The question of whether using extra elastics, often called double banding, can speed up orthodontic treatment is common among patients seeking faster results. These removable rubber bands are a specialized component of braces, designed to apply targeted force to move teeth and jaw structures. The force they exert is calculated precisely by your orthodontist to achieve specific movements. Unauthorized modification of this force can cause serious damage and actually delay treatment.
The Function of Orthodontic Elastics
Orthodontic elastics, specifically inter-arch elastics, are used primarily to correct the relationship between the upper and lower jaws, a process known as bite correction. While braces and archwires align individual teeth within each arch, the elastics apply force between the two arches to fix issues like overbites (Class II malocclusion) or underbites (Class III malocclusion). This connection creates an intentional, directed force vector that guides the entire arch or segments of teeth into the proper position.
The force generated by an elastic is specific to its material, diameter, and the distance it is stretched. For example, an orthodontist may prescribe a 3/16-inch elastic that exerts 3.5 ounces of force when fully extended, based on a patient’s treatment plan. This calculated force initiates a predictable biological response, ensuring movement is effective and safe for the surrounding bone and root structure. Wearing the elastics consistently, as prescribed, is required for effectiveness, as non-compliance can significantly prolong the overall treatment time.
The Serious Clinical Risks of Excessive Force
Applying double the prescribed force by using two elastics is not only ineffective but poses immediate and long-term dangers to the teeth and their supporting structures. The most serious long-term risk is root resorption, a process where the body begins to dissolve the tooth root due to excessive, uncontrolled pressure. While minor root shortening can occur in any orthodontic treatment, excessive force significantly increases the risk of severe resorption, permanently weakening the tooth’s stability.
Excessive force can also lead to the necrosis, or death, of the dental pulp, which is the soft tissue containing the blood vessels and nerves inside the tooth. High pressure can compress the blood supply entering the tooth’s apex, causing ischemia and potentially leading to a loss of vitality. Furthermore, the sudden strain causes severe pain and inflammation in the periodontal ligament, the tissue that anchors the tooth to the bone. The uncontrolled force may also result in appliance failure, such as broken brackets or wires, which requires emergency repair and causes treatment delays.
Why Slow, Controlled Movement is Essential
Tooth movement is a biological process that relies on the controlled remodeling of the alveolar bone surrounding the tooth root, not a simple mechanical push. This remodeling occurs through the coordinated activity of two specialized cell types: osteoclasts, which break down bone, and osteoblasts, which deposit new bone. When an optimal, light continuous force is applied, bone is broken down on the pressure side and built up on the tension side, allowing the tooth to move safely.
Doubling the force does not double the speed; instead, it crushes the blood vessels in the periodontal ligament, leading to a condition called hyalinization. Hyalinization is the formation of a sterile, necrotic tissue layer where the ligament cells die off, temporarily halting all tooth movement. The tooth cannot move again until specialized cells clear away this necrotic tissue, a process that can take up to 20 to 30 days. The orthodontist is the only person qualified to adjust the force to maintain the optimal level and achieve safe, efficient movement.