Braces

What Are Braces?

Braces are dental tools that help correct problems with your teeth, like crowding, crooked teeth, or teeth that are out of alignment. Many people get braces when they’re teenagers, but adults get them too. As you wear them, braces slowly straighten and align your teeth so you have a normal bite. Some people get braces to adjust their smile.

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, custom-made, removable or fixed tools that cover the outside of your teeth and help keep them in position.

Many general dentists do basic alignment and treat other tooth problems, but orthodontists specialize in correcting issues with your teeth.

The dentist or orthodontist you choose will ask questions about your health, do a clinical exam, take a digital scan of your teeth, take photos of your face and teeth, and order X-rays of the mouth and head. They’ll come up with a treatment plan based on this information.

You might only need a removable retainer. If you have an extreme overbite or underbite, you could need surgery. But most people need braces.

Types of Braces

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.

  • Metal/traditional braces: Traditional braces are made of metal. They include brackets that are attached to the front of your teeth or bands that fit around each tooth, as well as flexible wires or arch wires that hold the brackets or bands together. Some braces also include rubber bands or metal ties that link the brackets to the wire. These bands create more pressure to help straighten and align your teeth. Sometimes, your orthodontist will have you wear a device called headgear at night. It provides added pressure to help straighten your teeth. You can put it on and take it off.
  • Ceramic braces: The brackets in traditional braces are now also made in tooth-colored ceramic, so you don’t notice them as much. They can also be made with stainless steel, clear materials, or gold.
  • Lingual braces: The brackets on these braces are attached to the backs of your teeth, facing your tongue. Lingual braces are harder to see.
  • Clear aligners: You might also hear them called invisible braces. These are clear plastic trays that fit snugly onto your teeth. They use pressure to gently move your teeth into the correct positions and straighten your smile. You remove the aligners to eat, brush, or floss, but you should keep them in at least 22 hours each day for them to work. The orthodontist may also place tooth-colored attachments onto your teeth to hold the aligners in place.

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How Do Braces Work?

Braces work by putting pressure on your teeth over a period of time to slowly move them in a specific direction. The bone under them changes shape, too.

Braces are made up of these things:

  • Brackets are the small squares that go on the front of each tooth. The dentist uses a special bonding agent or attaches them with orthodontic bands. Brackets act like handles, holding the arch wires that move your teeth. There are several types of brackets, including stainless steel and tooth-colored ceramic or plastic. Dentists use these a lot because they’re harder to see. Sometimes the dentist will cement brackets to the backs of your teeth, in order to hide them from view.
  • Orthodontic bands are stainless steel, clear, or tooth-colored materials cemented to your teeth. They wrap around each tooth to provide an anchor for the brackets. The clear or tooth-colored bands look better, but they also cost more than stainless steel. Not everyone gets bands. Some people have only brackets and no bands.
  • Spacers fit between your teeth to create a small space for the orthodontic bands.
  • Arch wires attach to the brackets and act as tracks to guide the movement of your teeth. Some arch wires are made of metal. Others are clear or tooth-colored.
  • Ties 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.
  • The orthodontist may place springs on the arch wires between brackets to push, pull, open, or close the spaces between your teeth.
  • Elastics or rubber bands attach to hooks on the brackets. They go between your upper and lower teeth in various ways. They apply pressure to move your upper teeth against the lower teeth to achieve a perfect fit.
  • Some people need headgear, a wire gadget that moves your upper molars farther back in the mouth to correct bite problems or make more room for crowded teeth. The orthodontist will add headgear tubes to two bands on your upper teeth to hold the facebow part of your headgear in place. The rest of this horseshoe-shaped piece surrounds your face and connects to a strap at the back of your head.

Newer “mini-braces,” which are much smaller than traditional braces, may be an option for some. Another method of straightening teeth uses removable plastic retainers. This may also work if your teeth aren’t too crowded. Your orthodontist will discuss the various types of braces with you and figure out which option is best.

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How Long Will I Have to Wear Braces?

The time required for braces varies from person to person. It depends on:

  • How severe your problem is
  • The amount of room inside your mouth
  • The distance your teeth must travel
  • The health of the teeth, gums, and supporting bone
  • How closely you follow instructions

On average, once braces go on, they usually remain in place for 1 to 3 years. After braces come off, most people need to wear a retainer all the time for the first 6 months. After that, you have to wear it only while you’re asleep, but you may do it for many years.

Braces Treatment

The orthodontist will want to see you about every month or so in order to make sure the braces are putting steady pressure on your teeth. They’ll adjust the wires, springs, or rubber bands to create more tension and pressure. In some cases, braces alone won’t be enough to straighten your teeth or shift your jaw. That’s when the orthodontist will suggest headgear.

Will Braces Be Painful?

Some adjustments the orthodontist makes to your braces could make your mouth feel sore or uncomfortable. Over-the-counter pain relievers like acetaminophen or ibuprofen can help. Tell your orthodontist if you have a lot of pain after each adjustment. They may be able to make the adjustments a bit differently.

Braces and Age

The mechanical process used to move teeth with braces is the same at any age. That means braces can help both children and adults. The main difference is that some corrections for adults may require more than braces alone. The treatments could also take longer because adult bones are no longer growing.

Sports and Braces

If you have braces, you can take part in any sport you choose. If there’s a chance you might get hit in the face, you’ll need to wear a specially designed mouthguard to protect the inside of your mouth. It’ll be made of durable plastic and designed to fit comfortably over your braces.

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After Braces

After your braces come off, the orthodontist will thoroughly clean your teeth. They may want to take another set of X-rays and bite impressions to check how well the braces straightened your teeth and if you’ve developed any wisdom teeth. If your wisdom teeth are beginning to come in after the braces are removed, the dentist or orthodontist may suggest you get them pulled to prevent newly straightened teeth from shifting.

Your dentist or orthodontist will also fit you with a retainer, which is a very important part of post-braces care. Even though braces may have successfully straightened your teeth, they aren’t 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. That’s why the time frame for wearing a retainer will vary from person to person.

How Much Do Braces Cost?

The price varies, but you can expect traditional metal braces to cost about $5,000 (or less in rural areas). Some insurance carriers provide partial coverage for orthodontic treatment, so check to see what your policy covers.

WebMD Medical Reference Reviewed by Arefa Cassoobhoy, MD, MPH on August 17, 2020

Sources

SOURCES:

American Dental Association.

KidsHealth.org.

Mayo Clinic: “Dental braces.”

American Association of Orthodontists: “Braces vs. Clear Aligners.”

Dentaly.org: “Lingual Braces: Effective and Discreet Teeth Straightening.”

Consumers Advocate: “Best Invisible Braces Based on In-Depth Reviews.”

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