Once all of the doors have been opened, make sure there are no K-ties, wire-ties, etc that would hold the wire in when trying to remove the wire. When the wire is completely free, start by grabbing the wire with a weingart in between the 2's and 3's. The cuspids, in most cases, are high torque brackets and in order to remove the wire, you have to grab the wire distal to the 3 and slightly roll up (this applies to all high torque brackets, and the opposite for lower torque brackets). Torque and bends that are engaged can make it difficult for the wire to be removed, and if too much pressure is applied, it can break the bracket. In every case it is important to know what brackets and what torque is on each tooth because it can affect how the wire should be removed.

If all teeth are free of these restrictions, it is best to place the weingart in between the 5 and 6 and gently slide the wire, pulling up. To keep the wire from flinging out, use light force and switch from side to side until the whole wire is free. When pulling the wire out, keep an eye on the ends to make sure that they do not poke the patient or cause any discomfort.

Replacing the Archwires

First, you are going to pre-cut the wires roughly the length you need. You can always trim and smooth the wires when they are in the patients mouth, but it is easier and causes less discomfort the less you have to do inside the patients mouth. When placing the wires back in, you are going to pick the wire up with your hand and guide the first side through the molars (6's and 7's). The wire does not have to be in perfect place, you will guide the wire back and forth each side so do not worry about it being perfect. Then using the weingart you are going to guide the other end of the wire through the opposite molars. Grabbing the wire in between the 5's and 6's, gently push down and in guiding the wire in the direction the bracket is laying. You do not want to fight against the bracket or put too much pressure because you can break the brackets.

Once the wire is completely flush in the doors you are going to start closing and engaging all of the doors. Start with the anterior teeth so the wire does not get shifted forward once the midline of the wire is on. Use the weingart in your right hand and the left hand/finger will push down to make sure the wire is engaged. Gently squeeze on the door, making sure you are perpendicular to the position of the bracket. It is also a light force! The door should close with moderate ease, so if the door is not closing do not just apply more pressure, there may be something in the way, or the wire could not be fully engaged and you could pop the bracket off. Continue and close all the doors 5-5, the molar brackets (unless they are snaplinks) are tubes and do not have doors that close. Once all of the doors are closed, make sure and trim/smooth the wires if needed! The stops should be crimped tightly on the wire, 1mm mesial and distal to either of the upper ones. You always want to make sure if there is rotation that the crimps are mesial to rotation so it can work its way out. If the stops are too tight, it can restrict tooth movement.

Before the patient leaves double, triple check all of the doors to make sure that they are fully closed. If a door is left open the teeth will not move properly and can cause a digression of treatment. This gets more seriously as the patient goes through treatment and gets stronger, more active wires.

Double check that:

• Photos have been taken!

• Make sure no wires are poking the patient

• The patient is set up and hopefully scheduled their next appointment

• The patient has rubber bands (If needed)

• Ask the patient if more wax, gishy-goo, or any other patient comfort items are needed