What kinds of braces are there?

The type of braces are chosen based on the patient's degree of jaw and tooth misalignment. A dental exam will be needed in order to make the right treatment recommendation. You can sometimes choose between different types of braces or have a say in how they will look (e.g. colour and material).

1. Conventional fixed braces with brackets

Brackets are small squares made from metal or ceramic that are attached to the front of a patient's teeth. They are connected with wires and/or rubber bands. The brackets exert pressure on teeth, gradually pushing them into the desired position. The amount of tension and pressure is adjusted roughly in monthly intervals.

Conventional fixed braces are particularly well suited to correcting severely misaligned teeth. They can also be paired with headgear to correct misaligned jaws.

Pros

• Can be used for just about every kind of malocclusion

• Slight corrections can be made via regular adjustment

• Precise prediction of treatment results

• No impact on chewing and speaking

Cons

• Pain after fitting and adjustment

• Keeping your teeth clean becomes more difficult

• Cleaning braces is difficult and time-consuming

• Impact on your appearance (ceramic brackets are less obvious, but also more expensive)

Average length of treatment: around 12 to 24 months

Patient groups: children, adolescents, adults

2. Fixed braces with brackets behind the teeth (lingual braces)

Unlike conventional braces fixed to the outside of the teeth, lingual braces place brackets and wires behind the teeth. This makes adjusting the wire somewhat more difficult.

Lingual braces can be used for more pronounced malocclusions when the patient doesn't want the braces to be visible.

Pros

• Braces aren't noticeable

• Can also be used for severe misalignment

• Slight corrections can be made via regular adjustment

• Precise prediction of treatment results

Cons

• Pain after fitting and adjustment

• More expensive than conventional braces

• Tongue becomes irritated

• Keeping your teeth clean becomes more difficult

• Can cause difficulty speaking

Average length of treatment: around 12 to 24 months, depending on the degree of malocclusion

Patient groups: adults and sometimes teenagers

3. Invisalign – the transparent alternative

Invisalign is a removable system of braces that is mostly invisible to others. Your dentist will use 3D computer modelling to determine the desired endpoint for your teeth and to calculate the shape of the different trays you need to wear. With each new tray, your teeth will progressively move into the right position. Each tray is worn for about two weeks – then it's already time for the next one.

The patient can take out the trays to eat and brush their teeth. The teeth need to be brushed after each meal to prevent bacteria accumulating in the trays.

Invisalign can be used to correct misaligned teeth but not misaligned jaws. This method is only appropriate for smaller corrections.

Pros

• Barely visible

• Hardly any difficulties with speaking

• Can be removed to eat and brush one's teeth

• The trays can be easily cleaned

Cons

• Only suitable for minor corrections

• Success of treatment depends on patient cooperation: trays must be worn for approx. 22 hours per day.

• Chewing gum is not advised

• Trays can go missing/be forgotten

Average length of treatment: around 6 to 18 months

Patient groups: adults and adolescents

4. Retainers

Retainers typically consist of a plastic piece with small springs or screws and a wire. They are custom made for each patient and must be worn every night plus an additional six hours per day, approximately. Depending on the type of retainer, there might be additional corrective elements that need to be regularly adjusted by a dentist.

Depending on the type of problem to be corrected, the following types of retainers may be used:

• Retainers to temporarily keep gaps open are used for children to retain their bite when they lose teeth.

• Active retainers stretch the jaw and move teeth in the right direction. For instance, they can be used to improve the position of the upper and lower jaws. Active retainers work well for children and in some limited cases, also for adults.

• Activator appliances are also used to influence the muscles in the face, mouth and jaw. The upper and lower jaws are activated by the presence of a solid block of acrylic that contains wires or metal brackets. They are suitable for children who need to correct their lower jaw position and bite.

• Bionator appliances are retainers without any wires or springs that work solely via chewing pressure. They are used in children who need to correct the position and height of their bite.

• Biognator appliances are similar to bionator appliances but are produced in such a way to make them barely visible when the patient is wearing them and speaking. They are used to treat adults who have malocclusions and problems with grinding their teeth.

Pros

• Can be taken out for eating and brushing your teeth

• Damage to teeth is rare

• The trays can be easily cleaned

Cons

• Swallowing and speaking may become more difficult

• Success depends on patient cooperation: must be worn approx. 16 hours per day

• Need to be maintained and cleaned

• Can go missing/be forgotten

Average length of treatment: depends on the issue being corrected and how the treatment progresses

Patient groups: children, adolescents, adults

5. Headgear

Headgear is usually used in combination with fixed braces and helps to shift the patient's molars backwards to create more space for other teeth (e.g. incisors) to function properly. Headgear is fixed to the neck or the head and attached to the patient's braces. It usually only has to be worn at night.

6. Alternative: surgical correction

Braces are limited in what they can do for fully formed bones and more severe jaw misalignments. In these cases, a surgical procedure can be considered. Such jaw operations are performed by maxillofacial surgeons.

7. Braces for adults

Braces are also an option for adults who suffer from misaligned teeth. Taking this steps requires courage, patience and a sufficient budget. Both fixed and removable braces can be used to achieve an improved bite in adults. Patients often prefer invisible solutions. Visit a dentist to plan your treatment.