Orthodontic elastics, commonly known as rubber bands, are small, removable loops used during braces treatment to exert specific forces on the teeth and jaws. While metal brackets and wires primarily straighten individual teeth, elastics serve the distinct purpose of correcting the bite. Many patients view the introduction of these bands as the final hurdle before their braces are removed. This article clarifies the function of elastics, their placement in the treatment sequence, and what truly marks the conclusion of orthodontic therapy.
The Specific Role of Orthodontic Elastics
Orthodontic elastics are fundamentally designed for inter-arch correction, applying force between the upper and lower jaws to correct the bite relationship. They differ from the small elastic ligatures that hold the archwire to a single bracket. The larger rubber bands are stretched between hooks or posts on the upper and lower braces, creating continuous tension that moves entire groups of teeth.
This force addresses malocclusions, such as a Class II relationship (overbite), where the upper teeth are positioned too far forward relative to the lower teeth. For an overbite, elastics are typically attached from an upper front hook to a lower back hook, pulling the upper teeth backward and the lower teeth forward. Conversely, a Class III relationship (underbite) requires elastics configured to pull the lower teeth backward and the upper teeth forward. This customized placement ensures the teeth and jaws achieve a stable and functional bite, separate from the initial straightening process.
Placement in the Treatment Timeline
Elastics are generally introduced in the mid-to-late stages of orthodontic treatment, often several months after the braces are placed. The initial phase uses archwires to align individual teeth and level the dental arches. Teeth must be relatively straight before the inter-arch forces from elastics can be applied effectively.
Once the teeth are aligned on their respective arches, the orthodontist shifts the focus to correcting the bite using elastics. Patients are instructed to wear the bands for many hours each day, often 20 to 22 hours, only removing them for eating and brushing. Consistent wear is necessary because the force must be continuous to stimulate bone remodeling and tooth movement. Lack of compliance significantly delays treatment progress.
The final phase of elastic wear involves fine-tuning the occlusion to ensure the upper and lower teeth meet perfectly. While the removal of elastics usually coincides with or closely precedes the removal of the braces themselves, it is not the last step in the orthodontic journey. Elastics are a preparatory step that ensures the teeth are in their correct final position before the appliances are taken off.
The True Final Phase: Retention
The concluding phase of orthodontic treatment is called retention, which begins immediately after the braces are removed. This step is necessary because teeth have a natural tendency to drift back toward their original, misaligned positions, a phenomenon known as relapse. The bone and periodontal ligaments surrounding the newly moved teeth need time to stabilize and solidify the changes made during active treatment.
Retention involves the use of a retainer, which holds the teeth precisely in their corrected position. There are several types of retainers, including removable options like clear plastic Essix retainers or wire-and-acrylic Hawley retainers. Some patients also receive a fixed or bonded retainer, which is a thin wire cemented to the back surfaces of the front teeth, often on the lower arch.
The retention period is a long-term commitment, often lasting for many years or indefinitely, to safeguard the investment made in the smile. Initially, removable retainers are worn full-time, gradually transitioning to nighttime-only wear as the teeth stabilize. Consistent use of a retainer is the true final step that maintains the results achieved by the braces and elastics.