Orthodontic treatment uses braces to align teeth and improve dental health. While brackets and wires are the most visible components, many patients also receive small rubber bands, known as orthodontic elastics, as part of their treatment plan. Not everyone with braces needs these elastics; their use depends entirely on the individual patient’s bite alignment. Elastics provide a specific type of force that wires and brackets cannot deliver alone.
Elastics vs. Wires: Correcting the Bite
The primary function of brackets and the archwire is to straighten individual teeth within each dental arch. This system applies continuous pressure to guide teeth into the correct position, fixing issues like crowding, rotation, or spacing problems. The archwire dictates the shape of the dental arch itself.
Orthodontic elastics are used to correct the relationship between the upper and lower jaws, a process known as inter-arch correction or bite alignment. These bands are stretched between specific attachment points, usually hooks on the brackets of the top and bottom teeth. By connecting the upper and lower arches, the elastics apply a dynamic force that repositions the entire jaw structure relative to one another.
This applied tension guides the entire bite into proper occlusion, ensuring the teeth fit together harmoniously when closed. Without this specific force, the braces would only result in straight teeth that still meet incorrectly, potentially leading to functional problems.
Specific Bite Issues Requiring Elastics
Elastics are prescribed when the patient has a malocclusion, or “bad bite,” that needs correction by moving the entire upper or lower dental arch. The most common issues requiring elastics are classified based on the relationship between the jaws, which determines the direction and configuration of the rubber bands.
A common issue is a Class II malocclusion, often called an overbite, where the upper teeth sit too far forward relative to the lower jaw. To correct this, Class II elastics are used, typically running from an attachment point near the upper canine tooth backward to a lower molar hook. This configuration pulls the upper jaw backward and helps bring the lower jaw forward.
Conversely, a Class III malocclusion, known as an underbite, involves the lower teeth protruding beyond the upper teeth. To fix this, Class III elastics are prescribed, running from a lower canine or premolar forward to an upper molar hook. This configuration applies force to move the lower jaw backward and the upper jaw forward.
Elastics are also used for other complex alignments, such as crossbites or open bites. A crossbite occurs when the upper teeth sit inside the lower teeth, and this is corrected using cross-elastics that run diagonally across the bite. Vertical elastics are used to close an open bite where the front teeth do not overlap.
Consequences of Skipping Your Elastics
The success of bite correction relies on consistent patient compliance because the applied force must be constant. Orthodontists instruct patients to wear their elastics for 20 to 22 hours per day, only removing them for eating and brushing. Failing to maintain this wear time is the most common reason for extended orthodontic treatment.
If elastics are worn sporadically, the teeth and jaw are subjected to an inconsistent push-and-pull, which slows movement significantly. The ligaments and bone tissue surrounding the teeth need constant, gentle force to remodel and allow for movement. Interrupting this process means the teeth may regress toward their starting positions.
Elastics lose their tension and elasticity after only a few hours of use, which is why they must be replaced with fresh bands several times daily. Wearing stretched-out bands is ineffective, as the necessary force is no longer being delivered. Inconsistent wear can lead to treatment failure and extended treatment time.