Dental braces are devices designed and used to correct crooked or crowded teeth (malocclusion). Typically, dental braces are used during adolescence. However, more adults are now using corrective dental braces. Dental braces are made of wires, ceramic or metal brackets which are glued on to the surfaces of the teeth.

Braces can be successful depending on the treatment goals and the age when starting treatment. According to the Mayo Clinic, braces are generally effective. However, their effectiveness will depend on individual patient factors (bone density, oral muscular habits) and their ability to strictly follow the instructions of the treating clinician.

Different Types of Braces

The type of braces recommended will depend on several factors. For instance, factors like age, overbite, or crooked teeth will be taken into consideration. Braces are customized to meet the unique needs of patients. Classic fixed braces have metal brackets that are glued to the individual teeth.

An archwire is used to put force on the teeth by engaging the bracket slots. Elastic O-rings or stainless steel twist ties (ligatures) are used to connect the archwire to the brackets. Archwires are changed periodically as the teeth gradually move into the desired position. The elastic rings and ligatures are also replaced.

Other Types of Braces

  • Lingual braces (placed behind the teeth)
  • Ceramic braces (less visible)
  • Invisible braces or aligner trays (can be taken off and placed back on throughout the day)

Retainers are typically made once the patient has completed treatment. They are designed to help keep the new teeth in their place.

How do Braces Work?

Braces move the teeth by exerting consistent pressure for an extended period of time. The teeth will slowly move through the bone to adapt to the pressure. You may assume the teeth are directly connected to the jawbone as one solid object, so it can be hard to imagine how they can be moved.

However, there is a ligament (tendon) underneath the gums that connects the teeth to the jawbone. This ligament is responsible for controlling the position of the teeth. It also responds to the pressure placed on the teeth by the braces.

Installing the braces can take about an hour. Most patients report soreness and tenderness on chewing in the first week as they are trying to adjust. Each time the braces are adjusted, patients might feel soreness for a few days. Ulceration of the inner surfaces of the lips or cheeks may also occur due to increased friction from the brackets and wire.

How are fixed braces placed?

Once the teeth have been cleaned and dried, the brackets will be applied to the teeth using glue. Bonding on the brackets is generally painless.

The brackets are designed to move the teeth into their ideal final positions. They are connected to the archwire with elastic modules.

Elastic modules

Elastics, also commonly referred to as ligatures or O-rings, are placed around the brackets to keep the archwire in place.

Archwires

Archwires connect the brackets on the teeth. They are the mechanisms that help apply pressure to the teeth to move it in place. Archwires can be made of nickel titanium, copper titanium, or stainless steel. The archwire usually comes pre-formed in a U-shape.

Buccal tube

The metal part that can be attached to one of the molars is called a buccal tube. The buccal tube works by anchoring the different parts of the braces together at the back of the mouth.

Buccal tubes can be soldered to metal bands. Bands are normally used in children or when other types of appliances (such as TPA, expander, MARA, face mask) are being used. These appliances may be used in conjunction with brackets.