1. Before Starting Treatment

Every successful treatment begins with precise diagnostics and clear planning. There is no room for guesswork in orthodontics.

First Visit: History, Clinical Exam & Impressions

Your first check-up is a diagnostic appointment dedicated exclusively to analyzing the anatomy of your face, jaws, and teeth. It consists of three key steps:

• Detailed Anamnesis (Consultation): Successful treatment begins with a thorough conversation. Medical history helps us understand the broader context of your health and development. We discuss your aesthetic goals, childhood habits (such as mouth breathing or improper swallowing), and family genetic factors, as many malocclusions are inherited.
• Thorough Clinical Exam: The clinical examination led by Dr. Eleonora evaluates your chewing system as a whole. This includes facial and profile analysis (facial symmetry, lip posture), intraoral examination (health of every tooth and gum tissue), as well as functional and temporomandibular joint (TMJ) evaluation (checking for clicking or pain when opening the mouth).
• Diagnostic Impressions for Study Models: During this initial visit, we take impressions of your teeth to pour plaster study models. These allow us to analyze space, tooth inclinations, and arch relationships in 3D to the exact millimeter outside your mouth. At the end of this appointment, you will receive referrals for specific X-rays (panoramic orthopantomogram and lateral cephalometric X-ray).

Second Visit: Analysis Presentation & Treatment Plan

Once we thoroughly study your study models and perform precise measurements on X-rays, we schedule your second visit to present the analysis results. We overlay all data before you:

• Exact Cause of Malocclusion: We determine whether the issue lies solely in tooth position or in skeletal jaw bone discrepancy.
• Most Effective Treatment Plan: Tailored to your biology and lifestyle (choices offering aesthetic fixed braces, traditional systems, or advanced self-ligating braces).
• Estimated Treatment Duration: We define expected treatment timelines and transparent financial details, giving you complete clarity and confidence before appliance placement.

Pediatric Orthodontics – Removable Appliances for Growth Guidance

If the patient is a growing child, treatment typically begins with removable appliances. The goal is to guide jaw bone growth, expand the dental arch, and create sufficient room for permanent teeth to erupt, significantly simplifying later fixed brace treatment.

2. Fixed Appliance Treatment Workflow

The active phase of tooth movement utilizing brackets and wires to direct forces with precision.

Appliance Placement

The day braces are fitted is an exciting step toward your perfect smile. Placing fixed braces is a routine, completely painless procedure. Teeth are neither drilled nor damaged; brackets are gently bonded to the enamel surface using specialized, safe materials. In our clinic, we apply high-precision biomechanical protocols, and Dr. Eleonora utilizes two bonding techniques, choosing the one best suited to your case for maximum chairside comfort.

Direct vs. Indirect Bracket Bonding

• Traditional Direct Method: In this approach, Dr. Eleonora bonds each bracket directly onto every individual tooth inside your mouth. Each bracket is carefully positioned and cured with a dental light. This is a reliable, classic protocol yielding excellent results.
• Advanced Indirect Method (Maximum Comfort): As a practice adhering to modern laboratory protocols, we proudly offer indirect bonding. Based on your study models, Dr. Eleonora positions all brackets outside your mouth with surgical precision on a plaster model and fabricates a custom transfer tray. At your appointment, all brackets are transferred simultaneously to your teeth in just a few minutes. Chair time with an open mouth is cut by more than half, while placement accuracy is maximized.

Metal vs. Aesthetic Brackets: How to Choose?

The choice between aesthetic brackets and classic metal depends on your visual preferences as well as the specifics of the tooth anomaly being corrected. Both options deliver outstanding results:

• Classic Metal Brackets: Still the gold standard in orthodontic therapy. While visually prominent, their mechanical properties are superior. Metal creates minimal friction with the archwire, which can shorten treatment time in complex clinical cases. They are extremely durable and practically indestructible.
• Aesthetic Brackets: Made of sapphire glass or fine ceramic, these brackets are completely transparent or tooth-colored. They reflect your natural enamel color, making them an ideal choice for adult patients and professionals seeking discreet treatment. The brackets resist food and drink staining over time.

Important Clinical Note

Although aesthetic brackets are a great solution for most patients, certain situations require the mechanical forces that metal provides. Furthermore, pre-existing dental work such as fixed dental bridges represents a temporary contraindication for orthodontic treatment. Bridges must be sectioned or modified prior to placing brackets to allow unimpeded, safe tooth movement.

Adjustments & Check-ups

Check-up appointments are scheduled on average every 4 to 8 weeks. During these visits, Dr. Eleonora changes or adjusts archwires, replaces elastics, or incorporates auxiliary elements (coils, mini-implants, bite turbos).

Traditional Braces vs. Self-Ligating Systems

In modern orthodontics, appliance mechanics have evolved significantly. While traditional braces have proven effective for decades, self-ligating systems utilize low-friction mechanics to provide gentler, highly efficient tooth movement. Dr. Eleonora utilizes both systems in practice, selecting the optimal approach for every case.

Traditional Systems: Reliable Classics

Traditional braces consist of brackets holding an archwire secured by small elastic ties or fine wires on each bracket. At each visit, ties are replaced and wires adjusted to generate new forces. While reliable, this method requires more frequent visits and meticulous hygiene, as elastics can attract dental plaque.

Self-Ligating Systems: High-Efficiency Technology

Self-ligating brackets feature an integrated sliding clip mechanism holding the archwire without elastic ties:

• Less Friction, Faster Results: Because the wire slides freely inside the slot, friction is minimized, allowing teeth to move smoothly following natural biological forces.
• Comfort First: Forces are gentle and constant, making adaptation after placement or adjustments noticeably easier.
• Fewer Visits: Due to continuous force mechanics, appointments are required less frequently (every 6 to 8 weeks), ideal for busy schedules.

System Comparison Table

How long do you need to wear braces?

The initial estimate provided by Dr. Eleonora is that braces are worn on average for 18 to 24 months. However, exact duration is determined by tooth movement biology and jaw bone architecture. What a patient sees in the mirror is often only the "tip of the iceberg", while the true cause of malocclusion lies deeper within bone structures. Why do treatment timelines differ even when teeth appear similar?

• Case A (Incisor Protrusion with Diastemas): When front teeth are simply tipped outward with spacing, the problem is strictly dental. Space exists, the tooth root is well-positioned in bone, and teeth merely need uprighting. These cases are straightforward and typically take 12 to 15 months.
• Case B (Class II-1 Skeletal Discrepancy): Externally teeth may look similar, but X-ray analysis reveals a skeletal jaw imbalance (upper jaw too far forward or lower jaw receded). Correcting the bite requires shifting entire arch relationships and allowing bone tissue to adapt. Therefore, treatment takes longer — typically 24 to 30 months.

Auxiliary Treatment Elements

To ensure tooth movement is as fast and precise as possible, Dr. Eleonora utilizes specialized auxiliary elements during specific treatment phases:

Open Coil Spring

An open coil spring is a tiny spiral made of premium Nickel-Titanium alloys possessing shape memory. We use it in cases of severe crowding where a tooth is positioned completely out of line with no space to enter the arch. Placed compressed between two adjacent teeth, the coil naturally expands, gently pushing neighboring teeth apart to create room for the hidden tooth, avoiding healthy tooth extractions.

Intermaxillary Elastics (Bite Rubber Bands)

Designed to connect the upper and lower arches, intermaxillary elastics align the bite and bring jaws into proper relationship.

The 24-Hour Rule: To achieve results, elastics must be worn continuously day and night, replaced only once every 24 hours. A single pair is worn for a full day and night (removed only during meals) allowing gentle, biologically safe forces to work. Changing elastics too frequently during the day introduces excessive force, overloading tooth roots and slowing treatment.

Bite Blocks / Bite Turbos

Bite blocks are temporary miniature composite pads placed on chewing surfaces of molars or behind upper incisors. They temporarily prevent teeth from biting fully together. We use them so upper teeth do not dislodge lower brackets during chewing, preventing bracket breakage and speeding tooth movement by removing occlusal muscular interference. Most commonly used in deep bite therapy, creating a temporary gap between side teeth that closes as treatment progresses.

Orthodontic Mini-Implants

Mini-implants are miniature temporary screws (1.5 to 2 mm diameter) made of biocompatible titanium. They serve as an immovable anchorage point in bone, enabling Dr. Eleonora to move specific tooth groups with surgical precision without affecting adjacent teeth. Placement under local anesthesia takes minutes, is painless, and drastically reduces overall treatment duration in complex cases.

3. After Treatment (Debonding & Retention)

Once teeth reach their ideal positions and the bite is fully balanced, appliance removal and long-term retention follow.

Debonding Braces

Removing braces is a swift, safe, and emotional appointment — the moment you finally see your straight, newly aligned smile in the mirror. The goal is to debond brackets safely, leaving natural tooth enamel completely intact.

The debonding process involves several careful steps performed by Dr. Eleonora:

• Safe Bracket Removal: Using specialized instruments, Dr. Eleonora applies gentle pressure to detach brackets. Bonding adhesive is engineered to fracture at a specific interface, leaving enamel 100% untouched and safe.
• Adhesive Removal & Polishing: Residual adhesive is carefully removed using soft composite-removal burs that do not harm natural enamel. Teeth are then polished to a high shine.
• Ultrasonic Scaling: Mineral deposits naturally tend to accumulate around brackets during treatment. Immediately following polishing, we perform ultrasonic tartar removal, restoring pristine hygiene to teeth and gums.
• Retainer Impression: Once teeth are clean, polished, and healthy, we take final impressions to fabricate your clear retainer tray.

Retention – Preserving Your New Smile

Following tooth movement, teeth possess a natural biological tendency to shift back toward their original positions. Retainers hold teeth in place until surrounding bone fully mineralizes. Retention is the most essential phase of treatment for lifetime results.

• First 6 Months: Retainers (clear trays and/or bonded fixed wire behind front teeth) are worn continuously day and night, removed only during eating and brushing. Afterwards, daytime wear is gradually phased out to night-only.
• Bring Retainers to Dental Appointments: Whenever you receive a new filling or replace an old one, tooth anatomy changes slightly. Bring your retainer tray to your dental appointment so your dentist can confirm the tray fits perfectly without creating unwanted pressure.
• Age Guidelines: For teenage patients, Dr. Eleonora recommends nighttime retainer wear until age 25 due to late mandibular growth and wisdom teeth eruption. For adults, retention is lifelong (a few nights per week) as teeth experience natural micro-shifts over time.

4. Daily Life with Braces

Wearing braces calls for minor routine adjustments that quickly become second nature.

Diet, Hygiene, Sports & Travel

• ▸Diet: Avoid sticky foods (caramels, chewing gum) and hard foods (popcorn, almonds, biting directly into whole apples or carrots), as these can dislodge brackets. Cut foods into bite-sized pieces.
• ▸Hygiene: Brush after every meal. In addition to a standard toothbrush, use interdental brushes to clean under archwires and around brackets.
• ▸Sports: Active sports participation is unhindered; however, we recommend wearing a sports mouthguard during contact sports.
• ▸Travel: Before extended trips, schedule a quick check-up so we can verify everything is secure while you are away.

Adult Braces vs. Aligners (Clear Trays)

When selecting treatment methods for adult patients, it is important to rely on objective clinical evidence rather than marketing campaigns. While clear aligners offer cosmetic convenience, independent clinical studies demonstrate distinct biological and mechanical boundaries compared to fixed appliances.

Clinical Comparison: Braces vs. Aligners

Scientific Limitations of Aligners

Research published in leading journals such as the AJODO (American Journal of Orthodontics and Dentofacial Orthopedics) highlights biomechanical limits of clear plastic trays:

• Root Control & Relapse Risk: For long-term stability, tooth roots must be positioned at correct angles within jaw bone. Tipping crowns without full root control leads to rapid relapse. Fixed braces provide 100% control over root positioning.
• Rounded Teeth Rotations: Teeth like canines and premolars have rounded crowns. Plastic trays lack sufficient grip on these shapes, making rotation movements unpredictable with aligners.
• Skeletal Anomalies: When malocclusion stems from jaw bone discrepancies (Class II/III), aligners achieve only cosmetic tipping rather than true bite correction.

5. Orthodontic First Aid

Most minor incidents during braces treatment are easily managed at home and do not constitute emergencies: