Fixed appliances

This is the most common type of brace. Fixed braces have far more control over tooth movement as they control teeth in three dimensions.

Each tooth to be aligned has a bracket cemented to enamel surfaces. Flexible wires are placed into slots on the brackets and the teeth are gradually pulled into good alignment.

As teeth move towards the correct position, wires are changed for steadily stiffer ones that produce a better arrangement. The cement used is strong, but it is possible to break brackets off the teeth by eating something hard. So toffees and crusty bread need to be avoided whilst wearing braces.

Timing

Most braces can be put on once all baby teeth have gone and the adult teeth have come through. There is no easy way of knowing how long the treatment will take as people’s teeth move at their own rate. Having said that, it is very unusual for treatment to take longer than two years. To speed up treatment it is very important to adjust the brace every five to six weeks.

Stainless steel fixed appliances

This is the most common type of brace used. Brackets come in different shapes and sizes. To brighten the brace up, most people choose to have coloured O rings.

Aesthetic braces

For this type of brace the brackets used are of a ceramic material. They are translucent and less noticeable than stainless steel.

Lingual braces

This type of system is totally invisible as brackets are bonded to the inside surface of the teeth. They are trickier for the patient to get used to, and for the orthodontist to fit and adjust. Treatment tends to take longer, because the length of wire between each bracket is very much shorter, and therefore less movement occurs between each adjustment.

These braces are placed behind the teeth, are marked as a contra to conventional buccally placed braces, on the basis of their invisibility and the fact that they don't change facial contours.

Lingual braces are not suitable for every patient and they do not solve all orthodontic problems.

Ligual braces represent one of the viable treatment options now available to adults considering orthodontics.

Invisible braces

There are various braces on the market which are virtually invisible. They use either very small, non metallic brackets connected by tooth coloured wires, or use a series of custom made nearly undetectable aligners.

Advice for fixed appliances

When you first wear your appliance you may find that your teeth are tender for the first few days. You may take aspirin, paracetamol or similar pain killer, as directed on the packet, if you find it helps.

It is also best if you stick to a soft diet and avoid any sticky foods such as chewing gum or toffees. Cut hard food such as pie crust or apples into small pieces, and avoid biting pen tops or finger nails as these can distort the wires or break off brackets, which will delay treatment. Also avoid all fizzy drinks during treatment and take only milk or water between meals.

If you encounter any problems with your appliance contact the surgery immediately rather than wait for your next routine appointment. Emergency clinics are held every day between 0900 and 1400.

We recommend that you buy a fixed appliance kit from reception. This costs £15, and includes gel kam, full and travel size interdental brushes, travel toothpaste, disclosing tablets and wax.

Patients should brush their teeth, as directed by the hygienist, morning and night, and after every meal or snack. They should use the interdental brushes to clean underneath the wires and sides of brackets – no toothpaste is required with these brushes, which should be discarded when they begin to look worn.

Wax should be used to prevent rubbing and chaffing of cheeks and lips, and disclosing tablets should be used twice a week to keep a check on plaque. Gel Kam should be used nightly, last thing – no eating or drinking afterwards.

Patients will be seen on an eight weekly cycle, when wires and O rings will be changed.

Information leaflets on all aspects of orthodontics are available at reception.