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incisions.","sessions_or_stages":{"sessions":{"min":8,"max":16,"unit":"visits","qualifier":"Bonding, periodic adjustments every 8-12 weeks, removal and retainer fitting."},"stages":[{"code":"planning","label":"Exam, X-rays and treatment plan","after":{"min":0,"max":0,"unit":"days","qualifier":"First visit"}},{"code":"bonding","label":"Bonding self-ligating brackets and first archwire","after":{"min":0,"max":14,"unit":"days","qualifier":"Often same visit or within two weeks"}},{"code":"adjustments","label":"Archwire changes and adjustments","after":{"min":42,"max":70,"unit":"days","qualifier":"First adjustment at 6-10 weeks, then every 8-12 weeks"}},{"code":"debonding","label":"Brace removal and retainers","after":{"min":365,"max":730,"unit":"days","qualifier":"At end of active treatment"}}],"qualifier":"Self-ligating brackets use a built-in clip instead of elastic ties, allowing longer intervals between visits."},"success":{"metric":"Completed alignment with acceptable occlusion and straight teeth","value":85,"unit":"percent of patients","horizon":"At end of active treatment, 12-24 months","population":"Adults with mild to moderate crowding or malocclusion, good oral hygiene","evidence_status":"limited"},"techniques":[{"name":"Passive self-ligating brackets","suits_whom":"Crowding and mild-moderate cases needing low friction.","recovery":"Mild soreness; adjustments every 8-12 weeks."},{"name":"Active self-ligating brackets","suits_whom":"Cases needing more torque control and finishing.","recovery":"Mild to moderate soreness after adjustments."}],"treatment_conditions":["outpatient"],"treatment_duration_hours":{"min":1,"max":2,"unit":"hours","qualifier":"Bonding of both arches in one appointment; later adjustments take 15-30 minutes."},"initial_assessment_documents":["Panoramic dental X-ray (OPG)","Front and side facial photos","Photos of teeth in bite","Previous orthodontic records (if available)","Dental scans or impressions (if available)"],"travel_trips":{"min":2,"max":3,"one_trip_possible":false,"qualifier":"Bonding trip of 2-4 days; adjustments every 8-12 weeks over 1-2 years, often with a local orthodontist; removal trip."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check that treatment is provided by a dentist or orthodontist with orthodontic expertise","scope":"treatment_type","source":{"url":"https://www.ada.org/sitecore/content/ADA-Organization/ADA/MouthHealthy/home/all-topics-a-z/braces/","host":"ada.org","quote":"Orthodontic treatment may be provided by your dentist or an orthodontist, a dentist who specializes in the diagnosis, prevention and treatment of dental and facial irregularities.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C2","text":"Check that a dental professional performs the evaluation and takes radiographs before treatment","scope":"treatment_type","source":{"url":"https://www.ada.org/resources/ada-library/oral-health-topics/home-care","host":"ada.org","quote":"In addition to assuring proper fit, dental professionals can provide pre-treatment dental evaluations and take radiographs.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C3","text":"Check that regular visits and radiographs are included in the orthodontic treatment plan","scope":"treatment_type","source":{"url":"https://www.ada.org/resources/ada-library/oral-health-topics/home-care","host":"ada.org","quote":"Regular dental visits, including radiographs, as part of the orthodontic treatment plan can help identify tooth structure loss or other problems as they occur and address the problem in real time.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C4","text":"Check that the clinic documents diagnostic information, clinical notes, treatment performed, and patient communications","scope":"treatment_type","source":{"url":"https://www.ada.org/resources/practice/practice-management/writing-in-the-dental-record","host":"ada.org","quote":"The dental record is your official document that details all diagnostic information, health history, clinical notes, treatment performed, and patient-related communications that took place in the practice.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"C5","text":"Check the treating medical team’s qualifications","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"A clinic proposes treatment without a pre-treatment dental evaluation or radiographs","scope":"treatment_type","source":{"url":"https://www.ada.org/resources/ada-library/oral-health-topics/home-care","host":"ada.org","quote":"In addition to assuring proper fit, dental professionals can provide pre-treatment dental evaluations and take radiographs.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F2","text":"The clinic cannot answer your questions about treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you been able to ask them questions about your treatment?","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"F3","text":"The clinic cannot explain how aftercare will be coordinated","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Wire poking the cheek, tongue, or gum","urgency":"contact_clinic","general":false,"source":{"url":"https://dentistry.uiowa.edu/dealing-dental-emergencies","host":"dentistry.uiowa.edu","quote":"If a wire breaks or is poking the cheek, tongue or gum, try using the eraser end of a pencil to push the wire into a comfortable position.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W2","text":"Loose bracket or band","urgency":"contact_clinic","general":false,"source":{"url":"https://dentistry.uiowa.edu/dealing-dental-emergencies","host":"dentistry.uiowa.edu","quote":"Loose bracket or band","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},{"id":"W3","text":"Broken wire","urgency":"contact_clinic","general":false,"source":{"url":"https://www.hsdm.harvard.edu/sites/g/files/omnuum6001/files/2025-01/ortho_patient_instructions-qr.pdf","host":"hsdm.harvard.edu","quote":"A bracket or band may loosen, or a wire may break.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the 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scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"You prefer removable treatment under professional supervision","name":"Removable aligners","source":{"url":"https://www.ada.org/sitecore/content/ADA-Organization/ADA/MouthHealthy/home/all-topics-a-z/braces","host":"ada.org","quote":"Under the direct supervision of a dentist or orthodontist, removable aligners are another option for treating orthodontic problems.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200},"operation_id":null}],"checked_at":"2026-11-12","next_check_at":"2027-11-12","version":1},"technique_details":{"status":"ok","items":[{"id":"passive-self-ligating","name":"Passive self-ligating brackets","how_it_works":{"text":"A closing slide holds the archwire without exerting active force","source":{"url":"https://www.academia.edu/1932915/Systematic_review_of_self_ligating_brackets","host":"academia.edu","quote":"On the other hand, passive self-ligating brackets usually have a slide that can be closed which does not encroach on the slot lumen, thus exerting no active force on the archwire.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":403}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"active-self-ligating","name":"Active self-ligating 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