Appliance principles
Removable, fixed and functional appliances have different indications, limits and compliance demands. Explain maintenance and risks.
Understand
Fixed appliances give precise control but demand cleaning; removable and functional appliances have narrower indications and more reliance on wear. All can cause discomfort and complications.
Assess
Assess oral hygiene, caries, periodontal health, eruption stage and motivation. Explain the likely commitment to appointments and retention.
Apply
Choose appliances for the defined movement and the patient. Monitor decalcification, root resorption and soft tissue health; pause or adapt treatment if harm outweighs benefit.
Key distinctions
Appliance choice depends on the movement needed, anchorage, growth and patient participation. Fixed appliances can produce precise movements but create plaque-retentive areas. Removable appliances depend strongly on wear and have movement limits. Explain potential decalcification, root resorption and soft tissue effects, with a plan to pause treatment if oral health deteriorates.
Think through a case
A patient with poor brushing starts fixed appliances and develops widespread white-spot lesions. Hygiene and disease control were prerequisites, not optional extras.
The distinction to remember
Do not promise that an appliance alone produces a good outcome; wear, review and prevention are integral.
Test your recall
Why assess oral hygiene before fixed appliances?
Show answer
Poor hygiene raises decalcification and gingival risks.