Dental Braces (cont.)

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What are the different types of braces?

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There are various types of braces available today. Choosing the right type depends on various considerations such as esthetics, cost, and allergy concerns.

Metal wired braces: These are the most common and traditional type of braces. They are typically made out of stainless steel. Metal brackets are fixed (bonded) onto the teeth and secure a wire with elastic ties made out of rubber. As an alternative to using elastic ties, "self-ligating" brackets are used to clip onto the wire.

Ceramic wired braces: Also called "clear braces," these provide a cosmetic alternative to the metal wired braces. The brackets are ceramic to match the shade of teeth and clear elastic ties are used. Self-ligating ceramic brackets are also available. The downside to ceramic braces is that they are more prone to breakage compared to the metal braces.

Lingual braces: These are braces that are placed on the lingual surface (backside) of the teeth and are not easily visible. This is mainly for cosmetic purposes and usually lengthens the time for treatment.

Other metal braces: Gold-plated stainless steel or titanium brackets are usually used for those with nickel allergies.

Clear aligners: These type of braces are made of a clear plastic that is custom-made without the use of brackets or wires on the teeth. This can also be considered "clear braces" and presents a very comfortable option for treatment. However, there are limitations to this method. Clear aligners can only tilt and rotate teeth in their position. Conversely, the use of brackets with traditional braces enables the whole bodily movement of a tooth (and its root) into the desired position.

How do braces work?

Braces work by a slow and controlled process using force and constant pressure. For traditional braces, the wire that is attached to the brackets works to put pressure on the teeth to move to a specified direction.

Teeth move through a biomechanical process called "bone remodeling." When braces put pressure on a tooth, the "periodontal membrane" and bone surrounding this tooth are affected. The periodontal membrane completely surrounds a tooth in its socket and it essentially helps anchor the tooth to bone. With pressure from braces, the periodontal membrane of a tooth is stretched on one side and compressed on the other side. This effectively loosens the tooth out of its socket. The compressed side (the direction of pressure) is where bone is broken down to accommodate the new position of the tooth while the stretched side is where new bone is made. This process needs to be done very slowly and explains why wearing braces can take some time to achieve the desired results.

Medically Reviewed by a Doctor on 3/19/2014

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