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 impressions of your teeth, take photos of your face and teeth, and order X-rays of the mouth and head. An appropriate treatment plan is made based on 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. No one method works for everyone.
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. As the teeth move, the bone changes shape as pressure is applied.
Braces are made up of the following components:
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’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-colored materials that are cemented to the teeth with dental bonding agents. 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.
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.
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.
• Tiny elastic rubber bands
, called ligatures, hold the arch wires to the brackets.
may be placed on the arch wires 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.
Newer “mini-braces,” which are much smaller than traditional braces, may be an option for some. 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.