Braces are a highly effective and common method for correcting a crooked smile. A crooked smile refers to teeth that are misaligned, rotated, or improperly spaced within the dental arch. Orthodontic treatment addresses these issues by applying controlled, gentle forces to shift teeth into more functional and aesthetically pleasing positions. This article explores the biological process of correction and the different treatment paths available.
How Braces Straighten Teeth
The process of moving a tooth relies on the body’s natural ability to remodel bone tissue, a biological response triggered by mechanical pressure. Braces function by using brackets bonded to the teeth and an archwire threaded through them to apply a continuous, light force. This sustained force transfers through the tooth root to the surrounding jawbone.
Pressure exerted on one side of the tooth stimulates specialized cells called osteoclasts to break down adjacent bone tissue, a process known as bone resorption. This action creates the necessary space for the tooth to move in the desired direction. Simultaneously, tension is created on the opposite side, which activates osteoblasts.
Osteoblast cells are responsible for building new bone tissue, a process called bone deposition. By coordinating bone resorption and bone deposition, the tooth gradually moves through the jawbone into its new alignment. This slow remodeling process is why orthodontic treatment takes months or years to complete, with typical tooth movement occurring at about one millimeter per month.
Types of Alignment Issues Braces Address
Braces are designed to correct a wide array of malocclusions, the technical term for a poor bite or misaligned teeth. One of the most frequent problems addressed is dental crowding, which occurs when the jaw lacks sufficient space for permanent teeth to align naturally. This results in teeth that are twisted, overlapped, or pushed out of the arch.
Braces also treat spacing issues, or diastema, by gently pulling separated teeth together to eliminate gaps. Beyond straightening individual teeth, the treatment also corrects complex bite relationships between the upper and lower jaws. These bite problems include an overbite, where the upper front teeth overlap the lower teeth too much, and an underbite, where the lower teeth protrude past the upper teeth.
A crossbite, where the upper teeth bite inside the lower teeth, can be corrected to prevent uneven tooth wear and jaw strain. An open bite, where the upper and lower front teeth fail to meet when the mouth is closed, is also treated to restore proper chewing and speaking function. Braces offer comprehensive control to correct these skeletal and dental discrepancies.
The Orthodontic Treatment Process
The journey to a straighter smile begins with an initial consultation where the orthodontist takes diagnostic records, including X-rays, photos, and digital scans or molds of the teeth. These records allow for the development of a precise, individualized treatment plan detailing the exact movements required. Once the plan is established, the brackets are bonded, and the archwire is placed to initiate the active phase of movement.
Patients attend regular adjustment appointments, typically scheduled every four to twelve weeks, for the treatment to progress. During these visits, the orthodontist replaces or tightens the archwires, changing the force and direction applied to the teeth. The duration of the active treatment phase varies significantly depending on the complexity of the case, generally lasting between six months and two and a half years.
The phase following the removal of the braces is known as retention, and it is equally important to the success of the treatment. Newly moved teeth are susceptible to shifting back because the surrounding bone and soft tissues need time to stabilize around the new alignment. Retainers, which may be removable or fixed, are prescribed for long-term or even lifelong wear to maintain the corrected position and prevent relapse.
Options Beyond Traditional Braces
While traditional metal brackets and wires remain a reliable option, several alternatives are available for patients seeking a different aesthetic or treatment profile. Clear aligners, such as Invisalign, use a series of custom-made, transparent plastic trays to move teeth incrementally. These aligners are nearly invisible and can be removed for eating and cleaning, making them a popular choice for adults and those with less severe alignment issues.
Lingual braces are another discreet option, utilizing the same bracket and wire system as traditional braces but bonded to the back, or lingual side, of the teeth. This placement makes the appliance virtually undetectable from the front, appealing to individuals concerned about visibility. For minor crookedness or small gaps, purely cosmetic solutions may be considered.
Dental bonding involves applying a tooth-colored resin to reshape a tooth and camouflage slight imperfections in alignment. Porcelain veneers are thin, custom-made shells bonded to the front surface of teeth to instantly create a uniform, straight appearance. However, these cosmetic options do not correct underlying bite problems and are reserved for minor aesthetic concerns.