Any dental treatment is known to induce a feeling of anxiety, restlessness, and apprehension in a patient seeking it. This can be attributed to the fear of the unknown, amongst other things. Orthodontic treatment is considered to be one of the more complex dental procedures. Orthodontic braces are a small setup, made up of wires, brackets, etc., which are attached to teeth for correcting malalignment and crowding.

Types of braces are metal brackets, ceramic brackets, Invisalign, and self-ligating braces. Also, you may have to go through some procedures, such as cleaning of teeth, fluoride therapy, removal of cavities, etc., before going for orthodontic treatment.

Moving ahead in this article, we will try to familiarise you with types of braces, procedure before orthodontic treatment, what to expect (1) after getting orthodontic braces, and how to be better prepared for getting it done.

What are braces and why do we need them?

Orthodontic braces are a set-up of small, artificial, wires, brackets, elastics, tubes, etc. which are attached to our teeth to change their position or angulation.

The position of our teeth needs to be altered when they are not in line with each other, or there is lack of space, causing crowding between teeth. It is more commonly carried out in children when their permanent teeth are new. Orthodontic treatment is required to correct many problems like-

  • Unsightly appearance of teeth leading to lowering of self-confidence, self-esteem issues, and social anxiety.
  • Difficulty in cleaning teeth due to malalignment and crowding.
  • Difficulty in biting, chewing, speaking.

Who can get braces?

Almost anybody can get braces, as they possess no significant health risk or contraindication to any systemic conditions. However, patients suffering from seizures or any known epileptic condition should not be given any appliances in their mouth.

It is usually preferred that orthodontic treatment should begin in adolescence as soon as all the permanent teeth erupt, to avoid social awkwardness to those with severely malaligned teeth. This age is also best suited according to the human growth pattern.

However, adults can get braces too, at any age, as long as their oral hygiene is well maintained and teeth are in a healthy condition.

Types of orthodontic treatment

Depending on the type of correction required, the condition of the oral cavity, the cost factors, and the aesthetic factors, a patient may be given a variety of orthodontic treatment options. (2)

  • Fixed braces in the full mouth
  • Fixed braces in only the upper or the lower arch
  • Braces on the inner (lingual/ palatal) surfaces of teeth
  • Removable plates

Types of orthodontic braces

Brackets placed on the teeth may be of different types

Metal brackets

These are the conventionally used braces consisting of small rectangular metal devices attached to the tooth, more commonly on the outer surface and sometimes on the inner surfaces ( Lingual braces).

Ceramic brackets

These are similar to metal brackets but they differ in their appearance as they’re more color matching with the tooth and don’t give the prominently visible effect of the metal.

Self-ligating braces

These do not require elastic attachments and use a sliding mechanism to get the desired tooth movement.

Invisalign

These are the newest introduction to braces, which consist of plastic like molds of the teeth that are periodically replaced. As the name suggests, they are clear transparent, due to which they almost appear invisible.

Invisalign are preferred due to their high aesthetic value. (3)

Procedures before Orthodontic Treatment

Before an Orthodontist places the braces in your mouth, there are some procedures that may have to be done to restore all the teeth to their best function and appearance.

Removal of cavities

Any decay, known as dental caries, must be removed from the teeth and an appropriate restorative material is placed to prevent further deterioration and replace the lost tooth structure.

Fluoride therapy

In orthodontic care given to children, they may be given fluoride therapy in the form of gel or solution. Fluoride prevents dental caries and makes the teeth stronger against decay.

Cleaning and polishing

Cleaning and polishing of teeth may be required before putting braces, to ensure that the braces are held well to the teeth.

Removal of teeth

Sometimes in cases of severe crowding, removal of one or more teeth may be required to make space. This is explained to the patient in advance if needed.

Treatment Planning for Braces

Since orthodontic treatment is a somewhat different kind of dental treatment in terms of the type of appliances, appointment time, treatment duration, and result expectancy, it is essential for the patient to know and be aware of the procedure to reduce patient anxiety.

If the dentist precisely explains to the patient (and parents in case of pediatric patients) of what changes to expect, what compliance is required and what habits are to be maintained through the treatment, better co-operation can be expected over the course of the procedure.

To begin with, the dentist makes identical models of the patient’s teeth, by creating a replica through impression making. These models help to plan the tooth movement desired from orthodontics and explain this to the patient, and also assess and examine the position of several teeth with each other.

Specific investigative procedures like radiographs (x-rays) of the mouth are also carried out to examine the relation of various other parts and tissues with the teeth or the relationship of the teeth to each other. These include Digital OPG, Lateral cephalograms, CBCT, etc.

Photographs of the patient’s front and side profile are also taken, and with the help of all these aids, the dentist can now explain the entire procedure and expected the outcome to the patient, along with the expected time, cost and number of visits required.

The braces are attached to the teeth with a bonding material like a composite cement, and wires, elastics, etc.

Changes and Adaptations

  • Pain– In the beginning, a person may experience pain and discomfort due to the braces. This may be because of the pressure changes and the forces exerted by orthodontic appliances. It is advisable to avoid eating hard, and sticky food and soft food is preferable. (4)
  • Ill-fitting appliances– Rarely, the patient may find prolonged discomfort with the braces or removable plates. This may be due to a poorly fabricated appliance, or loosening or breakage of a wire or some other attachment. It is imperative that in such a case, the patient visits a dentist to have it corrected.
  • Duration– Braces may often require a long duration of wear. Desired tooth movement may also sometimes take over two years, and hence the patient must be compliant over a more extended period. Discontinuing treatment midway is not advised.
  • Invisible braces are also available. These help to improve the treatment regarding the appearance of the patient. However, not all patients may be recommended as invisible braces due to the complexity of the correction needed.
  • Periodic and regular visits to the dental clinic are a must. This is because it is vital for the orthodontist to monitor even the most minor changes in the mouth after getting braces.
  • The child or the adult must maintain good oral hygiene throughout. Timely cleaning of teeth, brushing, flossing, etc. are required to prevent any unwanted complications.
  • Once the desired tooth movement has been achieved, there is usually a retention phase, where a removable plate is to be worn by the patient. This is to maintain the teeth in that desired position without exerting much force and to prevent relapse.

Over to you on orthodontic braces

Lastly, though braces are an extensive treatment modality requiring immense patience and compliance from a patient’s perspective, they are a great way of correcting malaligned teeth. Though there may be relapses or recurrence of the malpositioning, it is rare and negligible if the treatment is planned and carried out meticulously.

Orthodontic braces are a small setup, made up of wires, brackets, etc., which are attached to teeth for correcting malalignment and crowding. Types of braces are metal brackets, ceramic brackets, Invisalign, and self-ligating braces.