April 21, 2025
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:
Developing a personalized treatment plan is the core of pre-treatment preparation. The orthodontist comprehensively analyzes all examination data, considering key factors including:
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.
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
Retainer wear is key to preventing relapse. Main retainer types include:
Retention checkups are equally essential, typically scheduled as:
Long-term outcome maintenance extends beyond tooth alignment to include:
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:
Adolescent comprehensive treatment (early permanent dentition, ~12-18 years) is considered the "golden period" because:
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