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Types of Braces and Appliances
Orthodontics has changed a lot in the past years. We work with smaller brackets made out of metal or clear porcelain, and invisible aligners such as Invisalign®. We use mini-implants and fixed appliances to avoid non-compliance and help avoid extractions and surgery in more complicated cases. For our patients this means better esthetics, enhanced comfort, decreased treatment time, and fewer trips to the orthodontist. Below follows a broad description of some of the appliances that are used the most in our practice.
Braces
Also called brackets, braces are little square pieces of metal or translucent porcelain that are bonded directly to the teeth. They all have a horizontal slot designed to receive archwires. These are secured to the bracket slot using colored or clear elastics, or metal ties. By engaging flexible and rigid archwires in all brackets, we are able to move teeth in all three dimensions of space. Recent improvements in traditional braces have resulted in smaller, stronger, more efficient and less conspicuous brackets. Metal brackets are the most familiar; however, clear ceramic brackets are now available for older teenagers and adult patients who have cosmetic concerns. While they are visually less noticeable, ceramic brackets are larger and require more attention to oral hygiene. They tend to be used more on the upper front teeth than on the lower teeth.
Lingual Braces
Lingual braces or iBraces™ (also known as invisible or concealed braces) are placed behind the teeth, making them virtually invisible. Just as conventional braces affect the cheeks and lips, these braces will initially affect the tongue. It will take between one and four weeks for patients to adjust to their new braces. Because special instrumentation, equipment and staff training are required for this technique, the cost is a bit more than conventional braces. Treatment time is the same as with other conventional braces. Many patients choose to have lingual braces on the top and clear braces in the bottom. However, some will chose lingual braces on both arches.
Invisalign®
Invisalign has become a popular treatment option that involves wearing a series of clear, removable aligners that gradually move your teeth without wires or brackets. Not only are the aligners invisible, but they are removable, so you can eat and drink what you want in treatment, and brushing and flossing are much simpler.
Mini-Implants
Mini-implants, or temporary anchorage devices inserted in between the roots of the teeth or on the palate, have become preferred adjuncts to replace headgear, decrease treatment length, make tooth movement more predictable and in some cases help avoid teeth extractions and certain surgical procedures. These very effective and efficient micro-implants act as an aid for your orthodontist to move certain teeth while not affecting the position of other teeth. Placement of these miniature titanium screws (1.5-2 mm in diameter and 7-10 mm in length) takes a few minutes. Your orthodontist, periodontist, or oral surgeon does it under minor local anesthesia. At the end of the treatment they are completely removed with topical anesthetic; the wound site heals very quickly.
Separators
Separators or spacers are little rubber doughnuts or metal springs that may be placed between your teeth to push them apart so that orthodontic bands can be placed during your next appointment. The separators will be removed before placing the bands. They do not mix well with sticky foods, floss or toothpicks.
Habit Correctors
Persistent thumb-sucking, tongue thrusting and lip biting habits can be corrected before braces with removable or fixed appliances of various designs.
Headgear
Headgear is a removable device for growing patients that helps align the upper and lower jaws and teeth. Worn at night, it is used to treat patients whose teeth are in an "overbite" or "underbite." It may be worn with braces or by itself.
Elastics
Elastics or rubber bands are often used during orthodontic treatment to provide a light, constant force to move the teeth toward each other or align upper and lower arches. Many times rubber bands are used to close spaces or settle (improve) the bite. This is effective only if elastics are worn all the time. Discomfort is mild and of short duration. Compliance with the recommended elastic wear schedule will assure the best results in the shortest amount of time.
Palatal Expander
A palatal expander is a fixed or removable appliance worn for four to six months that fits into the roof of your mouth. It widens the palate to improve the way your upper and lower jaws and teeth fit together, or to create more room for crowded teeth. Your orthodontist will instruct you about when and how to adjust your expander. Once the desired expansion is achieved, you will still wear the appliance for several months to solidify the bone and prevent regression.
Functional and Orthopaedic Appliances
Functional and orthopaedic appliances are fixed or removable devices used to move teeth in growing patients, to modify the jaw dimensions and relationship if these are altered. This therapy is frequently followed by a fixed multibracket phase to align the teeth and refine the bite.
Positioners
Positioners are removable appliances that complete and improve final tooth movement, putting the finishing touches on your new smile. With full cooperation, they are only needed for four to eight weeks, after which they'll be replaced with conventional retainers.
Retainers
Retainers may be removable or fixed (glued inside of your teeth). They hold the teeth in their new, corrected positions after the braces come off. Wearing the retainers as instructed by your orthodontist is essential to establish a stable tooth relationship and keep your smile looking beautiful.
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