The Orthodontic Treatment Process: From Assessment to Debond
For adults considering fixed braces: the orthodontic treatment process, from consultation and records through fitting, adjustments and debond to retainers and reviews, as British Orthodontic Society (BOS) and NHS guidance describe them. The core point: treatment is a run of regular visits over months or years, and retention starts when the brace comes off.
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Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
Dr Ibraheem Ijaz, principal dentist at Deepcar Dental Care and a General Dental Practitioner, reviewed this page. He holds a BDS, a BSc (Hons), an MSc (Leeds), a PG Dip in Implant Dentistry and a PG Cert in Restorative and Aesthetic Dentistry.
What is the orthodontic treatment process?
The orthodontic treatment process is a sequence of appointments: assessment and records, planning, fitting the brace, regular adjustments, removing the brace and fitting retainers.
The general pattern below follows a course of fixed braces, from BOS and NHS guidance; your own visits depend on your treatment. BOS says bringing the teeth into a better bite often takes between 1 and 2 years, and may take longer for more difficult problems.
| Stage | What generally happens | How often or when, in general |
|---|---|---|
| Consultation | Teeth and gums examined, options discussed | Braces very unlikely to be fitted |
| Records | X-rays, photographs or moulds | First visit or a later one |
| Treatment plan | Options, other procedures, written plan advised | Before treatment, with time to decide |
| Fitting day | Brackets glued on and joined by a wire | Usually a later visit than the consultation |
| Adjustment visits | Brace checked and adjusted | Every 6 to 8 weeks (NHS) or 4 to 10 weeks (BOS) |
| Progress | Dental check-ups continue | Throughout treatment |
| Debond | Brace removed, leftover glue cleaned off | When active treatment ends |
| Retainer fitting | Retainer fitted to stop teeth moving back | After the brace is removed |
| Reviews afterwards | Retainers checked | Less often than during treatment |
What happens at an orthodontic consultation?
At an orthodontic consultation, BOS says, your mouth is examined to assess the teeth and gums, and the possibilities for treatment are talked through.
BOS advises that whoever assesses you should ask about your concerns and explain the different types of braces.
What is an orthodontic records appointment?
A records appointment collects the X-rays, photographs or moulds used to plan treatment, at the first visit or a later one.
BOS says X-rays and/or photographs may be needed at the first appointment, and moulds may also be taken then if treatment is going ahead and there is no waiting list. York and Scarborough's hospital department says moulds and photographs may be taken at a second visit.
What should an orthodontic treatment plan cover?
BOS advises giving you a written treatment plan and fee estimate, if appropriate, and explaining at the beginning what other procedures may be needed.
BOS also says there are often different ways to improve the teeth, such as simple straightening or full bite correction, and that you should be wary if you are only offered one option or one type of brace.
What happens on the day braces are fitted?
On fitting day, brackets are glued to the teeth and joined by a wire, NHS guidance explains. East Sussex Healthcare NHS Trust says fitting is sometimes split over two appointments, a week apart.
In the NHS description, each tooth gets a metal bracket fixed with dental glue, a wire links the brackets and puts a small amount of pressure on the teeth to move them over time, and small elastic modules hold the wire in place. No anaesthetic is needed, BOS says.
NHS guidance says new braces may feel strange, and for a few days after fitting the teeth may be sore, when soft food and painkillers can help. As non-urgent advice, it says to contact the team treating your braces if:
- your teeth are painful for more than a few days after your braces are fitted or adjusted
- you have braces and your gums are very red, swollen or painful
- your braces are broken
To ask about orthodontic treatment, book online or call 0114 288 2121.
How often are braces adjusted?
NHS guidance gives an adjustment every 6 to 8 weeks for fixed braces, and BOS a usual range of every four to ten weeks.
Over a whole course, comprehensive fixed-brace treatment averaged 17.8 visits in the 5 studies that counted them, a 2016 systematic review found; its studies were prospective and run in university settings.
Why the teeth move only gradually between visits is covered on our page about the biology behind tooth movement.
How is progress checked during treatment?
Progress is checked at the regular visits: York and Scarborough's hospital department calls them checks and adjustments.
East Kent Hospitals says it checks how clean the teeth are throughout treatment. BOS says your teeth are actually at greater risk during orthodontic treatment, and NHS guidance advises regular dental check-ups for as long as you wear braces.
Day-to-day topics such as cleaning and eating have their own pages; browse this section to find them.
What happens on debond day?
Debond means removing fixed braces when treatment is finished, the term NHS Lothian's patient leaflet uses.
The leftover glue is then removed. A 2024 systematic review of 27 studies, 25 in the laboratory, with varying bias, concluded that enamel preservation seems optimal when a tungsten carbide bur removes most glue and a less invasive technique finishes; beyond its findings, a final polish also appears relevant. Using only a diamond bur, steel bur or hand scaler left clinically unacceptable roughness. Ceramic brackets can sometimes be difficult to remove, BOS notes, and carry a slightly greater chance of damaging the tooth surface. If you notice a chip or a rough patch on a tooth after a brace comes off, show it to a dentist.
Removing the brace starts settling and retention at the same time. BOS explains that the tissues and bone around each root need time to adjust to the new tooth positions, and that relapse is a particular risk in the early months after removal; the risk remains in the longer term, so it advises continuing retention long term.
When are retainers fitted?
A retainer follows once the brace is removed: NHS guidance says one is needed to stop the teeth moving back to their original position.
The team treating you will tell you how long to wear it, NHS guidance adds. Retainer types, wear and care are covered on our page about retention after treatment.
What happens at reviews after braces come off?
Reviews after braces check the retainers, and BOS says you will not need to be seen as often once retainers are in place.
BOS asks you to bring your retainers to each visit. It says fixed retainers, usually glued behind the teeth, need regular inspection, because if any glue fails, the tooth may start to drift; a broken fixed retainer should be reported at once.
Which braces are offered at Deepcar Dental Care?
Fixed metal, ceramic and lingual braces are offered at Deepcar Dental Care, provided by our dentists.
Orthodontic treatment at the practice is for adults only. The orthodontic problems treated include mild to moderate crowding and spacing, and bite correction; complex and extraction cases are assessed case by case. How these braces differ is set out among the options in this section.
By car, the practice is about 15 minutes from Sheffield city centre, and there is free parking directly outside. Local details are on our page about orthodontics in Sheffield.
Frequently asked questions
How long does each orthodontic appointment take?
It depends on what needs doing. York and Scarborough's hospital department says its check and adjustment visits take from 15 minutes to an hour, while Oxford Health's community dental service describes regular 20 to 30 minute appointments every 6 to 8 weeks.
What should you do if a bracket or wire breaks?
Contact the team treating your braces. Nottingham University Hospitals explains that a broken brace will not be straightening the teeth correctly, so treatment takes longer if it is not repaired, and it may irritate or damage the teeth, gums and cheeks.
What can make orthodontic treatment take longer?
Severity and cooperation both matter. East Sussex Healthcare NHS Trust says treatment length depends on several things, such as how severe the problem is and how cooperative the patient is. East Kent Hospitals adds that missed appointments, and a brace repeatedly broken through lack of care, extend it.
What extras can be used with fixed braces?
Elastics, for example. NHS Lothian's fixed braces leaflet says elastic bands between the upper and lower teeth may be needed to refine the bite, worn full time or part time. It also mentions headgear, usually worn at night, and possibly temporary anchorage devices (TADs).
Can you change your mind once treatment has started?
Yes, consent can be withdrawn. East Sussex Healthcare NHS Trust's leaflet says that although you consent to treatment, you may withdraw that consent at any time afterwards, and asks you to discuss this with the team treating you. It also says to understand what is involved first, because once started, completing the course is important to obtain a stable result.
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Patient reviews of Deepcar Dental Care are on our patient reviews page.
You can book online, or call 8am to 8pm, Monday to Sunday.
Options and risks of straightening teeth are introduced on our main page about orthodontic treatment.
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