If you have crooked teeth and/or a misaligned bite (an underbite or overbite), there are a variety of treatments that can help straighten teeth, including braces and retainers.Many general dentists are doing basic alignment and orthodontics, but orthodontists specialize in correcting irregularities of the teeth.The dentist or orthodontist you choose will ask questions about your health, conduct a clinical exam, take photos of your face and teeth, and order X-rays of the mouth and head. An appropriate treatment plan is made based on the analysis of the gathered information.
In some cases, a removable retainer will be all that’s necessary. In other rare cases (especially when there is an extreme overbite or underbite), surgery may be necessary. In most cases, however, braces will be needed.
What Types of Braces Are Available?
If braces are indeed the solution for you, the dentist or orthodontist will prescribe an appliance specific for your needs. The braces may consist of bands, wires, and other fixed or removable corrective appliances.
How Do Braces Work?
In their entirety, braces work by applying continuous pressure over a period of time to slowly move teeth in a specific direction.
Braces are made up of the following 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 archwires that move the teeth. There are several types of brackets, including stainless steel and tooth-coloured ceramic or plastic, which are often selected because they’re 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-coloured materials that are cemented to the teeth with dental bonding agents. They wrap around each tooth to provide an anchor for the brackets. 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.
- Archwires attach to the brackets and act as tracks to guide the movement of the teeth. Archwires can be made of metal or be clear or tooth-coloured.
- Ties are small rubber rings or fine wires that fasten the archwire to the brackets. They can be clear, metal, or coloured.
- A buccal tube on the band of the last tooth holds the end of the archwire securely in place.
- Tiny elastic rubber bands, called ligatures, hold the archwires to the brackets.
- Springs may be placed on the archwires between brackets to push, pull, open, or close the spaces between teeth.
- Two bands on the upper teeth may have headgear tubes on them to hold the facebow of the headgear in place. (A headgear is another tool used by orthodontists to aid in correcting irregularities of the teeth; see below)
- 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.
- Facebow headgear is the wire gadget that is used to move the upper molars back in the mouth to correct bite discrepancies and also to create room for crowded teeth. The facebow consists of an inner metal part shaped like a horseshoe that goes in the mouth, attaching to buccal tubes, and an outer part that goes around the outside of the face and is connected to a headgear strap.
There is another method of straightening teeth that uses removable plastic retainers that may also work when crowding of the teeth is not too severe. Your orthodontist will discuss the various types of braces with you and determine which might be the best option for your situation.
What Care Can I Expect After the Braces Come Off?
After braces are taken off, you should book in with a dental hygienist to get your teeth thoroughly cleaned. Your orthodontist may want to take another set of X-rays and bite impressions to check how well the braces straightened your teeth and to see if any wisdom teeth have developed. If wisdom teeth are beginning to come in after braces have been removed, your dentist or orthodontist may recommend the wisdom teeth be pulled to prevent newly straightened teeth from shifting.
Your dentist or orthodontist will also fit you with a retainer. A retainer is a custom-made, removable or fixed appliance that helps teeth maintain their new position after braces have been removed. The reason why a retainer is needed is that even though braces may have successfully straightened your teeth, they are not completely settled in their new position until the bones, gums, and muscles adapt to the change. Also, after long periods of time, teeth tend to shift.