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Dental braces, or just simply braces, are an orthodontic treatment used to realign crooked or crowded teeth. They can also address the issue of malocclusion, or a misaligned jaw.
Braces are metal or ceramic brackets that are bonded to your teeth and are connected with metal wires. Braces are placed and monitored by an orthodontist, a specialized dentist.
Braces are typically used during adolescence, but it is becoming common for adults to use them later in life.
Your orthodontist will discuss with you the different types of braces available and help determine which ones best meet your needs.
Classic braces use metal brackets that are cemented onto the teeth and are connected with a metal archwire. Brackets can also be made of ceramic that is tooth-colored, which makes them less visible.
Lingual braces are placed on the back of your teeth, as opposed to the front of your teeth with classic braces. The main benefit of lingual braces is they are not visible. (1)
Symptoms that may mean it is time to see an orthodontist about braces include: (2)
- Difficulty chewing or biting
- Sucking the thumb or fingers
- Speech difficulties
- Early or late loss of baby teeth
- Mouth breathing
- Crowded or misplaced teeth
- Grinding or clenching teeth
- Protruding teeth
- Biting your cheek or into the roof of your mouth
In children, most dental braces treatments begin between 8 and 14 years old, as it is best to get an early start. (3)
Malocclusion is technical term for teeth that are misaligned and do not interact properly. It is the most common dental concern to prompt braces treatment. (4)
The interaction between the teeth on your top and bottom jaw affects the health and functionality of your teeth and smile. Misaligned teeth can cause:
- Muscle pain in the head and neck
- Jaw pain (potentially TMJ disorder)
- Jaw clicking
- Abnormal wear and tear on teeth
What causes a malocclusion? There are severe factors that may contribute to misalignment. Some of the more common factors affecting bite include:
- Having extra teeth
- Missing teeth
- Tongue thrusting
- Thumb sucking
- Jaw function problems
The Initial Exam
Before treatment can begin, a thorough evaluation must first be conducted to determine the severity of the problem and any additional oral health concerns. Oral health issues such as gingivitis, tooth decay, and gum disease must be treated before braces can be placed.
The initial consultation may include an oral, facial and functional examination, intraoral and facial photos, x-rays, bite/teeth impressions, and more.
Placement of Your Braces
Once your treatment plan is in place, your orthodontist will place your dental braces. They will begin by placing a device in your mouth to keep it open and dry, and to hold your tongue into place. Your teeth are dried, and a chemical is applied to help the adhesive hold the braces.
The metal brackets of the braces are bonded to your teeth using a special cement; this is hardened using a curing light to set the bond. Finally, your orthodontist will run a metal archwire through the braces and hold it into place with bands. (5)
Depending on the look you want to achieve, you can choose from metal brackets or tooth-colored ceramic brackets. Metal brackets can be customized with colored bands that are changed each visit.
Once your braces are placed, you will need to visit the orthodontist every four to eight weeks to get them “tightened.” They will replace the archwire every time, helping shift your teeth gradually. Since your teeth will be moving, you may feel some discomfort after these appointments; this will usually go away after a few days. (5)
Typically, braces treatment takes between one to three years, although treatment can be much longer or involve more than one phase. (6)
After Braces: Retainers
When it comes time to get your braces removed, your orthodontist will create another mold of your mouth with your newly aligned teeth. This will be used to create a retainer that is worn to hold your teeth into place. There are three common types of retainers:
- Removable Hawley wire retainers
- Removable clear plastic retainers
- Permanently bonded retainers
Removable retainers can be easily adjusted and worn at any time to gradually shift teeth back into place if they move. They are also easier to clean than bonded retainers. However, they can be easily lost or broken since they are removable; replacing them may cost some extra money.
Permanent retainers can last for years if you take good care of your teeth and clean well around them. Since they are permanently bonded to your teeth, they cannot be removed. Be sure to avoid eating hard or sticky foods with a bonded retainer. With so many options, your orthodontist will discuss which one is best for you.7
Clear aligners (such as Invisalign and Clear Correct) are becoming a popular alternative to traditional bracket and wire braces. These are made of clear plastic or acrylic material, and they are worn over the teeth to straighten them.
The aligners are custom-made and are changed every few weeks to gradually move your teeth into the correct position. They are taken out when you eat, brush, and floss; be sure to put them into their case because they can be easily lost. (3)
Adapting to living with braces
Having dental braces will impact some aspects of your life. Most importantly, you should avoid foods that can get stuck in your braces or bend the wires. These foods include:
- Corn on the cob
- Hard candy
- Sticky foods like caramel, chewing gum, or other candy
If you play a sport, be sure to wear a mouth-guard to protect your mouth and jaw from getting injured. Talk to your orthodontist about what type of mouth-guard they recommend.
It is imperative that you keep up with excellent dental hygiene; brush your teeth twice a day and floss around your braces. This will help keep your teeth and mouth healthy and prevent stains that could show when your braces are removed.
Be sure to replace your toothbrush every three months, or when it becomes frayed, or else it will not clean your teeth properly. (3)
The cost of dental braces will depend on many factors, including the length of treatment, whether or not you need extra orthodontic equipment, your location, and your dental insurance. On average, braces can cost between $3,000-$7,350 without dental insurance coverage. (8)
There are various financing opportunities available to help offset the cost of dental braces. Your orthodontist may offer financing plans directly or through a third-party financing company that offers flexible payment plans that fit your budget. Ask your orthodontist for more information about financing options.
- Mistakidis I, Katib H, Vasilakos G, Kloukos D, Gkantidis N. Clinical outcomes of lingual orthodontic treatment: a systematic review. Eur J Orthod. 2016;38(5):447-58.
- American Association of Orthodontists. When to See an Orthodontist. https://prodv1-consumer.aaoinfo.org/_/why-you-should-get-orthodontic-treatment/#whenOrtho
- Johnson J. Braces and Orthodontics. American Dental Association Patient Smart. http://www.ada.org/~/media/ADA/Publications/Files/ADA_PatientSmart_Braces.ashx
- American Association of Orthodontists. Frequently Asked Questions – My orthodontist says I have a malocclusion? What is that? https://prodv1-consumer.aaoinfo.org/_/frequently-asked-questions/
- Types of Braces and Treatment. https://www.3m.com/3M/en_US/types-of-braces-and-treatment-us/getting-started-with-braces/
- American Association of Orthodontists. All About Orthodontics. https://prodv1-consumer.aaoinfo.org/wp-content/uploads/2018/07/All_About_Orthodontics-15-cons-hl.pdf
- American Association of Orthodontists. Will I Need to Wear Retainers After Treatment? August 22, 2019. https://www.aaoinfo.org/blog/will-i-need-to-wear-retainers/
- Cost Helper Health. How Much Do Braces Cost? https://health.costhelper.com/braces.html