How braces work on teeth, how the system works

Braces are locks fixed to the teeth with a groove and “wings”. The principle of operation of the system is the ability of the orthodontic arch to return to its original position. The straightening archwire puts pressure on the braces, causing the teeth to move. Fixed retainers and aligners stabilize the results obtained at the final stage of treatment.

The material was verified by Anna Rimkevich, senior product manager at Ormco Russia.

The basis of bite correction is the mechanism of action of weak forces and the movement of teeth in accordance with the bends and shape of the arch. The metal arch has “shape memory”: it straightens, pulls the braces along with it and moves the teeth in the desired direction. The formation and destruction of bone tissue is part of the natural process of tooth movement. The principle of operation of braces allows you to achieve the goal of orthodontic treatment - to create the best balance of occlusion, facial aesthetics and dentition.

Damon Clear with orthodontic arch

Excursion into history

At the beginning of the 20th century, the American doctor Edward Engle created the first prototype of the braces system and called it the Engle apparatus. Angle's apparatus consisted of an elastic stainless steel arc and ligature elements. The arc was tightly fixed in the tubes. The tubes were soldered to orthodontic rings placed on the first molars. Each tooth was tied to an arch curved in the shape of the dentition with a ligature wire.

Subsequently, the scientist significantly changed the original design and developed the edgewise technique. Orthodontic locks, edgewise, were a rectangular piece with a groove. An arc was inserted into the groove and the lock was locked with a pin. Subsequently, the design of braces was modified: orthodontic arches with a square and rectangular cross-section profile, with sharp and rounded edges, appeared.

Later, the edgewise technique was further modified by doctors. Thanks to the active development of orthodontics in the 20th century, the modern operating principle of braces was formed. Today, the doctor is offered various options for torque and angulation. Torque (or inclination) is the deviation of a tooth from its axis in the vestibulo-oral direction. Angulation is the deviation of the tooth in the mesio-distal direction. Taking into account torque and angulation allows, based on a specific clinical case, to individually select the optimal brace option for each tooth.

Do I need to take care of my teeth after braces?

During treatment, careful oral hygiene is indicated. Rinsing and brushing should be done every time after eating, including snacks. This way the patient gets rid of food particles in the interdental spaces and on the enamel surface.

It is better to use a brush with soft bristles and a small amount of fluoride toothpaste. There are special rinses and flosses (threads) for better care.

When the system is dismantled, the person needs to wear mouthguards (retainers). This consolidates the result obtained. If the aligned units are not maintained, they will soon return to their previous position.

After therapy, the enamel becomes thinner and more vulnerable. Doctors perform remineralization (fluoridation). Plaque and stone are first cleaned off.

To maintain oral health, it is necessary to visit the dentist regularly for preventive examinations. A beautiful smile will last for many years if you regularly care for the soft and hard tissues in your mouth (clean in the morning and evening, after meals, use an irrigator).

Construction of braces: comparison of non-ligating and self-ligating structures

There are ligature and self-ligating devices. The first includes traditional designs: the arc is fixed in the groove using elastic or wire ligatures. Example: Mini Diamond, Inspire Ice, Orthos devices. Ligature systems are characterized by a long treatment period - from one to three years, depending on the complexity of the clinical case, lengthy adaptation and labor-intensive hygienic care. Activate the device: replace arches and ligatures, it is necessary on average once a month, and sometimes more often.

traditional construction with ligatures

ligature Mini Diamond

The design of self-ligating braces has a fundamental difference: the system works without ligatures. Consists of a groove and a closing lid. The orthodontic arch slides in the groove. Ligature-free designs provide a reduction in treatment time compared to ligature devices by an average of 7 months. Less painful during the adaptation stage and easier from the point of view of oral hygiene. They turn out to be the option of choice in many clinical cases. The entire line of Damon System braces are self-ligating.

self-ligating Damon Q2

How does a braces system without ligatures work? The principle of operation of non-ligation devices is divided into passive and active self-ligation. With the passive type of fixation, the arc moves freely in the groove. The cover holds the arc and does not put pressure on it. Example: Damon Q, Damon Clear. With the active type of self-ligation, the clip presses on the arch and moves it to the base of the groove. Activation of self-ligating systems is carried out once every 2-3 months.

system without ligatures

Damon Clear and Q on typodont

Braces are made from various materials. Ligature and self-ligating structures are made of metal, transparent polycrystalline aluminum (ceramics), plastic and artificially grown sapphire. Metal braces, for example, Damon Q and Damon 3 MX, are the most durable. The Damon Clear2 ceramic and sapphire Inspire Ice models have the best aesthetic characteristics.

metal Damon Q2

ceramic Damon Clear

The orthodontist and the patient jointly overcome the path to high aesthetic smiles and a healthy dental system. Regardless of the type of braces and manufacturing material, the combination of the orthodontist’s professionalism with a high degree of patient responsibility allows one to achieve stable results in the treatment of malocclusions.

Dental braces: what are they?

The design consists of brackets made of metal, ceramics or other materials. The system is attached to the outside or inside of the jaws. All elements are held on a special thin wire.

An orthodontic apparatus is necessary to eliminate pathologies that are associated with incorrect position of teeth. People mistakenly believe that the main purpose of such intervention is the aesthetic appeal of a smile. Doctors do not agree with this and argue that the curvature of incisors, canines and molars is primarily a medical problem, since it often leads to health problems. Food is not crushed enough when chewed, and then poorly digested, as a result of which diseases of the gastrointestinal tract develop.

There are other pathological processes that can only be dealt with with the help of staples. In some cases, extraction is required before installation.

Biomechanics of tooth movement

To understand how braces work, let’s look at the biological and physiological processes that occur during tooth movement. The teeth are located in the alveoli - natural depressions in the jaw bones of the skull. The root of each tooth is surrounded by periodontal fibers that hold the tooth in the socket. The fibers also perform a shock-absorbing function: they allow the tooth to make micro-movements in all directions. After fixing the bracket and installing the arch, force begins to act on the root of the tooth. To move teeth slowly and less painfully, a weak and prolonged force is applied.

Due to the movement of the tooth root, there is a need to free up space in the alveolus. To do this, osteoclasts begin to destroy the bone where the root touches the alveolar wall. Osteoclasts are special cells that remove bone tissue. On the opposite side, osteoblasts produce new bone to fill the vacated space. Under the influence of osteoclasts and osteoblasts, the balance of formation and destruction of bone tissue ensures the progressive movement of teeth.

At what age does it make sense for adults to get braces?

In any case, there are no age restrictions. There are surmountable obstacles: the general condition of the teeth, periodontal and gum diseases, and possible common concomitant diseases. Absolute contraindications for installing braces for adults coincide with many other types of treatment: lack of teeth, tuberculosis, diabetes, a number of immune diseases, epilepsy, bone pathologies, blood diseases. If a person gets braces when he is over thirty, the treatment will be quite long, since tissue regeneration occurs more slowly due to age. Plus, skeletal growth has already been completed, and the position of the bones can be “corrected” only when they are still growing - in childhood and adolescence. However, dentists achieve excellent results with mature patients.

Installation of braces

A general understanding of how dental braces work, the design and installation process of the system is important for everyone. There are two installation options: direct and indirect method.

The direct method involves manually installing and positioning each bracket on a tooth directly in the patient’s mouth. Fixation is carried out on a light-curing material. The indirect method involves positioning the system on a plaster model. The braces are transferred from the model to the mouthguard. The mouthguard is formed individually for each patient. Next, glue is applied, the mouthguard is put on the teeth, and the braces are fixed in a predetermined position for each jaw in turn.

Does it make sense to get braces as an adult?

Correcting a pathological bite or incorrect position of teeth is, of course, not a matter of life and death. Rather, it is a matter of regaining self-confidence. The “curvature” of teeth has little effect on communication; after all, we perceive a person holistically, and not solely the state of his bite. But, you see, an open wide smile of any person will make him more attractive in our eyes. And only people who are not embarrassed to show off their teeth smile like that. Plus, when we talk about bite, it's not just about beauty, it's also about functionality. Nature intended that when chewing, the load on the teeth should be distributed evenly - this is only possible with straight teeth and a healthy bite. If this is not the case, then over time a person develops problems with the dental system: pain appears, clicks when opening and closing the mouth, etc. Therefore, orthodontic treatment for adult patients is not only possible, but also necessary.

Stages of treatment

The first stage is preparation for orthodontic treatment. Preparation includes x-ray diagnostics, sanitation of the oral cavity and removal of the required number of teeth.

The second stage involves fixing the structure. An initial thin arch with a round cross-section profile is installed. Further in the treatment process, the doctor changes the arcs from a smaller cross-sectional diameter to a larger one. At the final stages, rectangular rigid arches are used.

On average, it is necessary to visit a doctor from once a month when treating with ligature models to once every 2-2.5 months when treating with self-ligating systems. At the end of the second stage of treatment, the doctor removes the braces using enamel-safe forceps. The remaining adhesive is removed from the surface of the teeth with a low-abrasive bur, and the tooth is polished with a brush using a polishing paste.

The third stage is the retention period. The results of orthodontic treatment are stabilized with the help of permanent retainers and aligners.

The duration of treatment depends on the complexity of the anomaly being corrected, the individual anatomical characteristics of the patient and the professionalism of the orthodontist. The speed of tooth movement is influenced by the design of the brace: self-ligating systems can provide faster results in 1-2 years. Treatment with ligature models lasts on average 2 to 3 years.

Some dental anomalies are corrected using removable hard aligners. When treated with aligners, the patient is given a set of several rigid aligners that differ in shape. The patient changes the aligners independently every two weeks. Once every month and a half, the patient visits the orthodontist to assess the progress of treatment. Mouthguards are worn constantly: the device is removed only when eating and brushing teeth.

How long should adults wear braces?

It is impossible to answer this question unambiguously: maybe one year, or maybe several years. Bite correction in adult patients is a long, labor-intensive process that requires patience and discipline. Therefore, orthodontists rarely persuade adults to straighten their teeth. If a person himself does not want this, then nothing will force him to conscientiously fulfill all the doctor’s demands. When treating adults with orthodontics, it is important that the dentist find a compromise between what he wants to achieve and what the patient wants to achieve. Orthodontists, of course, always strive to restore the perfectly aligned position of teeth, no matter how long it takes - at least three years, at least five years. The patient may get tired of the treatment and abandon it. The dentist’s main task is to honestly tell you how long the treatment will take and how it will proceed. And then hear whether the patient is ready to go this route.

Comparison of lingual and vestibular constructions

Based on their location in the dental cavity, they are divided into lingual and vestibular systems. The vestibular position on the outer side of the dentition is classic and is used in the vast majority of cases.

Vestibular Mini Diamond

Lingual appliances are installed by patients with the highest aesthetic requirements. Adaptation to internal systems is more difficult compared to vestibular structures. The principle of operation of lingual and vestibular braces is not fundamentally different: in both cases, the arch is straightened and exerts a force on the braces, leading to the movement of teeth. If there is excessive crowding, the use of a lingual system is not recommended. The duration of treatment on the lingual structure is slightly longer than on the vestibular one. The patient sometimes experiences additional discomfort due to the interaction of the tongue with the brace system.

lingual braces STb

What is the bite like?

Occlusion - the position of the upper and lower dentition in the position of central occlusion. All types of bite can be divided into physiological and pathological.

Physiological:

Orthognathic is the “ideal” variant of the bite, which is characterized by tight contacts between the teeth and dentition, as well as overlapping of the lower dentition by 1/3 of the crown;
Biprognathic - a bite in which the crowns of the teeth are directed towards the vestibule of the mouth;
Progenic – a bite characterized by a slight protrusion of the lower jaw forward;
Direct - a type of bite in which, in the position of central occlusion, the upper and lower dentition touch the cutting edges.

These types of occlusion are allowed as variants of the norm of mutual arrangement of the dentition, since they are not capable of leading to functional disorders of the dentoalveolar system.

Pathological:

Mesial – a bite characterized by protrusion of the lower jaw forward;
Distal - a bite in which the upper jaw is more massive than the lower jaw;
Deep - a bite in which the upper teeth strongly overlap the lower ones;
Crossbite - a bite in which individual teeth of the lower jaw overlap the upper teeth in a separate area;
An open bite is a bite in which gaps are formed between the closed teeth.

Pathological types of occlusion cause functional disorders in the dental system, and also, in some cases, disrupt the aesthetics of a smile.

Only an experienced orthodontist can most accurately determine the type of bite and draw up a treatment plan. Request an appointment in Moscow with Irina Aleksandrovna Butorina. The specialist has many years of experience, as well as more than a thousand satisfied patients.

Installation of veneers

Veneers are porcelain or composite plates that replace the outer thin layer of a tooth.
Effectively correct dental discoloration, cover cracks or stains due to enamel hypoplasia. Veneers are an aesthetic solution and do not replace orthodontic treatment. Unlike veneers, braces move teeth. Treatment with braces ensures the formation of an aesthetically correct smile, restoration of the physiological bite and function of the dental system. The material is for informational purposes only and is presented for informational purposes. It does not replace consultation with an orthodontist and is not a guide to correcting dental anomalies.

Indications for treatment with braces

Like any treatment, indications for orthodontic therapy must be determined by a doctor. Installation of braces is indicated if the following conditions exist:

malocclusion when the dentofacial apparatus is formed;
occlusion defects that appear during the period of mixed dentition;
deviations from the correct growth vector of individual dental elements;
in preparation for prosthetics (classical or implantation) if tooth extraction causes the remaining elements to shift to the vacant space;
crowding or, on the contrary, gaps between teeth (diastemas and trema);
tilting the dental elements forward or backward;
micrognathia (reduced jaw size).

Sometimes the disorders are clearly expressed, but often only a specialist can notice the pathology. Contacting an orthodontist is necessary in order to promptly identify an anomaly in the development of the dental system and eliminate it.

It is important to change the arc on time

At each stage of treatment you need to get a certain result. Once it is reached and the teeth have assumed their new position, the archwire no longer works. And if you often postpone doctor's appointments, each week of delay prolongs the entire treatment.

Wearing one archwire for too long does not harm your teeth, but it does not make sense.

Treatment by an orthodontist requires self-discipline. Be prepared to adjust your schedule around your doctor's appointments. And remember that all this is done for the sake of health and a beautiful smile. And this is the best incentive!

Why is it important to choose the right orthodontist?

Orthodontic treatment is long-term, it will last from a year or more, so the patient cannot immediately determine whether it is being treated well or not. If something in the treatment goes wrong due to the doctor’s fault, you will find out about it months, or maybe years, later. In order not to waste time, money, nerves and health, it is important to immediately choose a good orthodontist with whom you will also enjoy communicating for a long time. If you want to know our recommendations on how to do this so as not to regret it, read the article: “How and why to choose an orthodontist?”