Disease: Braces (Dental)

    What are dental braces?

    Dental braces are devices that are placed on teeth to move the teeth. For most of us, braces are the most common method to achieve straight teeth. Aside from straightening teeth, braces are used to improve the relationship of how our teeth come together between the upper and lower jaws. Braces for tooth movement fall under the dental specialty of "orthodontics" which is the study and treatment of improper bites (malocclusion). Orthodontic treatment with braces can be for cosmetic as well as structural improvement.

    A general term, "braces" are the actual devices that are attached to teeth. This usually consists of "brackets" that are bonded to the teeth and a metal wire that is inserted into the brackets. The metal wires are "tightened" and work together with the brackets to move teeth into the desired positions. There are other components that are used in conjunction with braces to move teeth, jaw, and bone such as headgear and expansion devices. Orthodontics work on teeth movement and sometimes includes working with one's facial bone growth to achieve favorable jaw dimensions and relationship.

    Who is a good candidate for braces?

    Braces can be for any age group, but there are optimal times to begin treatment. These days, it is recommended that children have an orthodontic evaluation at the age of 7 to determine if early intervention is needed. If recommended, early intervention optimizes results by taking advantage of a child's skeletal bone growth and may require two-phase orthodontic treatment. The first phase ("phase-one") is considered interceptive orthodontic treatment as it addresses overcrowding of teeth or bite problems at an early age. As an example of interceptive treatment, a narrow upper jaw that has crowded teeth and does not fit correctly with the lower jaw can be widened with an expansion device called a "palatal expander." This lets the upper jaw line up better with the lower jaw and allows room for upper teeth to fit in alignment. Widening the palate can only occur during a small window of time in a growing child before the bone becomes too developed to change. During "phase-one," braces may or may not be used depending on the specific situation. After "phase-one," there is a resting period to allow most or all of the permanent teeth to come in. Around the age of 12 or 13, "phase-two" treatment begins. During this phase, the alignment of all the permanent teeth is addressed using full braces.

    If the window of time to use two-phase orthodontic treatment has passed, results can also be achieved with only one phase of treatment. However, if there is significant crowding of teeth, dental extractions may be required to create room for teeth to move into alignment. Dental extractions are another way to create space in the mouth for teeth movement.

    Essentially, anyone who desires to have straighter teeth or improve their bite may be a good candidate for braces. A thorough evaluation with a qualified clinician is very important in determining whether one is a good candidate for braces.

    What are the different types of braces?

    There are various types of braces available today. Choosing the right type depends on various considerations such as esthetics, cost, and allergy concerns.

    Metal wired braces: These are the most common and traditional type of braces. They are typically made out of stainless steel. Metal brackets are fixed (bonded) onto the teeth and secure a wire with elastic ties made out of rubber. As an alternative to using elastic ties, "self-ligating" brackets are used to clip onto the wire.

    Ceramic wired braces: Also called "clear braces," these provide a cosmetic alternative to the metal wired braces. The brackets are ceramic to match the shade of teeth and clear elastic ties are used. Self-ligating ceramic brackets are also available. The downside to ceramic braces is that they are more prone to breakage compared to the metal braces.

    Lingual braces: These are braces that are placed on the lingual surface (backside) of the teeth and are not easily visible. This is mainly for cosmetic purposes and usually lengthens the time for treatment.

    Other metal braces: Gold-plated stainless steel or titanium brackets are usually used for those with nickel allergies.

    Clear aligners: These type of braces are made of a clear plastic that is custom-made without the use of brackets or wires on the teeth. This can also be considered "clear braces" and presents a very comfortable option for treatment. However, there are limitations to this method. Clear aligners can only tilt and rotate teeth in their position. Conversely, the use of brackets with traditional braces enables the whole bodily movement of a tooth (and its root) into the desired position.

    How do braces work?

    Braces work by a slow and controlled process using force and constant pressure. For traditional braces, the wire that is attached to the brackets works to put pressure on the teeth to move to a specified direction.

    Teeth move through a biomechanical process called "bone remodeling." When braces put pressure on a tooth, the "periodontal membrane" and bone surrounding this tooth are affected. The periodontal membrane completely surrounds a tooth in its socket and it essentially helps anchor the tooth to bone. With pressure from braces, the periodontal membrane of a tooth is stretched on one side and compressed on the other side. This effectively loosens the tooth out of its socket. The compressed side (the direction of pressure) is where bone is broken down to accommodate the new position of the tooth while the stretched side is where new bone is made. This process needs to be done very slowly and explains why wearing braces can take some time to achieve the desired results.

    What is the procedure for getting braces?

    The initial step for obtaining braces involves a thorough evaluation and record-taking with an experienced clinician. Dental impressions (molds) are taken to make models for study and X-rays are taken to look at teeth positions. Measurements are taken in the mouth as well. Once thoroughly evaluated, a treatment plan is created. This plan will specify what has been diagnosed for correction, treatment recommendations, and an estimated time for how long treatment will take. A discussion between the clinician and patient takes place where all the risks, benefits, and alternatives of treatment are reviewed.

    If necessary, all dental extractions are performed prior to the placement of braces or other orthodontic appliances. For the two-phase process, appliances such as palatal expanders and headgear are used during the "phase-one" treatment to correct any developing skeletal growth problem.

    For placement of traditional braces, brackets are bonded with special dental cement to all the teeth in the arch. For some clinicians, elastic spacers are placed between the molars for 1 to 2 weeks prior to placement of the brackets to make room for metal bands with attached brackets. These metal bands are typically placed around the last molars and are able to withstand the forces of chewing better than bonded brackets in the back teeth.

    After the brackets and/or metal bands are in place, a metal wire (or "archwire") is placed in the brackets and secured with elastic rubber bands (or clipped into place with self-ligating brackets). As a side note, elastic rubber bands come in a variety of colors and can be an appealing component of a child's orthodontic experience.

    For clear aligner braces, accurate dental impressions (molds) are taken in order to have a set of aligners made. The aligners are a sequence of clear trays that fit over the teeth to achieve movement. Each tray is worn for a period of time before progressing to the next tray.

    Do braces hurt?

    Placement of traditional braces is usually pain-free, but your teeth and jaws will feel sore afterwards. This is due to the slow movement of teeth that is taking place. This initial soreness usually lasts for about a week and then for a couple of days after each adjustment of the archwire during treatment. This discomfort also applies to clear aligners as tooth movement is taking place. During this time, it helps to have a soft food diet and use over-the-counter (OTC) pain medications such as ibuprofen or acetaminophen when appropriate. Initially, orthodontic wax can be used to cover rough areas that rub against the cheeks until your mouth becomes more accustomed to the brackets.

    How much do braces cost? Does insurance cover orthodontic treatment?

    Cost of treatment is very individual as every mouth is different. Cost will depend on treatment time and steps involved. An estimated cost range for "phase-one" treatment is $2,000 to $4,000. For "phase-two" treatment, an estimated cost range is $2,000 to $7,000. Clear aligner treatment costs more by about 20 to 50 percent.

    Orthodontic treatment can be a covered benefit through dental insurance. Limitations may exist depending on the dental insurance plan.

    What's it like to have braces?

    There is no doubt that braces can initially be uncomfortable and be a cosmetic concern. Aside from the teeth soreness, the inconveniences of wearing braces include: constantly getting food stuck when eating, having to spend more time cleaning the teeth, and having to be cautious of the types of food that can be eaten. However, more often than not, individuals are happy to have gone through the process of orthodontic treatment to improve their smile or correct their bite. The results of treatment can be very rewarding.

    What are the different types of braces?

    There are various types of braces available today. Choosing the right type depends on various considerations such as esthetics, cost, and allergy concerns.

    Metal wired braces: These are the most common and traditional type of braces. They are typically made out of stainless steel. Metal brackets are fixed (bonded) onto the teeth and secure a wire with elastic ties made out of rubber. As an alternative to using elastic ties, "self-ligating" brackets are used to clip onto the wire.

    Ceramic wired braces: Also called "clear braces," these provide a cosmetic alternative to the metal wired braces. The brackets are ceramic to match the shade of teeth and clear elastic ties are used. Self-ligating ceramic brackets are also available. The downside to ceramic braces is that they are more prone to breakage compared to the metal braces.

    Lingual braces: These are braces that are placed on the lingual surface (backside) of the teeth and are not easily visible. This is mainly for cosmetic purposes and usually lengthens the time for treatment.

    Other metal braces: Gold-plated stainless steel or titanium brackets are usually used for those with nickel allergies.

    Clear aligners: These type of braces are made of a clear plastic that is custom-made without the use of brackets or wires on the teeth. This can also be considered "clear braces" and presents a very comfortable option for treatment. However, there are limitations to this method. Clear aligners can only tilt and rotate teeth in their position. Conversely, the use of brackets with traditional braces enables the whole bodily movement of a tooth (and its root) into the desired position.

    How do braces work?

    Braces work by a slow and controlled process using force and constant pressure. For traditional braces, the wire that is attached to the brackets works to put pressure on the teeth to move to a specified direction.

    Teeth move through a biomechanical process called "bone remodeling." When braces put pressure on a tooth, the "periodontal membrane" and bone surrounding this tooth are affected. The periodontal membrane completely surrounds a tooth in its socket and it essentially helps anchor the tooth to bone. With pressure from braces, the periodontal membrane of a tooth is stretched on one side and compressed on the other side. This effectively loosens the tooth out of its socket. The compressed side (the direction of pressure) is where bone is broken down to accommodate the new position of the tooth while the stretched side is where new bone is made. This process needs to be done very slowly and explains why wearing braces can take some time to achieve the desired results.

    What is the procedure for getting braces?

    The initial step for obtaining braces involves a thorough evaluation and record-taking with an experienced clinician. Dental impressions (molds) are taken to make models for study and X-rays are taken to look at teeth positions. Measurements are taken in the mouth as well. Once thoroughly evaluated, a treatment plan is created. This plan will specify what has been diagnosed for correction, treatment recommendations, and an estimated time for how long treatment will take. A discussion between the clinician and patient takes place where all the risks, benefits, and alternatives of treatment are reviewed.

    If necessary, all dental extractions are performed prior to the placement of braces or other orthodontic appliances. For the two-phase process, appliances such as palatal expanders and headgear are used during the "phase-one" treatment to correct any developing skeletal growth problem.

    For placement of traditional braces, brackets are bonded with special dental cement to all the teeth in the arch. For some clinicians, elastic spacers are placed between the molars for 1 to 2 weeks prior to placement of the brackets to make room for metal bands with attached brackets. These metal bands are typically placed around the last molars and are able to withstand the forces of chewing better than bonded brackets in the back teeth.

    After the brackets and/or metal bands are in place, a metal wire (or "archwire") is placed in the brackets and secured with elastic rubber bands (or clipped into place with self-ligating brackets). As a side note, elastic rubber bands come in a variety of colors and can be an appealing component of a child's orthodontic experience.

    For clear aligner braces, accurate dental impressions (molds) are taken in order to have a set of aligners made. The aligners are a sequence of clear trays that fit over the teeth to achieve movement. Each tray is worn for a period of time before progressing to the next tray.

    Do braces hurt?

    Placement of traditional braces is usually pain-free, but your teeth and jaws will feel sore afterwards. This is due to the slow movement of teeth that is taking place. This initial soreness usually lasts for about a week and then for a couple of days after each adjustment of the archwire during treatment. This discomfort also applies to clear aligners as tooth movement is taking place. During this time, it helps to have a soft food diet and use over-the-counter (OTC) pain medications such as ibuprofen or acetaminophen when appropriate. Initially, orthodontic wax can be used to cover rough areas that rub against the cheeks until your mouth becomes more accustomed to the brackets.

    How much do braces cost? Does insurance cover orthodontic treatment?

    Cost of treatment is very individual as every mouth is different. Cost will depend on treatment time and steps involved. An estimated cost range for "phase-one" treatment is $2,000 to $4,000. For "phase-two" treatment, an estimated cost range is $2,000 to $7,000. Clear aligner treatment costs more by about 20 to 50 percent.

    Orthodontic treatment can be a covered benefit through dental insurance. Limitations may exist depending on the dental insurance plan.

    What's it like to have braces?

    There is no doubt that braces can initially be uncomfortable and be a cosmetic concern. Aside from the teeth soreness, the inconveniences of wearing braces include: constantly getting food stuck when eating, having to spend more time cleaning the teeth, and having to be cautious of the types of food that can be eaten. However, more often than not, individuals are happy to have gone through the process of orthodontic treatment to improve their smile or correct their bite. The results of treatment can be very rewarding.

    Source: http://www.rxlist.com

    There are various types of braces available today. Choosing the right type depends on various considerations such as esthetics, cost, and allergy concerns.

    Metal wired braces: These are the most common and traditional type of braces. They are typically made out of stainless steel. Metal brackets are fixed (bonded) onto the teeth and secure a wire with elastic ties made out of rubber. As an alternative to using elastic ties, "self-ligating" brackets are used to clip onto the wire.

    Ceramic wired braces: Also called "clear braces," these provide a cosmetic alternative to the metal wired braces. The brackets are ceramic to match the shade of teeth and clear elastic ties are used. Self-ligating ceramic brackets are also available. The downside to ceramic braces is that they are more prone to breakage compared to the metal braces.

    Lingual braces: These are braces that are placed on the lingual surface (backside) of the teeth and are not easily visible. This is mainly for cosmetic purposes and usually lengthens the time for treatment.

    Other metal braces: Gold-plated stainless steel or titanium brackets are usually used for those with nickel allergies.

    Clear aligners: These type of braces are made of a clear plastic that is custom-made without the use of brackets or wires on the teeth. This can also be considered "clear braces" and presents a very comfortable option for treatment. However, there are limitations to this method. Clear aligners can only tilt and rotate teeth in their position. Conversely, the use of brackets with traditional braces enables the whole bodily movement of a tooth (and its root) into the desired position.

    Source: http://www.rxlist.com

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