In our practice, there are always some patients wearing so-called self-ligating silver braces.They are usually the Damon series from Ormco or Innovation from GAC. These braces have cleverly-designed gates incorporated into their design. When the gates are open, arch-wires can be placed. Once the wire has been placed, the gates are shut again. No elastic modules are necessary to hold the wire into the bracket slots - but chains of elastic modules may still be necessary if separate teeth or groups of teeth need to be pulled against each other.

Normal silver braces are the most commonly-used braces for teenagers. These modern braces have many digitally-derived technical features built into them. These features help the orthodontist achieve the best three-dimensional results possible for each individual patient - far more efficiently, safely and predictably than ever before. They are strong and easy to clean.

We have been using clear ceramic braces for many years. At present , we are using Clarity SL (self-ligating) from 3M Unitek.

The wearing of Clarity clear ceramic braces, at least across the upper front teeth, allows adults and late teenagers to live their lives without everyone immediately realising that they are wearing braces. If an adult is wearing steel braces, they attract attention, regardless of the lighting situation. If, on the other hand,  they have their upper smile teeth bonded with clear ceramic brackets, many people won't notice at all that they are wearing braces. Of course, if someone is up-close regularly, they will probably see the clear braces.

Lingual braces - on the inside surfaces of the teeth

In our practice, we have had patients in upper and lower lingual braces for some years. In fact, Michael Woods first practised lingual orthodontics while still working in the United States as a junior orthodontic clinical academic. We also accept lingual transfer cases - patients from overseas, especially from Europe.

 

Clear (so-called invisible) plastic aligner digital systems (eg Invisalign, Clear-smile or eCligner) have been marketed for the last ten years. Before that, orthodontists may still have constructed a similar suck-down clear retainer - with the teeth being moved manually on a model in the laboratory.

Removable plates are commonly used as retainers after active first phase or full-braces treatment.

Removable plates can also used to hold spaces and arch-width or to affect the vertical relationships while the adult dentition is developing. These plates can also include active screws or springs to provide limited tooth movements.

Generally, removable plates are not suitable for widespread alignment of crowded teeth or three-dimensional movements of individual teeth - or most bite changes. Control of rotated teeth and the uprighting of roots are not possible to achieve with removable plates.

RETENTION - IN MANY WAYS, JUST AS IMPORTANT AS THE ACTIVE TREATMENT

After any active treatment, retention is required. We start with the acceptance that teeth will continue to move, to a greater or lesser extent, throughout life. 

Retention simply means the holding-on after teeth have been aligned and bites corrected.

Types of retention will differ with different types of active treatment, and after treatment of different presenting problems in patients of different ages and with different facial shapes.

It is not reasonable to say that one size fits all.

Commonly used retainers are:

Traditional rigid removable acrylic plates with wires to hold the teeth firmly against the acrylic arch shape,

Clear flexible removable templates which, at first, fit like gloves over the aligned teeth, and

Fixed (bonded) wires on the inside of the teeth.

The safest, most efficient and most predictable form of retention for individual patients will be discussed throughout treatment and especially when it has been decided that active devices can be removed.