Types of braces

Fixed Braces

Invisalign is a removable brace system that uses a series of custom-moulded aligners to move your teeth. The great thing about Invisalign is that the aligners are transparent and invisible (no metal bands or wires), therefore nobody is going to realise that you are undergoing treatment – unless you tell them!

Fixed appliances which are also commonly known as ‘train tracks’. They straighten the teeth using brackets which are stuck on to the teeth and a wire which is inserted through the brackets to create tension to move the teeth. Ceramic (tooth coloured), gold and silver brackets are available to suit each patients preference. Coloured ligatures can be placed over brackets and are popular with teenagers wanting to personalise their brace!

A fixed brace is an orthodontic appliance which cannot be removed from the mouth by the patient. Amongst teenagers, fixed braces are commonly known as “train tracks” and they are one of the most effective ways of straightening teeth. They can be used in combination with removable or functional braces and while a fair number of patients benefit from more than one type of brace, most will have fixed braces.

The component of fixed braces which has the greatest variability is the bracket, which comes in various sizes, shapes and colours.

Features of a fixed appliance

fixed-braces

A

Ligature or Module

The archwire is held to each bracket with a ligature, which can be either a tiny elastic or a twisted wire.

B

Archwire

The archwire is tied to all the brackets and creates forace to move teeth into proper alignment.

C

Brackets

Brackets are connected to the bands, or directly bonded on the teeth, and hold the archwire in place.

D

Elastic Hooks & Rubber Bands

Elastic hooks are used for the attachment of rubber bands, which help move teeth toward their final position.

E

Metal Band (not shown)

The band is the cemented ring of metal which wraps around the tooth.

Every two weeks you will have to replace the old aligner for a new one which will continue to guide your teeth in the necessary direction. Each new aligner may give an initial feeling of minor discomfort for a couple of days – this sensation is typically described as a feeling of pressure and is a sign that Invisalign is working.

The aligners gradually reposition your teeth over the period of treatment – the length of which is determined by the complexity of the case and what you and your orthodontist have agreed to achieve. You will need to go in periodically for a few orthodontic appointments in order to check your treatment progress and make sure your teeth are responding to the aligners.

Invisalign aligners must be worn all day, except when brushing, flossing or eating. Fortunately, because you can remove your aligners to eat and drink you can eat all your favourite foods. After each meal, however, you must make sure that you brush your teeth prior to re-inserting your aligners to maintain good hygiene.

Irrespective of the simplicity of your case, your treatment is best handled by an orthodontic specialist, who is trained to diagnose and solve any problems which may arise during your treatment.

Types of fixed appliances

Metal Brackets With Colours

metal-bracket-with-colours

Stainless steel metal brackets are easily recognised and are widely used in the treatment of patients in all age groups. Their robustness and suitability for most cases make them an appliance of choice for most orthodontists. The designers have been making them smaller and decreasing the profile of these metal brackets, sometimes with beneficial results including higher treatment efficiency, decreased friction, decreased appliance breakage (due to increased bond strength) and superior fit or seating. These metal brackets can be customised with coloured ligatures or modules to provide individuality and make them more aesthetically pleasing.

Ceramic Brackets

ceramic-bracket

Attractive, translucent or tooth coloured, aesthetic fixed brackets appeal to patients in view of their less obtrusive appearance. These are made from a ceramic material and differ from plastic (polycarbonate) brackets in terms of the superior durability, colour stability, strength and overall performance throughout the treatment. Not all tooth coloured brackets are ceramic, if you are having problems with breakages and discolouration, you most likely have been fitted with an inferior plastic bracket.

Fixed braces can be made “totally white” by utilising ceramic brackets, white or tooth coloured arch wires and non-staining ligature wires This means that your appliance is virtually not visible!

Gold Brackets

gold-bracket

Others might be more attracted by the aesthetic appeal of the Gold appliance systems such as the ‘3M Unitek Victory Series’ 24K gold plated brackets, which can be complimented with gold wires – these provide the patient with an alternative to the traditional stainless steel look.

Self Ligating brackets

damon-self-ligating-bracket

These are fixed braces which function without ligatures and modules. These braces are designed to help the teeth move more efficiently and may result in fewer adjustment visits. The absence of modules and ligatures eliminates the hassle of staining.

Invisible braces

Lingual Braces

The word “lingual” originates from a Latin word meaning “tongue”. Lingual appliances are used to correct misaligned teeth and bite problems, using a fixed brace that has been bonded to the tongue side of the teeth. This enables teeth to be moved into their correct position without having the braces in plain view.

Lingual appliances differ from conventional fixed braces because they are placed behind the teeth giving invisibility with no change in lip contours. In fact a lot of actors and media personalities choose to undergo treatment using lingual appliances.

Lingual

Frequently asked questions for lingual appliances:

Can any malocclusion be corrected with lingual orthodontics?

Yes. Whereas some removable appliances allow only simple, minor tooth movements, a lingual appliance can correct even extreme malocclusions.

Is there an age limit for lingual orthodontics?

There is no age limit whatsoever, provided the teeth are fixed firmly in the bone, anyone should be eligible for a lingual appliance. A common misconception is the belief that braces are only for children and adolescents, but even if a patient is in their sixties they can be fitted with a lingual brace.

How long does a treatment take with a lingual appliance, and what is the standard with results?

Both the treatment time and the results from a lingual appliance are the same as for a normal fixed brace.

Can children use lingual braces?

Yes, but only after the eruption of most of the permanent teeth.

Is the only advantage of lingual braces aesthetic or are there any medical advantages?

There are both medical and aesthetic advantages to the lingual brace. The inner side of the teeth is much more robust and less susceptible to decalcification and decay. This means that with lingual orthodontics, permanent damage to the teeth is less likely than with a fixed brace worn on the outer side of the teeth. If white spots, traces or decalcification begin to appear on the outer side of the teeth even prior to commencing treatment then lingual orthodontics could be a better option for you.
Removable & Fixed

Retainers

Following orthodontic treatment to straighten the teeth, the teeth have a tendency to return to their original position, which is why wearing retainers is so important. Wearing a retainer is simple, but it is actually a complex piece of equipment and a significant part of your orthodontic treatment. To maintain the success of your orthodontic treatment, it is vital that you wear your retainer in the way that your orthodontist advises.

It is difficult to say how long you will need to wear your retainer – each patient is an individual case, so your orthodontist’s advice about how long you will need a retainer will be tailored to you.

There are a range of different retainers available and your orthodontist will recommend to you the type of retainer that will best keep your teeth in position. Here is an outline of the different types of retainers your orthodontist may recommend:

Vivera removeable retainers

Vivera Removeable Retainers

Like Invisalign, Vivera retainers are custom made especially for each individual patient. You are provided with three sets and they are made using:

  • Most advanced technology
  • 3D digital imaging
  • Clear thermoplastic material
  • Advanced fabrication technology

The combination of all of this technology enables the Vivera retainers to not only be strong and almost invisible, but also to have a precise fit.

Instructions for Vivera (Transparent) Removable Retainers

  • Wear these retainers EVERY NIGHT into the future if you want to keep your teeth straight. Your orthodontist might ask you to do additional hours if necessary.
  • Do not drink hot drinks whilst wearing the retainer as this will distort it, as will any contact with hot liquid
  • Take them out of your mouth when eating or playing sports.
  • When the retainers are out of your mouth, place them in a brace/retainer case for safety.
  • Brush your teeth after eating before replacing the retainer.
  • Clean them once a day using a toothbrush, water and a clear liquid hand soap only.
  • Do not use toothpaste to clean them, because it can make your retainers more brittle and prone to breakage.
  • Bring your retainers for the periodic check-up appointments.
  • Vivera retainers come in sets of three, so if you break or loose a set, you will already have a replacement to hand.
  • There is an additional cost for any additional replacement sets.

Bonded Fixed Retainers

Bonded Fixed Retainers

These consist of a wire bonded to the tongue-side of your teeth. They are designed to hold your teeth in a particular position for a long period of time, and the longer they remain in place the greater the guarantee that your teeth will remain straight.

Instructions for Bonded (Fixed) Retainers

  • Bonded retainers are designed to hold the teeth in the exact position over a long period of time. The longer they remain in place the greater the guarantee that your teeth will remain straight.
  • You must note and memorise the position of the thin wire behind the teeth and the special cement used to attach this wire to each tooth.
  • Check the wires with a small mouth mirror every morning.
  • Brush the back of your teeth and over the wires thoroughly 2-3 times a day, especially after eating sweet foods.
  • Sticky sweets and hard foods can break the wire or its attachments, so be careful!
  • If the wire breaks or an attachment becomes loose, telephone this clinic for an immediate appointment to have it checked. Ensure you wear your removable retainers to keep the teeth in position until your appointment.
  • When wearing a Bonded retainer you need only wear your removable retainers at night.
  • There is an additional cost for replacement or repair of this retainer.

Essix Removeable Retainers

Essix Removeable Retainers

This is a clear or transparent retainer that is moulded to fit over the teeth.

Instructions for Essix (Transparent) Removeable Retainers

  • Wear your retainers EVERY NIGHT into the future if you want to keep your teeth straight.
  • Take them out of your mouth when eating or playing sports.
  • When the retainers are out of your mouth, place them in a brace/retainer case for safety.
  • Clean them once a day using a toothbrush and toothpaste and then once a week using Retainer Brite tablets.
  • Bring your retainers for the periodic check-up appointments.
  • There is an additional cost for replacement or repair of this retainer.

Hawley Removable Retainers

Hawley Removable Retainers

This is the most common retainer and is made of a metal wire that surrounds the teeth, keeping them in place. The wire is rooted to a piece of specially moulded acrylic, which resides in the palate or floor of the mouth.

Intructions for Hawley Removable Retainers

  • Wear your retainers EVERY NIGHT into the future if you want to keep your teeth straight.
  • Take them out of your mouth when eating or playing sports.
  • When the retainers are out of your mouth, place them in a brace/retainer case for safety.
  • Clean them once a day using a toothbrush and toothpaste and then once a week using Retainer Brite tablets.
  • Bring your retainers for the periodic check-up appointments.
  • There is an additional cost for replacement or repair of this retainer.

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