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Braces are orthodontic devices that straighten crooked and misaligned teeth. When people think of orthodontics, this treatment is normally the first to come to mind. Dental braces are used for both aesthetic and functional reasons, not only to correct a patient’s smile but also to realign their jaw.
Orthodontic treatment is different for every patient depending on their needs, jaw and teeth structure, and age. There are seven main components of braces that connect together to realign teeth and create a healthier smile over time, including:
The most popular types of dental braces use brackets, which are small, square-shaped pieces of metal or ceramic. They are placed in the center of each tooth and are staggered depending on the patient’s needs and how their teeth are aligned.
A metal archwire fits through the center of the brackets and applies ongoing pressure to the teeth. The wire gradually shifts teeth into their ideal positions.
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Elastic ligatures are small rubber bands that go around each bracket. Ligatures ensure the archwire stays in its slot. They also help guide teeth into their correct positions. The elastics come in a variety of sizes and colors and are replaced during every orthodontic adjustment appointment.
Chain elastics, or power chains, replace the elastic ligatures on each tooth. They add even more pressure to the teeth and create a tightening force that pulls the teeth together. Typically, power chains are used at the end of treatment.
Wire ligatures are thin, stainless steel wires that keep the archwire in place. The wires also secure the individual brackets to each tooth. These may be used in place of elastic ligatures when it is difficult to keep the archwire in the bracket.
Coils, also called coil springs, are positioned between two brackets when the teeth are too close together (overlap). Coils separate the teeth and restore a patient’s bite.
Rubber bands are attached to hooks and connect the top and bottom brackets together. They ensure the teeth line up properly and help reposition the jaw. Rubber bands are placed and removed daily by the patient.
There are many different types and over a hundred brands of braces to choose from. For adults, there are more aesthetic options available for those who don’t want visible metal braces. For example, clear ceramic braces mirror the size and shape of metal braces but are actually made of porcelain. Four common types of dental braces include:
Traditional metal braces are the most effective and affordable orthodontic treatment option. They fix overcrowding, align the teeth, and reposition the jaw. An orthodontist easily moves the teeth in small increments during routine check-ups. For children and teens, traditional braces are the most popular option. Options for adults are also available if they do not mind visible metal brackets.
Clear braces, also called ceramic or invisible braces, are the same size and shape as metal braces and serve the same purpose. The main difference between the two types is that clear braces have tooth-colored brackets, which means they blend in with natural teeth and are less noticeable. The rubber bands and elastic components of clear braces are also see-through or white. Invisible braces are ideal for teens and adults.
Lingual braces are a lesser-known, alternative option to traditional metal braces. This “invisible” orthodontic treatment is similar to conventional braces. Although, the main difference is that the brackets and wires are placed on the backs of teeth. Lingual braces use the same hardware and methods as traditional “outside” braces.
Clear aligners, such as Invisalign, are another popular “invisible” orthodontic treatment option. They are minimally invasive and removable. They usually cost the same as traditional metal braces. Patients must wear each custom aligner for up to three weeks. Teeth move a fraction of a millimeter at a time and require less in-office visits. Aligners are a popular option for teens and adults.
Orthodontic headgear is an appliance that treats a variety of different bite problems. The appliances attach to your face or head with a neck strap. Treatment is usually only necessary if a child has an overbite, underbite, overjet, crossbite, or open bite. Most cases of mild to moderately crooked teeth can be straightened with braces alone.
Headgear can only be used in combination with braces. Braces move teeth, while headgear is capable of influencing the growth of the jaws. Only children are candidates for headgear because their jaws are not fully developed.
An in-depth orthodontic consultation is required before the placement of braces. The orthodontist recommends the best treatment option depending on individual needs.
Teeth must be deep cleaned by a dentist before braces are placed. If other oral care treatments are needed, such as periodontal disease treatment, cavity fillings, or tooth extractions, they should be completed before orthodontic treatment as well.
During the first visit with an orthodontist, x-rays are taken of the patient’s mouth and custom molds are made.
The bonding appointment takes about two hours. The orthodontist dries the patient’s teeth, places the braces on using a special adhesive, hardens the adhesive with a curing light, and sets the bond. Finally, the orthodontist runs the archwire through the brackets and applies the ligature to keep all of the materials in place.
Within four to eight weeks after placement, the first follow-up appointment is scheduled. The orthodontist routinely swaps out elastics and archwires to ensure the teeth are moving in the right direction. A patient visits their orthodontist every four to eight weeks until the braces are removed. Braces are left on for 18 months to three years.
The brackets and corresponding materials come off easily. The orthodontist first removes the bonding adhesive, brackets, wire, and elastics. Then the enamel is cleaned. Finally, a permanent or removable retainer (mouthguard) is created to ensure the patient’s teeth stay in place.
While braces are in place, paying extra attention to oral care practices is essential to see the best results. Flossing and brushing are recommended after every meal. This ensures food, debris, and bacteria do not get stuck between the brackets and cause more serious dental conditions.
Not only do straight teeth improve your appearance, but they also have oral health benefits. For example, straight teeth are easier to brush and floss between, which leads to better oral hygiene. If your teeth are crooked, however, it is more difficult to remove plaque. As a result, you have a higher risk of developing oral conditions over time.
During orthodontic treatment with metal, clear, or lingual braces, food choices are limited. This is because it’s crucial to not ingest anything that can damage the braces.
Hard and sticky foods, such as candy, get stuck between the brackets and are difficult to remove. This can lead to cavities, decay, and lose brackets.
Dental insurance for braces is required for children in some states. For adults, however, insurance may only cover part of the cost.
Dental insurance doesn't consider whether the reason for braces is esthetic or not. Most insurance companies cover treatment if the plan provides orthodontic benefits. They do not pay for treatment if the plan doesn't include orthodontic benefits.
The cost of braces typically depends on the type chosen, the length of treatment, and the patient’s individual needs:
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Blue Ocean Publishing Group. The Million Dollar Smile, Changing Lives with Cosmetic Dentistry. 2018.
Hollins, Carole. Basic Guide to Dental Procedures. John Wiley & Sons, Inc., 2015.
“Orthodontic Treatment Options.” American Association of Orthodontists, www.aaoinfo.org/orthodontic-treatment-options/.
Proffit, William R., et al. Contemporary Orthodontics. Elsevier/Mosby, 2019.
Syrbu, John DDS. The Complete Pre-Dental Guide to Modern Dentistry. 2013.
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