This appointment lasts about 20 minutes and can be done in the morning or the afternoon. We will take impressions of your upper and lower teeth which we will send to a lab and have digital 3-D computerized models of your teeth. We will also take a skull X-ray called a cephalograph which will allow us to look at not only the teeth but how they interact with the rest of the skull and jaws. Usually a Panorex is provided by your general dentist, however if it is not we will also take this X-ray during this appointment. The Panorex allows us to see all the teeth, including those that have not erupted. Finally we will discuss “Risks and Limitations” of orthodontic treatment and answer any final questions before scheduling you for the Bonding Appointment and the Banding Appointment.
Bonding and Banding Appointments
These appointments last about one hour each and are done in the morning session. At the first of these two appointments (Bonding Appointment) spacers will be placed around your 6-year molars in order to provide a small amount of space needed to fit bands at your next appointment. The doctors will then glue the braces onto all the permanent teeth, both on the top and bottom. At the end of this appointment the patient will receive a special hygiene kit and one of the assistants will thoroughly explain proper brushing, foods to avoid, and answer any other questions you may have. The second of these two appointments (Banding Appointment) will be done 1-week after the bonding appointment. The spacers will be removed and bands will be fit and cemented to place. Wires will be fabricated and tied in to allow the orthodontic movement to begin. We use the highest technology wires (designed by NASA) which deliver very light forces for optimal comfort and movement. We split getting braces on into two appointments to not overwhelm any patient and keep everyone happy and comfortable.
Routine Archwire Appointments
Once treatment begins we will see the patient every 4-6 weeks for about 30 minutes. During these appointments the doctors will be working a patient through their treatment plan regimen. Archwires will be changed and modifications will be made to those wires as needed to reach the desired final treatment result. We always save our afternoon appointments for these types of appointments in order to allow the bulk of treatment to be done without our patients missing school or work.
Removal of Braces Appointment
After all the hard work is done and you have achieved a beautiful smile and a solid harmonious bite, it is time to get the braces off. Other than the Banding and Bonding Appointments this is the only other appointment that we reserve for the morning session only. We will remove the braces, remove the cement, polish the teeth, take impressions for retainers, and take final photographs. This whole process takes anywhere from 1–1.5 hours. Retainers will be delivered one week later.
Retainers need to be tightened and adjusted periodically after their delivery. We normally see patients one month after initial retainer delivery to do the most crucial tightening and adjustment appointment. From that point we see patients on a 3-6 month schedule as needed to make sure that good retainer wear habits are being formed and to make sure the bite and smile are being maintained.