How Braces Work

how braces work

Published by Dr. Charles Gemmi

A Board Certified Orthodontist and a Diplomate of the American Board of Orthodontics, Dr. Charles Gemmi has been a practicing orthodontist with Orthodontics Limited since 2000 and is a member of the teaching staff at Einstein Medical Center. Orthodontics Limited is a Diamond+ Provider of Invisalign in Philadelphia and Hatboro, PA.

Braces are actually a pretty impressive invention. They gradually and safely move teeth, making it very easy for those who had crooked teeth, crowded teeth, or gaps in between teeth, along with serious bit problems, to get a healthier, more attractive smile. If you or your child is going to be getting braces on soon, you might be wondering exactly how they work. You probably already know that they put pressure on your teeth, pushing or pulling them into a better position. But how exactly do they do that? Here’s everything you need to know about how braces work.

The Components of Braces

Most people have three or four components to their braces. The first is the bracket. This is usually made out of metal, though also may be made out of ceramic, depending on what type of treatment the patient has chosen. These brackets will have little hooks or doors, onto which the wire is threaded. It might be secured by closing the door or by applying an elastic over the top of the wire.

The second component is the glue. This is what your orthodontist will use to attach your bracket to your tooth. Some brackets might simply be attached to a metal band, which is then crimped around the tooth to hold it in place, but it is much more common these days to attach the bracket directly to the tooth. In cases where more serious treatment is required, some metal bands and some glue may be used to give the braces more leverage.

The third piece is the wire. This is a thin piece of metal that runs from one bracket to another. Your orthodontist will change the shape and curvature of that wire in order to move your teeth in the right direction. Crimps might be made in the wire to help push or pull a stubborn tooth. In some situations, the wire will attach all of your bottom or upper teeth together, but an orthodontist might occasionally cut the wire is certain places, connecting only a few teeth if that is better for the treatment.

The last common component is the elastic. For patients that need their bite to be corrected in some way, the elastic is essential. It is strung between a hook on an upper bracket and a hook on a lower bracket, pulling the upper jaw backwards to help fix an overbite or the lower jaw backwards to fix and under-bite. Rubber bands can be used for a variety of different situations, especially for helping to exert more pressure on teeth or on jaws.

Of course, some patients will have other implements attached to their braces system. For example, a very narrow arch might require an expander in order to widen it to fit the bottom arch. Some patients will have lots of rubber bands, some might have no bands at all.

Other terms you might hear your orthodontist mention include orthodontic bands which are stainless steel, clear, or tooth-colored materials that are cemented to the teeth with dental bonding agents. They can provide an anchor for the brackets. They are not used in all patients however.

Some patients may also have spacers put it between teeth to create space where needed. Ties or small rubber rings are also used to attach the arch wire to the brackets. Another popular option is also to use ligatures, tiny elastic bands to attach the arch wires to the brackets. A buccal tube on the band of the last tooth is also somtimes used to hold the end of the arch wire securely in place.

How Braces Work

The wire is inserted into the brackets and this applies pressure to the teeth. Before applying the brackets, your orthodontist will probably take a mold of your teeth. From this mold, they will make a cast, so they can plan how each tooth needs to be moved, in order to get it in the best possible position, and can then decide how to place the brackets. For example, if you have some teeth that need to be tilted, the positioning of those brackets would be much different than the positioning of brackets that need to be turned.

The orthodontist then attaches the brackets and inserts the wire. This wire is probably not going to be perfect even, all across the arch. Bends in the wire are used to provide different types of pressure on different teeth. For example, a slight bend in the wire could help to move tooth that is too far forward and one that is too far back to be perfectly aligned with one another. A bend in the wire is also how most orthodontists will encourage a tooth that is twisted to turn and face the right way.

The process by which teeth move is called remodeling. When pressure is put on the tooth, cells called osteoblasts and osteoclasts form around the tooth’s root. The pressure of the wire and the osteoblasts and osteoclasts create a negative pressure on one side of the tooth. Here, bone is removed. On the other side of the tooth, bone is reformed. The tooth slowly moves into the correct position as pressure is put on the tooth and the bone of the tooth and the jaw remodel.

This process can only occur if constant pressure is put on the tooth (which is why, when patients have Invisalign, it is so important to wear the aligners as often as possible and why orthodontists are often strict about their parents keeping their adjustment schedule). As bone is absorbed on one side and deposited on the other side, the tooth can move. Once the pressure stops, like when the braces are removed, the tooth will begin to settle into its new position. It is possible, however, that it could start to drift back to its old position. This is why patients are often given retainers, so that the teeth will be kept in their current position and are not allowed to return to their crooked state.

When your orthodontist feel like the treatment has worked, your braces will be taken off and your teeth thoroughly cleaned. He or she may even was to take more x-rays and bite impressions to make sure all your teeth align up right and that none of your wisdom teeth have started to develop during treatment. If they have your orthodontist may suggest getting them pulled so they don’t cause your newly straigthened teeth to shift.

Most likely your orthodontist will also fit you with a retainer after the braces are removed. A retainer which is either removable or fixed appliance is worn to help your teeth maintain their new position after the braces have been taken off.  Most patients need to wear them all day for 6 months and then just at night after that.

The Cost of Braces

The cost of braces can be a big factor for a lot of people when they are told they need braces. It is a big investment and can run you anywhere from a couple of thousand dollars to $5,000 dollars. If you have dental insurance that will offset the cost and make it more manageable. Also most orthodontists offer flexible payment plans to help you get the work you need done.

Looking to get braces. Contact us for a Free Braces Consultation today.

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