Orthodontic treatment with braces is a personalized process designed to correct the alignment of teeth and the relationship of the jaws. Many people associate braces with the small rubber bands, called orthodontic elastics, that hook between the upper and lower teeth. If you have braces but have not been given these bands, it is usually because your treatment has not yet reached the phase where they are needed, or your specific bite mechanics do not require them. The absence of elastics reflects the tailored plan your orthodontist has designed.
The Specific Function of Orthodontic Elastics
Orthodontic elastics, also known as inter-arch rubber bands, are specialized tools designed to correct the bite, or the way the upper and lower jaws fit together. Unlike archwires, which primarily straighten teeth within a single arch, elastics apply force between the arches to achieve jaw alignment and correct malocclusions (misalignments). For example, in a Class II malocclusion (overbite), elastics pull the upper teeth backward while encouraging the lower jaw to move forward. Conversely, a Class III malocclusion (underbite) uses elastics in a reverse configuration to pull the lower jaw backward. The consistent tension created by the elastics allows the teeth and jaw to shift into their proper relationship over time.
The Staged Process of Braces Treatment
Orthodontic treatment is structured into distinct, sequential stages, which explains why elastics may not be needed yet. The initial phase is alignment and leveling, focusing exclusively on straightening the teeth within each arch. During this time, the orthodontist uses light, flexible archwires to correct crowding, rotations, and vertical discrepancies.
This foundational work must be completed before correcting the bite can begin. Introducing elastics too early would apply disruptive forces to unstable teeth, potentially causing unwanted movement or delaying alignment. Elastics are typically reserved for the later “Working Phase” or “Bite Correction” stage, which begins only after the teeth are largely aligned and can serve as stable anchors for the inter-arch forces.
When Elastics Are Not Necessary
In some cases, a patient may progress through the entire treatment without ever needing elastics. The primary reason for omitting elastics is that the patient already exhibits a Class I bite. This is the ideal relationship where the upper teeth slightly overlap the lower teeth and the jaws are correctly balanced. In these instances, treatment only requires aligning the teeth within the arch, eliminating the need for inter-arch correction.
Fixed Appliance Alternatives
Alternatively, the orthodontist may use fixed appliances that accomplish the same jaw movement without relying on patient compliance to wear removable elastics. Devices like the Forsus appliance, a spring-loaded rod connecting the upper and lower braces, can correct an overbite in a fixed manner. Temporary Anchorage Devices (TADs), which are tiny titanium implants placed temporarily into the jawbone, can also be used to anchor tooth movement. These fixed alternatives replace the need for elastics in specific complex movements, ensuring the most efficient and predictable result.