What to Know Before Starting Orthodontic Treatment

Deciding to begin orthodontic treatment involves more than wanting straighter-looking teeth. Tooth alignment, the relationship between the upper and lower teeth, jaw structures, oral health, age and the patient's treatment expectations should all be evaluated together.

For this reason, the first step in orthodontic treatment is not choosing an appliance or system, but accurately identifying the existing orthodontic problem. Fixed braces, clear aligners and other orthodontic approaches may be used for different purposes in different patients.

Understanding how the treatment process works, which assessments may be required and what responsibilities the patient may have during treatment can help create more realistic expectations before orthodontic treatment begins.

What Is Orthodontic Treatment?

Orthodontic treatment is a personalized process in which tooth alignment, the relationship between the upper and lower teeth and, when necessary, jaw relationships are evaluated and managed.

The objective is not limited to making the teeth appear straight from the front. Bite relationships, appropriate tooth positioning and maintaining the achieved positions after treatment are also parts of orthodontic planning.

When May an Orthodontic Assessment Be Recommended?

Dental crowding, spaces between teeth, teeth positioned too far forward or backward and certain bite differences may require orthodontic assessment.

The relationship between the upper and lower jaws, patterns of tooth eruption and some growth-related findings in children may also be assessed during an orthodontic examination.

The need for orthodontic treatment should not be determined only by the appearance of the teeth in the mirror.

What Is Evaluated During the First Orthodontic Examination?

During the first examination, tooth alignment, the presence of crowding or spacing, the bite and jaw relationships are evaluated.

The patient's current oral health, previous dental treatments and expectations from orthodontic treatment may also be relevant to treatment planning.

Based on these findings, an individualized pathway can be created regarding whether orthodontic treatment is required and which treatment methods may be considered.

Why Are Orthodontic Records Taken?

Different diagnostic records may be required to support the clinical examination during orthodontic treatment planning.

Clinical photographs, radiographic assessments and digital intraoral scans may help provide a more detailed view of the patient's current condition.

The records required are determined according to the individual's clinical needs.

What Is Digital Intraoral Scanning Used For?

Digital intraoral scanners can help create three-dimensional digital records of the teeth.

These records may be used to examine current tooth positions and support the planning of digitally assisted orthodontic treatments.

Digital scanning is an important planning tool, but it does not replace a complete orthodontic diagnosis.

How Is an Orthodontic Treatment Plan Created?

The treatment plan is created after analysing the patient's orthodontic condition.

The teeth that need to move, the direction of movement, space requirements, bite relationships and the intended treatment objectives are considered together.

For this reason, two patients with apparently similar dental problems may require different treatment plans.

Is Every Case of Dental Crowding Treated the Same Way?

No. The amount and cause of crowding can influence the treatment approach.

Some patients may have a limited space problem, while others may require more extensive planning because of tooth positions and bite relationships.

A standard treatment method cannot therefore be selected simply because the teeth appear crowded.

Why Are Bite Relationships Evaluated?

The way the upper and lower teeth contact each other is an important part of orthodontic assessment.

Teeth may appear straight from the front while the overall bite relationship is still not ideal.

For this reason, orthodontic treatment considers not only how the teeth are aligned, but also how the bite may change during treatment.

How Is the Orthodontic Treatment Method Selected?

The treatment method is selected according to the patient's clinical needs.

Fixed braces, clear aligners or other orthodontic appliances may be considered in different situations.

The type of orthodontic problem, required tooth movements, age, patient compliance and individual expectations are evaluated together when choosing the treatment approach.

What Is Braces Treatment?

Fixed orthodontic treatment uses brackets attached to the teeth and orthodontic wires to guide the teeth toward planned positions.

Braces may be considered for the management of different types of dental crowding and bite problems.

The type of fixed appliance and treatment mechanics are determined according to the patient's individual needs.

What Is Clear Aligner Treatment?

Clear aligner treatment is an orthodontic approach in which a series of individually designed removable aligners are used to guide teeth toward planned positions.

The removable and less visible nature of clear aligners may be one reason some patients consider this treatment option.

However, not every orthodontic case is suitable for clear aligner treatment.

Braces or Clear Aligners?

There is no single answer that applies to every patient.

Both methods have different clinical characteristics and practical considerations.

The removable nature of clear aligners makes patient compliance particularly important, while fixed braces remain attached to the teeth throughout active treatment.

The appropriate method should be selected according to the characteristics of the orthodontic problem.

Can the Treatment Method Be Chosen Only According to Appearance?

The patient's aesthetic preferences may be considered, but they should not be the only factor when selecting an orthodontic treatment method.

Wanting a less visible appliance does not necessarily mean that clear aligner treatment is appropriate in every clinical situation.

Similarly, fixed braces are not automatically required for every patient.

Treatment selection should be based on clinical assessment.

When Is Orthodontic Treatment Considered for Children?

Orthodontic assessment in children is not limited to the period after all permanent teeth have erupted.

Tooth eruption, jaw development and bite relationships can be evaluated during growth.

However, an early orthodontic assessment does not mean that treatment must begin immediately in every child.

In some cases, monitoring growth and development may be sufficient.

Can Adults Have Orthodontic Treatment?

Orthodontic treatment is not limited to childhood and adolescence.

When the teeth and surrounding supporting tissues are clinically suitable, fixed braces or clear aligners may also be considered in adult patients.

Existing fillings, crowns, implants, missing teeth and periodontal health may also be included in adult orthodontic treatment planning.

Why Is Dental and Gum Health Important Before Treatment?

Oral and dental health should be evaluated before orthodontic treatment begins.

If active decay, gum problems or other dental conditions are present, the necessary treatment may need to be coordinated with the orthodontic process.

Orthodontic treatment is ideally carried out on healthy teeth and supporting tissues.

Is Tooth Extraction Required in Every Orthodontic Treatment?

No. Tooth extraction is not a standard requirement for every orthodontic patient.

The need for extraction is evaluated according to available space, tooth positions, facial and jaw relationships and the overall treatment objectives.

This decision forms part of individualized orthodontic planning.

How Long Does Orthodontic Treatment Take?

The duration of orthodontic treatment varies from patient to patient.

The complexity of the problem, required tooth movements, bite relationships, treatment method and patient compliance may all influence the total treatment period.

For this reason, an exact treatment duration should not be stated before a clinical examination and individualized treatment plan.

What Can Be Expected During the First Days of Treatment?

Temporary pressure or sensitivity may be experienced when orthodontic forces are first applied.

The adaptation period for fixed brackets or clear aligners varies between patients.

If unexpected, severe or prolonged problems occur, the orthodontic clinic should be contacted.

Is Orthodontic Treatment Painful?

Temporary sensitivity may occur during orthodontic treatment, particularly after a new force is applied.

The level of discomfort varies from person to person.

Not every type of pain should automatically be considered normal, and unexpected symptoms should be assessed clinically.

Why Does Oral Hygiene Become More Important During Treatment?

Maintaining clean teeth and gums is important throughout orthodontic treatment.

With fixed braces, food and dental plaque may accumulate around brackets, so oral hygiene may require additional attention.

For patients using clear aligners, oral hygiene is also important before the aligners are reinserted.

Why Are Orthodontic Follow-Up Appointments Necessary?

Even when treatment has been carefully planned at the beginning, tooth movement should still be monitored clinically throughout the process.

During follow-up appointments, tooth movement, bite relationships and the orthodontic appliance or system being used are evaluated.

Clinical adjustments may be made when necessary.

What Happens if Follow-Up Appointments Are Missed?

Long gaps between follow-up appointments may make clinical monitoring more difficult.

Changes in tooth movement, bracket or aligner fit and bite relationships should be evaluated at appropriate intervals.

Appointment frequency is determined according to the patient's treatment plan.

Does Patient Compliance Affect Orthodontic Treatment?

Yes. Patient compliance may be important in different ways depending on the treatment method being used.

Following the recommended clear aligner wearing schedule, using elastics or other auxiliary appliances as instructed and attending follow-up appointments are all parts of orthodontic treatment.

What Should Be Done if an Urgent Problem Occurs During Treatment?

A detached bracket, irritating wire, broken aligner or lost aligner may require different management depending on the stage of treatment.

Patients should contact the orthodontic clinic rather than attempting to modify or repair the orthodontic appliance themselves.

Can the Treatment Plan Change During Orthodontic Treatment?

Orthodontic treatment follows a detailed initial plan, but adjustments may sometimes be required according to the clinical response of the teeth.

If certain tooth movements do not progress as expected, the mechanics or treatment stages may need to be reassessed.

How Is It Decided That Orthodontic Treatment Is Complete?

Completion of orthodontic treatment is not determined only by whether the teeth look straight.

The original treatment objectives, final tooth positions and bite relationships are evaluated together.

Once active treatment is complete, the retention phase may begin.

What Is Orthodontic Retention?

Retention is the stage after active orthodontic treatment that aims to help maintain the positions achieved during treatment.

Fixed or removable retainers may be used.

The retention protocol is determined according to the patient's individual treatment result.

What Can Happen if a Retainer Is Not Used?

Natural changes in tooth position can occur throughout life.

Not following the recommended retainer protocol after orthodontic treatment may affect the maintenance of the positions achieved during treatment.

Retention should therefore be considered an important part of the orthodontic process.

What Questions Can Be Asked Before Starting Orthodontic Treatment?

Patients may ask which orthodontic problem the treatment is intended to address, which treatment options are available and why a particular method is being recommended.

The expected treatment process, follow-up schedule, daily care requirements and post-treatment retention plan may also be discussed.

A clear explanation of the treatment process can help patients participate in their treatment with more realistic expectations.

What Can Be Considered When Choosing an Orthodontist?

Orthodontic treatment may require regular clinical follow-up over an extended period.

Relevant considerations may include specialist orthodontic training, individualized diagnosis and treatment planning, the use of treatment methods according to clinical need and planning for the retention phase after active treatment.

Treatment decisions should not be based solely on the appliance, technology or brand being used.

Orthodontic Treatment Assessment in Izmir

During orthodontic assessments performed by Orthodontist Çağrı Şibal, tooth alignment, bite relationships and the patient's individual treatment needs are evaluated together.

The suitability of fixed braces, clear aligners or other orthodontic approaches is determined according to clinical findings.

The objective of treatment planning is not to apply a standard method to every patient, but to create an approach appropriate for the existing orthodontic problem.

Frequently Asked Questions Before Starting Orthodontic Treatment

Does treatment begin immediately at the first appointment?

Not always. The orthodontic problem must first be assessed and any necessary diagnostic records identified. Treatment begins according to the individualized plan.

Can I choose between braces and clear aligners myself?

Patient preference is important, but the treatment method should also be clinically appropriate for the orthodontic problem.

Is orthodontic treatment only cosmetic?

No. In addition to tooth alignment, bite relationships and orthodontic function may also be considered during treatment planning.

Is it too late to have orthodontic treatment as an adult?

Age alone does not prevent orthodontic treatment. The condition of the teeth and surrounding supporting tissues should be evaluated.

Can I continue working or attending school during orthodontic treatment?

Most patients can continue their normal daily activities during orthodontic treatment. Temporary sensitivity or an adaptation period may occur when treatment begins.

Do follow-up appointments stop completely after active treatment?

A retention and retainer follow-up period may be required after active treatment. The schedule is determined according to the patient's treatment result.

Can the treatment duration be predicted exactly in advance?

An estimated treatment plan may be created after examination, but biological tooth movement, treatment complexity and patient compliance mean that an exact duration cannot always be guaranteed.

Content Last Updated: 1 September 2026

Content Reviewed By: Orthodontist Çağrı Şibal

This content has been prepared for general informational purposes and does not replace a clinical diagnosis or personalized treatment recommendation. The need for orthodontic treatment, treatment method, treatment process and retention plan are determined following a clinical examination, necessary diagnostic assessments and individualized orthodontic treatment planning.