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There are a number of different orthodontic appliances that are used to address orthodontic problems. The specific appliance or combination of appliances used varies by the constraints of the case and the patient’s personal preferences. The following are the orthodontic appliances we use most often.
Advanced metal braces have recently come onto the market. These braces are made possible due to new advances in metal alloys and machining. The advanced metal brackets are smaller than normal brackets, making them less noticeable.
When used in suitable cases, their built in springs and low friction design produces faster results, while placing less pressure on the teeth (which makes it more comfortable for many patients), and requiring fewer visits to complete treatment.
There are several companies making advanced metal braces, with the best know being perhaps the Damon System.
A bite corrector is an appliance that helps reposition the upper or lower jaw. Some bite correctors are removable, but some are attached to the inside of the mouth for the length of treatment. Bite correctors are sometimes a suitable and less visible alternative to headgear.
The patient can talk and chew normally while the bite corrector is in place.
Braces, perhaps the quintessential sign of orthodontic treatment, consists of two parts: brackets, that attach to the teeth, and a wire, that stretches between the brackets. The wire puts pressure on the brackets, which in turn gently pull the teeth into their new position. Braces might be placed on the upper, the lower teeth or both.
Often there is a third component to the braces, the elastics. Elastic ties might be placed around the brackets, or occasionally, the orthodontist might give you removable elastics to put in every day that stretch between the upper and lower braces.
Today, braces are smaller, more comfortable and more attractive than they were in the past.
If you are wearing braces, be certain to take appropriate care of your dental hygiene and avoid potentially damaging food. See the Tips section for some important suggestions.
Clear braces are preferred by many adult patients, as an alternative to normal braces, because they are less noticeable. The clear braces are made out of a plastic or a ceramic material.
It should be noted that “clear” refers to the brackets on the teeth. The wire that attaches to the brackets, and applies the force, is not clear, although it is thin. It should also be noted that the translucent elastic ties that are sometimes placed around the brackets can discolour between orthodontic visits.
Clear braces can perform the functions of normal braces, but are less visible. The drawback to the brackets is that they are more fragile, and hence more easily broken. Because they are more fragile, they cannot be used on all cases, but they are an option for many orthodontic patients.
Elastics are just what they sound like, they are small elastic bands that attach to small hooks on brackets that are attached to the teeth. They are often used in conjunction with braces. Elastics are used to apply pressure on a tooth in a way that a brace’s wire cannot, or to fine tune treatment.
To be effective elastics must be worn as often as recommended by the orthodontist, and must be replaced regularly (the office will give you a large supply).
Elastics should never be doubled up to make up for times when they were not worn, as doubling up the elastics might damage the brackets and may impede treatment.
If the jaw is crowded, there may simply not be room for all the teeth to fit properly. In these cases, the extraction of teeth is sometimes necessary in order to fix the bite. Like any medical procedure, we only recommend extractions when it is necessary.
If extractions are necessary, we will refer you to a specialist, an oral surgeon, to perform the operation. Extractions are normally quite safe, but like any medical procedure, there is a small chance of complications. We will go over the possible complications, and make sure you are comfortable with the decision before referring you to the oral surgeon.
The teeth are normally extracted in pairs or sets of four, in order to keep the mouth symmetrical. Generally, the wisdom teeth are the first set to be extracted, if additional extractions are needed, then the back bicuspids are usually chosen next.
The rare but possible complications from tooth extractions include dry socket, a painful but temporary condition when the nerves of the jaw become exposed, and possible nerve damage to the lips or chin. On average, this sort of nerve damage will heal.
Headgear is a removable appliance is used to apply pressure on the teeth and pull them backwards. It consists of two part, a strap that goes around the back of the neck and a facebow which connects to the strap and goes into the mouth where it locks into brackets on the back teeth. The headgear applies adjustable pressure, depending on which holes in the strap the facebow is locked into.
Many patients prefer to start on a low setting at first, until they adjust to the pressure. Generally, headgear needs to be worn about 14 hours a day. Once the patient acclimatizes to the pressure, it is a good idea to increase the setting so that the headgear works faster and continues to be effective as the teeth move.
Because the strap applies pressure to the facebow, it is important to to always disconnect the strap before removing the metal facebow from the mouth. Failure to disconnect the strap could cause injury or damage the headgear.
Inside braces function like normal braces, but are mounted out of view on the inside of the teeth. They are used to treat difficult problems where aesthetics are a prime concern.
Many adults prefer the inside braces, as it makes the orthodontic treatment completely unnoticeable. Because of the specialized parts, extra time, effort and skill needed to work with inside braces, they are more expensive than conventional braces.
Invisalign is a new way to straighten teeth without braces. Invisalign uses a series of clear, removable aligners to gradually straighten teeth, without metal or wires.
Many patients, particularly adults, prefer Invisalign over other treatment options. However, not all orthodontic problems can be treated with Invisalign.
More information about Invisalign can be found in our Invisalign section, or on their website.
A lip bumper consists of an arch wire attached to a molded piece of plastic. It is used to push the molars on your lower jaw back to create more space for other teeth. The plastic piece rests against the lips. When the patient talks or eats, it pushes the plastic piece back which pushes on the molars, gradually moving them backwards.
A palatial expander is an appliance that widens the upper jaw. It might be used to correct the shape of the jaw or to make more room for teeth. In certain cases, it can be an alternative to extraction.
A retainer is a removable appliance that is normally worn after the braces are removed in order to hold the teeth in their new correct position. Depending on the case, the retainer will need to be worn only part-time for a few months to full-time for a year or more. On occasion, indefinite retainer wear may be needed to keep the teeth straight.
In certain circumstances, retainers might be used as an independent part of treatment to fix minor problems.
Spacers are small rubber bands, or sometimes small metal hinges, that the orthodontist places between the teeth. They are used to gradually move the teeth they are placed between apart, creating the space needed for further orthodontic treatment. Spacers are often used in preparation for braces. The spacers are generally left in for about a week., and then removed by the orthodontist.
Patients usually find that spacers cause some soreness, as they are moving the teeth.
The patient cannot floss when the spacers are in, as the floss might pull out the spacers.
Sometimes abnormal jaw growth occurs, causing one or both jaws to grow too much or too little. The resulting abnormal jaw relationship may cause an improper bite, long term health problems for the gums, teeth and the jaw joint, and possible speaking and chewing problems.The person’s appearance might also be affected, with one jaw sticking too far out or back, facial imbalance or too much gums showing when smiling.
When the jaw relationships are so severely malposed that tooth movement alone cannot accomplish the desired changes, surgical intervention (called orthognathic surgery), may be necessary. For this procedure, we refer the patient to an oral surgeon.
The surgeon moves all or part of the upper and/or lower jaw into a more favourable position. The goal of surgical treatment is to restore proper function and facial balance. With recent advances in surgery the jaws rarely have to be wired shut after surgery, allowing the patient to open and close their jaws sooner, and allowing orthodontic treatment to resume sooner, so that the treatment as a whole is completed in a shorter time span.
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