Bonding day, step by step

Before the appointment

If molar bands are needed, small elastic separators are placed between the back teeth about a week beforehand to open a fraction of a millimetre of space. Separators feel like something stuck between the teeth and are mildly annoying for a day or two. Not every case needs them; many modern cases bond tubes directly to the molars instead.

Eat properly before you come. Chewing will be tender that evening, so a real meal beforehand is a kindness to yourself. Brush thoroughly — bonding to a clean surface is part of what keeps brackets on.

The appointment

1. Isolation. A cheek retractor holds the lips clear and keeps the teeth dry. This is the least comfortable part, and it is only awkward rather than painful.
2. Cleaning and preparation. The enamel is polished, then conditioned with a mild etch and rinsed. The surface is prepared, not cut — no enamel is drilled away.
3. Bonding. Each bracket is placed with adhesive in a position measured for that specific tooth, then cured with a light. Bracket position determines where the tooth ends up, so this step is slow and deliberate.
4. Molar attachment. Bands are cemented or tubes bonded at the back.
5. Wire and ligatures. The first archwire is threaded and secured, and if your system uses them, you choose your colours.
6. Instructions. Cleaning technique, what to eat, what to do if something breaks, and wax to take home.

The rest of that day

Teeth feel normal for the first two to four hours, and then a dull generalised ache sets in as the ligament responds. It peaks the following day and eases from there. Most patients are comfortable within three to five days.

• Soft food for two days: pasta, eggs, soup, yoghurt, smoothies, soft fish.
• Ordinary pain relief taken as directed is fine and works well.
• Cold water and cold food genuinely help.
• Wax over any bracket rubbing the cheek. The cheek toughens within one to two weeks.