Braces are the most efficient and accurate way of moving teeth. Brackets are adhered to each tooth with special dental glue and are usually made of stainless steel or a clear plastic material. These brackets act like a handle on the tooth so that it can be moved into its correct position using wires. The brackets remain on the teeth for the entire duration of treatment. Generally adjustments are made to the braces every four to six weeks.
During treatment, patients may need to wear such items as rubber bands. These provide important extra forces for the correction of the bite.
Teeth can shift with age – because of injury, a condition called tongue thrust, or natural growth – and some adults find that their previously straight teeth have become crooked and overcrowded. They may start experiencing jaw pain, having difficulty properly cleaning their teeth, or simply facing a smile they find unattractive.
Other adults get braces because they’ve always had crooked teeth, but their parents couldn’t afford to pay for braces when they were growing up. Finally, some people say they’re just finally getting around to it, or that they want straighter teeth for a new career.
Overall, many adults see braces as a worthwhile investment of a few awkward years in exchange for decades of straight teeth.
Teeth shift as you get older, and some people’s teeth shift more than others. If you didn’t wear your retainer as much as the orthodontist recommended, or are simply unlucky with your jaw’s natural growth, your teeth can return to their original position. Orthodontists have also recently realized that retainers should be worn much longer than they recommended in previous decades, and sometimes indefinitely, to prevent tooth movement. Unfortunately, this means that even adults who were model patients as kids may find themselves needing braces again.
- Can help prevent or improve periodontal problems
- Can help prevent or reduce further bone loss around teeth
- Improves ability of the dentist to restore missing teeth
- Improves aesthetics for a better smile and facial appearance
- Improves function of teeth
- Improves self-confidence and self-esteem
- Improves oral health
The following are some of the most popular orthodontic braces:
- Traditional braces – These braces are strong and tend not to stain the teeth. They are comprised of individual brackets which are cemented to each tooth and accompanied by an archwire which constantly asserts gentle pressure on the teeth. Traditional braces are generally metal but are also available in a clear synthetic material and “tooth colored” ceramic. The ceramic brackets are generally more comfortable than the metal alternative, but can become discolored by coffee, wine, smoking and certain foods.
- Invisalign® – Invisalign aligners are favored by many adults because they are both removable and invisible to onlookers. Invisalign® aligners are clear trays, and should be worn for the recommended amount of time each day for the quickest results. Invisalign® aligners are more comfortable and less obtrusive than traditional braces, but also tend to be more costly. Not all patients are candidates for Invisalign®.
- Lingual braces – These appliances are usually metal and fixed on the tongue side of the teeth, therefore not seen when a patient smiles. Lingual braces tend to be moderately expensive and in some cases, can interfere with normal speech.
The main difference between treating adults and children or teens is that the jawbones and the bone structures of younger patients are still developing and more maleable. For adults, the jawbones have stopped growing and the bone matrix is more dense. This may occasionally necessitate orthognathic surgery to realign the jawbones if there is a severe malocclusion. Other differences include:
- Gum or bone loss (periodontal disease) — Adults are more likely than children to experience gum recession or even bone loss due to gingivitis or advanced periodontal disease. Patients with straighter teeth are less likely to get gum disease.
- Worn or missing teeth — >Over time teeth can become worn down and shift into different positions that can only be corrected with orthodontic care. Missing teeth can cause other teeth to shift and tilt, creating a bad bite and increasing the possibility of gum disease.
- Incomplete orthodontic treatment as a teen — Many adults received some orthodontic treatment as a child or teen, but never completed their treatment. As an adult, they choose to complete their orthodontic treatment to achieve the healthy, beautiful smile they always wanted.
If your regular dentist notices problems with your teeth or jaws that may require treatment, he or she will likely refer you to an orthodontist — a dentist who specializes in diagnosing, preventing and treating dental and facial irregularities.
Most alignment problems become apparent once the permanent teeth begin to come through the gum (erupt). But your orthodontist may recommend waiting until enough teeth have come through before applying braces.
Preparation for braces generally involves:
- Oral exam: Your orthodontist conducts a full exam of your teeth, jaws and mouth.
- X-rays: You’ll get a series of X-rays to determine the position of teeth. The most common is the panoramic X-ray, which shows all the upper and lower teeth in biting position and any teeth still developing within the jaws. Special head X-rays also may help determine the size, position and relationship of jaws to teeth.
- Plaster models: Your orthodontist typically obtains plaster models of your teeth to evaluate your bite. To make an impression of your teeth, you’ll be asked to bite into soft material, which will remain on your teeth for a few minutes. From this impression, the orthodontist can create a plaster model of your teeth (dental cast). In some cases, this dental cast may be scanned into a digital format for further evaluation or treatment decisions.
- Potential tooth extraction: If your mouth is very overcrowded, your orthodontist may recommend removing one or more permanent teeth to allow room for the remaining teeth to fit comfortably. In severe cases, where tooth movement alone will not correct a bite that’s significantly out of alignment, jaw surgery is required in combination with orthodontics.
After your orthodontist has evaluated your teeth and jaws, he or she customizes a treatment plan for you. This most often involves the use of fixed braces, which are temporarily bonded to your teeth.
About one to two weeks after dental braces have been removed, an appointment is made for retainer placement. Sometimes, however, retainers can be fabricated and placed at the braces removal appointment.
Retainers are removable orthodontic appliances which are necessary during the “retention period” of orthodontic treatment. During this stage of treatment, the teeth are relatively unstable and must be retained to provide proper completion of treatment.
The retainer is specifically made for your mouth. During the first six months following the removal of dental braces, it is often necessary for someone to wear the retainer full time. After this period, the retainer may only need to be worn at night, but this time is determined at the orthodontist’s discretion.
Once your braces are removed, you should see your regular dentist for a teeth cleaning. Your orthodontist will clean any left-over adhesive off your teeth and the area where the braces were, but it is important to have a thorough oral cleaning after removal.
Teeth whitening also may be considered, since there may be a noticeable difference in color between where the brackets were bonded and the enamel surface. Although you can whiten your teeth with braces in place using gels or tooth pastes, it is recommended that you wait until the dental braces are removed to prevent any mismatches in color or possible damage to the orthodontic components.