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How are fixed braces adjusted?

Written by Dr. Chaw Su Kyi on November 13, 2018

You have probably heard of braces being ‘tightened’ and wondering what that may mean.

Your braces adjustment appointments will normally be scheduled every 4-6 weeks. Some braces systems like the Damon braces system allow these appointments to be 8-10 weeks. It is vital that your orthodontic treatment is regularly reviewed and monitored by your orthodontist, who will advise you at every visit when your next routine appointment is to be scheduled.

At these adjustment appointments your orthodontist will assess the amount of tooth movement which has occurred since the previous visit and ensures that your treatment is progressing as planned. At some visits, the wire may be ‘re-tied’ to further activate it, and at other appointments be changed and become slightly ‘stronger’ or larger in dimension.

The initial wire which is placed is very light and flexible. This allows it to be tied into the crowded teeth. The first few initial wires are of a predetermined shape and have a ‘memory shape’ effect. When the wire is tied into the crowded teeth, it is deflected from its original shape. What this means is that because it has ‘shape-memory’ properties it will want to move back into its original shape, and as it moves back it will move the tooth along with it. Thus the tooth will straighten as the wire resumes its original pre-determined shape.

As the teeth straighten and bite issues corrected, your orthodontist may change the wire or place ‘elastics’ if needed. The wires are progressively changed to ‘stronger’ thicker wires which allow the roots of the teeth to be moved into their correct positions.

The roots of the teeth support the teeth in position and it is vital that both the crowns (the visible portion of the teeth) and the roots are moved into the right position. The ‘stronger’ wires help move the roots into the correct position to help maintain stability. At this stage of treatment, there may not be so much dramatic change being observed, but the procedure is all important for long term stability.

There are some orthodontic treatments being marketed as ‘completed within 6 months’. This may possibly be successful in some very mild cases, but generally, it takes 6-month of treatment just to straighten the teeth, but with no consideration to the roots. This can result in problems with the bite or lack of stability, and consequent relapse.

It is vital that your treatment is assessed to ensure it is progressing correctly. Often the most difficult part of the adjustment appointments for the children is ‘choosing their colours!!’ with a choice for every colour under the rainbow. And for all our patients, each appointment is one step closer to achieving their natural healthy smile.

Picture (1) below is showing the lower teeth immediately after fitting the lower brace. As you can see the lower wire is very flexible and is not a straight piece of wire, but ‘bent’ up and down into all the crooked teeth. The upper brace was fitted a few months ago, and as the upper teeth have straightened, the wire itself is flat and straight too.

teeth photo

The picture (2) below is taken at the third appointment following the lower braces is fitted. Now the lower teeth are much straighter and a ‘thicker’ wire is placed, similar to the upper teeth. The wire is no longer ‘deflected’ as picture (1) above.

patient fixed braces photo

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