Dental Braces

 Braces-Video 

Dental braces (also known as orthodontic braces or simply braces) are devices used in the orthodontic industry that help align and straighten teeth and help to position them with regard to a person’s bite, while also working to improve dental health. They are often used to correct under bites, as well as, malocclusions, overbites, cross bites, open bites, deep bites, crooked teeth, and various other flaws of the teeth and jaw. Braces can be either cosmetic or structural. Dental braces or orthodontic braces are often used in comparison with other orthodontic appliances to help widen the palate or jaws and to otherwise assist in shaping the teeth and jaws. While they are mainly used on children and teenagers, adults are also big contributors to this type of treatments.

How braces work
The application of braces moves the teeth as a result of force and pressure on the teeth. There are four basic elements that are needed in order to help move the teeth. In the case of traditional metal or wire braces, one uses brackets, bonding material, archwire, and ligature elastic, also called an “O-ring” to help align the teeth. The teeth move when the archwire puts pressure on the brackets and teeth. Sometimes springs or rubber bands are used to put more force in a specific direction. Braces have constant pressure, which over time, move teeth into their proper positions. Occasionally adults may need to wear headgear to keep certain teeth from moving. When braces put pressure on your teeth, the periodontal membrane stretches on one side and is compressed on the other. This movement needs to be done slowly otherwise the patient risks losing his or her teeth. This is why braces are commonly worn for approximately two and a half years and adjustments are only made every three or four weeks. This process loosens the tooth and then new bone grows in to support the tooth in its new position which is technically called bone remodelling. A tooth will usually move about a millimetre per month during orthodontic movement, but there is high individual variability. Orthodontic mechanics can vary in efficiency, which partly explains the wide range of response to orthodontic treatment.

Types of braces
Modern orthodontists can offer many types and varieties of braces:

• Traditional braces are stainless steel, sometimes in combination with nickel titanium, and are the most widely used. These include conventional braces, which require ties to hold the archwire in place, and newer self-tying (or self-ligating) brackets. Self-ligating brackets may reduce friction between the wire and the slot of the bracket, which in turn might be of therapeutic benefit.
• Clear braces serve as a cosmetic alternative to traditional metal braces by blending in more with the natural color of the teeth or having a less conspicuous or hidden appearance. Typically, these brackets are made of ceramic or plastic materials and function in a similar manner to traditional metal brackets. Clear elastic ties and white metal ties are available to be used with these clear braces to help keep the appliances less conspicuous. Clear braces have a higher component of friction and tend to be more brittle than metal braces. This can make removing the appliances at the end of treatment more difficult and time consuming.
• Gold-plated stainless steel braces are often employed for patients allergic to nickel (a basic and important component of stainless steel), but may also be chosen because some people simply prefer the look of gold over the traditional silver-colored braces.
• Lingual braces (Incognito Braces) are custom made fixed braces bonded to the back of the teeth making them invisible to other people. In lingual braces the brackets are cemented onto the backside of the teeth making them invisible while in standard braces the brackets are cemented onto the front side of the teeth. Hence, lingual braces are a cosmetic alternative to those who do not wish to have the unaesthetic metal look but wish to improve their smile.
• Titanium braces look just like stainless steel braces but are very light weight and strong. People with allergies to the nickel in steel often choose titanium braces, but they are more expensive than stainless steel braces.
• Progressive, clear removable aligners (examples of which are Invisalign, Originator, ClearCorrect) may be used to gradually move teeth into their final positions. Aligners are generally not used for complex orthodontic cases, such as when extractions, jaw surgery, or palate expansion are necessary. These braces are the most recent type of braces. These are good choices for people who have slight orthodontic problems, but can also be used in severe cases. The main attraction of these braces is they are virtually invisible making them hardly noticeable on the teeth. They work to gradually move the teeth into their right position just like traditional braces, but without the constant help of wires that need tightening.
• Smart brackets: are the latest concepts under investigation. The smart bracket contains a microchip that measures the forces that act on the bracket and subsequently, the tooth interface . The aim of these braces is to reduce the duration of orthodontic therapy and the related expenses and discomfort to the individual.
• A-braces: are another new concept in dentistry. In the shape of a capital letter A, A-braces are applied, adjusted, removed and completely controlled by the user. At the ends of the A’s arms are angled knobbed bits that the user bites down over. The width between the bits is adjusted by turning the crossbar, housed across the arms. A user never has to experience pain because the pressure is so easy to control. A-braces may serve as self-adjustable retainers and palate expanders.

Traditional braces are mostly used in treating children as well as adults. They consist of a small bracket that is glued to the front of each tooth and the molars are adjusted with a band that encircles the tooth. An advantage is that one can eat and drink while wearing the brace but a disadvantage is that one must give up certain foods and eating habits while wearing them, such as, chewing gum and eating potato chips. Another disadvantage is they have to be periodically tightened by your orthodontist causing increased amounts of discomfort.

Procedure: the first step is to determine whether braces are suitable for the patient. The doctor consults with the patient and inspects the teeth visually. If braces are appropriate, a records appointment is set up where X-rays, molds, and impressions are made. These records are analyzed to determine the problems and proper course of action. Typical treatment times vary from six months to two and a half years depending on the complexity and types of problems. Orthognathic surgery may be required in extreme cases. About two weeks before the braces are applied brackets are required to spread apart back teeth in order confirm enough space for the bands.
When applying another type of dental brace such as invisalign, the process is quite different but there are similarities like the initial steps of molding the teeth before application. With invisalign they send your impressions to the invisalign company for evaluation and viewing who then create your braces. They then send the finished braces back to your orthodontist to be put on like a well fitted mouth guard. The dentist has no need for brackets or wires to be placed on the teeth but does need the appliance, glue, metal knobs, and rubber bands that can help the teeth move more effectively.

Post Treatment Retainers: in order to prevent the teeth moving back to their original position, retainers may be worn once the treatment with braces is complete for the patient depending on their specific needs. If the patient does not wear the braces appropriately for the right amount of time, the teeth will move towards their previous position. For regular traditional braces Hawley retainers are used. They are made of metal hooks that surround the teeth and are enclosed by an acrylic plate shaped to fit the patient’s palate. For invisalign braces an Essix retainer is used. They are similar to the regular invisalign braces have a clear plastic tray that is form fitted to the teeth that stays in place. There is also a bonded retainer where a wire is permanently bonded to the lingual side of the teeth, usually the lower teeth only.