The placement of braces often begins with the temporary insertion of dental spacers, sometimes called separators. These are small elastic rings or metal springs placed between specific back teeth. Their purpose is to create a tiny gap between these teeth, preparing the mouth for the next phase of orthodontic treatment. This step ensures the subsequent parts of the braces system can be fitted correctly.
Understanding the Purpose of Spacers
The space created by these devices is required to fit the molar bands. Molar bands are metal rings that encircle the back teeth and serve as anchors for the archwire system of the braces. Without this preparatory gap, it would be impossible to slide the bands comfortably over teeth that naturally sit flush against one another. Spacers apply gentle, constant pressure against the adjacent teeth, causing them to slowly move apart over a short period.
Two types of spacers are used: elastic and metal. Elastic spacers, which look like tiny rubber bands, are the most common choice when minimal space is needed. Metal spacers (small rings or spring clips) are reserved for tightly packed teeth or when a slightly larger gap is required. Spacers are temporary and are usually worn for only one to two weeks before removal and placement of the molar bands.
The Step-by-Step Placement Procedure
The process of inserting spacers is quick and is performed by the orthodontist or an assistant during a brief appointment. Before placement, the area around the designated molars is checked to ensure it is clean. For elastic spacers, the clinician uses a specialized tool, such as pliers or dental floss, to stretch the small elastic ring.
The stretched spacer is carefully inserted into the contact point between the two teeth using a gentle sawing or pushing motion. Once positioned correctly, it sits below the contact area, encircling the point where the teeth touch. For metal spacers, specialized orthodontic pliers are used to wedge the ring into the tight space with slightly more force. A correctly placed spacer will be slightly below the gumline and is confirmed to be properly seated before the patient is dismissed.
Managing Discomfort and Soreness
Because spacers actively push the teeth apart, it is normal to experience pressure or soreness after placement. This discomfort often begins a few hours following the appointment, indicating the teeth are beginning to move successfully. The soreness typically peaks within the first 24 to 48 hours as the teeth adjust to the space being created.
Patients often describe the feeling as a dull ache or similar to having food aggressively stuck between the teeth. To manage this predictable discomfort, over-the-counter pain relievers, such as ibuprofen or acetaminophen, are highly recommended. It is beneficial to take the pain reliever before the feeling of soreness becomes severe.
Applying a cold compress or ice pack to the outside of the cheek for 10 to 15 minutes can help reduce inflammation and numb the area. Rinsing the mouth several times a day with a warm salt water solution is another effective home remedy. Dissolving a half teaspoon of salt in warm water helps soothe irritated gum tissue around the spacers.
Daily Care and Dietary Restrictions
Maintaining the spacers requires temporary changes to oral hygiene and diet to ensure they remain in place. The most crucial instruction is to strictly avoid flossing between the teeth where the spacers are located, as this action will likely pull the spacer out. Regular brushing around the spacers with a soft-bristled toothbrush is encouraged to keep the area clean.
Dietary restrictions are equally important because sticky, chewy, and hard foods can dislodge or damage the spacers. Patients must avoid foods like gum, caramel, taffy, and other sticky candies. They must also avoid hard items such as nuts, hard candies, and popcorn kernels, as these can catch on the spacer and prematurely pull it out.
If a spacer falls out before the follow-up appointment, contact the orthodontist immediately. If the spacer has been in place for several days, enough space may have already been created, and replacement might not be necessary. Otherwise, the orthodontist may need to reinsert a new one quickly to prevent the teeth from shifting back together and delaying treatment.