This type of brace is made up of bands and brackets that are stuck onto each tooth. The teeth are moved by ‘straightening wires’ that run between the various attachments. The length of treatment varies between 9 and 18 months, although complex cases may take longer.
Adult patients do not want metal braces fixed to their teeth. ‘Train-tracks’ are very obvious, even from a distance, and there is an increasing demand for less conspicuous braces.
These are clear or tooth-coloured brackets which are usually made from porcelain. A metal wire is still used to straighten the teeth but this is only really obvious on closer inspection. If porcelain brackets were fitted to the lower teeth they could damage the edges of the upper teeth. Metal attachments are therefore normally recommended for the lower teeth. Some patients choose to have aesthetic braces for the upper teeth and lingual braces on the lower teeth.
Lingual braces are placed on the inside surface of the teeth and are ideal for those who prefer their treatment to go unnoticed.
Lingual braces may only be needed for short periods of time for simple problems, though complex cases can take up to 2 years.
There is a period of adjustment once the lingual brace is fitted. The tongue may become irritated and sore initially. Speech may be affected slightly, typically for first week.
90% of patients wearing lingual braces have very few complaints after the initial 10 days.
Self-ligating brackets are technologically advanced brackets that reduce friction and use lighter forces during treatment.
This has the following benefits:
Invisible aligners such as Invisalign involve a series of custom-made clear removable aligners which fit over your teeth. There are no metal wires or brackets. Each aligner is worn for about two weeks, moving your teeth gradually millimetre by millimetre until they are straighter. Some patients may require a short period with fixed appliances as well to achieve the best result.
Invisalign only work while you are wearing the aligners and these should be worn all of the time, day and night, except for eating, contact sport and brushing.
Functional appliances are usually fitted to reduce the prominence of upper front teeth and to improve the way the jaws relate to each other. This involves two removable appliances – one for the upper teeth and one for the lower teeth, they alter the bite of the teeth by holding the lower jaw forwards.
Functional appliances need to be worn on a full-time basis, day and night, for between 6 and 9 months. They must be removed for cleaning, swimming and contact sports. After this initial treatment period they are usually worn at night to allow the transition to the fixed braces.