Aftercare and Expectations
Following the installation, patients notice an initial sensation of pressure, which is a sign that the teeth have begun the movement process. This discomfort is typically mild but can be managed with common over-the-counter pain relievers, such as acetaminophen or ibuprofen. The soreness usually peaks within the first day or two and subsides within the first week.
The new hardware can cause temporary irritation to the soft tissues of the mouth, including the inner cheeks and lips. Orthodontic wax can be applied directly over any bracket or wire that causes rubbing, providing a smooth, protective barrier.
Patients must immediately adapt to an increased focus on oral hygiene, using specialized brushes and floss threaders to clean around the brackets and wires after every meal. Dietary restrictions are enforced, requiring the avoidance of hard, sticky, or crunchy foods that could dislodge a bracket or bend a wire. The first follow-up adjustment appointment is scheduled a few weeks later to monitor progress and change the archwire or ligatures to continue the tooth movement.