What are fixed braces?
Most patients require the use of fixed orthodontic appliances (‘train tracks’) to have really straight teeth, and achieve the best possible improvement of their smile. Small precisely designed metal or ceramic buttons called brackets are stuck/bonded to each tooth. Sometimes metal rings called bands are also fitted around the back/molar teeth. The brackets are then connected to each other using a thin metal wire, called an archwire. The wire is held in place with small elastic rings called modules, or with very thin wires called ligatures. Modules come in a variety of colours to customise your brace. The wires are adjusted at regular intervals to straighten the teeth and correct the bite.
Modern brackets are quite small, and they cover a relatively smaller area of each tooth, making braces more attractive than they used to be. With fixed braces, there is no plastic in the roof of the mouth. This means speech is unaffected and the flavour of food can be enjoyed fully. As the appliance cannot be removed, it acts full-time, and so it is very effective. Fixed braces are very good at achieving fine detail, and making the smile look really perfect!
How do fixed braces work?
Fixed appliances, by definition, cannot be removed by the patient. The simplest way to think of each bracket is as a handle with which it is possible to control each tooth individually and precisely.
As we have already mentioned, in the early part of treatment, a thin archwire is fitted to link up all the brackets. Because the teeth are irregular, the wire has to bend up and down or in and out between the teeth. This is the clever bit: the wire, a bi-product of NASA research, has perfect shape memory and will gradually return to its original shape, bringing the teeth with it.
As treatment progresses, stiffer wires are fitted and these act as a monorail. At this time, tiny springs and elastics are also used to guide the teeth in the desired directions.
What are the limitations of fixed braces?
Fixed braces are not very good at major alterations to the bite. For this, other appliances are used either before or at the same time as the fixed braces. Examples include changing the relationship of the jaws with a functional/orthopaedic appliance, or moving the upper teeth back to improve bite with headgear. Very occasionally specialist surgery needs to be used in conjunction with brace treatment to achieve the ideal result.
How are fixed braces fitted?
Will it hurt?
Do I need to modify my diet?
What else can damage my brace?
Biting your fingernails may result in damage to your brace. Do not touch, play with, or pick at your brace. Do not bite pens or touch your braces with them. Do not use your teeth as DIY or household tools! The more you look after your braces, the sooner your treatment will be completed.
What do I do if my brace is damaged?
If despite all your careful attention part of the brace becomes dislodged or damaged, contact the practice as soon as possible so that an appointment can be arranged either to repair the brace or to relieve any discomfort. Damage to your braces can prolong treatment. If appliances are repeatedly damaged and no progress is being made, treatment may have to be terminated.
How do I keep my teeth and fixed braces clean?
How long will treatment take?
This usually takes anywhere between 9-24 months but can vary according to how severe your case is. Failed and cancelled appointments or repeated breakages of the brace will add to the overall treatment time.
Will I need to wear retainers?
Once the active phase of your treatment has been finished, it will be necessary to wear a retainer. This may be removable or it may be fixed behind your front teeth. The length of time this has to be worn can vary.
How often will I need an appointment?
You will need regular appointments during treatment for the brace to be adjusted.
Do I still need to see my regular dentist?
Yes. It will be important you still have check-ups with your regular dentist throughout orthodontic treatment so that your teeth can be checked for decay.
What do I do in an emergency?
If your fixed braces become damaged, or a component is digging in your lips or cheeks, or if you are concerned that the fixed braces are continuing to be uncomfortable or troublesome beyond what is normally expected for the first few days, then telephone the practice for advice and/or an emergency appointment. Where possible, do not try and adjust the appliances yourself, as this may damage them.
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