Orthodontic spacers, also known as separators, are a temporary but necessary stage before traditional metal braces. These small devices prepare the back teeth for the subsequent hardware that will anchor the main archwire. Understanding this preliminary step can help demystify the start of orthodontic treatment.
Why Spacers Are Necessary
The primary function of an orthodontic spacer is to create a small gap between specific posterior teeth, typically the molars. Molars are often tightly aligned, making it impossible to fit the next component of the bracing system without this preparation. The space is required for the placement of metal orthodontic bands, which are small rings that wrap entirely around the tooth.
These bands serve as secure anchors for the archwire, the main wire that runs across the teeth to facilitate movement. Without the preparatory separation provided by the spacers, seating these metal bands would be extremely difficult and potentially painful. Spacers ensure the banding appointment is smoother and more efficient by gently nudging the teeth apart. Spacers are usually made of small elastic rings or small metal spring separators.
Step-by-Step Spacer Placement
The placement process is generally quick and does not involve drilling or local anesthetic. The most common type, the elastic separator, is inserted using a specialized technique that stretches the material. The orthodontist or assistant may use separating pliers or two pieces of dental floss looped through the elastic ring.
The elastic spacer is stretched thin, allowing it to be threaded through the tight contact point between the teeth. Once positioned below the contact area, the pliers or floss are released, and the elastic material snaps back to its original shape. This action applies gentle, constant pressure against the adjacent teeth. Metal spring spacers are typically wedged into the space using orthodontic pliers. The patient may feel a distinct pressure or a momentary pinching sensation as the spacer settles near the gumline.
Living With Spacers: Pain and Maintenance
The physical discomfort usually begins a few hours after placement, once the gentle force starts moving the teeth apart. This sensation is caused by pressure on the periodontal ligament, the fibrous tissue that holds the tooth in the jawbone. Patients often describe the feeling as a dull ache, similar to having food aggressively stuck between the teeth, or general soreness when biting down.
The discomfort is most noticeable during the first 24 to 48 hours and then gradually subsides as the teeth adjust to the pressure. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, are effective in managing this temporary aching. Patients should avoid foods that require heavy chewing during this initial period of sensitivity.
Proper maintenance is necessary to ensure the spacers remain in place and the process stays on schedule. Patients must avoid sticky foods like chewing gum, caramel, and taffy, as these can easily pull the separators out. Hard or crunchy items, such as nuts and popcorn, should also be avoided because they can dislodge the rings.
Brushing should continue as normal, using a soft-bristled toothbrush and gentle technique around the spacers. Flossing between the teeth that have spacers is strictly prohibited, as this action will almost certainly pop the separator out. If a spacer comes out before the next scheduled appointment, the orthodontist should be contacted promptly for replacement to maintain the necessary space.
Removal and What Comes Next
Spacers are worn for a relatively short duration, usually for about one to two weeks, which is sufficient time to create the separation. The removal process is quick and non-painful. The orthodontist uses a small dental instrument, such as a periodontal probe or a dental pick, to gently hook the spacer and pop it out. Since the teeth have already moved slightly, the spacer slides out easily.
Immediately following removal, the metal orthodontic bands are placed and seated. The newly created space allows the bands to slide over the molars without significant pressure or discomfort. The bands are then cemented into place to serve as a stable anchor point for the rest of the fixed orthodontic appliance.