The traditional and stereotypical movie, television, and commercial vision of orthodontic treatment is one of yards of metal wire tied down to teeth so covered with silver bands and brackets that the whites of the teeth are barely visible. With today’s advanced dental technology, this picture is far from accurate.
Changes in tooth alignment can be accomplished in several different ways. When appropriate, upper and lower arch expanders can be used to increase the curvature of the tooth-bearing supporting structures. These expanders are usually cemented into place and are not able to be removed by the patient. The expanders are often a prelude to fixed metal bands. They can be cemented to the teeth as well as longitudinal arch wires and springs and still be used to move teeth.
Some time ago, the desire of patients to show less metal resulted in the development of bonded tooth-colored and clear brackets (as opposed to the metal bands that completely surround a tooth). These brackets cover only about 25% of the tooth surface and are bonded into place. The trade-off with the more esthetic bonded brackets is a higher percentage of dislodgement of the bracket, requiring additional office visits for repair and replacement. The wires and springs are changed periodically to accomplish the various stages of movement. The metal components stay in place until the tooth movement is finished. Some dental conditions mandate the use of this traditional orthodontic process.
