By Dr. John White

Braces by White

With ever-evolving technology, the process of attaching braces to the teeth has changed over the decades since the introduction of materials that allow orthodontists to bond braces directly to the enamel.

Orthodontists no longer have to place bands around each tooth to attach braces, which took much longer and showed more metal than the current direct and indirect bonding techniques.

Since beginning my practice in 1982, I have been using the direct bonding technique to place the braces right on the teeth and cure them into position.

How does this work?

First, the teeth are cleaned and then phosphoric acid is applied, which is the same acid you find on the label in Pepsi, Coke, Dr. Pepper and a few other sodas. The acid etches the enamel slightly, leaving a surface that is microscopically rough.

After preparation of the tooth, the orthodontist uses a self-etching primer with plastic incorporated into it, so it flows into those little spaces and bonds to the tooth. The composite adhesive used next to bond the braces forms a mechanical lock that holds the braces into place. The adhesive is polymerized with LED blue light and takes about 15 seconds per tooth.

After curing, the wires can be attached. All in all, it takes only about 50 minutes from the time the patient sits down in the chair, the braces are put on, and then he or she is instructed on proper care before leaving the office.

In the foreseeable future, I will be transitioning to indirect bonding to improve the precision of bracket placement in difficult-to-envision areas.

Utilizing my 3D intraoral scanner to acquire a virtual model of the mouth, and a 3D digital printer to create the template for precise bracket placement, I can put brackets on that model, put a transfer tray over the whole group of brackets, then lift it off the model and place into the mouth so the braces are all bonded at the same time.