Orthodontic appointment for bonding and fixing up the appliance usually takes about 30-45 mins per arch. Since it’s a time consuming procedure, many orthodontists prefer to have them split into two appointments upper arch and lower arch procedures. The process of attaching braces to the teeth, requires effective bonding of material to the enamel of teeth.

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There are two main types of bonding

Indirect bonding – method of applying brackets in a way that an entire set of braces can be applied.

Direct bonding – method of applying brackets on each individual tooth one at a time.

Although each have their advantage and disadvantages, direct bonding is most commonly used by all orthodontists.

Placement of brackets and tubes in a step by step process:

• Teeth is first scaled and polished a day or two before, so as to allow the gums to be healthy so as to bear the forces of the new appliance.
• Cheek retractor is used to keep the area visible and dry
• Teeth are air –dried, and an etchant is used to make the surface area of tooth rough enough to bond the brackets.
• After rinsing and air drying, adhesive primer is coated in very thin layers and light cured using LED light.
• Following this the bonding cement is placed in required quantities on the back of brackets, and placed on the tooth surface. Excess cement is removed, and the brackets are placed in the precise positions and light cured with LED light. Some cements sets by chemical cure in which case LED lights are not required.
• The cheek retractor is removed and the wires are placed to hold the brackets and to impart the necessary forces required to align the teeth.

Placement of bands or rings

Bands or rings are placed on the back molars. An advantage of using molar band is to have increased stability of attachment on a large tooth in a very highly active part of the mouth. They provide additional attachment tubes for head gear and other external appliances.

The process of placing bands on the molars involves the following:

• Separators are placed a week prior to appointment of band placement.
• Separators are removed and bands are placed on the space created by them.
• They come in different sizes and are selected to fit each tooth.
• Once the bands are selected and finalised to fit the molars, they are removed and dried.
• The inner portion of the band is lined with band cement and positioned on the teeth and chemical cured.

What to expect after placing the brackets and appliance?

When braces are first placed and then later adjusted, some tightness is felt, which naturally leads to soreness, for a day after the first appointment. This is because of the arch wires tightening the teeth into position. Over the counter pain relievers are recommended to help relieve this pain. Soreness and pain will be improved and completely go away in a week time.

For more queries and clarifications visit us at Oris Dental center.

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