Concord Orthodontics Photographed by H. Ivan Orup, Jr. Concord Orthodontics Photographed by H. Ivan Orup, Jr.


More Than Just Braces

While most people associate braces with orthodontic treatment, orthodontists use many different types of “appliances” to move or stabilize teeth and jaws. Some are designed primarily to move teeth (orthodontic), while others are used “orthopedically” to modify facial growth.

Fixed appliances are the brackets, bands, and wires most commonly associated with braces, as well as other devices used to hold some teeth in place while others are moved. Palate expanders, for example, are fixed appliances that widen the upper jaw (maxilla).

Removable appliances can be taken out of the mouth, which makes them simpler to clean but also easier to lose or misplace. Retainers and nightguards are examples of removable appliances

Braces are fixed orthodontic appliances consisting of brackets, bands, and wires.

Brackets are the part of the braces that attach to the teeth; they are the handles that help control movement of the teeth. Brackets can be made of high-grade stainless steel, ceramic, plastic, or a combination of these materials. Ceramic brackets are typically tooth-colored and are generally used by patients who want to minimize the visibility of their braces.

Bands are stainless steel “rings” that are usually placed on molar teeth. Bands are a common component of most orthodontic treatment and are often used in the fabrication of palate expanders.

Braces require a wire that connects the brackets, shapes the dental arch, and provides the forces to properly direct the movement of teeth. The interaction of brackets and wires enables the orthodontist to have three-dimensional control over tooth movement. .

Aligners are clear, thin, plastic-like trays that are formed to fit an individual’s teeth. Patients are responsible for putting in and removing their aligners. A series of aligners is created to move teeth. Each aligner is worn for 2-4 weeks, and moves teeth a fraction of a millimeter at a time. Patients must remove aligners for meals and when brushing/flossing. The number of aligners needed to correct misaligned teeth varies based on the individual’s orthodontic problem and its correction.

This treatment may be an option depending on the severity of  an individual’s malocclusion.

Small elastics, or rubber bands, are often used in treatment to help move teeth into the correct position.

A functional/Herbst appliance is a combination fixed and/or removable appliance that can be used to improve discrepancies in growth between the upper and lower jaws as well as dental relationships.

These custom-made appliances are commonly used in children and adolescents with retruded lower jaws (the lower jaw is situated disproportionately behind the upper jaw).

Sometimes braces alone aren’t enough to move teeth appropriately. In some cases, additional forces are needed to help balance the underlying jaw structure and to help the upper and lower teeth to fit together properly. In this case, you may be fitted with headgear. These appliances are commonly used to correct an excessive overjet (when the upper front teeth extend far beyond the lower front teeth). The headgear is a removable, external device that fits into the molar bands on the upper arch and is held in place with either a neck strap or a head strap. This device is typically worn during the evening and overnight.

This is a custom-made removable plastic appliance worn at night to prevent the harmful effects of teeth clenching and/or grinding. A nightguard aids in the resolution of Temporomandibular Joint Disorder (TMD) symptoms.

A palate expander is a fixed appliance that is cemented to the upper teeth. This device is used to widen (or expand) the upper jaw to improve the occlusion and/or to create space for crowded teeth. This device contains an expansion screw that is turned daily for two to four weeks until the necessary width has been achieved. When the turning is completed, this device remains in place for approximately five to ten months to stabilize the change that has been attained.

When the expansion screw is turned, it is normal for patients to feel some pressure around the teeth, jaw, and nose area. This usually goes away within about half an hour.

Just as the name implies, retainers are used to hold teeth in their new positions after orthodontic treatment is completed. Retainers are an important component in maintaining the changes that have taken place during orthodontic treatment. Retainers can be removable or fixed (attached to the back of the teeth).

Separators are elastic O-rings or small wire loops placed between the teeth to create space for the placement of bands. Separators are usually placed between the teeth a week before orthodontic bands are scheduled to be placed.

Temporary Anchorage Devices are miniature screws that are placed in bone on a short-term basis to provide anchorage for moving teeth. While local anesthesia is used for the placement procedure, it is not necessary for the removal of the TAD. The amount of time the patient has the TAD varies based on the treatment plan and individual factors.


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