Orthodontic elastics, commonly known as rubber bands, are used in the final stages of orthodontic treatment. While brackets and wires straighten individual teeth, elastics correct the bite—the way the upper and lower jaws fit together. They are stretched between specific attachment points on the top and bottom arches, applying continuous force to guide the jaw relationship into proper alignment. This pressure achieves a stable, functional result.
The Primary Role of Orthodontic Elastics
Braces and archwires initially align the teeth within their dental arches. However, they often cannot generate the force needed to move entire groups of teeth or adjust the relationship between the upper and lower jaws. Orthodontic elastics take over this role, applying inter-arch tension. This constant, gentle force stimulates the biological process of bone remodeling, where bone is broken down and rebuilt. This coordinated process allows teeth to gradually shift into their prescribed positions, correcting issues like overbites and underbites.
Mapping the Placement Patterns
The placement of elastics depends entirely on the specific misalignment being corrected, using tiny hooks on select brackets or bands as attachment points. The most common configuration is the Class II elastic, which addresses an overbite where the upper teeth protrude over the lower teeth. This pattern typically runs from an attachment near the upper canine tooth backward and down to a hook on a lower molar. This arrangement pulls the upper teeth backward while simultaneously pulling the lower teeth and jaw forward, resolving the overbite.
Conversely, the Class III elastic corrects an underbite, where the lower jaw sits too far forward. This elastic runs in the opposite direction, usually from a lower canine or premolar up and back to a hook on an upper molar. The resulting force pulls the lower teeth backward and the upper teeth forward, achieving a balanced jaw relationship. Other patterns include crossbite elastics, which connect teeth diagonally across the mouth to bring misaligned teeth into their correct lateral position.
Auxiliary patterns are also used to fine-tune the bite. These include triangular or V-shaped elastics, often employed to close open bites or settle the back teeth into a tight fit. Box elastics connect four points—two on the top arch and two on the bottom—to help close vertical gaps or tighten the overall bite. The orthodontist customizes the size, strength, and precise connection points of the elastics to generate the exact force vector needed.
Daily Management and Compliance
The effectiveness of elastics is directly tied to consistent use, as teeth must be under near-constant pressure to move. The general rule is full-time wear, meaning 20 to 22 hours per day, including while sleeping. They should only be removed for eating and for proper brushing and flossing, as leaving them in hinders effective hygiene. Elastics lose their force quickly and must be replaced with fresh ones multiple times a day. Many orthodontists recommend changing them at least once daily, or after every meal, to maintain the prescribed force level. Never reuse elastics, even if they appear intact, because they lose the precise elastic properties necessary for movement.
Addressing Common Elastic-Related Issues
When first starting to wear elastics, temporary soreness or discomfort is common as the teeth and jaws adjust to the new force. This initial discomfort is normal and typically subsides within two to three days as the mouth adapts to the pressure. Over-the-counter pain relievers can manage this adjustment period. A frequent problem is a broken or lost elastic, which should be replaced immediately; patients are advised to carry extras. The most significant challenge is inconsistent wear, which severely compromises treatment. Wearing elastics intermittently allows teeth to shift back toward their original positions, a process known as relapse, which can undo previous progress. Forgetting to wear them for even a single day can require two days of correct wear to regain lost ground, significantly extending the overall treatment time.