What patients should know
Fixed Orthodontics is a system of dental treatment
whereby braces are fixed onto the teeth in order to move them to
the desired position. Here, it is performed by senior
orthodontists who are specialists in the field.
Duration of the treatment - is highly variable –
it depends on the age of the individual undergoing treatment,
the nature of the corrective tooth movements involved and a host
of other factors. Generally a time period of one year to a year
and a half will be sufficient. However patients requiring
complex tooth movements and those who are comparatively older,
tend to require more time for completion of treatment than
Commencement of treatment and frequency of
following visits – Treatment can commence only after complete
scaling (cleaning), fillings and extractions (if they are
required). Other treatment procedures such as periodontal
surgery etc. may also be required prior to commencement of
orthodontic treatment. The first orthodontic appointment will be
a long one as sufficient time period is required for fixing the
After completion of fixation of braces, the subsequent visits
are generally short – for about half an hour. However, much more
time may be required in the event of breakage or damage to the
braces. Generally, a time gap of approximately one month is
given between appointments, unless otherwise required.
Instructions to be followed by patients during
+ The appliance is likely to cause certain amount of discomfort
during the initial phase. This can manifest itself as ulcers in
the mouth, difficulty in chewing and talking. Once the patient
gets used to the appliance, these problems will gradually
subside. In the event of ulceration in the mouth caused by the
appliance, the drugs, mouthwash and ointment prescribed by the
doctor are to be taken. Warm saline may be used for rinsing the
mouth twice or thrice a day. Place a clean cotton bolus over the
area of the appliance which appears sharp and tends to hurt.
+ If the appliance gets damaged, kindly report to the clinic so
that appropriate measures are taken. Please do not try to tamper
with the appliance or try to repair the same yourself. If you
are wearing elastics (rubber bands), kindly wear them in the
manner you have been asked to. In case you miss an appointment,
please discontinue using the elastics so that further tooth
movement is prevented. In case any portion of the appliance gets
dislodged and comes out, please retain them with you and hand it
over to the doctor during your next visit. It would be ideal if
the patient is able to identify various parts of the fixed
appliance such as the brackets, molar bands, archwire, elastics
and rubberbands. It helps improve communication concerning
+ Maintenance of meticulous oral hygiene is a must during the
phase of treatment. If this is not done, food debris are likely
to accumulate in the appliance spaces. This will further lead to
tooth decay and gum diseases. Hence, lack of proper daily
brushing will eventually lead to loss of the teeth which we have
been attempting to reposition. Brushing after every meal is
+ Do not have hard or sticky food stuffs during the treatment
period. If used, they can cause damage of the appliance, cause
accumulation of the food debris on tooth and appliance surfaces
and the spaces. Avoid chewing using the front teeth. Avoid
aerated drinks as they tend to dislodge the bands and brackets
by dissolving the bonding/cementing medium.
+ Try to avoid all activities, which tend to apply pressure on
the appliance thereby damaging it. These include boxing,
wrestling, forcible wiping your face with towels etc.
+ Ulceration in various parts of the mouth is likely to develop
during the first few days after fixation of the appliance. You
may apply the anesthetic gel suggested by the doctor in the area
of ulceration. If a sharp portion of the appliance is found to
be the cause for the ulceration, you may cover up the sharp
margin with a small wisp of wet cotton or a piece of moist
Completion of treatment -
+ After completion of fixed appliance treatment, you will be
given a removable retention-appliance. This is meant for
maintaining the position of the repositioned teeth. This
appliance has to be ideally worn for a period of total one and a
half years – the first 6 months day and night, the next 6 months
night alone and the last 6 months on alternate nights. The
appliance need not be worn during food intake. Discontinuance of
the retention appliance can cause relapse – ie., return of the
teeth to the original position, prior to treatment.
Do not hesitate to seek clarifications with the
doctor(s) if you have any.
Please contact us one week prior to your scheduled
appointment to confirm the same.
Kindly keep appointments. If you miss an
appointment, your treatment period will certainly get prolonged.
If, due to unavoidable circumstances you have to change the
appointment date / time, kindly inform us at the earliest.
Dr. Prasanth Pillai K.S., BDS,MDS-OMFS.