Fixed braces – types, prices, rules of use and hygiene

Fixed orthodontic appliances are used in orthodontics to correct malocclusion. Treatment with fixed orthodontic appliances is relatively long and expensive. The average treatment time is 2 years, and the entire process of correcting curved teeth can cost up to 10 zlotys. What should you know about fixed appliances and how to use them?

Fixed orthodontic appliances – indications

Placing permanent orthodontic appliances on the teeth is the most frequently used method of correcting a malocclusion. Fixed orthodontic appliances are used because of their precision and efficiency. It is also important that their operation is independent of the patient’s duty, as he does not have to think about putting on the apparatus or adjusting it. Treatment of malocclusion with an orthodontic appliance is possible at virtually any age, although it should be remembered that in younger patients the time required to wear braces is shorter than in the case of older people. The most important indication for the installation of a fixed orthodontic appliance is malocclusion visible and disturbing the daily functioning. However, the orthodontist always decides about the need to wear a fixed orthodontic appliance. It is worth remembering that in the case of minor malocclusions or early age of the patient, appropriate exercises performed with the use of removable orthodontic appliances are often sufficient. The indications for putting on a fixed orthodontic appliance are:

1. Overshot bite – this is one of the malocclusions most often diagnosed by an orthodontist. Its specificity lies in the fact that the lower dental arch is recessed in relation to the upper dental arch. This malocclusion accounts for over 70% of all diagnosed malocclusions in patients. It causes a visible distortion of the face and a speech impediment;
2. Undershot bite – this is the reverse of the undershot bite, which means that the upper dental arch is recessed in relation to the lower bite. This defect is also visible at first glance, as patients with undershot bite have a clearly protruding jaw and chin. Wearing a fixed orthodontic appliance allows the teeth to be corrected so that they touch each other when closing the mouth;
3. deep bite – this is a defect in which the upper dental arch largely overlaps the lower teeth. The unfavorable result of this defect is the asymmetry of the face and intense abrasion of the teeth. A deep bite leads to serious dental problems, therefore the imposition of a fixed orthodontic appliance is particularly advisable;
4. open bite – this is a disadvantage in which the teeth on some sections of the dental arch are more ingrown into the gums, which overlap with each other. This defect may cause the patient to crack the enamel, severe abrasion of the teeth and gum recession;
5. open bite – a malocclusion that is recognized by the fact that the teeth do not touch each other at all. An example of this defect is, for example, diastema, which manifests itself in a visible gap between the teeth. If left untreated with fixed braces, open bite results in problems with chewing food and correct pronunciation.
6. crowding – this is a malocclusion in which the patient struggles with too narrow arches and too many teeth. In the case of crowding, there is a need to remove one or more extra teeth before applying a removable fixed appliance. The time and cost of treating crowding largely depends on the complexity of the defect and the degree of tooth curvature.

Do you want to know more about malocclusion? Check: Malocclusion and orthodontic prophylaxis

Fixed braces – contraindications

Although the correction of incorrect positioning of the teeth is recommended by dentists and orthodontists, in reality not every patient with a malocclusion may decide to put on a permanent orthodontic appliance. Unhealed teeth are the most important obstacle preventing the application of permanent braces. Caries, gingivitis or periodontitis exclude the treatment of malocclusion with a fixed appliance. A necessary condition for the application of the braces is the complete healing of any cavities in the teeth. In addition, fixed braces cannot be worn by people who are struggling with periodontal diseases, diseases that reduce the body’s immunity or advanced diabetes. Crowns and bridges on the teeth are also contraindications for the use of permanent braces.

Do you want to learn more about braces? Read: Teeth braces. Types of orthodontic appliances, price

Fixed braces – structure and the most important information

Permanent orthodontic appliances are stuck to the patient’s teeth with a special glue for the entire treatment period. The type of orthodontic appliance used in a patient depends on the type of malocclusion, the patient’s age and hygiene rules. A fixed orthodontic appliance, regardless of the selected model, consists of several basic elements, including:

1. brackets – are the basic element of any fixed orthodontic appliance. The brackets are glued to the teeth with a special glue for the entire period of treatment of the malocclusion. They are glued exactly in the central axes of the teeth. Various types of locks are available, but metal locks are the most frequently chosen. Despite the visual differences between different types of locks, they are distinguished by a similar structure and function, and differ in terms of aesthetics. In the central part of the glued bracket there is a gap through which the orthodontic arch runs. On the brackets, which are glued on the sixes, so-called rings are placed, the purpose of which is to pre-separate the teeth. On the other hand, the sevens sometimes have smaller tubes than the zippers. In addition, some locks have special hooks that are used when applying additional treatment elements;
2. orthodontic arch – it is a titanium-nickel wire that runs through the slots of the brackets, causing the teeth to move. The orthodontic arch is replaced at subsequent follow-up visits. At the beginning of orthodontic treatment, a delicate and flexible arch is used, while in later stages the wire becomes stronger and more rigid;
3. flexible ligatures – they are popularly called rubber bands and for many patients they constitute the basic element of their fixed orthodontic appliances. Ligatures are responsible for keeping the arch in the brackets and it is thanks to them that the fixed orthodontic appliance is more stable and performs its function better. The greatest advantage of flexible ligatures is the wide availability of colors. Thanks to this, each patient can choose the elastic bands according to their taste and at every stage of the treatment stand out with a different color of their smile. Orthodontists, for the less determined, often offer rainbow-colored ligatures, thanks to which all colors can be applied to the apparatus at once;
4. elastic chains – a type of ligatures connected with each other that form the form of a bead. Flexible chains connect the teeth to each other, preventing them from sliding apart;
5. silicone covers – these are thin and colorless covers that are placed on the dental arch in the case of missing teeth. The purpose of the silicone covers is to protect the gums and mucous membranes;
6. springs – they can be placed on a fragment of the arch to separate the teeth using the spring mechanism.

Do you want to know what are retention devices? Check: Retention apparatus and its role in orthodontic dental treatment

Fixed orthodontic appliances – types

Despite the name that is customarily used for different kinds, there are 3 different types of fixed orthodontic appliances:

1. orthodontic appliances – these are the most commonly used appliances, which consist of brackets, arches and rings. In such an apparatus, the orthodontic arch presses against the teeth, forcing them to move. The locks are adjusted every few months and the wire is replaced with a stronger one. Treatment with such apparatus may last from several months to several years, depending on the type of defect, age of the patient, etc .;
2. special fixed braces – these are devices that are used to monitor unwanted habits, such as pushing the teeth with the tongue or sucking the thumb. These appliances are attached to the teeth with rings. Due to the fact that such devices are very uncomfortable, especially when eating, they are used only in exceptional cases;
3. fixed spacers – these are devices that are usually used in children. If a child loses a milk tooth too early, an appliance is used that maintains a gap until a permanent tooth appears in its place. In this case, a ring is attached to the tooth next to the free space, and a wire is stretched to the tooth on the opposite side.

Fixed orthodontic appliances – types of brackets

Choosing the right fixed orthodontic appliance is not the easiest thing to do. Patients can choose from the offer of various brackets that form the basis of orthodontic appliances. The offer of orthodontists includes an extensive list of brackets, but the most frequently chosen ones include:

1. metal brackets – these are the brackets most often chosen by patients in orthodontic appliances. Metal locks are made of stainless steel, which is characterized by high durability. Metal locks are distinguished by their small size and low profile of the lock. These types of brackets adhere very well to the tooth surface and are very easy to remove;
2. rhodium-plated locks – this type of locks are a combination of metal locks with aesthetic locks. The rhodium from which the locks were made is a silvery-colored platinum group element. The rhodium-plated surfaces of the lock acquire a silvery, snow-white color. They are resistant to blackening. The advantage of rhodium-plated locks is the price similar to less aesthetic metal locks;
3. micro sprint zippers – these are zippers of a very small size and a smooth surface, which make patients comfortable to wear. Their advantage is high aesthetics;
4. antiallergic zippers – these are zippers that are nickel-free in the material composition. Nickel is an element to which a large part of society is allergic;
5. composite-ceramic locks – this is a type of aesthetic locks with a small size and inconspicuous color. These types of brackets are used in cases of minor malocclusion;
6. ceramic brackets – these are aesthetic brackets, the color of which is very similar to the natural color of the teeth. As a result, the fixed orthodontic appliance is practically invisible to the naked eye;
7. crystal locks – These locks are made of monocrystalline sapphire. They are completely transparent, thanks to which they give the teeth a natural look. Crystal locks are distinguished by a smooth surface and rounded contours, which ensures maximum patient comfort.

Fixed braces – the most common problems

Wearing a fixed orthodontic appliance is associated with many unexpected situations that the patient often has to deal with on his own before he can make an appointment at an orthodontic office. The most common problems among people wearing permanent braces that do not require immediate medical attention are:

1. abrasions on the gums and mucosa – permanent orthodontic appliances, despite their high precision and application on the teeth, may cause abrasions on the gums and mucosa. In such cases, you should locate which element or fragment of the apparatus causes abrasion and cover it with a special wax for this type of apparatus. An abrasion should be rinsed with hydrogen peroxide and lightly rubbed with an anti-friction agent. For example, sacchol will work for abrasions of the mucosa;
2. detachment and falling off of the bracket – although the brackets are glued to the teeth with specialized and firmly holding glue, it may happen that one of them loosen, come off or simply fall off. This is not a situation that requires immediate medical attention. If a loose lock irritates the mucosa, remove the ligature and gently disentangle it from the apparatus. Then you should contact the orthodontist who will stick a new lock to the tooth;
3. protruding wire – it is not uncommon that a wire protrudes from the fixed orthodontic appliance, irritating the gums and mucosa. If it is not possible to visit the orthodontist’s office, you can deal with this problem yourself. Use sharp pliers to trim any protruding wire as close to the lock or ring as possible. The procedure should not be performed with scissors. Always be extremely careful when trimming a wire;
4. toothache and gum pain – some patients complain of tooth and gum pain shortly after putting on the fixed braces. Most often it is temporary pain, so there is no need to perform specific actions. However, if the pain is severe and interferes with your daily activities, you can take a pain reliever.

If other serious problems arise after the application of a fixed orthodontic appliance, you should not delay visiting your orthodontist.

Learn more about oral and mucosa problems. Read: Oral mucositis

Fixed braces and oral hygiene

You should constantly take care of oral and dental hygiene, but after putting on a fixed orthodontic appliance, there are a few additional issues that should not be forgotten. The main difficulty in this case is reaching all tooth surfaces and parts of the braces. Therefore, when wearing a fixed orthodontic appliance, you should equip yourself with special accessories for brushing your teeth. The basic oral hygiene accessories include: orthodontic brushes with a groove, pens of various thicknesses, dental floss with a hardened tip and mouthwash. Cleaners are used to clean places that are difficult to access, moreover, they can be used to clean larger spaces between the teeth. A special dental floss allows you to reach tight interdental spaces where food debris can accumulate. The brush for people wearing fixed braces is equipped with a special groove, which makes it easier to clean the teeth with brackets and an orthodontic arch. On the other hand, the mouthwash allows for greater protection of the gums through its anti-inflammatory effect. Patients with fixed braces should not forget that professional tooth cleaning with braces should be performed periodically during corrective treatment. This service is available at most orthodontic offices.

To clean your teeth with braces, buy the Vitammy Aquarius Wireless Dental Irrigator, which will allow you to take better care of your oral hygiene. We also recommend the Vitamma SMILS Sonic Toothbrush with 5 brushing programs, one of which is designed for the care and cleaning of orthodontic appliances.

How to properly care for your teeth and oral hygiene? Read: Oral Hygiene

How much do fixed braces cost?

It is difficult to pinpoint a specific amount that should be paid for a fixed orthodontic appliance. The prices of fixed braces vary and largely depend on the types of braces, treatment time or the number of follow-up visits.

1. metal locks – these are the cheapest possible locks. The price of one bow is approximately PLN 1500. Including the costs of preparing the plan, diagnostics and control visits, you should count with the amount from PLN 3200 for one arch;
2. porcelain brackets – the price of the apparatus for one arch is about 1800 zlotys. Including the costs associated with checkups, diagnostics or treatment plan, the final price may range from PLN 3200 to PLN 5000 for one arch;
3. crystal locks – the price of the camera for one arch is about PLN 2100. Including check-ups, tests and preparation of a treatment plan, the final price may range from PLN 3500 to PLN 5500 for one arch.

Find out more about the prices of braces. Take a look: Orthodontic appliance cost – how much does a beautiful smile cost?

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