Braces

Lingual braces

The brackets on these braces attach to the backs of your teeth, facing your tongue. That keeps them out of sight as they do their job. 

Self-litigating braces

Made from either metal or ceramic, these braces cause less friction because they have clips built into the brackets to hold the wire. Self-litigating braces usually allow you more time between appointments. Easier to clean and harder to spot, they may require less time than other braces to correct your teeth.

Mini braces

These are about 30% smaller than traditional braces, but they are made of stronger stainless steel. They’re less noticeable, easier to keep clean, and work just as well as larger braces.

Braces vs. Invisalign

Invisalign is the brand name of a popular alternative to braces called clear aligners. While both braces and clear aligners help straighten your teeth, they have significant differences.

Clear aligners are plastic models of your teeth. When you wear them, they apply mild pressure that gradually repositions your teeth. Tooth-colored attachments can help hold your aligners in place if necessary. Unlike braces, which remain fixed to your teeth at all times, clear aligners like Invisalign can be removed easily. In fact, you will take them out to eat as well as to brush and floss. It’s recommended that you wear them at least 22 hours per day. Clear aligners are much less noticeable than traditional braces. One potential drawback compared to braces: You can lose or damage your clear aligners when you remove them. You also have to avoid drinking acidic and/or sugary drinks, like sodas and sports drinks, while wearing clear aligners. If such liquids get in your aligners, they can stain your teeth and cause tooth decay.

How Do Braces Work?

Braces put pressure on your teeth over a period of time to slowly move them in a specific direction. This pressure slowly moves your teeth into a better alignment. The bone under them changes shape, too.

Braces are made up of many parts, including:

Brackets

Brackets are small squares that fit on the front or back of each tooth, depending on the type of braces you and your orthodontist select. The dentist attaches them with a special bonding agent or with orthodontic bands. Brackets act like handles, holding the archwires that move your teeth. Your brackets will be made of stainless steel or tooth-colored ceramic or plastic.

Orthodontic bands

These stainless steel, clear, or tooth-colored materials are cemented to your teeth. They wrap around each tooth to provide an anchor for your brackets. Your orthodontist will use small rubber bands, called spaces or separators, to create a space between your teeth for your orthodontic bands. Clear or tooth-colored bands are less visible, but they also cost more than stainless steel. Not everyone needs bands. Your orthodontist will determine if you require them. 

How Long Will I Have to Wear Braces?

Expect to wear your braces for about 2 years, but keep in mind that this varies from person to person. You could have yours for less than a year or up to 3 years. The time it takes for your braces to fix your problem depends on a few things, including:

• How severe your problem is
• The amount of space in your jaw 
• Your overall oral health
• How closely you follow your orthodontist’s instructions

After your braces come off, you will need to wear a retainer. Your retainer will help keep your newly positioned teeth in place. If you don’t wear it, your teeth can shift back to their previous position. You will wear it all the time for the first 4 to 6 months. After that, you will only wear it in bed. How long you will have to keep wearing your retainer depends on your orthodontist’s recommendation; you may need to wear your retainer for the rest of your life to keep your teeth in proper alignment.

Braces Treatment

Your orthodontist will want to check your progress about every 4 to 8 weeks, depending on the stage of your treatment. At your appointment, your orthodontist will either tighten or loosen your braces. These adjustments likely will cause you some discomfort for a day or two. Over-the-counter pain medications can help.

Will Braces Be Painful?

You may have some discomfort when you first get your braces, when they are adjusted, and when you start using a new appliance, such as rubber bands or headgear.

Over-the-counter pain relievers like acetaminophen or ibuprofen can help. Tell your orthodontist if you have a lot of pain after each adjustment. They may be able to make the adjustments a bit differently. If your braces cause irritation, your orthodontist or your pharmacy can provide a special dental wax that you can put over the sharp areas on the braces.

Can You Be Allergic to Braces?

Some people are allergic to certain metals used to make braces, such as nickel. When this happens, other materials can be used instead. People can also be allergic to the latex gloves worn by the orthodontist and the assistants.

Caring for Teeth With Braces and Retainers

Plaque and tartar can build up around your braces and their various parts, and that can lead to cavities and gingivitis. Most orthodontists recommend brushing after every meal or snack with fluoride toothpaste and carefully removing any food that may have gotten stuck in your braces. Some orthodontists will also prescribe or recommend a fluoride mouthwash, which can get into places in the mouth that a toothbrush can't reach. A Waterpik or AirFloss can also help flush out stuck food.

To floss teeth if you have braces, feed the short end of the floss through the space between the main archwire and the upper portion of the tooth closest to the gum. Use a gentle sawing motion to work the floss on each side of the two teeth the floss is between. Be careful not to pull with too much force around the archwire. 

Begin brushing your teeth by using a regular soft toothbrush. Brush down from the top and then up from the bottom on each tooth with braces. Next, brush your teeth with a Proxabrush or "Christmas tree" brush. This brush is specially designed for cleaning between two braces. Insert the brush down from the top and then up from the bottom between two braces. Use several strokes in each direction before moving on to the next space between two braces. Repeat the procedure until all teeth have been cleaned.

Once your braces are off and you start to wear a retainer, brush your retainer every time you brush your teeth, but not with toothpaste. Once a day or at least once a week, disinfect the retainer by soaking it in a denture cleanser, such as Efferdent, Polident, or other solution, according to the instructions on the package. Add the cleanser to a cup full of warm – not hot – water. Thoroughly rinse the retainer with plain water before putting it back in your mouth.

Foods to Avoid With Braces

Braces are delicate. If they break, that could prolong your treatment. To protect them, avoid foods that are hard, sticky, or chewy, including:

• Ice
• Nuts
• Popcorn
• Hard candy
• Chewing gum
• Chewy candy, like caramel
• Gummies
• Hard or tough-to-bite foods, such as apples or bagels, hard rolls, and pizza crust
• Corn on the cob
• Hard pretzels and snack chips
• Carrots and other crunchy raw vegetables

When to Get Braces

Your dentist can tell you when to seek evaluation from an orthodontist. The American Association of Orthodontists and the American Dental Association recommend that all kids be evaluated for orthodontics by age 7. By this age, the orthodontist can spot subtle problems with jaw growth and emerging teeth. Most kids begin active treatment between ages 9 and 14. Orthodontists recommend that you correct dental problems while your child is still growing. 

The mechanical process used to move teeth with braces is the same at any age. That means braces can help both children and adults. The main difference: Treatment may take longer because of the maturity and density of adult bone tissue.

What to Do if a Bracket or Wire Breaks

Broken braces, loose bands, or protruding wires can cause problems but rarely require emergency treatment. But call your orthodontist to set up an office visit to fix the problem. If you have a more severe mouth or facial injury, get help right away. Here are tips to get through some of the more common problems until you are able to see your orthodontist:

• Loose brackets. Apply a small piece of orthodontic wax to temporarily reattach loose brackets, or place wax over the bracket to provide a cushion between the bracket and your gums and other soft tissues of the mouth. Your orthodontist usually gives you orthodontic wax when you get braces.
• Loose bands. These will need to be replaced or recemented into place. Save the band and schedule an appointment for the repair.
• Protruding or broken wire. Use the eraser end of a pencil to move the wire to a less bothersome position. If you can't move it out of the way, put a small amount of orthodontic wax over the protruding end. Do not attempt to cut the wire, because you might accidentally swallow it or inhale it into your lungs. If a mouth sore develops from the wire poking the inside of your mouth, rinse your mouth with warm saltwater or an antiseptic rinse. An over-the-counter dental anesthetic can also be used to numb the area.
• Loose spacers. These will need to be repositioned or replaced if they slip or fall out completely.

Side Effects of Braces

Because braces and retainers brush up against the inside surface of the mouth, you may be more prone to having canker sores. If you get a canker sore, your orthodontist or dentist may prescribe a corticosteroid ointment or a prescription or nonprescription solution to ease the pain and irritation and help heal the sore. You can use dental wax to cover the portion of your braces that brushes against the sore. Other side effects of braces include:

• Short-term discomfort when you first get braces and after each adjustment
• A hard time eating (mostly after an adjustment)
• Pain in your jaw
• Irritation, such as on your tongue, cheeks, and lips

After Braces

After your braces come off, the orthodontist will thoroughly clean your teeth. They may want to take another set of X-rays and bite impressions to check how well the braces straightened your teeth and if you’ve gotten any wisdom teeth. If your wisdom teeth are beginning to come in after the braces are removed, the dentist or orthodontist may suggest you get them pulled to prevent newly straightened teeth from shifting. Your wisdom teeth may also start to hurt, become infected, or damage neighboring teeth.

Your dentist or orthodontist will also fit you with a retainer, which is a very important part of post-braces care. Even though braces may have successfully straightened your teeth, they aren’t completely settled in their new position until the bones, gums, and muscles adapt to the change. Also, after long periods of time, teeth tend to shift. Your retainer will prevent your teeth from moving and keep them straight.

How Much Do Braces Cost?

The price varies, depending on how much work is being done, the type of braces being used, and where you live, but you can expect traditional metal braces to cost about $5,000 (or less in rural areas). Some insurance carriers provide partial coverage for orthodontic treatment, so check to see what your policy covers.

Most orthodontists offer payment plans and will let you make payments over the course of treatment without charging interest. They also may offer a discount if you pay in advance or if you have multiple family members who need braces. Ask your orthodontist about all treatment fees and payment plans they offer before treatment begins.

If your child could benefit from braces but you can't afford them, there may be other ways to cover the cost, including:

• Financial aid programs. Low-income families can apply to the Smiles Change Lives program. This provides orthodontic treatment for children between the ages of 11 and 18. If accepted, the child can receive braces for $250 to $500. To be accepted, you must meet certain income requirements (for example, a family of four cannot earn more than $40,000 per year), and your teeth must be moderately to severely crooked.
• Medicaid. Medicaid may cover braces, especially if your child's teeth cause problems with talking, eating, or swallowing. This coverage varies from state to state.
• Dental schools. If you live close to a dental school with an orthodontics program, you may be able to get treatment from a student (supervised by an experienced orthodontist) for a lower cost.
• Dentists. Some general dentists provide orthodontic treatment and may be able to take care of your orthodontic needs at a reduced rate since they are not orthodontists.

Deciding to have orthodontic treatment may not be easy, but an improved smile can make a huge difference in appearance and self-esteem.

Braces FAQs

Who needs to wear braces? If you have problems like overcrowded or crooked teeth, or issues with your bite or jaw alignment, you likely will benefit from braces.

What types of braces work faster? Some experts say traditional metal braces work the fastest, while others say that self-ligating braces get the job done more quickly. But it’s best to base your decision on what your orthodontist says are the type of braces that will work best for you.

What is the best age for braces? Braces work at any age, but you may need to wear them longer if you get them as an adult.

Can you play sports with braces? Yes! But you do need to be cautious. You should always wear a mouth guard to lessen the risk of damage to your braces and your teeth. Your orthodontist can recommend the right one for you. Custom-made mouth guards offer the most protection.