Removable braces
What does removable mean? Removable means that the orthodontic appliance is not permanently in the mouth. It is not worn at certain times, for example during meals or sport. However, it is very important that the brace is worn every day (and at night) for as long as possible. The brace usually consists of a plastic plate into which wires and wire elements or expansion screws are inserted, for example. This can then be used to move teeth or shape the jaw. Removable braces are often used before the start of fixed treatment and after completion of active treatment to stabilize the therapy results.
Wires and screws are designed to stretch the jaw and move teeth. Plate appliances almost always only act on one jaw, one-piece appliances for both jaws (e.g. activators) act on the remodeling of the temporomandibular joints and are intended to shift the bite. The effectiveness depends on the patient's growth, the biological remodeling and the patient's cooperation, i.e. how long the appliance is worn in the mouth!
The most striking part of removable braces is the anatomically shaped plastic plate. The plastic used for this must meet very high physical and medical requirements. Above all, it must be extremely biocompatible. This also applies to the colors or inlays used. These make braces really attractive, especially for children, and help to ensure that the braces are worn long enough. Talk to your orthodontist about the many creative possibilities.
The plastic plate is divided into one or more segments so that the teeth can be moved as required. So-called expansion screws are installed at the interfaces. If these screws are turned apart, the respective segment is pressed in the desired direction. This allows a single tooth or a fixed group of teeth to be moved.
The wires used in removable braces basically have two functions. One is a retaining function and the other is a shaping function. Wire elements such as the arrow anchor or the Adams clasp are used to ensure that the braces are securely and firmly anchored in the dentition, i.e. they hold the braces in the correct position. Other wires such as the labial bow or the retrusion spring help to stabilize the teeth in the correct position within the dental arch or to move them to the desired position. Almost all of these wires and wire elements must be custom-made by the orthodontist.
This always depends on the treatment. It is individually determined by the orthodontist according to the requirements of your child. Please adhere strictly to these instructions, otherwise the treatment will be delayed or even fail. The braces must almost always be worn at night. In the event of poor cooperation, your health insurance company may withhold part of the costs incurred (the personal contribution) from you.
Yes, then the brace should definitely be placed in the brace box. Never wrap the brace in a handkerchief or place it loosely, it could be accidentally thrown away or bent!!! The brace box is a protection for the treatment appliance.
Your orthodontist can use the allergy passport to check which allergy you have. They can then decide which materials may not be used for the treatment. There are alternative options for allergies, such as titanium brackets and ceramic brackets if your child reacts to nickel. Removable appliances are made from clinically tested plastics, and this is also possible without dyes.
At the beginning of treatment, the appliance is perceived as a foreign body and is therefore not accepted and removed during sleep as it is disturbing. As the patient has to get used to it during the day, a little patience is required. After some time, the braces are tolerated. If you still have problems after wearing them for a long time, talk to your dentist.
The easiest way to clean the braces daily is with a hard toothbrush and a little toothpaste. Only hold the appliances carefully by the plastic part and ensure that the wires are not bent. The use of cleaning tablets is not absolutely necessary.
Stubborn plaque is deposited tartar. Regular mechanical cleaning with a brush is therefore important. The deposits can possibly be removed by placing the braces in diluted vinegar for some time.
Fixed braces
What does fixed mean? Fixed means that the orthodontic appliance is firmly attached to the patient's mouth. This can be brackets or a so-called quadhelix, for example. The advantage of a fixed appliance is that the necessary forces, e.g. for tooth movement, can act continuously over 24 hours, which means that the duration of therapy is shorter compared to removable therapy. The method is also very precise and particularly easy to plan. The patient cannot forget to wear the appliance, which is particularly problematic if they do not cooperate sufficiently and can jeopardize the success of the treatment.
Brackets are small precision guide rails that are bonded directly to the teeth. An individually shaped archwire runs through a slot, which then exerts the desired forces on the teeth in all spatial directions via the brackets. Brackets are available in very different shapes, sizes and materials.
The decision on which bracket to use depends not only on the therapeutic requirements but also on your demands in terms of biocompatibility or esthetics.
The classic brackets are made of metal. They have proven themselves over decades, are very robust and have excellent mechanical properties. As a rule, an alloy made of well-tolerated medical stainless steel is used for metal brackets.
Lingual brackets are also made of metal. As they are glued to the back of the teeth, they are not visible to others. Lingual therapy is much more complex than traditional therapy with brackets and is therefore more expensive, but has the great advantage of excellent aesthetics.
Plastic or ceramic brackets are undoubtedly the most aesthetic option for brackets that are visible from the front, especially in combination with tooth-colored archwires. Ceramic brackets have the advantage that they are particularly color-stable, i.e. they do not discolor over the course of treatment and their color effect comes closest to that of natural teeth. However, they are significantly more expensive than metal brackets. Plastic brackets are cheaper, but can be discolored by foods such as curry or ketchup.
Buccal tubes are small tubes through which the arches in the molar region are guided. They are usually only glued directly to the last molar or attached to a band that is placed around this tooth. This ensures that the archwires cannot slip out. However, other elements, such as an outer archwire, can also be anchored in the buccal tubes.
Bands are anatomically shaped "metal tires" that are bonded to a tooth and surround it seamlessly. Buccal tubes are welded onto these bands. This ensures maximum stability and bond strength. This is important because high forces often act in the posterior region. This prevents a buccal tube, for example, from coming loose prematurely.
Archwires are dental arch wires in various thicknesses, diameters and alloys. They are attached (ligated) into the slots of the brackets. The tension forces that are activated by the deformation in them cause specific movements of the teeth via the brackets, such as rotation, inclination or displacement.
A new, very effective and patient-friendly treatment method is tooth movement with the help of a fixed anchorage point for the classic orthodontic appliance outside the dental arch. To create such an anchoring point, a mini-screw (also known as a pin) is inserted between the roots of two adjacent teeth for a short period of time (approx. 6 months). Mini screws can be used for adolescents and adults.
In principle, yes, but chewing gum or chewy caramel candies can easily get caught in the brackets and damage the braces. You should also be careful with hard foods, such as carrots. It goes without saying that you should not crack nuts with your teeth or chew hard on a pencil.
This depends entirely on the initial situation and the degree of difficulty of the treatment. As an initial guide, a period of 1 to 2 years is realistic. Please clarify this with your orthodontist.
Yes, for example tooth-colored ceramic and plastic brackets or lingual brackets that are invisibly bonded to the back of the teeth.
No. Before bonding, the tooth is only roughened on the surface so that the brackets adhere securely. After removing the brackets, the tooth is usually sealed again with a fluoride varnish.