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How does an orthodontist fit dental braces?

If you’ve got crooked teeth, braces are an obvious solution. But have you ever wondered how they are fitted?

In this post I explain the steps an orthodontist takes to fit braces. If you find this useful please share and if you have any questions, please leave them in the comments section below.

The fitting of braces usually requires two separate appointments.

The first appointment: Fitting spacers

Your first appointment will be fairly brief and usually takes place about a week before your second appointment. Spacers will be fitted in between your back teeth. These create space for bands to be fitted around your molars during your second appointment. Expect your teeth to feel a little bit uncomfortable and tight with the spacers fitted. This is very normal! You also need to be careful not to dislodge them with your tongue or toothbrush or with sticky foods.

The second appointment: Braces on

At Turner Lim, we usually book the second appointment for late morning — when the clinic isn’t too busy. You will be with us for about an hour and a half, so I recommend you have a good morning tea beforehand and some mild pain relief, like Panadol, to ensure you are comfortable for the rest of the day.

Removing the spacers

The first step is to remove the spacers that were fitted during your first appointment. We will then give your teeth a good polish — even when clean, your teeth have a very thin coating that will prevent glue from setting on your braces.

Fitting the bands

The next step is to fit bands around your back molars. We will select a band that looks like it might fit (we have lots of sizes) and put it on the tooth. A special tool is used to fit the bands and we will ask you to help out by biting on, what’s known as, a “bite stick”. Fitting a band is a bit like fitting a shoe — we’ve got to find the right one.

The removal of the spacers and fitting of the bands is usually carried out by a skilled orthodontic auxiliary. As the orthodontist, I come in to make sure the bands are well fitted and make adjustments if necessary. I’ll then remove the bands from the molars and cement them back on.

Orthodontic bands and spacers

Fitting the brackets

Next, the brackets are fitted. These are the little square-shaped metal or ceramic buttons that are attached to the other teeth in your mouth.

Before they can be fitted, though, your mouth must be very dry. This is very important so that the braces stay on the teeth. So, to absorb saliva, we’ll apply small absorbent pads to the corners of your mouth and use a small vacuum. We’ll also fit a kind of lip guard into your mouth that holds your lips out of the way — you won’t thank us for this; you’ll look a bit like a hapuka fish, but at least your mouth will be nice and dry.

fitting the brackets

We then squirt a jelly onto your teeth. This stays on for about 30 seconds before it’s washed off and a primer is painted onto your teeth, which will ensure the brackets stick.

Next, we work methodically around your mouth applying the brackets. A blue light is used to cure the glue and make sure it sets.

Once we’ve fitted all the brackets, your mouth no longer needs to be kept dry. So, we’ll remove the pads and lip guard.

Fitting the wires

The final stage is to apply a flexible wire, known as an “archwire”, through the tubes on the bands and brackets. The wire is held in place with either coloured o-rings or little gates, depending on the kind of braces you have chosen. We start off with a thin, flexible wire. Later, when your teeth become lined up, it is replaced by a thicker wire. We then make sure the ends of the wires are turned away so they don’t catch on your cheek.

fitting of wires

Caring for your braces

It’s important that you understand how to properly care for your braces. So, once your braces are fitted, we take about 20 minutes to explain how to keep them clean, what foods to avoid and what to expect now your braces are fitted.

What do you think?

If you found this post useful please share. If you have any comments or questions, please leave them in the comments section.

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Turner Lim Orthodontists: Luca’s Experience

Turner Lim Orthodontists provide a broad range of orthodontic care. This post details the recent treatment of eight-year-old Luca De Biasio.

The problem

Luca visited Turner Lim with his mum, Eloise, after his school dental nurse noticed his six-year-old molars (the first adult molars a child develops at about six years of age) were growing off course.

Dr. Fiona Turner: “Luca’s six-year-old molars should have been growing behind his baby molars; instead, they were growing directly beneath. If left untreated, they would have eventually caused his baby molars to fall out prematurely. Because Luca’s six-year-old molars were too far forward, there would also be no room for his adult pre-molars to grow into his mouth.”

The treatment

To fix the problem, Dr. Turner says that Luca’s six-year-old molars needed to be pushed towards the rear of his mouth. To do this, she used a Halterman Appliance.

“With this appliance, ‘little wings’ are attached to the baby molar. Then an extension arm, much like a fishing rod, is attached to a little button on the six-year-old molar. This provides the necessary pressure to push the six-year-old molar back,” she says.

Halterman appliance

A picture showing how a Halterman Appliance is fitted

Working with kids

Dental or orthodontic treatment can be traumatic for anyone, let alone an eight-year-old boy. This is why Dr. Turner says it’s important to be open with patients. With Luca, she and her staff made a point of explaining to him what was happening as much as possible. “He needed to be comfortable with what was going on,” she says.

Luca’s mum, Eloise: “Luca is a bit of a ‘panicer’ and was quite nervous about the treatment. But they made him feel comfortable — everyone was very friendly and supportive. He was always happy to go to his appointments, even though it might hurt a bit.”

Because Luca was only eight years old, his mouth was small. So, the application of a Halterman Appliance was more complicated than if used on an adult.

Eloise: “There were two appliances fitted on his top and bottom jaw — they were quite massive.”

Eloise says that the appliance caused swelling to Luca’s cheek, so it needed to be adjusted several times.

“Turner Lim was very responsive. Whenever I phoned to make appointment, they were available straight away,” says Eloise. “Despite the extra appointments, the lump sum I paid at the beginning didn’t change.”

The result

Dr. Turner says that Luca’s treatment took about four months and his six-year-old molars are now in the correct position.
“Luca’s baby molars will now stay in his mouth for the appropriate amount of time, which is 11 to 12 years, and his adult teeth will develop normally,” says Dr. Turner.

Eloise: The clinic is modern and well designed — it’s a cheerful and happy place. Despite some discomfort, Luca was always happy to go to his appointments and was confident the treatment would work — and it did.

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Need your teeth straightened? See a Specialist Orthodontist

teeth straightening

You needn’t be an orthodontist to straighten teeth. Some dentists perform orthodontic treatment too. So, if you need orthodontic treatment, for yourself or your child, who should you see?

In this post I explain why it’s important that you see an orthodontist.

If I had a problem with my heart, I’d see a cardiologist. If I had an electrical problem I would use an electrician. Most people would.

An orthodontist is a specialist. Before they can use the title “orthodontists” they must complete at least eight years of study — five years of general dentistry followed by three years of orthodontics.

Also, only a specialist orthodontist can be a full member of the New Zealand Association of Orthodontics (NZAO), which aids with their ongoing professional development.

When performing orthodontic treatment, dentists, who are not fully trained, often don’t see the whole picture. For example, they might focus on straightening a patient’s teeth without giving enough thought to putting the teeth in the right place. Sometimes they overlook teeth that are growing off course, which can cause damage to other teeth. Some dentists even extract children’s baby teeth claiming it avoids treatment later. The science just doesn’t back up this claim.

At Turner Lim we mostly treat adult teeth. This way there’s no guessing what a patient’s tooth alignment will be like. Also, because we deal with the whole bite, we don’t get nasty surprises if teeth grow off course.

Removal of teeth

There is a perception that orthodontists always remove teeth. Some dentists who do orthodontics “close the deal” by telling patients that they won’t.

We don’t aim to remove teeth; however, there often isn’t enough room in the patient’s mouth. There are also many other factors to take into account. So, extracting teeth is often the best treatment. Failure to remove teeth can push teeth out of the jaw bone leaving them unsupported and in less healthy positions for good long-term dental health. Additionally, trying to fit too many teeth into a small mouth can leave the teeth looking too full for the face — the lips won’t be able to close over the teeth. When it’s time for the patient’s braces to be removed, the teeth just move back to their original positions.


Sometimes people say they don’t need a specialist. But you really don’t know what you don’t know.

If you have “vampire fangs”, then the problem is obvious. However, often patients with nicely aligned teeth have issues they’re unaware of. For example, a person with straight teeth might have a deep bite — when the lower teeth bite too deeply behind the upper front teeth. If a person is in their forties, they may have already lost considerable gum and bone. It’s only when we show them what’s happening that they see it as an issue.

As specialist orthodontists, we have the training and ability to assess new and existing treatment techniques (such as Invisalign and Suresmile) and use the most appropriate techniques for your bite — one size; one solution does not necessarily fit all.

Any questions?

Hopefully this explains why it’s important to see a specialist orthodontist, rather than a dentist who does orthodontic treatment. If you have any questions, please leave them in the comments section below.

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