Treatment consists of three phases: the initial placement of the braces (or clear aligners), periodic adjustments and wearing of a retainer after the braces are removed.
Placement of braces
Fixed braces typically consist of these components:
- Brackets attached to the outside surfaces of the teeth. Or they can be attached to the backside of teeth, hiding them from view, but this makes them a bit harder to access. Brackets can be made of stainless steel, ceramic (clear or tooth-colored) or other materials. Modern metal brackets are smaller and less noticeable than they used to be.
- Ring-like bands that encircle the molar teeth. Before bands are applied, space is created by placing very small rubber bands (spacers) between the molar teeth. Bands are made of stainless steel or titanium. A buccal tube attached to the band of the last molar holds the end of the connecting wire in place.
- A flexible wire that connects all of the brackets and bands, controlling movement of the teeth.
- Various accessories to help position the teeth, in addition to the fixed components. Small rubber bands (elastic ties) secure the wire to the brackets. Larger rubber bands also may be used to help move teeth. Headgear (usually worn at night) may be used to help hold or move teeth into the correct position.
Removable clear aligners
Instead of using fixed braces, certain people who need only minor corrections may benefit from a series of customized, removable appliances called clear aligners. Typically, each set of aligners is worn for two to three weeks, as close to 24 hours a day as possible — except when eating, brushing or flossing — until it's replaced by the next set.
You should also remove the aligners when drinking liquids that might stain the aligner, such as coffee or tea.
After fixed braces are placed on your teeth, your orthodontist adjusts them periodically by tightening or bending the interconnecting wires. This puts mild pressure on the teeth and gradually shifts them into new positions. The jaw responds to the pressure by dissolving bone in the path of the moving tooth and laying down new bone behind it.
Occasionally, the orthodontist may use tension between the upper and lower jaws to help promote correct alignment. This is often done with elastic bands stretched between opposing teeth.
Your teeth and jaws may feel slightly sore for a day or two after an adjustment. This discomfort can usually be eased with an over-the-counter pain reliever. Tell your orthodontist if the discomfort is severe or becomes worse.
After dental braces are removed, the newly straightened teeth need to be stabilized for a period of time (retention period) to prevent them from shifting back to their original position. This is accomplished with the use of a custom-made appliance typically made of plastic or plastic and metal wires that help teeth stay in place (retainer).
Retainers are usually removable, but may be fixed. Or a combination of fixed and removable may be used.