This is the most widely used type of fixed orthodontic treatment appliance and what most individuals picture when they think of “braces.” It includes a metal band or bracket around the molars, and metal brackets on all the teeth (premolars, canines and incisors) in front of the molars. These brackets are placed on the front surface of each tooth, and metal wires are placed in these brackets connecting the teeth making each tooth move into a more aligned and ideal position. These wires are held in place by elastic ligatures, which come in a variety of colors and you get to pick at each appointment. Traditional braces are worn for a period of time typically lasting 18-30 months. However, each individual case is different and may require more or less time, depending on the treatment required to align the teeth. This is still the most efficient and cost effective way to treat malocclusions (i.e. crooked teeth!).
Ceramic braces are exactly the same as the traditional metal braces but the difference they offer is a more esthetic appearance than traditional braces (i.e. there are not quite as noticeable). Patients may still have a metal band around the molar teeth and metal wires connecting the teeth, but the brackets on the front teeth are made out of ceramic, which is white in color. Ceramic brackets have come a long way since their introduction into orthodontics. They do not stain or discolor as easily as before, and they have become much harder than the original ceramic brackets however, ceramic brackets can break more easily than metal brackets due to their physical properties of strength and hardness. This is especially true near the end of treatment due to the larger wires used at the end of orthodontic treatment. The other downside of ceramic brackets is that the removal of these brackets can be a little more challenging sometimes even though it takes about the same amount of time to complete as with the removal of traditional brackets.
Lingual Braces (Incognito® and Harmony®)
Lingual braces have been used in orthodontics for approximately 30 years. However, many people are unaware that lingual braces are available to them. “Lingual” is a dental term that means the surface of the tooth closest to the tongue. Lingual braces do not usually use a metal band around the molars but still utilize the metal wire to connect the teeth. Additionally, each lingual bracket is usually custom made to fit each individual’s own unique tooth shape. They are usually smaller and smoother than the brackets that go on the front surface of the tooth (i.e. traditional or ceramic braces) and are just as effective as traditional braces while offering an almost invisible treatment option for the patient who does not want others to see any braces on the fronts of their teeth. The treatment time for lingual braces is about the same as traditional braces (18-30 months).
Invisible Braces (Clear Image Aligner®)
Invisible Braces have become very popular recently in the United States. The advantage to invisible braces is that the patient does not have any metal in their mouth, making invisible braces the most esthetic and comfortable option for patients. Invisible braces are a series of clear plastic-like retainers that must be worn 22-24 hours a day to be effective. The disadvantage of clear braces is that the teeth can only be tipped into position and not moved completely into position as in traditional orthodontic treatment. Consequently, the relapse of the teeth (the movement of teeth back to their original position) is potentially greater. Also, invisible braces are only meant for minor tooth movements and are not really meant more difficult cases. Only a small portion of patients truly qualify for invisible braces even though more and more people are inquiring about this option. Invisible braces are most ideal for someone who has had braces in the past and their teeth have moved slightly out of alignment due to not wearing their retainer. If worn correctly the treatment time is usually 6-30 months with the variation in treatment time being due to the nature of the case being treated and the amount of compliance given by the patient (i.e. if you don’t wear them correctly teeth don’t move).
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