Fixed braces that are most commonly used
Orthodontic braces can be either fixed to the teeth or may be removable from the mouth to allow cleaning. Fixed braces are the most commonly used type of orthodontic brace. Orthodontists normally glue them onto the front surface of the teeth; however, some braces are fitted on the inner surface of the teeth (See lingual braces).
Orthodontic treatment with fixed braces can be as short as a few months but usually takes around 2 years. A recent review of research studies suggested that 20 months is the average time for fixed brace treatment (Tsichlaki et al., 2016). Fixed braces are very effective in straightening teeth and therefore in improving the appearance of the teeth. However, this does not come without risks (See risks). If you want your treatment to work out well you will need to look after your brace, keep your mouth very clean and make some changes to your diet.
Metal fixed braces
Fixed braces are made of metal (conventional) or non-metal materials (white or “tooth coloured”). Metal braces are sometimes called “train tracks”. Most orthodontists use metal braces to straighten teeth. These are the braces which are usually provided by the NHS. However, adult patients often choose to have tooth-coloured braces because they are not so noticeable.
Metal fixed braces are usually made of stainless steel (which contains small amounts of the metal nickel) and will therefore be seen on the front of your teeth. If you are allergic to nickel it is important that you discuss this with your orthodontist or dentist as some nickel free options are available.
The metal squares that are glued on the teeth are called “brackets”. The wires are held in place using elastic rings which are often coloured and are changed at most orthodontic visits. You need to see your orthodontist regularly. Appointments are usually every 6 to 8 weeks (although may be more or less depending on your what needs to be done).
Your orthodontist or dentist will glue the brackets on the middle of each of your teeth. They then put a wire between the brackets. A series of different wires are used through the treatment, with flexible wires generally used for the first few visits before stiffer wires are used later where more precise control of tooth movement is required. One of the first things which happens during treatment is the straightening of the teeth over the first 4 to 8 months. After that, your orthodontists or dentist will need to spend time getting the bite right. They do this by using elastics and springs that are attached to your brace.
There are many types, designs and brands of fixed metal braces available. Manufacturers may claim that their braces can give better results than others (See self-ligating braces). However, there is no scientific clinical evidence to support the use of one brace system over another (Chen et al., 2010). In fact, the selection of the type of metal brace will usually be based on the orthodontist’s choice. How well the brace works and how long it takes will depend on what tooth movements are needed and how well you look after your teeth and brace.
Chen SS, Greenlee GM, Kim JE, Smith CL, Huang GJ. Systematic review of self-ligating brackets. Am J Orthod Dentofacial Orthop. 2010 Jun;137(6):726.e1-726.e18; discussion 726-7. doi: 10.1016/j.ajodo.2009.11.009.
Tsichlaki A, Chin SY, Pandis N, Fleming PS. How long does treatment with fixed orthodontic appliances last? A systematic review. Am J Orthod Dentofacial Orthop. 2016 Mar;149(3):308-18. doi: 10.1016/j.ajodo.2015.09.020.