The process of having orthodontic braces placed, known as bonding, often takes less time than anticipated. This procedure involves a detailed sequence of steps designed to securely affix the necessary components to the teeth. The total duration of this first visit is not fixed but typically falls within a manageable range, depending on various individual factors. Understanding the specific stages of this installation can help set clear expectations.
Preparing the Teeth for Installation
Before brackets are bonded, the teeth surfaces must be meticulously prepared to ensure maximum adhesion. Preparation begins with a professional cleaning to remove plaque, tartar, or debris that could interfere with the dental cement. A successful bond depends heavily on a clean, dry enamel surface.
Next, a cheek retractor is placed to keep the lips and cheeks away from the teeth and maintain a dry field. The teeth are air-dried, and a conditioning agent, often an acid etchant, is applied for about 30 seconds. This etchant creates microscopic porosities in the enamel, allowing the bonding material to physically lock onto the tooth surface.
The etchant is rinsed away, and the teeth are dried again, leaving the enamel with a chalky, frosted appearance. This confirms the surface is ready for the adhesive. Finally, a thin layer of primer is applied to the conditioned enamel to ensure a strong bond.
The Bracket Bonding Process
Bracket placement begins once the tooth surface is prepared with the primer. The orthodontist or assistant applies dental adhesive, often a resin cement, to the back of each bracket. Each bracket is then carefully positioned onto the center of the tooth according to the treatment plan.
After placement, the orthodontist removes any excess adhesive squeezed out around the edges. A specialized blue LED curing light is used to harden the resin cement, taking only a few seconds per bracket. This light-curing step chemically sets the adhesive, creating a strong bond between the bracket and the enamel.
Once the brackets are bonded, a flexible archwire is threaded through the slots of each bracket. The wire is secured using small elastic bands (ligatures) or by closing a small door in self-ligating systems. For a full installation covering both upper and lower arches, this bonding process generally takes between one and two hours.
Variables That Affect the Total Time
The total installation time varies based on several patient and appliance factors. The type of braces chosen influences the duration; for instance, ceramic brackets require more precise handling than traditional metal ones. Complex systems, such as lingual braces placed on the back surface of the teeth, inherently require a longer, more intricate procedure.
Applying braces to a single arch versus both arches in the same appointment significantly impacts the time. Some practices split the procedure into two visits for patient comfort and optimal bonding conditions. The need for auxiliary appliances, such as molar bands or specialized hooks, can also add extra minutes to the procedure.
Patient cooperation also plays a role in keeping the appointment on schedule. Since the teeth must remain dry and the mouth open for an extended period, a patient who remains still helps the procedure move efficiently. Unexpected issues, such as a bracket needing re-etching, will also slightly extend the overall time.
Immediate Post-Appointment Instructions
The final part of the appointment focuses on providing the patient with knowledge and tools for immediate care. The dental staff provides instructions on managing initial discomfort, which is common as the teeth feel the applied pressure. Over-the-counter pain relievers are often recommended for the first few days of soreness.
Patients receive a demonstration of proper brushing and flossing techniques, which must be adapted to clean around the new appliances. They are also given orthodontic wax to apply to any brackets causing irritation to the lips or cheeks. A review of dietary restrictions advises against hard, sticky, or chewy foods that could damage the braces.
The final step is scheduling the first follow-up appointment for an adjustment, typically four to eight weeks later. Adherence to the immediate care instructions is important for maintaining the integrity of the braces and ensuring the treatment progresses as planned.