Introduction

During the bonding appointment, you will have braces placed on your teeth. Usually, a number of visits are needed to have braces placed on all of your teeth. Each visit will last approximately two to three hours. During the procedure, your teeth will be polished, dried, and each brace will be individually glued to each tooth. Following the bonding of your braces, a light wire will be placed into the braces and provides the forces required to straighten your teeth.

Clinical Procedure

The clinical procedure involved in bonding braces can be broken down into the following steps:

1. Preliminary tooth preparation and moisture isolation
2. Primary enamel preparation
3. Bracket placement, positioning and cure
4. Archwire insertion
5. Post bonding instructions.

1. Preliminary tooth preparation and moisture isolation

Your orthodontist will polish your teeth with a sand-like paste, called pumice. The paste will then be rinsed out with water. This step is just like what happens when your regular dentist cleans your teeth. Teeth must be dry in order for the bonding agent to be effective. If not kept perfectly dry, the braces will not bond well and may come off. In order to keep the teeth dry during the procedure, a cheek retractor will be placed in your mouth. Cheek retractors are plastic holders that keep the lips and cheeks away from the teeth. A little plastic tube, called a saliva ejector, will be placed in your mouth to remove any excess saliva and moisture that accumulates.

2. Primary enamel preparation

Once your teeth are well dried, a small brush will then be used to apply a yellow liquid on the surface of each tooth. It is very important to stay still during this process as the material has an unpleasant taste and it is the aim of your orthodontist to keep all of the material on your teeth. Once the material has been applied, a short burst of air will dry it completely.

3. Bracket placement, positioning and cure

Next, a specific brace, with glue applied to it, will be placed on each tooth. The orthodontist may take several minutes to ensure that the brace is in the correct position. Again, it is important not to move as the position of the brace is critical. A blue light will then be shone on each brace for 30-60 seconds to harden the glue so that the brace sticks to the tooth. You should not look at the light as it can damage the eyes. After all the braces have been placed, your orthodontist will ask you to bring your teeth together to ensure that you are not biting on any of your braces. If you are, some braces may be removed and repositioned via the above procedure.

4. Archwire insertion

A wire will now be placed into your braces, in essence, connecting all of your teeth together. Initially, the wire is usually a little longer than necessary when first placed in the mouth, in order that it can be cut down to the correct size. Little colored elastic circles (you get to choose the color!) will be placed around each brace to hold the wire into place. You may feel some light pressure as these elastics are applied.
The orthodontist will then bend the wire at the back of the last tooth. Be sure that it is not sharp and you do not feel it poking your cheek.

5. Post bonding instructions

1. It is important that you maintain a soft diet (soup, noodles, etc) for the first twenty four hours after having the braces placed because the glue is not completely hardened until then.
2. After the first twenty four hours, you may maintain a fairly normal diet with the exception of hard and sticky foods (ice, hard candy, nuts, toffee, bubble gum, etc.). Also, you should not bite on pens and pencils, etc. These foods and items can easily break a brace. Foods with high sugar content (candy, pop, etc.) should also be avoided to prevent cavities. If you get a cavity during treatment, the braces need to be removed in order to be fixed, which can lengthen treatment time considerably.
3. You may begin to feel some tenderness to chewing a day or two following placement of your braces. Over the counter pain medications can be taken according to the guidelines on the package. This tenderness usually goes away after approximately a week, but may persist for up to two weeks.
4. As your teeth begin to straighten, the wire sometimes moves around and can begin to poke your cheek. Also, your lips might become a little irritated as they get used to the braces on your teeth. Wax will be given to you to place over your braces or wire so that any areas of irritation can be protected.
5. It is also very important that you keep your teeth clean during treatment as it not only prevents cavities but also maintains healthy gums. Both are important for efficient tooth movement. You should brush your teeth after every meal and before bedtime. Since braces make it more difficult to clean your teeth, brushing well should take at least two minutes. Flossing should also be done at least once a day.