Now this is the patient’s 3rd appointment back. This patient either has .018 U/L or 14x25CuTi U/L. There are a few options for this appointment

1. Once the patient is seated remove all arch wires. Now take a look in their mouth and assess everything. Make sure all of their brackets on still on. Take a look and see if any new teeth have grown in. Have their 7’s grown in yet? Check their bite to see if they could benefit from starting elastics. If they were already given elastics at their initial bonding appointment, check to see how well they have been wearing them. Also assess their hygiene. See if they are missing any areas when brushing. (if so show them the areas before the go brush and floss without their wires in)

2. Now that you have the wires out and you have assessed everything, before you the patient go brush and floss, take a look and see what you recommend for advancing treatment for this appointment. If the 7’s have grown in, prophy paste and prep them. If that is not needed, then you will check the flow of the clinic and the grid. See where Dr will be. If he is about to go into an exam or about to sit down and do a full bonding, maybe have the doctor come over now for a check out rather than waiting until the patient brushes and floss. (if the patients hygiene is terrible, please no matter what have them brush first because Dr will not be thrilled to check everything if it is hard to see due to food and plaque). If Dr comes to the chair first, before pt brushes that is fine. But as an assistant it is your job to introduce the patient to Dr Frost and introduce the parent or friend that came back with them to the clinic.

3. If patient already has 14x25CuTi’s U/L, you will advance to 18x25CuTi U and 16x25CuTi L (or a 17x25 reverse curve in the lower if pt has a deep bite) wire tie upper and lower 3-3 if patient does not have that already ***pt will be seen back in 8 weeks for their PANO REPO appointment

A. Advance to 18x25CuTi and 16x25CuTiL (or a reverse curve in the lower if patient has a deep bite) and power chain U or L if there is extreme spacing ***patient will still go 8 weeks for their next appointment which will be Pano/repo visit.

B. Advance to 14x25CuTi U/L and wire tie as needed ***patient will go 6 weeks and be seen back for a quick adj. simple to place 18x25U and 16x25 L. Then patient will be seen in 4-6 weeks for their pano/repo visit.

*** Keep in mind; if we started elastics at their first appointment (initial bonding appointment), each time they come in we should be checking their bite and advancing elastic size each adjustment.

4. If the patients next appointment is a pano/repo visit, make sure to explain this to the patient and the patients parents the importance of this visit. Also let them know this is an hour visit, which is longer than the previous so they can plan accordingly.