There are several types of fixed and removable braces that we can use to correct problems with the teeth and bite. This is not an exhaustive list but covers the most commonly used options.
Conventional Fixed Braces (train- tracks)
Small metals attachments (brackets) fit onto the outer surface of the teeth. A wire (archwire) connects the brackets together and is held in place with coloured elastic bands. The wire/bracket combination allows the orthodontist to move the teeth into the new position.
Self-ligating Braces (Damon)
Often called low-friction braces, these are a relatively new development in orthodontic treatment. Each of the brackets has a small built-in clip, which holds the archwire in place and avoids the use of conventional elastic bands to hold the wire in. There is also a ceramic (tooth coloured) version of this appliance –
There are a number of advantages to this system:
- Reduced force levels on the teeth, which have been shown to reduce the damage to the health of the teeth (root resporption) during orthodontic treatment.
- Other reports have demonstrated a reduction in treatment time, which means the braces may have be on a shorter period.
- There is also a reduction in the likelihood of healthy adult teeth being removed as part of the orthodontic treatment.
Ceramic Braces (Clarity)
The bracket of the fixed braces is made of a tooth-coloured ceramic. They are a significant improvement in appearance over a conventional metal brace and are commonly used in the treatment of older adolescents and adults. In adolescents, we often put the tooth coloured braces on the top teeth and metal self-ligating braces on the lower teeth.
Lingual Braces (Incognito)
Adult orthodontics has been revolutionised by the development of high quality lingual appliances. These braces are custom made to fit each tooth to ensure they are as small and sit as close to your teeth as possible. Unlike older systems, this means the braces are comfortable and discrete allowing you to have the smile you have always wanted without any visible braces. Treatments take the same time as conventional fixed braces.
They can be fitted to the top and bottom teeth or the system can be mixed so that the upper invisible brace is used on the top teeth, where it is most needed and a ceramic brace can be used on the lower teeth, where it is less visible and offers some cost advantages.
Aligners (Invisalign or Clear Step)
This is a style of treatment where a series of clear, vacuum formed 'aligners' are used to move the teeth into their new position. The main benefit of this style of treatment is that the aligners are made of a clear plastic and as such as much less visible than conventional braces. They can also be removed when required but generally need to be worn virtually full time for them to work effectively.
Like any removable appliance, they are not capable of complex movements of the teeth and are more suited for less complicated problems.
Functional Braces
This is a special type of removable brace. It is used to correct the bite of the teeth where the top teeth 'stick out'. This is often because the lower jaw is deficient.
The brace is formed of an upper and lower removable brace, which 'fit' together and hold the lower jaw forward. It feels like you are biting on the tips of your teeth with a small gap between them. They are usually worn full time (except eating and contact sports) so any initial problems with speech wear off very quickly.
The most commonly used function brace in the UK is called the 'Twin-Block'.
Removable Braces
These braces are often used as an early treatment option (before all the baby teeth have fallen out) or in addition to fixed braces to make the treatment easier.
They have metal clips to hold the brace over the teeth and use springs or expanding screws to move the teeth into the new position. They often feel bulky for a few days and can make speaking a little difficult initially. They are usually worn all the time (except sports and eating) so the initial difficulties wear off quite quickly. Often the brace will be just over the upper teeth.
Removable Retainers
All teeth need to be retained following orthodontic treatment. All retention (fixed and removable) is for life. Removable retainers generally worn at night time (sometimes after a short period of full time wear). This would usually be every night for a year to retain the orthodontic movements and then one to two nights per week indefinitely. This is to prevent age related changes to the teeth which cause a deterioration in the alignment.
Fixed Retainers
These are supplemental retainers, which are bonded onto the inside surface of the teeth. They are generally placed on teeth which are likely to move with age or onto those which are very likely to move back towards where they came from originally. They are made from a small diameter wire or braided ribbon and are fitted so they cannot be seen. This kind of retention is ideal as after a couple of days they feel completely 'normal' and will continue to maintain the perfect position of the front teeth indefinitely.