Lesson 1Last mouth checks and bite confirm: make sure no sharp bits, patient bite test, bite paper if neededLooks at final mouth check after tying. Checks sharp bits, wire seating, bite test, and bite paper when needed.
Inspect brackets and tubes visuallyCheck for exposed or sharp wire endsVerify full archwire seatingAssess patient bite and comfortUse articulating paper if neededLesson 2Handling loose brackets found in process: isolate area, put bracket on cotton, guard soft bits and decide if to hold off stickingTells how to deal with loose brackets found mid-process. Covers isolating, safe keeping, soft tissue guard, noting, and when to wait rebonding or go ahead after check.
Recognize signs of loose bracketsIsolate bracket with gauze or cottonRemove bracket from archwire safelyStore bracket on labeled gauzeInform and consult orthodontistLesson 3Putting new rubber ties: pick size and colour, single vs loop way, placing to dodge tissue pinchCovers picking and placing rubber ties, size and colour picks. Compares single vs loop ways and stresses dodging tissue pinch and too much pull on brackets.
Select correct ligature size and typeColor selection and patient inputSingle tie versus figure-eight useStepwise placement around bracketsCheck for tissue impingementLesson 4First patient talk and confirm: name check, health/dental past update, explain steps in easy wordsCovers checking patient name, looking at health and dental past, and explaining wire and tie change in clear, calming words for safety, okay, and patient help.
Confirm identity with two identifiersReview medical alerts and medicationsUpdate dental and orthodontic historyExplain procedure in simple languageObtain and document informed consentLesson 5Putting metal ties: twist way, right pull, guard gums and dodge over-tightDetails putting metal ties, threading, twisting, tucking. Stresses right pull, dodging over-tight, guarding gums and lips from sharp wire ends.
Select appropriate ligature gaugeThread ligature through tie wingsTwisting technique and tension controlCut and tuck pigtails safelyCheck for sharp or exposed endsLesson 6Spotting and clearing bits and plaque before wire take-out: plaque clean, cotton use, pull back for seeLooks at spotting plaque, food bits, stone before wire out. Stresses pull back, suck, cotton for better see, less germs, ready teeth for right wire place.
Visual inspection for plaque and debrisUse of air, water, and suctionGauze use for wiping and isolationRetraction for visibility and accessPatient education on oral hygieneLesson 7Putting new archwires: pick right wire, pre-bend and test fit, insert order for top and bottomOutlines picking, pre-bending, test fitting new archwires. Details insert order top bottom, handling crowd, smooth slot without too much force or tissue hurt.
Confirm prescribed wire size and alloyPre-bend and contour arch formTrial fit and adjust before full seatingInsertion sequence by quadrantManage crowding and rotated teethLesson 8Securing archwires and check fit: twist/slot checks, cut ends, use end cutters and coversExplains securing archwires and check fit. Covers twist slot checks, cut ends, end cutters, add covers to stop rub or slip.
Check full bracket engagementAssess torque and rotational controlTrim distal ends safelyUse distal end cutters correctlyAdd overlays or stops if neededLesson 9Safe archwire removal: steps for top and bottom wire out, hold brackets, control snap-back, cut patient acheExplains step-by-step top bottom archwire out, cutting, hold brackets, control snap. Stresses cut patient ache, stop soft tissue hurt or wire swallow.
Check wire type and attachmentsCut wire in safe strategic segmentsControl spring-back with cotton rollsStabilize brackets and tubesRetrieve and secure removed wireLesson 10Dealing with stuck or tissue catch in wire out: step moves to free wire, tools to use, when call brace docGuides stuck or tissue catch in wire out. Covers step moves, tool picks, soft guard, clear stop and call rules.
Identify source of resistanceUse mirror and retraction for viewGentle back-and-forth wire mobilizationUse hemostats or Weingart pliersIndications to stop and call orthodontistLesson 11Taking off rubber ties: tool pick, safe take way, handle and bin used rubbersDetails tool pick and safe way for rubber tie off. Covers control out order, dodge bracket hurt, stop tissue harm, right handle bin dirty rubbers.
Select appropriate ligature removerSequence for quadrant by quadrant removalStabilize brackets during removalAvoid snapping toward soft tissuesDispose of used elastics as biohazardLesson 12Process overview and jobs: clear task split between helper and brace doc for each partGives full process overview and clears task split between hygienist, helper, brace doc. Highlights talk, timing, safety checks each step.
Outline full archwire change workflowDefine hygienist and assistant dutiesIdentify orthodontist-only proceduresHandoff communication checkpointsTime management and chairside flow
