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What are dental braces?

Dental braces – often called simply braces – belong to the branch of dentistry known as orthodontics. Orthodontics is a specialism in dentistry which deals with the misalignment of teeth. The American Academy of Orthodontists (AAO) describes orthodontics as: ’An area of dentistry that prevents, diagnoses and treats dental and facial irregularities’. Orthodontic misalignments, which are called malocclusions, can be caused by a variety of different reasons. Sometimes malocclusions are congenital such as jaw growth problems, congenitally missing teeth, extra teeth, crowded or protruding teeth and general mouth/jaw spacing problems. Sometimes, however, these problems can be caused by other issues like the premature loss of baby teeth, the retention of baby teeth, thumb-sucking, accidents and certain types of dental disease. 

Dental braces are appliances, frequently wire-based, which an orthodontist uses to align the teeth and jaws. The braces gently ‘push’ the teeth into the right position and straighten teeth. The optimum age for this treatment in the early teenage years, usually about 10-15 years old, however, the treatment can be effective at any age. 

braces women

One of the main tasks of the braces is to straighten or move the teeth to improve their look and remove any occlusion problems

Interestingly, some crude forms of braces for teeth were used hundreds of years ago by the Ancient Greeks, Romans and Etruscans. However, it wasn’t until the 18th century that orthodontics took a giant leap forward, when a Frenchman, Pierre Fouchard, invited an appliance called a ‘bandeau’. This was a strip of metal, in a horse-shoe shape which has regularly spaced holes which fitted around the teeth to hold them in the correct place. 

Nowadays, modern technology and materials mean that braces are much more comfortable than they were in the past. It is even possible now to be fitted with clear aligners or ‘invisible braces’. However, these tend to be a much more expensive option and cannot correct more major misalignments.

Even NASA has had a hand in the development of braces when it created a heat-resistant metal alloy (nickel-titanium) for its space shuttles. This alloy was perfect for making thin, highly flexible wires that kept their shape when they were bent and attached to the teeth.

Dental problems which may be corrected by dental braces include situations such as:

  • Overcrowded teeth
  • Crooked teeth or wonky teeth
  • where there is too much space between the two or more teeth

Also any jaw realignment necessary when:

  • the upper front teeth come over the lower teeth too much. This is known as ‘overbite’ when the teeth overlap vertically or ‘overjet’ when they overlap horizontally.
  • the upper front teeth go behind the lower ones when biting. This is known as an ‘underbite’
  • An uneven bite caused by other misalignments of the jaw and teeth

Sometimes dental braces are used as an effective aesthetic procedure for those people who want to improve the overall appearance of their teeth and their smile. However, in some cases, braces are required to correct malocclusions which seriously affect, or can seriously affect in the future, the dental health of the patient. Some of the above mentioned dental problems can lead to:

  • speech problems, like lisping
  • overlapping teeth can create areas in the mouth where it is easy for bacteria and plaque to form and this, in turn, can lead to gum disease.
  • difficulties in cleaning crooked and misaligned teeth can lead to discolouration
  • malocclusions may lead to a narrowing of the airway when sleeping – which in turn could lead to sleep apnea
  • Lack of pressure stimulation on parts of the jaw bone may lead to erosion of the bone
  • Incorrect or incomplete chewing of food makes it more difficult for the digestive system

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How do braces work?

In a nutshell, braces push misaligned teeth back into a correct position. As the teeth move, the bone changes shape to accommodate the new position. Braces are always custom-made to suit the patient’s mouth and dental problem. Basic dental braces are made up of the following basic components:

how to braces work

Typical braces consist of the following elements like brackets, archwire and hooks. It happens that sometimes other components are needed in order to correct a particular problem

  • Brackets: These are small squares which are attached to the front of the teeth and hold the ‘archwires’. Often they are made of metal, ceramic (tooth-coloured) or plastic. Sometimes they are attached to the back of the tooth rather than the front.
  • Archwire: A stainless steel wire which is threaded through each bracket to hold the teeth in place.Rubber bands/Ligatures: Small rubber bands or ligatures are used to secure the wire in place
  • Hooks: These allow elastic chains or bands to be attached to the teeth. Elastic chains help to close the gaps between teeth. Elastic bands correct the patient’s bite. One end of an elastic band is attached to the upper brace, with the other end attached to the lower brace.

Sometimes other components can be included in a brace in order to correct a particular problem.

The braces work by forcing the teeth into the correct position. The teeth move because of the pressure that is put on the brackets by the archwire. Little by little the tooth changes position and as it loosens, new bone grows to support the tooth. This process is known as bone-remodelling and is a natural response where bones are made stronger due to any load-bearing activity or weakened if they are not used.

How long do braces take to move teeth? Wearing braces is not a quick fix. On average they have to be worn for about two years, but this does depend on the correction needed and the type of braces.

At the end of the treatment with the braces, patients will need to wear a retainer which will stop the teeth returning to their old position. Initially, this retainer will need to be worn 24 hours a day, but later just at night. The orthodontist will advise how long the retainer should be worn – for some people a retainer will have to be worn indefinitely. Hawley retainers are the most common type. They fix around the teeth with a wire and mould themselves to the shape of your mouth. It is also possible to get fixed retainers. These are cemented to the backs of the teeth and will stay in place for many years. The retainer applies less pressure than braces – the job of the retainer is to maintain the position of the teeth not to move them.

Do I need braces?

The optimum age for braces is during our teenage years when the adult teeth are fully formed but the jaw bone is still not fully hardened. However, this does not mean that braces will not work when a person is older – the results are just as encouraging. How long do you need to wear braces? – the average length of time is about two years, but this is dependent on the malocclusion and the type of braces. Over the age of 14/15 the jawbone starts to harden, so treatment for adults may take longer.

The British Orthodontic Society (BOS) reports that the number of adults fitted with dental braces is increasing all the time. Their survey showed that adult patients are most likely to be female and in the 26 to 40 age bracket. However, the number of men seeking treatment also appears to be on the rise.

How do you know if you need braces? It may be that you need braces for medical reasons if you suffer from any sort of misalignment of your teeth. Do you have crooked teeth – caused by not having enough space for them to grow straight in the normal way? Are your teeth too close together generally? Or too far apart? When you bite down – do your front teeth correctly line up together? Can you line up your back teeth together when you bite down? If your bite is not correct this can lead to pain in the jaw and even headaches. In fact, there are quite a few dental issues that may cause headaches, and, in extreme cases, can even cause migraines. These headaches are typified by the fact that they subside overnight when your jaw is resting. You, therefore, feel great in the mornings, but as your jaw gets to work during the day the headaches re-appear. If you think any of the above may apply to you the best course of action is to go to your dentist and ask ‘Will I need braces?’ Generally, your dentist is the best person to advise you if you have a medical need to wear braces and what type of braces would work for you.

Sometimes adults chose braces for aesthetic reasons. Research published in Journal of Dental Education (ADEA) showed that: ‘There is ample evidence that patients focus primarily on aesthetic and social aspects as a motive for seeking orthodontic treatment; this is true for children as young as age eight and for adult patients’. 

Other articles also point to the fact that braces are often chosen, not only for the dental improvements that they offer but, just as importantly, for their aesthetic properties. Indeed many adults, who have just slightly misaligned teeth, choose braces as an effective non-invasive treatment to improve their smile. Bear in mind though, that braces will not help discoloured teeth, and, depending on the braces used, could mean a very ‘non-aesthetic’ smile for a few years when you open your mouth to reveal a mouth full of metal! Admittedly this will depend on the type of braces you have the more expensive ones are almost invisible to the naked eye. Braces can be used in conjunction with tooth whitening if tooth discolouration is an additional issue.

Orthodontic treatment can also change the shape of your face slightly. The braces will correct any alignment problems and mean that you will have a more natural look to your mouth and jawline. It may also affect the muscle system in the face thus making, for example, your cheekbones sharper.

Let’s look at some of these medical problems which may be corrected by braces in more detail:

Crowded Teeth

red head pportrait female red jumper

Crowded, crooked teeth, overbite, crossbite those are only a few reasons that may require wearing braces. Not only teenagers decide on the treatment it is getting more and more popular among adults who want to improve the look of their teeth

Crowded or overcrowded teeth means that, basically, your teeth do not fit into the space allotted to them in your mouth. They are one of the most common orthodontic problems. You may have crowded bottom teeth, crowded upper teeth or both. The lack of space causes some of the teeth to grow crookedly. Crowded teeth mean that it is harder to clean the teeth properly because of the plaque which accumulates on and between the teeth. This means that there is a greater risk of tooth decay, gingivitis, and periodontal disease. Sometimes people feel quite self-conscious about their appearance with crowded teeth and this can lead to poor self-esteem. Braces are the most usual crowded teeth treatment and can often fix crowded teeth.

 Crooked Teeth

Slightly crooked teeth do not necessarily obligate the patient to have a dental procedure like dental braces. If the crooked teeth are not creating a secondary dental problem and the patient practises good dental hygiene, then from a medical point of view the status quo can be maintained. In fact, in Japan, slightly crooked canine teeth are regarded as attractive, especially for women. For children, however, crooked teeth may be a psychological problem when they are called names such as rabbit teeth and goofy teeth at school.

What causes crooked teeth?

Crooked teeth can be caused by various reasons – some of these include:

  • Crowded teeth: As above
  • Baby teeth: Sometimes problems start with or are compounded by issues with the baby teeth. Baby teeth are sometimes crooked because they are too small for the gum space they have and they, therefore, have plenty of room to turn. Habits, like sucking on a dummy/pacifier and sucking a thumb, can also lead to crooked baby teeth. None of this necessarily means that the adult teeth will be crooked but if, for example, a baby tooth falls out early due to one of the above reasons, or through decay or accident then the adult tooth may push through the gums slanted rather than straight. In addition, if baby teeth are crowded, often the permanent teeth will also be crowded.
  • Genetics: If your parents had or have crooked teeth there is a possibility that you will inherit this characteristic.
  • Food/eating: Scientists believe that our jaw size has evolved and become smaller because our diet, full of soft processed foods, means that we don’t have to chew as much as our ancestors. In addition, poor nutrition, especially in childhood, can lead to crooked teeth
  • Poor dental care: Foregoing regular visits to the dentist, leading to gum disease and cavities, can also cause crooked teeth

 Overbite

Overbite, also known as buck teeth, is a malocclusion. In simple terms, it is when the front upper teeth protrude out over the lower teeth. For most people, there will be a slight overlap of the top front teeth when the back teeth are clenched together. This is perfectly normal. However, when the overlap is too much it can cause problems. Some people choose to accept their overbite and never seek treatment for it. Freddie Mercury of ‘Queen’ fame was one such person. An overbite can be hereditary or caused by thumb-sucking or the excessive use of a dummy/pacifier. Teeth grinding is also known to cause overbite. Occasionally, temporomandibular joint disorders (TMJ) can be the reason for an overbite. This name refers to various dysfunctions of the joint controlling the jaws, which can sometimes be painful.

Crossbite

Crossbite is also a malocclusion and occurs when the two rows of teeth (upper and lower) don’t meet correctly. A posterior crossbite is when the back teeth bite down inside the bottom row of teeth. An anterior crossbite, on the other hand, is where the upper front teeth sit behind the lower front teeth. Crossbites are also sometimes referred to as, buccal and lingual crossbites. A buccal crossbite is when the tooth or teeth in question are closer to the cheek than their equivalent on the other (upper/lower) jaw. A lingual crossbite is when the tooth or teeth in question are closer to the tongue than their equivalent on the other (upper/lower) jaw. Usually, a crossbite appears in childhood and rarely corrects itself. An article in the Cochrane journal estimates that between 1% and 16% of children have posterior crossbite with their baby teeth and 50% to 90% will have the same problem with their adult teeth. This type of dental problem can lead to a raft of other problems including teeth grinding, chronic jaw, shoulder and back pain, headaches and tooth decay and gum disease. Depending on severity crossbite treatment can also include jaw surgery and removal of teeth.

 Overjet

Overjet is often confused with an overbite. Although both terms can be used for an overlap of the front teeth they are actually two different things. Whereas an overbite describes how the upper front teeth come down over the lower front teeth, an overjet describes how far horizontally the front teeth protrude. So, buck teeth may be either overbite or overjet teeth. According to The Journal of Pediatric Genetics, an overjet may be influenced by your genetic makeup. The length of your bones and strength of your muscles also plays a role. Excessive thumb and finger sucking may also be a cause. Overjet correction in adults and children may include surgery, but often braces do the job very well.

 Open Bite

Open bite, another type of malocclusion, occurs as anterior open bite and posterior open bite. These conditions happen either because of skeletal problems or because of dental problems. An anterior open bite (probably the most common) means that the front teeth do not touch when the jaws are brought together. A posterior open bite means that the back teeth cannot close together. Sometimes these conditions are caused due to problems with the jaw bone (skeletal open bite), sometimes they are caused by dental problems (dental open bite). As with many of the other malocclusions, this problem may start in childhood through thumb or finger sucking, improper use of a dummy or tongue thrusting – where the tongue is constantly pushed between the upper and lower teeth. It should be noted, however, that ‘open bite’ is not uncommon in young children during the period when their baby teeth fall out and their adult teeth push through. When all the adult teeth are through the malocclusion will often rectify itself automatically. A dental open bite, particularly in children, is usually treated with orthodontics, such as teeth braces, and therapy to change modify the behaviour. A skeletal open bite is more difficult to treat with orthodontics and, very often, open bite surgery by a maxillofacial surgeon will be required. Likewise, open bite syndrome in adults which has persisted since childhood may also need surgery. Your dentist is the best person to advise what open bite treatment is best for your particular circumstances.

Gummy Bite/Gummy Smile

The term gummy bite or, more often, a gummy smile is used, according to the International Journal of Surgery Case Reports, when more than 2mm of gum is exposed when smiling. This condition occurs in 10.5%-29% of the population, chiefly in females. It is more of anaesthetic and/or psychological problem and is less likely to lead to major dental issues. It can be caused by a variety of different reasons including adult teeth coming through incorrectly, excessive growth or downward movement of the upper jawbone or short or overactive upper lip muscles. Orthodontic treatment is only one of a few treatment options for gummy smile. These include treatment by a periodontist to remove the excess gum and extend the length of the teeth, botox injections or, in extreme cases, surgery to move the teeth upwards.

For all the above conditions teeth braces may be used as a sole method of correction or may be used in tandem with other types of treatment, such as surgery, in order to rectify the problem. In all cases, your dentist is the best person to advise you on the treatment most appropriate to your situation.

Types of Braces

There are a variety of different types of braces for teeth available and the choice can be enormous. Your choice of teeth braces will depend on the condition you wish to rectify and how much money you wish to pay for the braces.

Train track braces

Train track braces or traditional braces are probably what most of us think of when we hear the words dental teeth braces. They are the most conspicuous, but their construction has progressed considerably over the past few years. Train track braces are also known as fixed braces

Metal Braces

Girls with braces on

Metal braces are one of the most popular types. Usually, this is the cheapest option available although there are different types of metal braces and some of them may be more expensive than the other ones

The metal used in these teeth braces is high-grade stainless steel. Brackets are cemented to each tooth, with the archwire being held in place by the rubber/elastic bands or ligatures. These elastics can now be multicoloured – a fashion statement which may help to detract from the ‘mouthful of metal’ syndrome. There are several different train track braces colours. Sometimes the teeth will ache for the first few days as the brace begins to re-align the teeth. The dentist will advise how often the braces will need to be adjusted – usually about every six weeks. For some people, the pain will return briefly after each dentist visit as the teeth are pushed and pulled into their correct position. Most people report feeling this pain for only a few days after each adjustment. Generally, these are the cheapest type of brace, the type usually offered by the NHS and, possibly the most versatile, due to the fact that they can be used for a wide range of corrections and conditions.

A few different types of metal braces are available. For those who really want to make a fashion statement, these fixed metal braces also come with gold plating or even a 24-carat gold coating.

Pros: usually the cheapest, work the fastest, colour choice

Cons: the most conspicuous braces, white calcifications can build up around the brackets

Ceramic Braces

Clear ceramic braces or white ceramic braces are very similar to metal braces except that the brackets are made of a clear or tooth-coloured ceramic material instead of stainless steel. Sometimes your orthodontist can arrange ceramic braces with white wire or tooth-coloured wire. The ceramic braces work in exactly the same way as metal braces. They are less conspicuous from a distance but can usually be seen from a closer perspective.

Pros: not so obvious as metal braces, work fast

Cons: cost more than the metal option, staining and discolouration may occur

Lingual braces

Instead of being attached to the front of your teeth, lingual braces are attached to the ‘lingual’ or ‘tongue side’ of your teeth. This means that they are invisible (although they may be seen when the mouth is opened wide) and that a shorter archwire is needed. Sometimes they are known as incognito lingual braces. They function in exactly the same way as the metal and ceramic braces, where the archwires are regularly adjusted to re-align the teeth. Each bracket, however, is often custom-made to fit the back surfaces of the teeth which are more irregular than the front surfaces. For some people, the additional cost and difficulties associated with lingual braces are offset by the fact that they are virtually invisible. So what are lingual braces pros and cons?

Pros: they are usually hidden from sight, work in the same way as metal and ceramic braces

Cons: more expensive than regular braces, initially may hurt the teeth and tongue, very difficult to clean, adjustments, which are more complex, are needed more often, not always suitable for every malocclusion.

Self-Litigating braces

What are self-litigating braces? They are very similar to the old train-track type teeth braces in the way that they work. They come with either metal or ceramic brackets but the big difference is that, instead of elastic bands to hold the archwire in place, self-litigating braces use special clips. They are much easier to clean around, so the chances of bacteria build-up is minimised. The clips provide a sort of sliding mechanism which means the archwire moves naturally as the teeth re-align. This eliminates some of the pain associated with traditional braces as well as producing faster results.

Pros: treatment time reduced, fewer visits to orthodontist/dentist required, less pain than usually associated with train track braces

Cons: Even with the clear/ceramic option braces are still visible, require careful teeth cleaning, more expensive than

conventional metal braces

invisalign braces

Invisalign is the type of braces that works in a different way than the standard braces and offer the treatment which usually requires only one visit at the dentist

Invisalign

Invisalign is a trading name for a new type of teeth braces known as aligners. These devices work in a slightly different way to standard teeth braces. They consist of a series of aligners that are changed on a regular basis – about every two weeks – and which are specially custom-made for the wearer. They must be worn for a minimum of 20 – 22 hours a day but can be easily taken out for eating and cleaning. They are made from a type of clear plastic with no metal attachments at all, so once in place, these trays are virtually impossible to see. Each tray is manufactured so that your teeth are slightly straighter than the previous tray. Typically teeth are moved 1/10mm per tray. Invisalign are not suitable for very bad malocclusions.

Pros: can be removed for eating, drinking and brushing, are virtually invisible, they can be removed for easier cleaning

Cons: cost, require some self-discipline to ensure they are worn for the minimum recommended time and changed on schedule

What age can you get braces?

So, what is a good age to get braces? Ideally, the best age for braces is 10-15 years old when all the adult teeth are through but the jaw bone is still relatively soft and growing. Problems may be identified before this age, however, if braces are used at too young an age additional treatment will almost certainly be needed later because the mouth/jawbone is still growing and further malocclusions will probably appear. However, all of this does not mean that anybody over the age of 15 cannot get braces. Indeed many adults are now seeking treatment for crooked and crowded teeth for aesthetic reasons with wonderful results. Sometimes these results may take a little longer than in a teenager but treatment can start for anybody between 10 years and 100 years!

woman with braces and glasess on

In recent years the number of adults who are considering the braces increases significantly this is because the treatment gives the same effects as for young people and it becomes more and more popular even among celebrities

Adult Braces

The AAO estimates that more than a million adults in the USA and Canada are being treated with teeth braces. According to the BOS, the number of people looking for orthodontic treatment in the UK remains high with 75% of orthodontists reporting an increase in adult private patients. They can be divided into two main categories: younger adults who had braces as teenagers, but who subsequently did not look after or lost their retainers so that their teeth have now moved back to their old positions or adults in their 50s and 60s who are looking for treatment for the first time. For adults, this may mean that their crooked teeth, overbite, crossbite, overjet or other dental issue were not corrected when they were younger and, now they feel that the treatment would be appropriate mainly for aesthetic reasons. All of the above-listed types of braces are suitable for adults. In the UK NHS, adult braces are not routinely available, although it may be possible if the treatment is essential for health reasons. Dental insurance for adult braces is not common and will only be included in the most expensive policies.

Kids Braces

As mentioned above childhood/teenage years is the ideal moment for orthodontic treatment. In the UK, orthodontic treatment with braces for children is sometimes free of charge. On the NHS only standard metal teeth braces are offered. With private treatment, in theory, all types of braces are possible, however, there may be some limitations depending on the best type for a particular malocclusion. Lingual braces are not really an option if the child’s teeth are very small. Likewise, the results of the clear aligners, Invisalign, are dependent on the wearer being responsible enough to take them out for eating and cleaning, and, most importantly, replacing them afterwards. Some parents may feel that their child may have an issue with compliance and having the willpower to follow the instructions. If your child is prone to losing things, leaving things at the bottom of their schoolbag and the suchlike then Invisalign is probably not for them. Another factor to bear in mind is the visual impact of the braces. For younger children, who are possibly less self-conscious about their appearance, then metal braces with or without coloured brackets may not be a problem. However, those teenagers at the higher end of the age scale may become very self-conscious about their appearance when they are wearing metal braces and less obtrusive types of braces may be the answer.

As with any dental procedure, it is important that any remedial work takes place on the teeth prior to the brace being fitted. The procedure for putting on braces is the same whether for a child or an adult. The orthodontist will thoroughly clean and dry the teeth before applying a special glue to the teeth. A bracket will be attached to each tooth and then the archwire will be threaded through the brackets. Lastly, the elastic or rubber ligatures will hold the archwire in its correct place. Typically this procedure will take between one and two hours. The patient may feel some pain after the procedure due to the pressure on the teeth. It will also take some time to get used to braces in your mouth. The tongue and cheeks may feel very sensitive because they may rub against the braces. However, after about one week you will find you will have got more used to the feeling of the braces in your mouth and these problems should disappear.

Braces Aftercare

How many control visits do I need during orthodontic treatment

Teeth braces are not a one-off quick fix treatment. On average the treatment programme can last up to 24 months. In order to obtain a successful outcome it is vitally important that, after the braces have been put on the teeth, the patient sticks to a consistent cleaning routine and attends all their dental appointments. Generally, the orthodontist/dentist will want to see you about every 4-6 weeks. He/she will check the progress of the treatment so far and make adjustments to the wires, springs or elastic/rubber bands. It is important that the braces are exerting steady pressure on the teeth. Depending on various factors, this means that that the full treatment plan could include 18-24 visits to the orthodontist. If the wires are not adjusted in a timely manner the whole treatment plan could be jeopardised.

Girl brushing teeth

After the dentist installs the braces the patient should remember about the proper aftercare. There are even special interproximal or interdental toothbrushes which are recommended to use for patients with braces on

Teeth brushing with braces

Once installed in your mouth it is important that your braces and teeth are looked after properly. Tooth brushing with braces is a little bit trickier with many more awkward places to get into! Generally, your dental hygiene routine should continue as normal, but patients must take extra care when brushing. After a while, wearers perfect their own ‘brushing with braces’ routine. There is no special toothpaste for braces – any of the standard available toothpastes are OK. It pays to be careful, however, when using whitening toothpaste with braces as the whitening agent will only work where it touches and you could end up with two-tone teeth! It is possible to buy a special ortho toothbrush for braces, but usual toothbrushes or electric toothbrushes such as an Oral-B electric toothbrush or Sonicare toothbrush work just as well. In addition to a normal toothbrush or electric toothbrush, braces can additionally be cleaned with an interproximal or interdental brush. This brush has short bristles that can get under the archwire or between the brackets to remove trapped food. It is also important not to forget to clean at the gum line to remove any accumulating plaque. Flossing with waxed floss will also help – the wax will prevent the floss from getting stuck between the braces. A floss threader is useful to help thread the floss under the braces in order to reach the gap between two teeth. In this way, all the teeth can be flossed regardless of the teeth braces. Not brushing with braces means that food particles, bacteria and plaque will accumulate around the brackets and lead to tooth decay and cavities

How to eat with braces

Once the braces are attached it may pay to give some consideration to what you are eating and drinking. What foods can you eat and what foods shouldn’t you eat?

The first thing to remember is that you now have some quite expensive equipment in your mouth and it will pay dividends to look after it and think about what you are actually putting into your mouth.

What not to eat with braces:

  • It is better not to eat hard, crunchy foods – this includes popcorn, nuts and hard sweets/candies
  • Sticky and chewy food like fudge and toffee can loosen the wires and/or damage the brackets
  • Sugary and starchy food produce plaque acid which can lead to gum disease and tooth decay
  • The ligatures can be easily stained so it’s better to stay away from foods which have strong colourants like: beetroot, blackcurrants, grape juice etc.

What to eat with braces the first week:

  • In the first week, when your mouth is still sore it may be best to stick with soft foods. This can include yoghurt, boiled and/or mashed vegetables, pasta and soft, seedless bread, eggs etc. As the soreness in the mouth disappears other foods can be introduced

What can you eat with braces:

  • As always it is best to eat a well-balanced diet both for your general health and for your dental health. Healthy, but hard foods like carrots and apples may be cut into small pieces to prevent any damage to the tooth braces

One of the most frequently searched questions on the Internet is: Can you eat chocolate with braces? The important thing to think about when assessing any food is its hardness and stickiness. Using these criteria, we can say that yes, it’s fine to eat chocolate with braces as long as it isn’t too hard!

Are braces painful?

The procedure of actually fitting the braces in your mouth at the dental clinic is generally a fairly pain-free experience. However, we should remember that the purpose of the braces is to manoeuvre a tooth or teeth into different positions in your mouth. This means that there may be some pain later. So, how to deal with braces pain?

Girl bitting fingers

Generally fitting the braces at the dentist is painless, however, it is important to remember that on each tooth there are special locks installed which makes tooth move in different positions and this can be painful

Braces pain first week – as already mentioned it may take up to one week for your mouth, tongue and cheeks to get used to the device in your mouth. There may well be some soreness associated with this process.

How long does braces pain last – after the first week the pain should subside. However, the teeth may become painful after each visit to the orthodontist, when the ligatures are altered to put more pressure on the teeth. This should last a few days at the most.

How to get rid of braces pain – any over-the-counter pain relief medication like paracetamol or ibuprofen will help to ease braces pain. In addition, topical mouth analgesics like benzocaine (marketed worldwide under a variety of different brand names) may also help but should be used sparingly.

How to get rid of braces pain without medication – ice packs and consuming cold drinks and food may help as may frozen teething rings – the type usually associated with teething infants. If the coldness does not seem to work then the alternative is applying a heated cloth or pad over the affected area. Rinsing the mouth with warm salted water will also act as a disinfectant as well bringing some relief.

Cost of Braces

How much do dental braces cost? Teeth braces are expensive. When considering the cost of dental braces for adults, it is important to remember that a fairly large proportion of the cost will be the numerous visits which will have to be made to the orthodontist. Costs will, therefore, vary quite considerably from dentist to dentist depending on their charges for a visit. It is also worth taking into account the distance you may have to travel on a fairly regular basis for these appointments. So, when thinking about braces’ costs for adults the location of the orthodontist can be quite an important factor. An orthodontist will not be able to give a final quote until he/she has examined your teeth and taken x-rays. When you receive the quote remember to always check exactly what it includes. What about the cost of any additional work prior to the fitting of the brace e.g. tooth extractions? Is the price of the retainers included in the price? What about the cost of any follow-up appointments after the treatment? It may be, that even if your local orthodontist’s prices are higher, this could be offset by the inconvenience and additional travelling charges to an orthodontist further away. Hidden braces costs also include a possible charge for the initial consultation.

The sort of costs that you may have to pay for the full treatment procedure for braces are listed below:

Type of Braces


Estimated UK cost in £

Metal braces costs

£1,500 - £3,000

Ceramic braces costs

£2,000 - £6,000

Lingual braces costs

£2,000 - £10,000

Self-ligating braces costs

£1,500 - £6,000

Invisalign braces costs

£1,500 - £5,500

The above costs are all based on the fitting of braces to both the upper and lower teeth. The higher figures represent costs where more complex work is required. Your orthodontist will be able to tell you which types of braces are appropriate for your dental needs.

It is possible to reduce the cost of ceramic braces slightly, by having just the ceramic brackets on the front teeth which are normally visible when we smile and having metal brackets on the back teeth which are not normally so easily noticeable.

Many orthodontists can offer financial packages to help spread the cost of the procedure.

Braces for under 18s may be covered by the NHS – see our section below on the UK NHS to find out more information.

Why are braces expensive?

Here are some of the reasons why braces are expensive.

Teeth braces are not a quick procedure, the whole treatment package may take up to two years and sometimes longer. This may involve many visits to your orthodontist.

The newer technologies used in the more modern braces like Invisalign currently cost more

In some cases, the braces are individually designed for your mouth/teeth

Braces work should always be done by a trained orthodontist – some dentists are orthodontists but not all

Braces Abroad

Due to the high costs of treatment for teeth braces in the USA, UK and other western European countries, many people consider getting their dental work done abroad. Although the costs of dental treatment including braces are much cheaper in some other countries like Turkey or Poland, what will need to be included in your calculations is the frequent return visits (every 4-6 weeks) which are needed after the bridge is installed. If you live fairly near a destination or visit it on a regular basis the total ‘package price’ may work out cheaper than at home. However for many people, once the price of up to 18 return flights is factored into the total price (and of course the time needed for all these trips), overseas treatment is not such a viable or cost-effective option.

If you believe that overseas treatment may be a good option for you, then the first step is to obtain a quote for the work required from an orthodontist in your own country. This will help the orthodontist overseas to have a better idea of the exact work required and therefore enable he/she to prepare a quote for you. He/she will, of course, also require x-rays of your teeth. Countries such as Poland and Turkey are popular for cheap braces abroad. The quality of the actual brace is no different from those available in other countries of the world. Savings are made on the costs of the visits to an orthodontist. In these countries, particularly, labour costs fall well below other western European countries. Standards of care and available facilities are still extremely high and sometimes even better than in western European countries. It is important to find out at the very beginning how many times you will be expected to visit the orthodontist abroad. Remember to add the expected cost of the additional visits (flights) to your final calculation. Always check that the quote you are given covers all the costs e.g. cost of regular check-ups as well as the price for the initial consultation and installation of the braces. What’s also important, patients can get secured for their medical trip, which makes their travel and stay abroad much safer. Clinic Hunter & AXA Partners have created travel insurance for surgery abroad dedicated solely to medical tourists.

Braces in Turkey

turkey

While planning a vacation in Turkey close to the Mediterranean sea it is worth to consider a visit to a local dental clinic where putting braces on can be half cheaper than in the UK

Getting dental work done in Turkey offers the opportunity of a holiday along its Mediterranean or Aegean coastline or even a visit to Istanbul where European and Eastern cultures collide. Prices for metal braces in Turkey range from £400 to £1800 and for Invisalign prices can be from £793 to £3,100. These costs are considerably cheaper than UK prices, however, the additional costs of flights to Turkey will raise these prices. Invisalign, although the more expensive treatment does require fewer visits. Remember to factor in the cost of the required number of flights from your local airport to the appropriate Turkish airport when comparing costs.

Braces in Poland

For some people obtaining braces in Poland may be a better option than Turkey, purely because of the availability of cheap flights to the main Polish airports from the many UK and European airports. As in other places, the cost of braces in Poland will vary hugely depending on the precise work that needs to be undertaken and what exactly needs to be rectified. Prices for metal braces start at £336 in Poland with Invisalign costing up to £3,000. This Invisalign price does cover everything including all check-ups for two years. Adding the cost of several trips to Poland may mean that the savings (if any) are not great.

 

Braces NHS

According to the NHS website orthodontic treatment with braces is ‘free for people under the age of 18 with a clear health need for treatment. But because of high demand, there can be a long waiting list’. For all patients the ‘clear health need’ is assessed by the orthodontist using the Index of Orthodontic Treatment Need (IOTN scale) which is produced by BOS:

Grade 1

This means almost perfection

Grade 2

This is for minor irregularities

Grade 3

This is for greater irregularities which normally do not need treatment for health reasons

Grade 4

The is for more severe degrees of irregularity which do require treatment for health reasons

Grade 5

This is for severe dental problems

A patient under 18 who is assessed at Grade 4 or 5 will be able to get free treatment on the NHS. Those assessed at Grade 3 are judged on an individual basis. The NHS also recognises that some children need and indeed would benefit from orthodontic treatment for aesthetic reasons and the IOTN has a separate scale to take this into account.

So, the first step for a patient under 18 years is to be assessed by an orthodontist, who will advise whether the patient is eligible for free braces on the NHS. In cases where the NHS will pay for the cost, there is often a waiting period as demand often outstrips the availability of NHS orthodontists. Only metal braces are available through the NHS, although children may be given the option of coloured brackets. Other types like ceramic braces, lingual braces and aligners like Invisalign are only available privately.

If you or your child is approaching 18 years and you feel that tooth braces may be needed it is worth making an appointment with an NHS orthodontist as soon as possible. After the age of 18, the cost will be much much higher.

It is very unusual for the NHS to pay for orthodontic treatment for adults unless it is necessary for health reasons. In cases where the treatment is approved for adults, braces fall into Pricing Band 3 – £269.30. As with children, the choice is limited to metal braces only. Certainly, adults wanting braces for aesthetic reasons will always have to pay for private treatment.

Braces Summary

Braces can either be used as a standalone non-invasive treatment for various malocclusions or used in conjunction with other treatments for more complex deformities. The optimum age for braces is 10-15 years old when all the adult teeth (except wisdom teeth) have come through but the jawbone is still flexible enough to be easily manipulated. Treatment at an earlier age is not recommended, but treatment at a later stage in life is often very successful although the period of treatment may need to be a little longer when bones are fully grown and not so malleable. Treatment for under-18s, where deemed necessary, is free on the NHS. In exceptional circumstances, adults may be able to have braces fitted under the NHS for £269.30 when dental problems could lead to further medical complications. Usually, adults have to pay the full cost of private treatment which varies according to the type used. Overseas treatment is not such a good option as with other dental treatments because of the necessity to return to the dental clinic frequently. Our consultants will be happy to offer you quotes for braces in Turkey and braces in Poland if you believe that this may be a cheaper option for you.

Get the insurance for treatment abroad:

Sources

https://www.nature.com/articles/sj.bdj.2018.455

https://www.cochrane.org/CD000979/ORAL_orthodontic-treatment-for-posterior-crossbites?_ga=2.138415926.408278548.1576403985-699739092.1535887278

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5123890/?_ga=2.138399669.408278548.1576403985-699739092.1535887278

https://www.researchgate.net/publication/321473493_A_Successful_Management_Of_Sever_Gummy_Smile_Using_Gingivectomy_And_Botulinum_Toxin_Injection_A_Case_Report

https://www.nhs.uk/live-well/healthy-body/braces-and-orthodontics/

 

Anne Beckett

In the UK Anne was a professionally qualified trainer with many years of experience in the training industry. She mainly worked in the travel, tourism and leisure industries (including Thomas Cook and British Airways) as well as in other sectors.

Since moving to Poland  twelve years ago, Anne has become involved in other business sectors – teaching English as a foreign language and translating documents from Polish into English. She specialises particularly,  in  medical translations and  works closely with dentists, cardiologists and neurologists in translating and preparing articles for publication. She has also trained as a practitioner in the field of neuro-linguistic programming and is a qualified hypnotherapist.

Any spare time is spent renovating the house in Poland which Anne bought some years ago.

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