The process of getting braces involves carefully affixing a specialized dental system to the teeth to guide them into new positions. Braces are composed of small attachments, called brackets, which are bonded to the tooth surface, and an archwire that runs through them to provide the necessary force for movement. The placement appointment is a methodical procedure designed to ensure a strong, long-lasting bond and the correct initial alignment of the components. Understanding this step-by-step application helps prepare those beginning orthodontic treatment.
Initial Chair-Side Preparation
The application process begins by ensuring the mouth is ready for the bonding agents. Cheek retractors are placed to gently pull the lips and cheeks away from the teeth, providing necessary visibility and access. These devices also help maintain a dry environment, which is essential for successful bonding.
Next, the tooth surfaces are cleaned using a specialized, oil-free pumice paste. This removes any plaque or debris that could interfere with the adhesive bond. The teeth are then rinsed and dried completely with compressed air, as moisture contamination weakens the bond strength.
Applying and Curing the Brackets
Once the teeth are clean and dry, a conditioning agent, typically an acidic etching gel, is applied to the enamel surface. This etchant creates microscopic pores that allow the bonding agent to grip the tooth effectively. The tooth is then rinsed and dried again; a successful etch leaves the enamel surface with a characteristic frosty white appearance.
Following the etching, a thin layer of primer or bonding resin is painted onto the prepared enamel. This liquid seals the microscopic pores and links the tooth to the bracket adhesive. An adhesive paste, often a composite resin, is applied directly to the base of each bracket.
The orthodontist places each bracket onto the tooth surface with precision, aligning it according to the treatment strategy. The specific placement dictates the direction and degree of force applied to the tooth. After positioning, a high-intensity light, often a blue LED curing light, is shone onto the bracket. This light causes the resin adhesive to harden instantly, securely affixing the bracket.
Connecting and Securing the Archwire
With the brackets bonded, the focus shifts to installing the archwire, which generates tooth movement. The initial archwire is typically a flexible material, such as nickel-titanium (NiTi), designed to fit the current misalignment of the teeth. This wire is threaded through the horizontal slot in the center of each bracket.
The wire is secured using small elastic rings, known as ligatures, or fine metal wires. These wrap around the bracket wings, pressing the archwire into the slot. Patients often select the color of the elastic ligatures at this stage. Finally, the orthodontist clips the ends of the wire extending past the last molar to prevent irritation to the cheeks and gums.
Immediate Post-Procedure Guidance
After the application is complete, the patient receives instructions for navigating the initial adjustment period. It is normal to experience soreness in the teeth and jaw, resulting from the initial pressure exerted by the archwire. This discomfort usually lasts two to four days and can be managed with over-the-counter pain relievers.
The new hardware may cause temporary irritation or chafing to the inner cheeks and lips. Orthodontic wax is provided and should be applied directly over any irritating brackets or wires to create a smooth surface. For the first few days, a soft-food diet is recommended to minimize chewing and reduce pressure on the teeth, consisting of items like soups, mashed potatoes, and yogurt. Patients are advised to contact the office if a bracket becomes loose or if a wire breaks or shifts.