Traditionally, four basic elements are used: brackets, bonding material, arch wire, and ligature elastic (also called an "O-ring").
A dentist must complete 2–3 years of additional post-doctoral training to earn a specialty certificate in orthodontics.
[medical citation needed] Typical treatment times vary from six months to two and a half years depending on the complexity and types of problems.
About 2 weeks before the braces are applied, orthodontic spacers may be required to spread apart back teeth in order to create enough space for the bands.
Once heated to body temperature, the arch wire will stiffen and seek to retain its shape, creating constant light force on the teeth.
The fitting process can vary between different types of braces, though there are similarities such as the initial steps of moulding the teeth before application.
When the archwire has been placed back into the mouth, the patient may choose a colour for the new elastic ligatures, which are then affixed to the metal brackets.
Patients may need post-orthodontic surgery, such as a fiberotomy or alternatively a gum lift, to prepare their teeth for retainer use and improve the gumline contours after the braces come off.
[7] In order to prevent the teeth from moving back to their original position, retainers are worn once the treatment is complete.
Retainers help in maintaining and stabilizing the position of teeth long enough to permit the reorganization of the supporting structures after the active phase of orthodontic therapy.
They are made of metal hooks that surround the teeth and are enclosed by an acrylic plate shaped to fit the patient's palate.
Typically the prescribed daily wear time will be between 14 and 16 hours a day and is frequently used as a post-primary treatment phase to maintain the position of the jaw and arch.
If a person's teeth are not ready for a proper retainer the orthodontist may prescribe the use of a preformed finishing appliance such as the pre-finisher.
This appliance fixes gaps between the teeth, small spaces between the upper and lower jaw, and other minor problems.
The researchers concluded that functional appliances used to harness natural forces (such as improving the alignment of bites) do not usually have major effects on the gum after treatment.
But if someone with braces does not clean their teeth carefully, plaques will form, leading to more severe gingivitis and gum recession.
Experiencing some pain following fitting and activation of fixed orthodontic braces is very common and several methods have been suggested to tackle this.
This reduction in blood supply results in inflammation and the release of several chemical factors, which stimulate the pain response.
Orthodontic pain can be managed using pharmacological interventions, which involve the use of analgesics applied locally or systemically.
These analgesics are divided into four main categories, including opioids, non-steroidal anti-inflammatory drugs (NSAIDs), paracetamol and local anesthesia.
Catgut, a type of cord made from the natural fibres of an animal's intestines, performed a similar role to today's orthodontic wire in closing gaps in the teeth and mouth.
[15] The Etruscans buried their dead with dental appliances in place to maintain space and prevent the collapse of the teeth during the afterlife.
Roman philosopher and physician Aulus Cornelius Celsus first recorded the treatment of teeth by finger pressure.
Unfortunately, due to a lack of evidence, poor preservation of bodies, and primitive technology, little research was carried out on dental braces until around the 17th century, although dentistry was making great advancements as a profession by then.
Fauchard, in his practice, used a device called a "Bandeau", a horseshoe-shaped piece of iron that helped expand the palate.
He perfected the "Bandeau" and was the first dentist on record to recommend extraction of the premolar teeth to alleviate crowding and improve jaw growth.
In 1819, Christophe François Delabarre introduced the wire crib, which marked the birth of contemporary orthodontics, and gum elastics were first employed by Maynard in 1843.
Dentist, writer, artist, and sculptor Norman William Kingsley in 1858 wrote the first article on orthodontics and in 1880, his book, Treatise on Oral Deformities, was published.
[16] In 1979, Dr. George Andreasen developed a new method of fixing braces with the use of the Nitinol wires based on their superelasticity.