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The Complete Guide to Orthodontic Treatment Process: From Initial Consultation to Retention

April 21, 2025

Orthodontic treatment is a complex and precise medical procedure that requires accurate diagnosis and personalized treatment plans from professional orthodontists. This article details the complete orthodontic process, from initial consultation to the final retention phase, helping you fully understand the scientific basis and clinical steps of this "investment in beauty." The content is based on professional dental resources and clinical practice, aiming to provide authoritative and practical guidance for readers considering orthodontic treatment.

Orthodontic treatment is far more than simply "getting braces"—it's a systematic medical process whose professionalism and complexity far exceed common perception. Before officially beginning treatment, comprehensive evaluation and thorough preparation are essential, as this phase directly impacts treatment effectiveness and safety.

Initial consultation is the first step and a critical opportunity to establish trust between doctor and patient. Patients should consult with a qualified orthodontist who will conduct a preliminary oral examination, understand the patient's chief complaints (such as improving tooth alignment, adjusting bite relationship, or enhancing facial aesthetics), and explain possible treatment options, estimated duration, and cost ranges. Notably, excellent orthodontists spend significant time communicating with patients to understand their expectations because "orthodontics isn't solely the doctor's decision" but requires collaborative goal-setting based on the patient's actual situation.

Comprehensive examination and data collection form the foundation for developing a scientific treatment plan.

This phase typically includes:

  • Modern digital orthodontic technologies like the SPARK Align system can integrate CBCT data with 3D tooth arrangement plans, allowing orthodontists to "know the roots" before treatment begins, significantly reducing risks such as fenestration and dehiscence. Such technological advancements have greatly improved the safety and precision of orthodontic treatment.

    Developing a personalized treatment plan is the core of pre-treatment preparation. The orthodontist comprehensively analyzes all examination data, considering key factors including:

    • Treatment options may include whether extractions are needed (typically 4-8 teeth to create space), choice of appliance (metal brackets, ceramic brackets, or clear aligners), and estimated treatment duration. Notably, adult patients with periodontitis must first control inflammation before starting orthodontics to prevent accelerated alveolar bone loss.

      Preparatory work includes:


      • Treating oral diseases: Filling cavities, treating periodontal disease, professional cleaning

      • Necessary extractions: Usually performed in batches with 1-2 week intervals

      • Separating teeth: Using spacers to create space between molars for about 1 week

      • Psychological preparation: Understanding potential discomfort and precautions during treatment

      Active Treatment Phase


      • Fixed appliances (metal or ceramic brackets): The orthodontist precisely positions and bonds brackets to tooth surfaces before placing archwires. Bracket positioning requires three-dimensional consideration—mesiodistal, vertical, and angular—accurate to the millimeter level, far more complex than simple "gluing." This process typically takes 2-3 hours.

      • Clear aligners: The orthodontist may bond transparent attachments to teeth to facilitate movement, then provide a series of custom-made clear trays changed every 1-2 weeks.

      • Lingual braces: Brackets are placed on the tongue-side of teeth, offering maximum discretion but with greater technical difficulty.



      • During each visit, the orthodontist checks appliance status and treatment progress, making necessary force adjustments. For fixed appliances, this may involve changing archwires or ligation methods; for clear aligners, evaluating current tray effectiveness and distributing subsequent trays. Mild soreness for about a week after adjustment is normal, indicating planned tooth movement.

        The biological process of tooth movement underlies orthodontic treatment. When appropriate constant force is applied, alveolar bone undergoes "resorption and formation" remodeling:


        • Tooth alignment: Teeth usually become properly aligned within about 6 months

        • Space closure and bite adjustment: Using elastics to close extraction spaces while aligning dental midlines and improving occlusion

        Modern digital orthodontics like the SPARK Align system, through TruGen biomaterials and upgraded APPROVER software, provides 3D images of roots and jawbones, helping orthodontists more accurately design tooth movement paths and anticipate risks, significantly improving safety and efficiency.

        Emergency management and plan adjustments are also crucial during active treatment. Individual variations may cause deviations from expected progress, requiring plan modifications. Patients should promptly contact their orthodontist for issues like loose brackets, poking wires, or lost aligner attachments.

        Patient compliance is vital throughout treatment:


        • Strictly following appliance wear instructions (clear aligners require ≥22 hours daily)

        • Maintaining excellent oral hygiene to prevent cavities and gingivitis

        • Avoiding hard/sticky foods that could damage appliances

        • Attending all scheduled appointments without arbitrarily extending intervals

        Completion and Retention Phase




        1. After removal, many patients opt for whitening or restorative treatments to further enhance their smile. However, this isn't the endpoint but the beginning of another crucial phase—retention. Teeth's memory of original positions combined with periodontal tissue and occlusal forces may cause gradual "relapse."

          Retainer wear is key to preventing relapse. Main retainer types include:

          • Wear time varies but generally follows these principles:
            • Notably, adult patients typically need longer retention than adolescents due to stronger periodontal memory—some cases even require lifelong nighttime wear. Professor Bai Yuxing from Beijing Stomatological Hospital notes: "Post-orthodontic stability directly correlates with retainer wear time—premature discontinuation is a primary cause of relapse."

              Retention checkups are equally essential, typically scheduled as:

              • Checkups evaluate:
                • Early signs of relapse prompt timely intervention, like retainer adjustments or short-term reappliance use.

                  Long-term outcome maintenance extends beyond tooth alignment to include:

                  1. Studies show patients completing professional orthodontics with proper retention achieve significantly improved tooth stability, oral health, and quality of life. Cases like "Hao Hao" (pseudonym), through 5 years of systematic treatment (including retention), transformed from a shy boy to a confident young man, achieving both "smile freedom" and psychological confidence.

                    Special considerations:


                    • Retainer cleaning: Removable retainers need regular specialized cleaning; fixed retainers require careful adjacent-area cleaning

                    • Retainer storage: Removable retainers should be kept in cases when not worn to avoid loss

                    • Retainer replacement: Damaged or loose retainers should be promptly repaired or remade


                    Early childhood treatment (primary or mixed dentition, ~6-12 years) offers unique advantages:

                    • Early treatment typically uses:
                      • Cases like Hao Hao avoided potential orthognathic surgery through early expansion and myofunctional training. Note that early treatment usually requires later comprehensive orthodontics after all permanent teeth erupt for final detailing.

                        Adolescent comprehensive treatment (early permanent dentition, ~12-18 years) is considered the "golden period" because:

                        • Common adolescent approaches include:

                            • Periodontal health: Must control inflammation before treatment, with close monitoring throughout

                            • Camouflage treatment: Dental compensation to improve profiles, with severe skeletal discrepancies possibly requiring orthognathic surgery

                            • Appliance selection: Often prefer clear aligners or lingual braces for aesthetics

                              • Greater challenges: Completed jaw growth limits skeletal change

                              • Complex issues: Frequent comorbidities like periodontal disease, tooth wear, or restorations

                              • Higher aesthetic demands: Greater emphasis on appliance discretion and treatment-period appearanceTypical treatment duration:


                              • Non-extraction: ~2 years

                              • Extraction: ~3 year