Fixing of the braces
On the day the braces are to be fixed the dentist or his assistant cleans the teeth and polishes them so that all surface deposits are removed from the teeth, enabling fixation of the brackest on the teeth. The next step involves the placement of bands on the back teeth. The bands come in various sizes. The orthodontist selects the size that would fit your tooth and cements it around them. The next step is the fixation of the brackets on the other teeth. This is called bonding. Before the fixation is done the orthodontist or his assistant slides a cheek retractor between your lips and the teeth to keep the lips away from the teeth. He would also place cotton rolls and a suction device to remove the accumulating saliva. This is done because the teeth have to be dry and devoid of any surface wetness during the fixation of brackets. Next the teeth are etched using acid solution or gel so that small amount of surface roughness is created to help in adherence of the brackets. The brackets are fixed on to the teeth by using a special adhesive that is applied on the under surface of the bracket.

Does it hurt when the braces are being fixed?
It does not hurt when the braces are being fixed. The soreness and pain start after a few hours. You can ask the dentist to prescribe a pain reliever for you like aspirin. You can use wax over areas of the braces that hurt the lips or cheeks. Sometimes the wire starts piercing the cheeks from the end of the braces after a few days or weeks of treatment. This is because the teeth have already started moving. So you can go to the orthodontist and have the wire trimmed.

How long does it take to fix the braces?
The braces take about 11/2 - 2 hours to fix. So keep yourself free to be with your dentist for a few hours. You can even take half day off from office or school.

Do I have to go back to the orthodontist after the fixation?
The orthodontist schedules an appointment after 4-6 weeks. The follow-up orthodontic appointment is every 4 weeks. During these appointments the dentist may change the wires as the desired results are achieved and may even tighten the braces. Teeth move very slowly (about 1mm /month). The force applied on the tooth by the braces should be tolerable by the teeth and the comfort of the patient. So the tightening is done gradually at regular appointments so that the teeth and the surrounding tissues are not hurt.

Does it hurt while removing the braces?
Once the treatment is completed the orthodontist will remove the braces. It does not cause any pain to remove the brackets. They are easily removed by using special pliers.

Do I have to wear elastics?
Many a times the orthodontist advises you to wear some rubber bands. These are called elastics and are meant to deliver forces on the teeth to move them to the desired position. The orthodontist would advice you on how to wear them. They are to be removed while eating and replaced with new ones. Many orthodontists advice fresh elastics every 24 hours. The elastics come in various sizes and you should wear the ones prescribed by the dentist. Do not be over enthusiastic and wear more number of elastics. This can harm the teeth. Your orthodontist knows what is best for you. You can ask the orthodontist for flavored rubber bands.

What happens if i don't change the rubber band?
For one the teeth would stop moving. Thus the duration of the treatment would be prolonged. Old rubber bands also snap off and cause a little pain in the mouth.

What happens if I swallow the rubber band?
Accidental swallowing of a rubber band will not hurt you. They come off the next day in your feces.

Any special oral hygiene procedures during the treatment ?
Regular brushing and flossing should be carried out. Try to brush your tooth after every meal and before sleeping. The braces trap foodstuff under them and predispose to dental decay and gum problems. Thus good hygiene is a must when the braces are on. The dentist may prescribe a special orthodontic toothbrush for you. Fluoridated toothpaste may also be prescribed by your orthodontist to help prevent dental decay.

What are retainers?
Once the braces are removed the orthodontist will give you a retainer. A retainer is a removable type of braces that you can remove and replace in the mouth. These should be worn for a few months throughout the day and later for a few hours a day. The orthodontist would advice you on how long you have to wear them.

Why use retainers?
One of the greatest challenges faced by the orthodontists is the relapse of treatment. This means that the teeth tend to go back to the original position. This occurs due to a number of factors. This is avoided by wearing the retainers that holds the teeth in the corrected position. The retainers give time for the bone and other tissues around the teeth to adapt to the new position. In case you are too absent minded and tend to loose your retainer or misplace them or forget to wear them you can ask the orthodontist to give you a fixed retainer that you cannot remove. Some patients have to wear the retainer permanently.

What are face bows?
The orthodontist may prescribe the use of a face bow. The face bow is a steel framework in the form of a bow that is inserted into small tubes fixed on the molar teeth. The outer part of the bow is attached to elastic straps that are anchored on to the neck or the head. The purpose of the headgear is to aid your braces in keeping the back teeth in their position or even to push them further back. Some orthodontists don't prescribe the use of these headgears as they may at times snap off and rarely even pierce the eye. In case your orthodontist feels that you have wear one, take care to protect them by avoiding playing etc. with them. They are often worn for 8-12 hours a day.

Am I too old for orthodontic treatment?
Well to be honest you can have braces at any age provided of course that your gums and surrounding tissues are in a healthy state and you maintain good oral hygiene. As you get older your tissues become less elastic and the bone gets harder. So the duration of the treatment is likely to be more and you tend to have more pain during the treatment.

Can the braces be fixed on the inner side of the teeth?
Yes they are called lingual braces. The braces are fixed on the inner surface of the teeth so that they are not visible from the outside. Not all orthodontists practice this type of treatment. So if you are interested in the lingual braces you should inform your orthodontist about your desire. Even if he does not practice lingual braces he may refer you to the right person. But I should tell you that these braces pose more discomfort to the tongue and are harder to fix and tighten for the dentist. So the fees are naturally higher.