Metal braces are an age-old, tried, and tested technique for teeth straightening, correcting the alignment of teeth, and other asymmetries of the face.
They are usually bonded/fixed on the outer surfaces of the teeth and act as handles that control tooth movements.
What are the metal braces made of?
Since the braces remain in the oral cavity for an extended time duration, they are prepared from materials that possess sufficient strength and excellent resistance to corrosion.
Therefore, conventional metal braces are made of high-quality stainless steel or titanium-based alloys.
These are the components that comprise the metal brace assembly :
- Metal Brackets: Brackets are small appliances attached to your teeth and become visible when you smile or open your mouth for speech. These are made of Stainless / Titanium alloys/gold and serve as the base for force application. Brackets are attached to the teeth with the help of special dental cement that is polymerized with the help of visible light ( UV Light) Orthodontic braces contain slots through which an archwire passes.
- Wires: These are the active components that exert force in the brackets and result in the desired tooth movements. They pass through specially designed slots within the brackets. Metallic archwires are either prepared from stainless steel, nickel-titanium, or ß-titanium alloys. Currently, Ni-Ti (55% nickel and 45% titanium) alloys are used more commonly than stainless steel alloys because of the superelasticity and shape memory. Stainless steel alloys include 18% chromium and 8% nickel. The thickness and rigidity of the archwires determine the force that is generated onto the teeth. Usually, flexible wires are used initially to gradually align the teeth followed by using more rigid wires (like stainless steel) to bring about major orthodontic movements of teeth.
- Orthodontic Ties / Ligatures: Also commonly known as rubber bands or O-rings, these are simply elastics that are used for holding archwires into their places in the bracket slots. Ligatures come in a variety of wonderful colors and our patients can choose the color of their ligatures at every appointment when they are replaced with the new ones. These are the passive components of the braces assembly.
HOW DO THE METAL BRACES WORK?
The metal brackets are attached to the teeth directly with the help of the bonding agent.
Earlier metal bands were used on which the metal brackets were welded and these bands were cemented separately on each tooth surface. But this is outdated as :
- It was not at all esthetically pleasant
- Took time to fix
- Caused many problems like dental decay between the teeth due to lack of maintenance.
The archwire passes from all the bracket slots and extends to the molar teeth (back teeth) which form the anchorage unit and are attached to the molars with the buccal tube which is banded/bonded on the molars.
They are called anchorage units because they are multirooted teeth and they firmly hold the archwire and act by pulling the front teeth without any change or a slight change in position of themselves.
When a force is applied, the archwire is pulled and held in place with the help of the brackets and secured posteriorly in the buccal tubes. The tightened/activated archwire moves and relaxes which creates a force on all the teeth, front teeth as well as back teeth.
As front teeth have the lesser surface area and are single-rooted teeth, they move easily into the required position and the rear teeth which has a comparatively greater surface area and are multirooted teeth act as the anchorage units resisting the forces without any movement or slight movement if required (Absolute Anchorage - Moderate Anchorage)
The type (material) and thickness (cross-section) of the orthodontic wire, determine the amount of force that is generated onto the teeth. This force is then used to move the teeth in their proper positions.
At every appointment, which is usually three-four weeks apart, the orthodontist will replace your ligatures and change/adjust the orthodontic wires so that they are tight enough to move your teeth.
Sometimes springs and elastics are also placed in this brace assemble for putting more forces to move the teeth in a specific direction.
FREQUENTLY ASKED QUESTIONS ON METAL BRACES
What’s the age limit for wearing metal braces?
The bone quality and health of the oral cavity are the major factors that determine the success of orthodontic treatment. Adult patients over 50 years plus can be treated for crowding or for other orthodontic if the periodontal health of the patient permits and they have sufficient bone supporting the teeth and good general health.
What’s the time duration of Treatment / How long does it take to straighten the teeth?
The entire treatment for correction of teeth positions depends from case to case, treatment times range between 6 and 18 months. Complex cases obviously require more time, as it takes almost 3 - 4 weeks after every appointment for very small portions of bone to form (Bone remodeling) and adapt to the new position with a very small change in position.
What health problems can metal braces cause?
If oral health is maintained properly no health issue is seen. Proper brushing techniques, with the use of interdental toothbrushes, are critical and important as the placement of brackets favors plaque accumulation in and around the brackets and between the brackets and the archwires. This leads to bacterial colonies forming in these regions leading to gum issues and bad breath too. The use of mouthwashes (Chlorhexidine containing) significantly reduces the bacterial load in the mouth thus favoring the reduction in plaque formation aiding in good overall oral health.
Will braces stain my teeth?
There have been reports of teeth discoloration with earlier brace systems. But the newer generation brackets have passivating metals (like chromium) added to the stainless steel alloys to reduce staining and improve the cosmetic results.
Improper cleaning of the teeth may stain the teeth due to plaque accumulation. Drinking beverages like sodas, tea, and coffee lead to staining.
Can I have braces if I have a dental crown?
f the tooth possesses full-coverage crowns then there is absolutely NO problem in bracket placement. The mechanism of tooth movement is the same as that of natural teeth without crowns.
Partial crowns / Veneers may get removed during complex tooth movements like torque application where the crown may dislodge due to the consistent stress with the intermediate cement layer used for bonding the crown with the tooth. Also, this happens a lot during debunking/removal of braces from the teeth.
Can I smoke if I have metal braces?
Smoking aids in tooth staining. Also, it’s not good for periodontal health too which is always under active repair and reconstitution during the entire treatment. Therefore its recommended to avoid smoking during the treatment.
Can I switch from metal braces to ceramic braces / Invisalign?
Yes, it can be done.
It's always better to discuss and decide prehand with your orthodontist/dentist which system of braces you want to opt.
This is because there is damage to the enamel on debonding and re-etching the tooth surface that leads to the enamel surface getting damaged, sometimes even micro-fractures on the tooth surface.
Which is cheaper a Metal Brace or Ceramic Brace?
When comparing the rates between the two, traditional metal braces are cheaper than ceramic braces.
HOW MUCH DO THE METAL BRACES COST ??
Orthodontic cases varies a lot from individual to individual so does the cost, but metal braces are the most affordable type of braces.
It depends on the teeth positions, the complexity of the treatment, and the level of correction required ranging from minor simple crowding to severe crowding and proclination, posterior crossbites, tipped molars, etc.
The charges add up if there is a need for bone growth redirection using an orthopedic treatment along with orthodontic treatment in growing children.
Your dentist after the diagnosis and the treatment plan will exactly tell you about the cost and the duration of treatment required.
The average costs for orthodontic treatment with traditional metal braces range between:
- INR 25,000/- to INR 75,000/-