Preparing for orthodontic treatment involves steps designed to ensure the braces can function effectively. A common question during this initial phase is whether temporary devices called spacers are necessary before the brackets and wires are placed. Spacers, also known as separators, are small, temporary devices used in orthodontics to make room between specific back teeth.
What Are Spacers and Their Function
Orthodontic spacers are typically small elastic rings or metal spring-like devices. They are placed snugly between the back molars, which naturally sit very close together. Their purpose is to gently push these adjacent teeth apart over a short period.
This separation is necessary to create a minimal gap for the installation of metal molar bands. These sturdy metal rings are cemented around the back teeth, serving as anchors for the main archwire system. Without this slight space, forcing the rigid bands over tightly aligned teeth would be difficult.
Criteria for Needing Spacers
Not everyone needs spacers before braces; they are not a universal requirement for all orthodontic patients. Spacers are only used when the orthodontist determines that metal molar bands are necessary for anchoring the appliances. If a patient’s back teeth already have adequate natural space, the bands can often be placed without pre-treatment separation.
Spacers are most often required when back molars are tightly aligned, which is common in many patients receiving traditional metal braces. They are also used when the treatment plan includes other fixed appliances, such as palatal expanders or headgear, which rely on the secure anchoring provided by molar bands. Conversely, patients using clear aligner systems, which do not typically use molar bands, usually do not require spacers.
In some cases, the orthodontist may opt for an alternative anchoring method, such as bonding a small metal cylinder, called a molar tube, directly onto the tooth surface. These bonded tubes can sometimes negate the need for the full metal band and the prior use of spacers. The decision rests on the specific mechanics required to achieve the patient’s individual tooth alignment goals.
What to Expect While Wearing Spacers
The installation of spacers is a quick procedure, taking only a few minutes, where the device is slipped between the molars’ contact points. Spacers are temporary and are usually worn for one to two weeks, depending on the tooth movement rate. They are removed immediately before the molar bands are cemented into place during the next appointment.
It is common to experience discomfort, which is a sign that the teeth are actively moving apart. Patients often report a feeling of pressure, dull soreness, or a sensation similar to having food stuck between the teeth. This discomfort tends to peak within the first 24 to 48 hours after placement and then gradually subsides as the teeth adjust.
Soreness can be managed with over-the-counter pain relievers, such as acetaminophen or ibuprofen. Patients should maintain a soft diet and avoid sticky, hard, or chewy foods that could dislodge the devices. If a spacer falls out a few days before the next appointment, it usually means enough space has been created, but the orthodontist should be contacted to confirm if replacement is necessary.