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Braces are devices attached to the teeth to realign their position. Braces can be used to address a wide variety of dental issues from underbites, malocclusions, overbites, cross bites, open bites, deep bites, crooked teeth, and other problems with the teeth or jaw. They can be structural or cosmetic and are frequently used in tandem with other orthodontic devices to adjust the shape of the palate or jaw.
The archwire moves the tooth in the desired direction which creates tension with the periodontal ligament. This manipulation of the periodontal blood flow causes a biological response which leads to bone remodeling. Bone is formed on one side by osteoblast cells and fused on the other side by osteoclasts. Tooth movement usually occurs at a rate of around one millimeter per month, but there is a wide range of individual tooth variability. Different orthodontic devices can have varying degrees of efficacy, causing a diverse array of results depending on the type of treatment.
The dentist will perform a visual inspection of the teeth and if braces are recommended, will schedule a records appointment. For this follow-up appointment, molds, x-rays, and impressions will be made of the teeth so that they may be analyzed to determine the best course of action. Generally, the treatment time for braces ranges from six months to six years. Surgery may be required depending on how severe the issues are. Before the braces are applied, an etching solution is applied to the surface of the teeth to help the brackets and dental cement bond to the teeth. Then an intense light is shined on the cement until it hardens, a process which usually requires a few seconds per tooth. Orthodontic spacers may be required to create room for molar bands to be installed at a later date. Molar bands are necessary to make sure that brackets will hold or when fillings or other dental work prevent the attachment of a bracket to a tooth. Wire is threaded between the brackets and attached with rubber or metal ligatures. Before, the archwires had to be carefully bent, shaped, and frequently re-tightened for them to be effective. Modern technology has led to the development of nickel-titanium wires that are temperature-sensitive. At room temperature, the wires are flexible, but once the wires are heated up to body temperature, they become rigid and taut, creating a light tension to push or pull the teeth into position. Rubber bands of various size and strength are typically used to close open bites or adjust jaw alignment. Overcrowding of teeth is a common problem and braces are often used in combination with tooth extraction or palate and arch expansion to alleviate the issue. Some patients can require post orthodontic surgery such as a fiberotomy or a gum lift to improve the gumline after braces are removed.
Retainers are usually required after treatment with braces is complete. Based on the individual patient’s needs, the orthodontist will recommend a retainer and the required amount of time for wear. If a patient discontinues use of the retainer, teeth could migrate back to their original positions. Some patients may not be ready for a retainer, and in those cases, the orthodontist will suggest the use of a pre-finisher. A pre-finisher is a rubber appliance similar to a mouthguard that is designed to close the gaps between the teeth and small spaces between the jaw which could worsen. These are minor issues which are typically unable to be corrected by braces alone.
The cost of braces can vary, and the final price is determined by a few different factors. The type of braces, the particular dentist, and the geographical location can all affect the total price.
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