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What Are Braces & How Do They Work?

Written by: Dr. Laura Edwards, Orthodontist

Medically Reviewed by: Dr. Oleg Drut, Orthodontist and Diamond Braces CCO

Date: October 7, 2020

Dental braces are used by a licensed orthodontist to correct a variety of dental conditions. Orthodontic care goes beyond just creating a beautiful smile: your orthodontist carefully positions your teeth to ensure the overall health of your teeth and gums. Braces can correct dental misalignments such as gaps, twisted teeth, crowding, and more, but they also help prevent major oral health issues. Without proper orthodontic intervention, using braces or another form of care, serious oral health concerns can result.

The goal of quality orthodontic care is to provide patients with healthy, beautiful smiles, as well as a lifetime of oral health and overall health.  Your whole body's health begins with your mouth, so if your teeth, gums, and bite aren't healthy, the issues will affect the rest of your health, too.

Dental braces are applied directly to the teeth and achieve results in different ways, depending on the type of braces suggested by your orthodontist. The most common form of braces, metal braces, use metal brackets affixed semi-permanently to the teeth, connected by a thin, flexible wire. Over a period of 6 to 36 months, depending on your case, your teeth will shift into their correct positions as the orthodontist adjusts the braces appliance.

In certain cases, your orthodontist may need to include other components to shift the teeth, jaw or bone in the correct direction. Headgear, rubber elastics, and expansion devices are all used in certain cases to ensure the dental braces deliver the desired results.

The following guide has answers to all your braces questions.

Braces Colors

Many braces treatments use colorful rubber bands to secure the metal brackets to the wire. The colorful options for rubber bands are a fun way to personalize your braces treatment, and a great accessorizing feature for kids and adults alike.

You'll switch out your rubber bands at your regular orthodontic visits, so you can change your look every month, or stick to your favorite color scheme! Some fun ideas for colorful rubber bands: opt for seasonal colors to celebrate the holidays, or rep your school or favorite sports team with their team colors. Some offices even offer glow-in-the-dark rubber bands!

Braces vs. Invisalign

Braces and Invisalign are both safe and effective treatment options, but braces use a permanent, fixed appliance, while Invisalign uses removable clear plastic aligners. There are great benefits to both – it’s just a matter of which is right for you.

Braces tend to be less expensive than Invisalign and are more often covered by state-subsidized insurance, while Invisalign is less noticeable than braces and provides a more streamlined, subtle appearance.

Interested in the differences between braces and Invisalign?

What Are the Different Types of Braces?

Metal Braces

Patient with Metal Braces

Metal braces, also called traditional braces, are the most commonly used to correct dental problems. These braces have two main components: the brackets and wire. An individual bracket is applied to each tooth, and a bendable wire is threaded through each bracket. The brackets apply pressure to the teeth to gradually move them in the desired directions.

Most metal braces are constructed of stainless steel and are worn for about 18 months or longer, depending the specifics of the case. Modern braces are smaller than those in years past, and new heat-activated archwires use your body heat to shift the teeth more quickly and with less pain.

Traditional metal braces are the most commonly used and the least expensive, but they are also the most noticeable.

Ceramic Braces

Patient Smiling with Clear Braces

While they use a similar style, ceramic braces are less noticeable than metal braces. These braces are also called “clear braces” or “invisible braces” because they're designed to match the shade of your teeth to make them less visible. It's also possible for the wire to match your teeth and blend into your smile. This makes them popular for patients who want a more discreet treatment.

While this style of braces is a great cosmetic choice, the ceramic material is more likely to chip or break than their metal alternatives. In addition, the ceramic brackets can stain easily. Coffee, tea, wine and other foods and beverages known to discolor teeth will have the same effect on ceramic braces.

Lingual braces

Example of Lingual Braces on a Patient

Lingual braces are similar to metal and ceramic braces, with an even less noticeable appliance than ceramic braces. Also known as invisible braces, the process for lingual braces involves placing the metal brackets and wire on the backside of the teeth. This discreet style is attractive, but lingual braces come with a number of challenges.

Because of their placement, lingual braces are more difficult to clean. These braces are often more expensive and less effective for many orthodontic problems. Lingual braces can be more uncomfortable and may have an effect on your speech. These drawbacks may slow the pace of treatment, making this a less attractive option for many patients.

Self-Ligating braces

Patient with Self-Ligating Braces

Designed to hold less food and be more comfortable for the patient, self-ligating braces can be designed with metal or ceramic brackets. Rather than using rubber bands, this style utilizes brackets with clips to hold onto the wire.

Self-ligating braces usually require fewer trips to the orthodontist compared to other braces options, but they’re not appropriate for all patients. There are some oral challenges too severe for this treatment. Your orthodontist will be able to determine whether self-ligating braces are right for your smile.

Invisalign

Patient with Invisalign Clear Aligners

Invisalign aligners use removable, clear plastic aligners; one for the top row of teeth and one for the bottom, as needed. Each set is worn for 1-2 weeks, gradually correcting your smile over time. Each set of aligners is custom designed by your orthodontist.

Although it tends to be more expensive than other types of braces, Invisalign is often requested by patients because it's subtle, can be removed for proper cleaning, and doesn't come with food restrictions. Many patients also find them more comfortable than braces.

Do You Need Spacers?

Spacers, also called orthodontic separators, are generally used for a week or two before braces treatment, to create small gaps between certain teeth. A part of the orthodontic appliance, called metal bands, will be placed around those teeth and will anchor the archwire that goes across your teeth.

Spacers are usually used on the back molars, where the metal bands will be attached. The spacers are made of rubber or metal. Not everyone will need them, but if your orthodontist uses them for your case, you will only wear them for 1-2 weeks. Spacers may feel uncomfortable, like a piece of food trapped between your teeth.

Are Braces Painful? Some Tips for Pain Relief

Pain is different for everyone, so not everyone will experience pain during braces treatment. However, discomfort or pain is a common experience for braces patients of any age. It takes a while for your mouth to get used to the new appliance, and adjustments may cause irritation after your monthly orthodontic visits.

There are many ways to treat braces pain: you can take an over-the-counter pain medication such as ibuprofen, or drink a soothing cool beverage like a smoothie or iced tea. Most braces pain goes away after a few short days.

What Can & Can't You Eat with Braces?

Certain foods are best to avoid with braces, especially hard or sticky foods like candy, nuts, and popcorn. Anything hard you have to bite into with your front teeth could stress the brackets: whole apples, corn on the cob, hard bread crusts, and raw carrots should all be cut into small pieces that you can chew with your back molars.

Avoiding these foods will protect the appliance and prevent breaking or stressing the brackets and wire. In addition, some foods easily get stuck between the brackets and under the wires, which can cause bacteria and plaque to grow on the teeth and cause decay.

How Much Do Braces Cost?

Typically, you can expect to pay between $1,700 and $6,000 for braces treatment. Braces costs vary considerably depending on your orthodontic provider, the severity of your case and length of treatment, and the region where you live.

Insurance can help cover the cost of braces; most state-subsidized insurance plans cover some or all of the cost of metal braces for qualifying children and young adults. It may be harder to find insurance coverage for adults or for treatment with specialty orthodontics like Invisalign aligners. Your insurance provider and your orthodontist will have more information about using insurance to cover braces. Your orthodontic provider may offer cost-saving measures such as monthly payment plans, family discounts, and seasonal savings.

Can You Get Braces for Free?

Braces themselves are not free: the orthodontists require payment and the materials themselves cost money. However, it is possible to get certain braces treatment fully covered for qualifying individuals.

For instance, state-sponsored insurance plans and Medicaid/CHIP may cover traditional metal braces treatments for children and/or young adults. However, eligibility for this coverage requires a diagnosis from your child's orthodontist that their condition is severe. Most orthodontic conditions do not qualify as severe. To get approved for coverage from a state-subsidized insurance program or Medicaid/CHIP, your orthodontist must submit x-rays, photos, and treatment plan for the insurance provider to review.

Your insurance provider can help you find out whether you can get braces fully covered for your child, and your orthodontic provider can offer more information about how to use insurance for braces treatment.

How to Get Braces

Getting braces begins with scheduling a consultation with a local orthodontist. You may get a referral from your dentist, but a referral is not necessary: you can go directly to the orthodontist to see if your teeth can be straightened with braces.

At the orthodontist's office, the doctor will examine your teeth and gums, and may take pictures or x-rays to get a full image of your dental structure. The support team will discuss payment options with you, and then you will be ready to begin braces treatment.

How Long Do You Need to Wear Braces?

You can expect to wear braces from between 6 months to 36 months. The average length is usually 18 months to 24 months, about two years. Braces treatment times vary depending on your specific case, the severity of your dental misalignment, and the complexity of successful treatment.

A more experienced orthodontist in a dedicated, freestanding orthodontic facility usually has the most direct experience with braces treatments, which may result in shorter treatment times. Your orthodontist will be able to provide a more exact estimate of treatment length for your specific case.

Conditions Braces Treat

Braces treat a variety of dental conditions, also called malocclusions. Below are some of the common dental conditions correctable with braces.

Open Bite

An open bite occurs when the top and bottom row of teeth stay open even when the mouth is closed. Usually an open bite occurs in the front teeth but is also possible in the back teeth. Braces can effectively close an open bite.

Overbite

Overbites occur with a too-large overlap of the top teeth over the bottom teeth. In some severe cases the bottom teeth may even connect with the roof of the mouth, which can cause tissue and bone damage. This malocclusion can be treated with orthodontic care, including braces.

Impacted Teeth

Impacted teeth have not properly passed through the gum-line and haven’t grown into their correct positions. This may or may not cause problems for other teeth: if they need to be drawn out or extracted, orthodontists can do this as part of braces treatment.

Crossbite

Crossbites occur when the top and bottom rows do not overlap properly. Certain bottom teeth sit past the top teeth when the jaw is closed, causing them to stick out past the top teeth. Crossbites are complex to treat, but braces can create excellent outcomes for patients with this malocclusion.

Excessive Overjet

An overjet occurs when there is a horizontal gap between the top and bottom rows of teeth when the mouth is closed – some people unkindly refer to this as buck teeth. A healthy bite has a small amount of overlap, but a too-large overlap is excessive and should be treated to prevent further dental health issues. Braces are extremely effective for closing an overjet.

Crowding

Crowding occurs when teeth have grown in unnaturally, causing them to overlap or complete for space in the mouth. This can be caused by genetic skeletal issues or interruptions to proper dental growth during development. Each case of crowding is unique and requires careful treatment planning by an expert orthodontist, but you can expect good results with braces.

Gaps Between Teeth

Gaps between teeth occur when the natural growth of the teeth results in spaces between one of more teeth. This may be a single gap between the two front teeth, called a diastema, or multiple gaps, sometimes caused by teeth being too small for the jaw. Braces can help close gaps, although some individuals prefer to keep a diastema for cosmetic reasons.

What is the Perfect Age to Get Braces?

Patients can begin braces treatment once most of their adult teeth are grown in, usually by 11 or 12 years old. Young patients between 11-14 can expect more reliable and long-term results than older patients, because the bones are still growing and are more receptive to orthodontic realignment. Depending on their development, some children can begin braces as young as 8. Patients of any age can expect excellent results with braces treatment.

Braces Treatments, Before and After

Patient with crossbite during braces treatment

Patient During Metal Braces Treatment  Straight teeth after braces

Clear braces treatment in progress   After clear braces treatment

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