Braces are usually custom-made and are prescribed and designed by the orthodontist according to the problem being treated. Other orthopedic appliances are designed to correct jaw-growth problems. These appliances, which include headgear, bionator, Herbst and maxillary expansion appliances, use carefully directed forces to guide the growth and development of jaws in children and/or teenagers.

Braces

Braces place a constant, gentle force in a carefully controlled direction, and are designed to slowly move teeth through their supporting bone to a new desirable position. Braces can either be removable or fixed (cemented and/or bonded to the teeth). They are usually made of metal, ceramic or plastic.

Today's braces are generally less noticeable than their predecessors: a metal band with a bracket (the part of the braces that hold the wire) placed around each tooth. Today, the front teeth typically have only the bracket bonded directly to the tooth (instead of surrounding the tooth). This greatly diminishes the old characteristic "tin grin."

Brackets can be clear or colored, depending on the patient's preference. In some cases, "lingual braces" are bonded behind the teeth.

Wires are also less noticeable than their stainless steel predecessors. Some are made of technologically advanced alloys of nickel, titanium, copper and cobalt. Some are even heat-activated. All kinds of new wire materials are designed to exert a steady, gentle pressure on the teeth, so that the tooth-moving process may be faster and more comfortable for patients, and ultimately, reduce the number of appointments needed to make adjustments. Clear orthodontic wires are currently being tested and developed, but are not on the market yet.

Care of your braces

Generally, those who wear braces need to practice good oral hygiene in much the same way as those who don't. Of course, wearing braces creates unique problems. For example, avoid hard and sticky foods. Don't chew on pens, pencils or fingernails because chewing on hard things can damage the braces, almost ensuring longer-than-needed treatment times and cost. After application of braces, your orthodontist will show you how best to care for your teeth, gums and braces. This includes tips on how often to brush, how often to floss, and, if necessary, other cleaning aids that might help you maintain good dental health.

About pain

Overall, orthodontic discomfort is short-lived and easily managed. Most people have some discomfort after their braces are first put on or when adjusted during treatment. After the braces are on, teeth may become sore and may be tender to biting pressures for three to five days. The lips, cheeks and tongue may also become irritated for one to two weeks as they toughen and become accustomed to the surface of the braces.

Patients can usually manage this discomfort well with whatever pain medication they might commonly take for a headache.

Braces and your active lifestyle

Those who wear braces and play any contact sports should always wear a protective mouth guard.

Playing wind or brass instruments, such as the trumpet, will clearly require some adaptation to braces. With practice and a period of adjustment, braces typically do not interfere with the playing of musical instruments.

Retainers

Retainers are needed after orthodontic treatment and removal of braces because the teeth can shift out of position if they are not stabilized. Retainers are designed to hold teeth in their corrected, ideal positions until the bones and gums adapt to the treatment changes. Wearing retainers exactly as instructed is the best insurance that the treatment improvements last for a lifetime.

Space maintainers

What is a space maintainer? Baby molar teeth, also known as primary molar teeth, hold needed space for permanent teeth that will come in later. When a baby molar tooth is lost, an orthodontic device with a fixed wire is usually put between teeth to hold the space for the permanent tooth, which will come in later.