Dental Braces


Megan Freedman

What are braces?

Braces are devices that your orthodontist attaches to your teeth to change their position. Braces straighten crooked teeth and correct an abnormal bite. Braces prevent and correct problems caused by a bad bite, overcrowded teeth, and too much space between teeth. These problems include difficulty chewing and speaking, jaw problems, tooth decay, and gum disease.

The average age for beginning treatment with braces is 8 to 14 years. The length of treatment with braces varies from person to person. The number and type of procedures you will need depends the type of braces, the severity and current position of your teeth, and how quickly your treatment progresses. 

Braces consist of two main parts. Small metal or ceramic brackets are attached to your teeth and metal archwires move your teeth. Your orthodontist passes archwires through slots in the brackets and adjusts the archwires to move your teeth. Rubber bands and hooks may also be attached to brackets as part of your treatment.

Placing and adjusting braces is generally considered safe, but there are risks and potential complications. Braces are only one method used to reposition teeth. Another method is clear aligners. Discuss all of your treatment options with your orthodontist to understand which options are right for you.  

Types of braces

There are several types of braces available to realign your teeth. Your orthodontist can help you decide which braces are best for you. You will have to consider your treatment goals, budget, and personal preference.

The different types of braces include:

  • Traditional metal braces have brackets made of steel, titanium, gold, or a metal blend. They are the most popular type of braces because they are generally the most effective, sturdy, and least expensive.

  • Clear braces have brackets made of tooth-colored ceramic or plastic. They are less noticeable than metal braces. They can also often break off more easily and be more costly.

  • Lingual braces have metal brackets similar to traditional metal braces. However, the brackets are placed on the inside of your teeth instead of the outside. This makes them less noticeable.

  • Aligners are an alternative to braces. They are clear removable trays molded to the shape of your teeth. They are made of plastic or acrylic and tend to be more costly and require a longer treatment period than braces. They are the least noticeable type of orthodontic treatment for crooked teeth.

Other procedures that may be performed

You may need to have one or more teeth extracted (pulled) before you get braces. Tooth extraction makes room to straighten teeth properly and fix a bad bite. Tooth extraction may be needed for:

  • Baby teeth that have not fallen out naturally

  • Impacted adult teeth that grow into and damage other teeth’s roots. They can also become infected and cause other problems.

  • Not enough space in your mouth or a jaw that is too small for all the teeth that you have

Why do people get braces?

Your dentist or orthodontist may recommend braces to straighten your teeth and improve your smile. Braces also prevent and correct problems caused by a bad bite, overcrowded teeth, and too much space between teeth. Problems can include difficulty chewing and speaking, jaw problems, tooth decay, and gum disease. 

Dentists and orthodontists may recommend braces to help dental and oral conditions including:

  • Bite problems, such as overbite, underbite, open bite, and crossbite. Bite problems can make chewing and speaking difficult. They can also make it difficult for you to close your mouth completely or comfortably.

  • Crowded teeth, which can be hard to clean. This can cause bacteria and plaque to build up, leading to tooth decay and gum disease.

  • Jaw problems including catching, jutting in one direction, narrow jaw, or jaw pain that can make eating, breathing and talking difficult.

  • Too much space between teeth can cause teeth to crowd in clusters or to be less effective in chewing and speaking.

Who performs procedures for braces?

Orthodontists often treat people who need braces. An orthodontist is a dentist with extra education and training in alignment of the teeth, jaw, and facial structure. 

Other dental providers who treat patients needing braces include:

  • General dentists prevent, diagnose, and treat diseases and conditions of the teeth, gums, mouth, and associated structures of the jaw and face.

  • Pediatric dentists specialize in caring for the dental needs of children and teens.

How are procedures for braces performed?

Treatment with braces involves several different procedures that are performed in a dental clinic or office. The length of time needed for treatment varies from person to person. The number and type of procedures you need depends on various factors. These include the type of braces, the positioning of your teeth, and how quickly your treatment progresses.

The braces process generally includes a combination of these steps:

Your orthodontist will take images of your teeth in order to get a thorough visualization of their position. These images can include X-rays, molded impressions of your teeth, and photographs. Your orthodontist will then study the images of your teeth and determine the number and positions of the brackets. 

Your orthodontist will apply your braces. Your orthodontist will first polish your teeth and apply different solutions that condition and prime your teeth. Your orthodontist then attaches the braces brackets to your teeth with cement. Your orthodontist may use a special light to help the cement dry. Then he or she will attach the archwires to the brackets.

Your orthodontist will adjust your braces every few weeks. Your orthodontist will examine your teeth’s positioning and determine which adjustments or changes in treatment are needed. These can include adding elastic bands, headgear, and attaching new archwires. 

Your orthodontist will remove your braces after determining that your treatment is complete. Your orthodontist will remove the archwires and use a tool to squeeze the base of each bracket gently. This releases the bracket from your tooth, but leaves the cement. Your orthodontist will use a tool to remove the bracket cement from your teeth.

Your orthodontist will make a retainer, a device that you wear to prevent shifting of teeth after removing braces.  

Will I feel pain?

Your comfort and relaxation is important to you and your care team. After your braces are applied, the inside of your mouth may feel tender and a little chafed as your skin adjusts to the feeling of the brackets and wires. 

Your teeth, gums, and jaw may also feel sore for a few days after your first get braces. This will probably also be true after your orthodontist adjusts your braces. This is because the braces and archwires apply pressure so that the teeth may move into better positions. 

Take a few long, deep breaths to help you relax through any soreness. Your orthodontist may recommend over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) to help relieve pain. Tell your orthodontist if any discomfort does not pass a few days after you received braces or adjustments to them. This may indicate the development of a complication.

What are the risks and potential complications of braces? 

Any dental procedure involves risks and potential complications. Complications may become serious in some cases. Complications can develop during the braces procedures or throughout your recovery. 

Risks and potential complications of braces include:

  • Allergic reaction to the braces materials

  • Damage to the braces

  • Increased risk of cavities caused by more difficulty cleaning teeth with braces

  • Injury to the mouth

  • Loosened teeth caused by pressure of braces on teeth and their roots

  • Mouth sores and ulcers caused by braces brackets and wires rubbing against the insides of the mouth

  • Buildup of plaque, which can lead to gum disease. This is due to food getting caught in braces or by challenges with maintaining good oral hygiene while braces are installed on teeth

  • Root resorption, resulting in shorter root length

Reducing your risk of complications

You can reduce the risk of certain complications by:

  • Following activity, dietary and lifestyle restrictions and recommendations before, during and after the time that you have braces on your teeth. This includes following oral hygiene measures.

  • Informing your orthodontist if you are nursing or if there is any possibility of pregnancy

  • Notifying your orthodontist immediately of any concerns after braces procedures such as pain, fever, bleeding, and difficulty chewing

  • Taking any medications exactly as directed

  • Telling all members of your care team if you have any allergies, especially metal or latex allergies

How do I prepare for getting my braces? 

You are an important member of your own care team. The steps you take before your procedure can improve your comfort and outcome. You can prepare for braces by:

  • Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications and allergies at all times.

  • Telling your dental care team if there is any possibility of pregnancy

Questions to ask your orthodontist

Having braces can be stressful. It is common for patients to forget some of their questions during an office visit. You may also think of other questions after your appointment. Contact your orthodontist with concerns and questions before getting braces and between appointments.

It is also a good idea to bring a list of questions to your appointments. Questions can include:

  • What types of braces are appropriate for me?

  • Which procedures will I need as part of my braces treatment?

  • How long will I need to have braces?

  • How long will it take to apply my braces?

  • How often will I need to come in to your office to have my braces checked and adjusted? How long will those appointments typically take?

  • What restrictions will I have while I have braces? What types of foods should I avoid?

  • How do I clean and take care of my braces?

  • How will you treat my pain?

  • How should I contact you? Ask for numbers to call during and after regular hours.

What can I expect after getting my braces?

Knowing what to expect can help you get back to your everyday life as soon as possible.

How will I feel after getting my braces?

Your teeth, gums and jaw may feel sore for a few days after your first receive braces. This will likely also happen after your orthodontist makes adjustments to your braces. This is because the braces and archwires loosen your teeth and apply pressure to them so that they may move into better positions. 

Your orthodontist will recommend over-the-counter oral or topical medications to use for pain. Tell your orthodontist if any discomfort does not pass a few days after you get braces or adjustments because it may be a sign of a complication.

When can I go home?

You will probably go home and resume most of your normal activities shortly after getting your braces. Your orthodontist may recommend you eat only very soft foods like soup and oatmeal after adjusting the braces. This is because your mouth may be sore for a few days when the braces apply pressure to your teeth. 

When should I call my orthodontist?

It’s important to keep your all of your treatment appointments. Call your orthodontist if you have any concerns between appointments. Call your orthodontist right away or seek immediate medical care if you have:

  • Bleeding
  • Fever
  • Intense pain in your gums or teeth

Seek immediate medical care if you have itching, hives, sudden mouth or tongue swelling, or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing. This may be due to a rare