Fixed braces can be placed on the outside or on the inner side of teeth. These are the best way to control tooth position. They are almost always necessary for complex orthodontic treatment and have been shown to produce the best results when compared to most removable appliances.
Fixed braces can be either metal or tooth coloured depending on their placement (on the outside or on the inner side of teeth). At Devonshire House we use tooth coloured appliances for the visible part of the brace. The part that is fixed to the tooth is called the bracket and these are connected to each other using wires.
Braces placed on the inner side of teeth
This special type of fixed solution is called a lingual brace. The braces are fixed to the inner side of the teeth and are virtually invisible from a face on view. However, the metal brackets anchoring the brace can be viewed when the mouth is open wide. They do have some disadvantages such as encroaching on the tongue which can be uncomfortable initially and can cause a lisp for the first 1-2 weeks. The treatment complexity is increased when using lingual appliances because they are more difficult to adjust during the treatment and this leads to longer appointment times for each session. Lingual appliances are generally customised for each patient and require longer fitting and adjustment appointments and are therefore more expensive than braces fixed to the outside of the teeth.
Micro-implants are small screws that can be used to help orthodontic treatment. They are often used to replace headgear. If micro-implants are used during the orthodontic treatment they are at no extra cost and are already included in the overall fee schedule.
We do our utmost to provide an environment which is low in allergenic substances. For patients with allergies we use completely nickel free braces and latex free gloves.
To extract or not to extract?
Orthodontic treatment involving the extraction of permanent teeth is a controversial issue. Generally orthodontic extractions are undertaken to create space and alleviate crowding. However there are alternatives to extraction which will be discussed with you. However, it is important to note that not all cases can be treated on a non-extraction basis.
There are a large number of removable appliances that can be used to move teeth into better positions. Aligners (such as Invisalign) are used to provide more complex treatments using attachments that are fixed to the teeth.
Retainers are also used at the completion of orthodontic treatment for retention so that teeth can stabilise in their new position. The most commonly used retainer for the upper front teeth at Devonshire House is virtually invisible.
A large number of patients will have their first orthodontic assessment at approximately 8 years of age but most will not start their treatments until they have reached their early teens. Start of treatment may vary significantly and depends on the emergence of adult teeth as well as the growth of the patient.
We try to do our best to time patient’s treatment appropriately and all available options will be discussed at the treatment planning stage.
Retention starts once your orthodontic treatment has been completed. Long-term follow-up to check the maintenance of the aesthetic changes is a good idea for most patients. Retainers can be withdrawn gradually to test the stability of the orthodontic result and most patients will then see their orthodontist approximately once a year for approximately 3 years.