Orthodontic spacers, formally known as separators, are a temporary first step before getting braces or other fixed dental appliances. These small devices are placed between back teeth, typically the molars, to prepare the mouth for treatment. Their function is to create a minute amount of space where virtually none existed before. This preparatory measure allows the orthodontist to proceed with the placement of metal bands, which anchor the archwire or other corrective tools.
Understanding Orthodontic Separators
Orthodontic separators are made of two types of material: small elastic rings or tiny metal springs. The most frequently used are elastic rings, which look like small rubber doughnuts. These rings are flexible and elastic, allowing them to be stretched and inserted into the tight contact points between teeth.
The purpose of these spacers is to generate gentle, sustained pressure on the adjacent teeth. This pressure slowly pushes the teeth apart by a fraction of a millimeter, creating a sufficient gap for the fitting of molar bands. Without this space, fitting the rigid metal bands would be difficult and could cause unnecessary discomfort. In cases where the teeth are extremely crowded, metal separators, which operate like miniature springs, may be used because they exert a greater separating force than the elastic type.
The Step-by-Step Placement Procedure
The placement of orthodontic separators is a quick procedure usually performed by the orthodontist or a trained assistant. The first step involves isolating and drying the area where the spacer is to be placed to ensure the area is clean and visible.
The most common technique for placing an elastic separator involves using dental floss or a specialized placement instrument. The floss is threaded through the elastic ring, creating a loop that allows the separator to be stretched significantly. The clinician then uses a gentle seesaw motion to thread the stretched separator through the contact point between the two molars.
Once the elastic is past the tightest point, the floss is carefully removed. The separator snaps back to its original shape, fully encircling the contact point of the teeth. The patient may immediately feel pressure or temporary tightness as the elastic contracts against the teeth. This initial pressure confirms that the separator is correctly positioned and has begun gently pushing the teeth apart. For metal separators, a specialized plier is often used to compress the spring mechanism and wedge it into the contact area.
Managing Life with Spacers
It is normal to experience soreness and mild discomfort once the spacers are in place, as the pressure causes initial tooth movement. This tenderness usually peaks within the first 24 to 48 hours following placement. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, are recommended to manage the temporary ache. Consuming soft, cool foods can also help soothe the area during this adjustment period.
Dietary changes are necessary to prevent the spacers from becoming dislodged. Patients must strictly avoid sticky foods like gum, taffy, and caramels, as well as hard or crunchy items that could pull the elastic out of position.
For daily oral care, brushing should continue as normal, but use extra care and a soft-bristled brush around the spacers to avoid accidentally moving them. Patients must completely avoid flossing in the areas where the separators have been placed. Flossing will inevitably catch the separator and pull it out, reversing the work it has done.
Spacers are temporary appliances and are typically worn for one to two weeks, which is sufficient time to create the necessary space for the molar bands. If a separator falls out more than a couple of days before the scheduled appointment, the orthodontist should be contacted, as it may need to be replaced to prevent the space from closing up again.