FIXED BRACES :

These are the most common type of orthodontic brace. Most patients require the use of fixed orthodontic appliances ('train tracks') to have really straight teeth, and achieve the best possible improvement of their smile. Small precisely designed buttons called brackets are stuck/bonded to each tooth. Sometimes rings called bands are also fitted around the back/molar teeth. The brackets are then connected to each other using a thin wire, called an archwire. The wire is held in place with small elastic rings called modules, or with very thin wires called ligatures. The wires are adjusted at regular intervals to straighten the teeth and correct the bite.

With fixed braces, there is no plastic in the roof of the mouth. This means speech is unaffected and the flavour of food can be enjoyed fully. As the appliance cannot be removed, it acts full-time, and so it is very effective.

Fixed braces are very good at achieving fine detail, and making the smile look really perfect!

Fixed appliances, by definition, cannot be removed by the patient. The simplest way to think of each bracket is as a handle with which it is possible to control each tooth individually and precisely. The brackets are highly sophisticated as every tooth has its own bracket design engineered to achieve correct position and angle of axis.

As we have already mentioned, in the early part of treatment, a thin archwire is fitted to link up all the brackets. Because the teeth are irregular, the wire has to bend up and down or in and out between the teeth.

This is the clever bit: the wire, a bi-product of NASA research, has perfect shape memory and will gradually return to its original shape, bringing the teeth with it. As treatment progresses, stiffer wires are fitted and these act as a monorail. At this time, tiny springs and elastics guide the teeth.

There are different types of fixed brace, and subject to the right clinical indications Dr Sunil Hirani is pleased to offer them all in our practice.

STAINLESS STEEL FIXED BRACES :

The brackets in these fixed braces are made of metal. Modern brackets are quite small, and they cover a relatively smaller area of each tooth, making braces more attractive than they used to be. These conventional braces are very practical, reliable and relatively fast-acting.

COLOURED BRACES :

These are basically the normal metal brace, but the modules used to hold the archwire in place come in a multitude of colours to make the wearing of braces more fun. These colours can be changed at every appointment.

TOOTH-COLOURED, CLEAR OR CERAMIC BRACES :

The brackets are made of ceramic or plastic; they are translucent or the same colour as the teeth, making them much less noticeable than metal brackets.

LINGUAL BRACES/HIDDEN BRACES (on the Inside of the Teeth) :

These are custom made of milled gold, but they are bonded to the surface of the teeth facing the inside of the mouth, so they are concealed and almost invisible to the observer. They are suitable only in specific orthodontic cases.

Lingual braces will affect the tongue and initially will have some impact on the patient's speech and eating. The amount will vary with each patient's dental arch and tongue position. Lingual appliances are more expensive than conventional braces, because they are specifically custom-made to each patient's teeth, require special instruments, and special orthodontist and staff training. Dr Hirani is happy to discuss the suitability of this appliance for your specific needs.

REMOVABLE BRACES :

Sometimes fixed braces are not the ideal appliances to bring about the required changes to the bite, and a removable brace has to be used. A removable brace consists of a plastic base and custom-made metal wire components. Some of these wires are designed to keep the brace secured to the teeth.

A removable brace simply clips onto the teeth, and can be easily fitted or removed. Its insertion or removal does not cause any pain.

CLEAR REMOVABLE ALIGNERS/ INVISALIGN :

Clear aligners like Invisalign look like small gum-shields that are made of a colourless thin plastic material. A series of aligners are worn over the treatment period, each one bringing about a minor change to the bite, until gradually the treatment goal is achieved. There are no wires involved, and the aligners can be removed for eating or brushing. The great thing about this type of brace is that it is almost invisible; but they are not suitable for all orthodontic cases.

FUNCTIONAL/ORTHOPEDIC BRACES :

A functional appliance is a functional brace that is worn on the upper and lower teeth at the same time in order to correct the way upper and lower teeth fit over each other. For example a functional brace may be used to correct very protruding upper or lower front teeth, improve the way molar teeth bite together, or even improve your facial profile so that the jaws look more aligned with each other when you look at the face in profile.

Functional braces only work in growing children and adolescents. Research is still being carried out to evaluate exactly how functional braces work. It is thought that functional braces deliver their effects through a combination of ways. They may promote or modify growth of the jaws, adapt the soft tissues and muscles of the face to new positions, move whole groups of teeth at the same time or change the angulation of teeth.

Depending on the condition of the bite, functional brace treatment starts either at an early age when milk teeth are still present (age 7-10), or around the time of the pubertal growth spurt (age 11-14) when all or nearly all the milk teeth have been shed.

HEADGEAR :

Headgear is being used less and less by orthodontists these days; but its use is still necessary in a small minority of cases. Headgear is worn to move the back teeth further back in order to create extra space; or to stop the back teeth from moving forwards and keep them in their present position, whilst the front teeth are being straightened. Headgear also helps you achieve the best possible bite between your upper and lower teeth.

RETAINERS :

Retainers are appliances that maintain and hold the alignment of your teeth and the improvement of your bite after the completion of active orthodontic treatment. They are usually passive and are not designed to move teeth. Even after orthodontic treatment, your teeth can lose their alignment throughout growth and even in adulthood. For example, most people notice increasing irregularity of their lower front teeth with age. Retainers are designed to prevent such undesirable changes.

Retainers are either removable or fixed to your teeth. Removable retainers can be made either from wires and hard plastic (where you only see a thin horizontal wire on the front of your teeth), or from soft clear plastic (which fits over your teeth a little like a mouthguard).

Fixed or bonded retainers are made from a fine piece of special wire that is stuck to the back of the teeth so that it is not visible from the front. Having taken various factors into consideration, your orthodontist will determine which retainer or combination of retainers is suitable for your teeth.