Braces are mechanical devices used to apply gentle, continuous pressure to teeth, shifting them into a straighter position to correct alignment and bite issues. The installation process is a meticulous, multi-step procedure performed by an orthodontist to ensure each component is securely and correctly placed. Treatment success relies heavily on establishing a strong bond between the brackets and the tooth surface, followed by the precise connection of the wires that provide the force for movement. Understanding this detailed application process can help demystify the experience for anyone preparing for orthodontic treatment.
Preparing the Tooth Surface
The first stage of applying braces focuses on preparing the enamel to receive the bonding agent. This is essential because the adhesive needs a clean, receptive surface for a secure, long-lasting connection. The orthodontist begins with a thorough professional cleaning, often using a non-fluoridated pumice paste to remove plaque or debris that could compromise the bond.
Once cleaned, the teeth must be completely dried and isolated from saliva, typically using cheek retractors and suction. The next step involves applying an etching solution, most commonly a phosphoric acid gel, to the front surface of each tooth for 15 to 30 seconds. The acid microscopically roughens the enamel, creating tiny pores that allow the adhesive to penetrate and create a strong mechanical interlock. After rinsing and drying, the treated enamel appears dull and “frosty white,” indicating it is ready for bonding.
The Process of Attaching Brackets
With the tooth surfaces prepared, the orthodontist attaches the brackets, which serve as anchors for the system. A dental adhesive, often a composite resin, is applied to the back of each bracket. This adhesive is strong enough to withstand chewing forces but can be safely removed without damaging the enamel at the end of treatment.
The orthodontist places each bracket precisely onto the etched surface, ensuring correct alignment according to the planned tooth movement. Accurate positioning is crucial because the bracket’s slot determines the direction and angle of the force applied by the archwire. After removing excess adhesive, a high-intensity curing light is used to instantly harden the composite resin, securing the bracket firmly to the tooth.
Connecting the Archwire and Ligatures
The system becomes functional with the introduction of the archwire, the main component that generates the force to move the teeth. The archwire is a thin, flexible metal wire threaded through the horizontal slot of every bonded bracket. These wires are often made of materials like nickel-titanium, which provides a light, continuous force, or stainless steel, which offers a firmer, controlled force, depending on the treatment stage.
To keep the archwire securely seated, small ties called ligatures are used. The connection of the archwire and ligatures completes the mechanical setup, applying the first continuous pressure that begins aligning the teeth.
Types of Ligatures
- Traditional braces use tiny elastic rings, known as elastomeric ligatures, stretched over the wings of the bracket.
- Thin metal wires, called steel ligatures, may be twisted tightly around the bracket, often used when a tighter engagement is needed.
Immediate Post-Application Care and Expectations
After the braces are installed, patients should expect a period of adjustment as their mouth adapts to the new appliances. Within the first few hours, general soreness or a dull ache in the teeth and jaw is common as the initial pressure takes effect. This discomfort is a normal response to the mechanical movement and usually lasts for the first two to three days.
Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can manage this initial soreness. The brackets and wires may also cause minor irritation to soft tissues like the inner cheeks and lips. Orthodontic wax provides a simple solution; a small piece can be pressed over any bracket or wire causing rubbing or discomfort, creating a smooth, protective barrier. Patients are advised to stick to soft foods for the first few days to minimize chewing discomfort while the teeth are tender.