Braces are used to correct misaligned teeth or malocclusion. When teeth are not straight or create a ‘bad bite’ eating and speech can become difficult. Braces can correct this as well as creating a more pleasing aesthetic. When correction is needed your dentist will refer you to an orthodontist, whose specialty is to correct irregularities in teeth.
First you will be asked questions regarding your health and then the orthodontist will conduct a clinical exam. Following this a cast or impression of your teeth will be
made, (as shown opposite) this will help to ascertain what kind of braces you will need and what treatment plan to decide upon.
In some cases just a retainer will be necessary, in extreme cases surgery may be recommended, however in most cases a brace is required.
Braces are designed for specific needs, be it an overbite, an under-bite or misaligned teeth. Such problems are shown below:
Braces work by applying continuous pressure to teeth to slowly move them in to a correct position. Over a period time the teeth are moved in specific directions based on the purpose of the braces. The desired effects are shown below:
They are made up of a number of components:
- Brackets are the small squares that are bonded directly to the front of each tooth with a special dental bonding agent or are attached to orthodontic bands. Brackets act like handles, holding the arch wires that move the teeth. There are several types of brackets, including stainless steel and tooth-colored ceramic or plastic, which are often selected because they are less obvious. Occasionally, brackets are cemented to the back of teeth, in order to hide them from view.
- Orthodontic bands are stainless steel, clear, or tooth-colored materials that are cemented with dental bonding agents or cement to teeth. They wrap around each tooth to provide an anchor for the brackets. The clear or tooth-colored bands are more cosmetically appealing options but are more expensive than stainless steel. They are not used in all patients. Some people have only brackets and no bands.
- Spacers are separators that fit between teeth to create a small space prior to placement of orthodontic bands.
- Arch wires attach to the brackets and act as tracks to guide the movement of the teeth. Arch wires can be made of metal or be clear or tooth-colored.
- Ties are small rubber rings or fine wires that fasten the arch wire to the brackets. They can be clear, metal, or colored.
- A buccal tube on the band of the last tooth holds the end of the arch wire securely in place.
- Ligatures are tiny elastic rubber bands which hold the arch wires to the brackets.
- Springs may be placed on the arch wires between brackets to push, pull, open, or close the spaces between teeth.
- Elastics or rubber bands attach to hooks on brackets and are worn between the upper and lower teeth in various ways. They apply pressure to move the upper teeth against the lower teeth to achieve a perfect fit of individual teeth.
The time braces are needed to be worn varies from person to person depending on your specific treatment plan. However usually the braces remain in place from about 1 to 3 years. Once the braces are removed a retainer may also need to be worn for around 6 months. Whilst the braces are in place you will be required to make regular appointments with your orthodontist so the progress the braces are making can be measured and any adjustments can be made. In some cases it may be found that the braces are not enough and you may be asked to wear a headgear at night to supplement them.
Initially you may suffer some discomfort and pain whilst your teeth get used to the appliance, you may also feel the same when the braces are adjusted. If the pain does not subside after a week or so you may want to make an appointment with your orthodontist and he will be able to make the adjustments differently. There are also over the counter pain medications which will ease the discomfort, just ask your orthodontist for details.
Once your braces are removed your teeth will undergo a thorough cleaning to remove any debris which would have built up in the time you were wearing your appliance. Another set of x rays or photographs may be taken so as to gauge the effect the braces have had on your teeth. Your orthodontist will then check to see if any wisdom teeth are coming through, if so it may be recommended that they are removed so as not to disrupt your newly aligned teeth. You will then be fitted with a retainer, a small appliance which should be worn every night for six months to ensure the new positioning of your teeth remain. The retainer will give your teeth and gums a chance to adjust to the new positioning without the risk of them moving back in to place.