Dental braces are orthodontic devices that help straighten and position the teeth while enhancing dental health. Using brackets that are adhered to the teeth, braces rely on wires and elastics to apply pressure and force to the teeth, moving the teeth in specific directions and with specific goals. The constant pressure exerted by braces causes the teeth to very slowly loosen and move into their desired position; in a biomechanical process called bone remodeling, new bone forms to support the tooth in its new location. Braces may be used to close gaps between teeth, or to address issues with the alignment of the bite, crooked teeth, or other dental issues. Some braces are medically recommended, serving a structural, mechanical function first and foremost, while others may be strictly cosmetic in purpose.
Braces may be made of any number of materials. Traditional metal wired braces are the stainless steel braces we all envision when we think of braces. These traditional braces consist of brackets cemented to the teeth and connected to wires, sometimes using elastics, to exert consistent pressure on the teeth in varying directions. If patients are allergic to nickel, which is present in stainless steel, they may opt for gold-plated stainless steel braces. These braces are also an appealing option for people who prefer gold-colored metals to silver. Titanium may also be an option for people with nickel allergies, though titanium braces are more costly than stainless steel. Some people prefer braces that aren’t visible at all; for these people, lingual braces may be the best option. Lingual braces consist of brackets that are bonded to the backs of the teeth -- the lingual, or tongue, side -- and are therefore not visible when the wearer is smiling. If orthodontic needs are minimal, orthodontists may recommend removable aligners, which are progressively sized clear plastic trays that gradually move the teeth into their desired positions.
Braces are provided by licensed orthodontists, dental specialists who focus on diagnosing and treating alignment issues in the teeth and jaws. These specialists undergo 2 to 3 years of training following completion of their dental degree to become certified in orthodontics. Following the initial patient consultation, if it is determined that braces are an appropriate treatment, the orthodontist will take x-rays and molds of the teeth, or digital imaging, to design the course of treatment. Treatment usually takes anywhere from six months to three years to complete, and it may be necessary to surgically modify the structure or shape of the jaw before placing braces, or to use orthodontic spacers to prepare the teeth for braces. If it is determined that there is not enough space in the mouth to accommodate all of the teeth in proper alignment, the orthodontist may extract teeth or expand the patient’s palate, either surgically or with a custom-fitted mechanical device.
Patients, especially children and teenagers, may be required to wear headgear along with their braces, to anchor certain teeth and prevent them from moving. Pressure from braces must be administered slowly to preserve the health of the teeth and allow bone remodeling to occur. Every 3 to 6 weeks, the orthodontist will adjust the braces by removing and replacing the wire that bears the primary load of moving the teeth. Patients usually report some discomfort after getting their braces adjusted, but this is a necessary part of the meticulously engineered project that is dental braces. Following removal of dental braces, patients wear retainers to support and stabilize the teeth while the bone is healing and solidifying. Some retainers are removable and some are not; some are visible and some are not.