Everything About Spacers (Orthodontic Separators) for Braces
Written by: Dr. Laura Edwards, Orthodontist
Medically reviewed by: Dr. Oleg Drut, Orthodontist and Diamond Braces CCO
Date: October 8, 2020
What Are Orthodontic Spacers & How Do They Work?
Orthodontic spacers, also known as separators, are used at the very beginning of braces treatment. They are worn temporarily to create a small amount of space in the back molars, where metal bands will be placed to connect the archwire.
If your orthodontist uses spacers for your braces treatment, it will generally be temporary – you will wear spacers for 1-2 weeks before the bands are installed on your back teeth. They gently create a small amount of space between the teeth, where your orthodontist will fit metal bands which anchor the archwire of the braces appliance. These metal bands go on your back molars, so this is where the orthodontic spacers will be placed.
There are two kinds of orthodontic separators:
These are very small elastic loops that slide between two back teeth. They are usually blue in color.
These are small metal rings that are inserted between two back teeth.
Which one your orthodontist uses depends on your specific case and the treatment style of that provider. For most braces cases, rubber spacers will be used.
Spacers are included as part of your braces treatment, so you don't need to worry about an added cost. The total cost of braces is about $1,700 to $6,000, depending on your specific case and where you seek treatment, and spacers are a part of that price.
When the spacers are applied, you may feel some discomfort or pressure: this means the spacer is successfully creating the necessary space in your teeth for the braces. It may feel as if you have a piece of food wedged between your teeth.
Not everyone will need spacers: some people's teeth naturally have enough space between them to put on the metal bands, but most patients' teeth are naturally close together, and will require spacers if metal bands are used for their treatment.
If your orthodontist is not going to use metal bands for your braces, you won’t need spacers. It depends on your specific case: sometimes, the orthodontist will avoid using spacers and bands altogether. Invisalign clear aligners treatments, for instance, do not require spacers.
The application process is simple: the orthodontist or an assistant will use a specialized instrument to install the spacer between two of your back teeth. This procedure occurs about 1-2 weeks before the bands are inserted.
During the insertion procedure for metal bands, the spacers are removed and the bands are inserted over the back molars. The braces brackets are bonded to the teeth, and the archwire is inserted into bands and brackets.
You will only get spacers for braces treatment: if you are straightening your teeth with removable clear aligners like Invisalign, you will not need spacers, and there is no other dental reason to get spacers except for braces treatment.
Do You Need Spacers for Braces?
Not everyone will need spacers during their braces treatment, but it is a common aspect of treatment for many patients. Many people's teeth are nestled close to each other, so spacers are necessary to create a bit of space where the metal bands will go.
However, your orthodontist may not use metal bands for your treatment, depending on the specifics of your case. And some patients naturally have enough space between their teeth that they will not need orthodontic separators.
In certain cases, spacers are worn for a longer part of your treatment or even throughout treatment, but in the majority of cases, patients who get spacers will wear them for 1-2 weeks before getting the braces appliance installed.
Spacers are used as part of braces treatment to treat a variety of dental conditions.
Spacers for Braces - Pain or Discomfort
Spacers are used to create a small amount of space between certain teeth to affix parts of the braces appliance. For that reason, you might experience some pressure when the spacers are applied, leading to discomfort or pain. The process of getting the spacers put in may be uncomfortable, but patients do not generally find this extremely painful.
How much pain you feel is related to your sensitivity, as well as how tightly your teeth are nestled against each other. For those with very tightly-placed teeth, the spacers may cause more discomfort. Many patients describe the discomfort as similar to having a piece of food wedged between the teeth.
Generally, this discomfort of spacers will fade as your teeth get used to the feeling of the spacers. Your teeth should stop hurting after 2-3 days, but you might still feel the pressure of the orthodontic separators throughout the time they are between your teeth. This is normal, because it means the spacers are working. If pain or discomfort persists, you can take an over-the-counter pain medication such as ibuprofen or Advil, or drink a soothing cool beverage like a smoothie. You can also suck on a clean washcloth soaked in cold drinking water.
Many patients report feelings of pressure, discomfort, or pain during parts of braces treatment – there are many ways to alleviate the discomfort throughout treatment, and most people will find they get used to it as part of straightening their teeth.
What Can You Eat When Using Spacers?
After your orthodontic separators are installed, you will have to be careful not to loosen them from between your teeth. Sticky or gummy foods can stick to the spacers and potentially pull them out.
On the other hand, soft foods will feel good if your teeth feel uncomfortable due to the spacers, and will be gentle on them without dislodging them.
Because you can't floss where the spacers are inserted between your teeth, you should also avoid foods that can get stuck between your teeth.
What to eat with spacers:
Smoothies (blend in fruit and veggies for a healthy, soft meal)
Steamed veggies, chopped into small pieces
Meat cut off the bone in small pieces
Foods to avoid with spacers:
Gum or gummy candy
Hard or sticky candy like toffee
Popcorn or anything that can get stuck in your teeth and loosen the spacers
Pretzels, nuts, any other hard and crunchy foods
Caring For Your Spacers & What to Do If They Fall Out
While you will only wear your spacers for a few days, it is important to care from them and ensure they don't fall out too early.
You should continue brushing and flossing your teeth, but don't floss in the places where the spacers have been inserted between your teeth, as this could dislodge the spacers. When brushing, try to brush back and forth across the tops and sides of your teeth, rather than up and down vertically, which can move the spacer from its correct position.
Be careful what you eat to ensure that the orthodontic separators don't get dislodged – see the guide above on foods to avoid. Make sure to not chew gum.
If the spacers fall out just 1-4 days before your next visit to the orthodontist, that's okay: it means the spacers have successfully created enough space for your braces to be put on. If they fall out more than 4 days before your visit days, they may need to be put back in, so contact your orthodontist for more information.
Can You Use Rubber Bands Instead of Spacers?
Orthodontic separators are a medical device and should only be used under the supervision of a licensed orthodontist and their staff.
Elastic rubber band separators may look like rubber bands, but you cannot use regular rubber bands as spacers. This could damage your teeth or gums, or even get stuck and cause infection or inflammation in your gums.
Be sure to follow your orthodontist's instructions when seeking braces care – your compliance and oral health are an important part of achieving a healthy, beautiful smile.