TREATMENT PROCESS WITH BRACES
Spacers / Separators
Many patients require bands on the back molars to provide additional support and allow for different attachments. Approximately one week prior to having bands put on the teeth, separators (or spacers) will be placed between the molars to create space for the band. These spacers are small elastic rings that may create some pressure and feel as though there is food between the teeth. They may cause some discomfort due to the teeth shifting and creating space.
Placing the brackets
Placing the brackets on the teeth is an exciting day! Called a “bonding”, the procedure can typically last about an hour. While it should be painless, keeping your mouth open in a cheek retractor may be a little uncomfortable. First, the teeth are polished and a conditioner is applied to prep the surface of the tooth. The conditioner is rinsed and the teeth are again dried using suction and air. A primer is painted onto the teeth. The bonding cement is placed onto the back sides of the braces, which are then placed onto the teeth. The brackets are placed in a very precise position onto the teeth, and excess bonding cement is removed. If the bonding cement is light sensitive, a bright blue light is used to “cure” the glue.
Wires and bands
Once the braces have been placed, wires are attached into the braces with very small rubber bands (elastic ties). These elastics come in many colors and can be switched regularly. Clear elastic ties can also be used with ceramic brackets and to make the braces be less noticeable. The wires used today are very flexible and return to their original shape, thereby applying a continuous and gentle force on the teeth. The pressure applied to the teeth through the braces are what cause the teeth to move into position. As the teeth shift in the proper direction, the pressure with decrease. Regular “adjustment” appointments are therefore needed to replace the weakened elastic ties and re-establish the forces necessary to move the teeth.
Elastics and wires are replaced every few weeks to keep treatment on track. Adjustment appointments also give Dr. Cline the opportunity to evaluate hygiene, compliance and tooth movement to make any necessary adjustments. It is common for patients to feel discomfort and pressure during and following the adjustment appointment. The pressure turns into soreness that evening, worsening the next day. This soreness is a result of the tighter wire and elastics putting more pressure on the teeth. Dr. Cline will make recommendations on managing the pain. The pain will usually decrease over the next 3-5 days.
Many patients require rubber bands (or Interarch Elastics). These rubber bands attach to brackets and are used to improve jaw alignment and bite. The can also be used to close spaces and improve midlines and crossbites. Because these rubber bands are placed by the patient and can be removed for eating, brushing and flossing, cooperation and compliance is essential to staying on track with the treatment plan and timeline. Because the length of time in wearing rubber bands is more important than the force, doubling up on bands cannot compensate for a failure to wear them according to instructions.
Removal day is an exciting day at All-Star Orthodontics! The appointment typically lasts about an hour and consists of removal of the brackets and bands, as well as a polishing of the teeth to remove any adhesive. The patient will feel pressure when the bracket is removed. The bracket is squeezed to release the bond, and lower teeth especially can feel some discomfort during this process. The teeth will feel slimy and gum tissue may be slightly inflamed, but it will subside.
Once the braces are removed, the patient enters the retention phase and given a retainer to maintain teeth positioning. We use three different types of retainers – Essex clear retainers, Hawley plastic retainers and fixed / permanent retainers which are bonded to the back of the teeth. The teeth are still relatively unstable, so the patient must typically wear the retainer full time for about 6-9 months except for meal times and for brushing and flossing. It is easy to lose your retainer. Keeping them in a case and clean will make them last. If a patient does lose a retainer, All-Star Orthodontics provides replacement retainers at no additional cost.
What Our Braces Patients Are Saying
When I decided to have braces put on, I searched in Google ‘best orthodontists in Richmond Virginia’. That is exactly what I got. Dr. Cline and his staff have been nothing but amazing; they made me feel welcome. I’ve never had an issue getting in contact with anyone,Dr. Cline has an awesome attitude/level of professionalism, and my overall experience has been outstanding. I would recommend this particular team to everyone that I know. I am so grateful to have found this orthodontist, this team, and can say without a doubt that I am in good hands these guys are really wonderfulDesiree H.