Orthodontic elastics, commonly known as rubber bands, are small, removable loops of medical-grade latex or non-latex material. They are used to apply specific, controlled forces that the fixed components of braces cannot generate alone. The decision to incorporate them into treatment is based on the particular tooth movements and jaw alignment required to achieve a stable bite.
The Purpose of Orthodontic Elastics
Elastics are primarily prescribed to correct malocclusion, which is the relationship between the upper and lower dental arches. While braces and wires align individual teeth within each jaw, elastics provide the necessary inter-arch force to move the jaws relative to each other. This force is created by connecting specific points on the top and bottom sets of braces.
The configuration of the bands addresses specific bite issues, such as a Class II malocclusion, where the upper teeth and jaw protrude past the lower jaw (overbite). In this instance, the elastics apply a rearward force to the upper arch and a forward force to the lower arch. Conversely, a Class III malocclusion, or underbite, requires the opposite force vector. Elastics ensure the upper and lower teeth meet correctly when the patient bites down, which is necessary for long-term stability and function.
Treatment Stages Requiring Elastics
Elastics are typically introduced during the later, or “working,” phase of orthodontic treatment. This phase begins after the initial leveling and alignment of individual teeth are mostly complete, a process that can take six to twelve months. The orthodontist waits until the teeth are sufficiently straight within their respective arches before coordinating the relationship between the two arches.
The specific timing depends on the patient’s biological response and the complexity of the bite correction needed. Once the orthodontist identifies that the teeth are ready to handle the force, they will prescribe a custom configuration. A common pattern for Class II correction, for example, involves stretching the elastic from a hook on the upper canine tooth to a hook on a lower molar tooth. These placements ensure the force vector is directed precisely to correct the jaw misalignment.
Daily Wear Schedules and Compliance
For elastics to effectively move the jaws, they must exert a continuous, gentle force, necessitating consistent wear. The most common instruction is for full-time wear, meaning the elastics must be kept in for 22 to 24 hours per day. Patients are generally advised to remove them only for brushing, flossing, and during meals.
The effectiveness of the elastics is dependent on patient compliance. The rubber material loses elasticity and force over time, often after about eight hours of wear. Therefore, patients must change the elastics at least two to four times a day to maintain consistent pressure. For minor corrections or retention, a limited schedule, such as nighttime-only wear (approximately 8 to 14 hours), may be prescribed.
The total duration of elastic wear varies significantly, ranging from a few weeks to several months; three to nine months is a common period. Following the prescribed schedule closely helps keep the treatment plan on track, as inconsistent wear turns the gentle, continuous force into an intermittent, ineffective one.
What Happens If You Do Not Wear Them
Inconsistent use of orthodontic elastics is the leading cause of treatment delay. The teeth and jaw structures require constant pressure for the bone remodeling process to occur in a predictable direction. Skipping even a single day can reverse the progress achieved over the preceding two or three days.
If elastics are worn intermittently, the teeth move back and forth, creating resistance that halts forward progress. This “jiggling” motion can potentially damage the roots of the teeth over time, complicating future treatment. Poor compliance can easily add six months or more to the total time spent in braces, leading to an incomplete correction of the bite. The prescribed force must be continuous to be effective, and stopping and starting simply prolongs the minor initial discomfort experienced when beginning a new set of elastics.