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Why orthodontics?
Right age for Braces
Types of Braces
What to expect during your orthodontic visits
Instructions
Retention

1

Consultation

  • You need to fill a patient information form in which detailed medical/dental history of the child is given. Your perception about child’s orthodontic problem and expectations from the treatment etc. are written.
  • Orthodontist will examine your child clinically to evaluate findings related to the chief complaint. He will also examine for jaw proportions, status of dentition, persistant habits, speech, swallowing breathing patterns.
  • There will be brief discussion with the parents and the patient regarding the chief complaint and any additional clinical findings. A tentative treatment plan and possibility of teeth extractions will be discussed
  • Approximate range of treatment duration and orthodontic fee structure may be discussed.
  • Referral note is given for the required X rays  or any preorthodontic dental treatment with the dentist.
  • Appointment for pre orthodontic records is given.

2

Pre Orthodontic records

 
  • Study model impressions of both upper and lower teeth are taken.
  • Intra oral and extra oral photographs are taken.
  • Detailed clinical examination is done and findings are recorded.
  • Appointment for treatment conference is given.


(Before the treatment conference , Orthodontist studies and evaluates your plaster records which is called Study model analysis. He traces your Lateral cephalogram X ray to find out how your teeth are related to the jaws, to each other and to the cranial base and quantifies these findings. He evaluates your OPG x ray to rule out hidden bony pathology, impacted teeth, extra teeth or missing teeth. After studying your study models, x rays and photographs, individual treatment plan is chalked out for you which can give you best possible facial esthetics, function and dental alignment.)

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3 Treatment conference
 
  • Xray findings and study model evaluation is discussed with the patient and the parents
  • Ideal treatment plan is discussed
  • Alternative treatment plan if available is discussed
  • Different Orthodontic appliances which may be needed is discussed
  • Total treatment duration , the fee structure and payment options are discussed
  • Treatment plan is finalized and patient's / parent's signatures taken on consent form
  • Patient is briefed about certain dos and don'ts in the treatment and molar separators are given. Referral note is given for the extractions of certain teeth if discussed in the treatment plan

 
4 Bracket bonding or strap up
 


  • The selected orthodontic fixed appliance is glued to the teeth, molar bands are cemented and initial aligning wires are given
  • Long appointment, about 1 hr. 30 min. duration. Little if any pain is encountered.
  • Instructions regarding tooth brushing and food habits are given

  • Certain medicines are prescribed to take care of initial pain and discomfort.
  • Patient is called after a week for check-up
   
5 A week later
 

  • Orthodontist will check if you are still uncomfortable with the appliance. Pokey wire are cut
  • Your brushing technic and efficiency is checked and if needed, brushing technic is explained again
  • You will be called after a 1 month for check up
 
6 Check-ups ( once a month or 6 wks further on )
 
  • Aligning wires may be further tightened
  • Wires may be changed, fixed elastics put or removable rubber bands are prescribed
  • Accessory appliances if needed may be put
  • Process continues till all or most of the objectives of the treatment plan are achieved
   
7 Appliance removal or debonding
 
  • Orthodontic appliance is removed after evaluating additional set of x rays and study models to make sure that most treatment objectives are met.
  • Either fixed retainers are bonded or impressions are taken for removable retainers
  • The composite or glue marks left after braces removal are cleaned with special instruments which avoids damage to natural tooth structure
  • Post treatment intra and extra-oral photographs are taken
  • Patient is called a week later for retainer delivery
   
8 Retainer delivery
 
  • Removable retainer is delivered and instructions are given about it's wear
  • Generally retainers are worn day and night continuously except while eating food and brushing teeth
   
9 Post retainer check up
 
  • Generally done every 3 month for a year and then as per the patient's requirement
  • It is advisable to come for check ups even after the retainers are discontinued to check for any natural or age related changes

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