Services - Orthodontics: Different Types of Braces

Metal Braces
Ceramic Braces
Lingual Braces


Metal Braces

Gaps, overlaps, crowding, rotated teeth—these are just some of the things your teeth can do to ruin your smile. Fortunately, all these conditions are curable thanks to orthodontic appliances, or braces. Braces are metal, plastic or ceramic devices that put tension on your teeth to shift them into a more desirable position. Braces can also correct malocclusion, or bad bites. Braces worn in conjunction with headgear can level out an overbite (when your top jaw is larger than your lower jaw) or an underbite (when your lower jaw is larger than your top jaw).

Metal braces consist of metal wires and metal brackets. These brackets are glued to the front of your teeth. The wire is shaped into the ideal position of your teeth, then threaded through the brackets. As the wires struggle to get back to their original shape, they gradually pressure your teeth into that shape as well. Dr. Adrian Sarchisian will tighten the wires every four to six weeks. You should see a nice, straight smile within two or two and a half years (though this time period can be shorter or longer, depending on the severity of your problem). Once your braces come off, you will likely wear a retainer for six months to a year to keep your teeth from shifting and your new smile in place.

Though braces are most commonly seen on children and adolescents—at these ages, bones are still growing, making it easier to shift teeth and jaws into place—they can be worn at any age. If you feel you (or your child) may be a candidate for braces, talk to Dr. Adrian Sarchisian. He can recommend the type orthodontic treatment that you or your child will require,

Braces can be unpleasant at times. Initially, the brackets can irritate the back of the lips (though you will get used to them within a few days). Braces require special brushing and flossing techniques, as food can collect around the brackets, causing bacteria buildup and bad breath. They can also hurt at times, especially immediately after wire-tightening visits to the orthodontist. This hurt, too, will go away in a day or two. Keep an eye out for the many, many people in the media and on the street who have worn braces. Their straight, beautiful, hard-earned smiles should motivate you to stick to your treatment.

Unlike other types of braces, such as Invisalign, metal braces can treat just about every type of orthodontic problem imaginable (though sometimes, in more complicated cases, they work alongside other procedures, such as tooth extraction or periodontal work). Their main drawback is their highly conspicuous appearance. Luckily, it's possible to make braces fun. Young orthodontic patients can spice up their "tin grins" with colored elastics. Orthodontists can color-coordinate these elastics according to themes (for example, red and white for Valentine's day, red and green for Christmas) or to the patient's mood. These elastics can be changed with each visit to the orthodontist, so the patient can look forward to a new look every month. If you really cannot stand the thought of a metal mouth, talk to your orthodontist about other options, such as ceramic braces.

Pros
- Metal brackets tend to be the least expensive of all the types of braces.
- They tend to take the least amount of time among all the types of
   braces.
- You can choose a darker ligature, which will not show curry, smoking,
   or black coffee stains.
- Self-ligating brackets do not contain rubber ligatures, so staining will
   never be a problem..
- They are strong and rarely break.
- The golden brackets are different, novel, and generally look nice.
- Viazis Brackets and self-ligating brackets can complete treatment in a
   shorter time with less pain; however orthodontists need special training
   in these systems, and they not available everywhere.


Cons
- They are more visible than ceramic and Invisalign
   (the traditional "metal mouth."))
- They tend to be a bit less comfortable at first
   (but that feeling wears off after a couple of weeks).
- When you have a canker sore, they tend to irritate your gums more
&   than ceramic brackets.

Ceramic Braces

Ceramic brackets are made of composite materials. They are very strong and generally do not stain. Three popular brands are Clarity and Transcend, made by 3M Unitek; and Mystique, made by GAC. Adults like to choose ceramic because they "blend in" with the teeth and are less noticeable than metal. These are the type of braces actor Tom Cruise had.

The ligatures (tiny rubber bands) that hold the arch wire on to the ceramic brackets are often white or clear. This looks great at first, but the ligatures can stain (see the Help! Did I Stain My Braces?). Unless you eat a lot of curry, smoke, or drink a lot of black coffee, this generally isn't a problem. Note that the ligatures are changed each time you get an adjustment -- usually, monthly. It's only the ligatures that stain, not the brackets themselves!

Pros
- They blend in with most teeth, particularly if they are not perfectly white.
- They are not very noticeable at a distance or in photos.
- Some people feel that they are more comfortable than metal and irritate
   your gums less.
- Contrary to what you may have heard, ceramic brackets do not usually
   break or come off your teeth. They are very strong, and if bound with a
   plasma light, stay on as well as metal brackets.


Cons
- The clear or white ligatures (little elastics that hold the arch wire to the
   brackets) can stain, which defeats esthetics of the ceramic braces. But
   those are changed at your monthly adjustment.
- Ceramic brackets are are usually more expensive than traditional metal
   brackets.
- Treatment can take a few months longer in ceramic braces.
- From a purely esthetic point of view, they are a bit larger than metal
   brackets.
- If you have severe problems, your orthodontist will not use ceramic
   brackets in many cases, because they may not be strong enough to
   withstand the forces of some types of treatment.

Lingual Braces

Lingual orthodontics are not your ordinary "tin-grin" braces. Lingual braces are attached to the back side of the teeth, which makes them completely non-visible. This advanced method makes lingual orthodontics particularly well-suited for adults, who often want to improve the look and function of their teeth without letting anyone else know about their treatment. Don't confuse them with so-called "invisible" braces, which are merely semi-transparent ceramic or plastic attached to the front of the teeth.

Braces are made up of two main components: the small metal pieces (known as brackets) attached directly to the teeth, and the wire which connects them together (known as the arch wire). With standard braces, the brackets are cemented to the front of the teeth, which are quite uniform in their shape. However, lingual brackets are attached to the back side of the teeth.

The back side of each tooth has its own unique shape-unlike the front of each tooth, which is fairly uniform among all people. Standard brackets are mass-produced, but each lingual bracket must be custom-formed to the unique shape of each individual tooth. To help you learn more about the process of fitting a person with lingual orthodontics we have compiled an illustrated tour of the procedure.

Making Lingual Orthodontics

First, a plaster cast of the teeth is made, and is sent to a laboratory to prepare brackets custom-molded to each tooth. The brackets are then removed from the cast and set in a layer of wax, and placed into a small plaster applicator. This ensures all the brackets stay perfectly aligned while being cemented.

1. The lingual brackets for the front teeth set in a layer of wax in the plaster applicator.

2.Cement is applied to each lingual bracket. Note the uneven surface of each bracket, resulting from the custom-molding process.

3. With the aid of the applicator, the lingual brackets are pressed into place against the backside of the teeth.

4. Once the cement sets, the applicator breaks away easily, leaving the lingual brackets on the teeth.

5. The remaining lingual brackets have been cemented into place and the arch wire has been installed. (Upper mouth)

6. View of completely installed lingual orthodontics. (Lower mouth)

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