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How Braces Work
Types of Braces
Braces for Adults
Braces for Kids
Cost of Braces

How Braces Work

Teeth move through the use of force. The force applied by the archwire pushes the tooth in a particular direction and a stress is created within the periodontal ligament. The modification of the periodontal blood supply[2] determines a biological response which leads to bone remodeling, where bone is created on one side of the tooth by osteoblast cells and resorbed on the other side of the tooth by osteoclasts.

Two different kinds of bone resorption are possible. Direct resorption, starting from the lining cells of the alveolar bone, and indirect or retrograde resorption, where osteoclasts start their activity in the neighbour bone marrow. Indirect resorption takes place when the periodontal ligament has become subjected to an excessive amount and duration of compressive stress. In this case the quantity of bone resorbed is larger than the quantity of newly formed bone (negative balance). Bone resorption only occurs in the compressed periodontal ligament. Another important phenomenon associated with tooth movement is bone deposition. Bone deposition occurs in the distracted periodontal ligament. Without bone deposition, the tooth will loosen and voids will occur distal to the direction of tooth movement.

A tooth will usually move about a millimeter per month during orthodontic movement, but there is high individual variability. Orthodontic mechanics can vary in efficiency, which partly explains the wide range of response to orthodontic treatment.

More on How Braces Work

Before we talk about how braces work, let’s talk about what braces are. Braces are a device that is used to straighten teeth, to correct a bite and to correct irregular teeth. They are made of three basic parts: brackets, bonding (or band), and an arch wire. The brackets are fixed to the teeth with the bonding. The arch wire is run through the brackets and is held in place with small rubber bands.

The brackets and arch wire work together to move the teeth into new positions that will correct the person’s bite, straighten the teeth, correct gaps, etc. The arch wire puts pressure on the brackets with distribute the pressure to the entire tooth, and the orthodontist uses the arch wire to dictate how the teeth are moved into their new positions. When your teeth have pressure applied to them, the membrane that surrounds the roots of the tooth expands on one side and constricts on the other, causing the tooth to loosen from the gums. When the tooth stops moving, the bone around the membrane grows in to provide support to the tooth in its new place. This movement needs to be done slowly otherwise the patient risks losing his or her teeth. This is why braces are commonly worn for two to two and a half years and adjustments are only made every three or four weeks.

The reason this works is because arch wires are wires that want to keep their original shape and will exert a great deal of force to return to their original arch shape. The materials used to make the arch wire increase their stiffness when exposed to a person’s body heat. It is the combination of your body heat and the desire of the arch wire to keep its shape that provide the wire with enough strength to pressure your teeth to move.

Braces alone, however, are not always able to do the work by themselves. Sometimes your orthodontist will also use rubber bands to manipulate the pressure to pull the teeth in the correct direction. Other times, your orthodontist will require you to wear headgear. Headgear keeps some teeth in place while allowing others to move, and to enforce the alignment of the teeth as they move into their new positions.

Another part of the braces process is the Retainer, which needs to be worn for up to ten months after your braces are removed, to hold the teeth in their fixed positions until the bone can grow in to keep them there.

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