Braces and Retainers (Cleveland Clinic)

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If you have crooked teeth and/or a misaligned bite (an underbite or overbite), there are devices that can help straighten your teeth, including braces and retainers.

Your dentist will refer you to another dentist – called an orthodontist – who specializes in straightening teeth.

The orthodontist will ask you questions about your health, conduct a clinical exam, gather impressions (molds) of your teeth, take photos of your face and teeth, and order X-rays of your mouth and head. A treatment plan is then developed.

In some cases, a removable retainer will be all that's necessary. In other rare cases (especially when there is an extreme overbite or underbite), surgery may be needed. In most cases, however, braces will correct the bite and alignment of teeth.

What types of braces are available?
There are five types of braces:

  • Brackets: Made of stainless steel or clear or tooth-colored ceramic or plastic, brackets are bonded to the front of each tooth. Ceramic or plastic brackets are often selected for cosmetic reasons. Plastic brackets, however, may become stained and discolored by the end of treatment. Another disadvantage of ceramic or plastic brackets is that they cause more friction between the wire and brackets, which can increase treatment time.
  • Invisible Aligners: These are a series of clear aligners. They may be a treatment option when only minor alignment adjustments are needed and are also often selected for cosmetic reasons.
  • Lingual-type brackets: These are brackets that attach to the back of teeth, hiding the bracket from view.
  • Traditional bands: These are the generally outdated "full metal-mouth" look. With this option, metal brackets are soldered to metal bands that wrap around each tooth.
  • Mini-braces: These braces are much smaller than traditional braces and may be an option for some patients.

How do braces work?
Braces apply constant pressure to teeth over a period of time. This pressure slowly moves the teeth. As pressure is applied and the teeth move, the bony socket of each tooth is able to adapt to its new position. The bony socket is the area where each tooth attaches to the jaw bone.

What are the names of the parts of braces and what do they do?

  • Brackets are the small squares that are bonded directly to each tooth. The brackets are held in place by a special dental bonding agent (a ‘glue’) or are attached to orthodontic bands. Brackets act like handles. They hold the arch wires that move the teeth.
  • Orthodontic bands are stainless steel, clear or tooth-colored materials that are cemented to teeth with either dental bonding agents or cement. They wrap around each tooth to provide an anchor for the brackets. The clear or tooth-colored bands are more attractive because they can’t be seen. They blend in with the color of the teeth. However, they cost more than stainless steel. They are not used in all patients. Some people need only brackets and no bands.
  • Spacers are small appliances that are placed between teeth. They create a small space and are positioned before the orthodontic bands are put in place.
  • Arch wires attach to the brackets and act as tracks to guide the movement of the teeth. Arch wires can be clear, metal 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 tooth-colored.
  • A buccal tube is a small metal part that is welded to a molar. The part has slots that keep the arch wires and other parts used to straighten teeth in place. Instead of welding the buccal tube to molar, mini-implants can also be used as anchors.
  • Ligatures are tiny rubber bands that hold the arch wires to the brackets.
  • Springs may be placed on the arch wires between brackets to push, pull, open or close the spaces between teeth.
  • Two bands on the upper teeth may have headgear tubes on them to hold the facebow of the headgear in place. (Headgear is another tool used to aid in correcting the position of the teeth.
  • Elastics or rubber bands attach to hooks on brackets and are worn between the upper and lower teeth in various ways. They apply pressure to move the upper teeth against the lower teeth to achieve a perfect fit of individual teeth.
  • Facebow headgear is the wire gadget that is used to move the upper molars back in the mouth to correct the alignment of the bite. It also creates room for teeth that are crowded in the front of the mouth. The facebow consists of an inner metal part shaped like a horseshoe that goes in the mouth, attaching to buccal tubes, and an outer part that goes around the outside of the face and is connected to a headgear strap. Mini implants can be used for anchorage.

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Last Updated: 12/12/2011

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