When most people think of straightening crooked teeth, they picture teenagers with metal orthodontic braces. The mainstay for aligning teeth for decades, braces have transformed smiles, improving confidence and function along the way. Straight teeth don’t just look better, they are easier to clean and work better for chewing when placed in the correct position.
Orthodontic braces are also commonly used in adults, but in the past few years there are more discrete clear aligner options that can straighten crooked teeth.
So how do braces work to change the position of your teeth?
The main components are brackets and wires. Brackets are glued to the tooth surface and have a slot for a wire to pass through them. The wire is often secured to the bracket by elastic bands (you may notice some folks get creative with the colours of the elastics).
Wires, if bent carefully, will want to spring back into place, and this elastic memory can be used to pull or rotate a tooth in a particular direction. Pretty clever! Orthodontic braces are adjusted at regular intervals as it is important not to put an excessive force on the tooth or move it too much in a short period of time.
Even more interesting is how a tooth actually moves. Each tooth has a root or roots that are surrounded by bone. If you push gently on a tooth for long enough, the cells in your body that grow and remodel bone kick into action and remove and rebuild bone around the tooth and allow it to shift into its new position. If a tooth is moved too fast there is an increased risk of complications.
Whilst braces are a fantastic tool to move teeth, there are also some less desirable factors when it comes to living with them. For some, they do not wish to put up with the appearance and discomfort of metal. There are also more challenges when it comes to cleaning, as the wires and brackets tend to trap plaque, and it is much harder to clean in between teeth.
Braces can generally move or correct more complex crooked teeth, and another advantage is that the orthodontist or dentist sees you regularly for adjustments and because you can’t remove them yourself, you will generally track better.
So what is new when it comes to moving teeth?
In recent years, the use of 3D computer technology has meant there is a new kid on the block. Invisalign. Invisalign is a brand of clear aligner. A clear aligner is just that – a clear plastic tray designed to specifically align or move your teeth. Other brands include Clear Correct, and the Australian made Smile Styler. There are also some aligner companies that bypass the dentist or orthodontist and sell directly to the patient using DIY moulding kits and shopping centre kiosks. There is often great complexity and oversight required to assess an individual’s general dental health, plan their tooth alignment around their other needs and manage any complications or hurdles along the way. People should treat these companies with a great deal of skepticism, and are encouraged to get a second opinion from a dental professional if they are considering them.
So how do clear aligners move teeth?
It all starts with a computer simulation. Once your teeth are scanned, your photos are taken and your goals are understood, your dentist works with the clear aligner company and its software to develop a plan. Your teeth can be moved virtually into their desired position, and it becomes possible to demonstrate the final outcome so your new smile can be visualised. On a computer at least. Once approved a series of clear aligners are made, with each one (worn between 1-2 weeks) moving your teeth in small increments until you reach the end result. Clear aligners can be removed for meals and hot drinks, but otherwise need to stay in for 22-23 hours per day. Initially people may find their speech more challenging, and like when braces are tightened,
there is discomfort each time you move to a new aligner.
Clear aligner companies like Invisalign and Smile Styler can use attachments which are small, discrete white fillings to enable and better control particular tooth movements as it gives the aligner something to grip. These are something that are not part of direct to customer aligners (Smiles direct) and are another reason they are less likely to be effective. Once your treatment is completed, the attachments are polished off.
You can remove your clear aligners easily to clean and floss your teeth as you would normally which means there is less risk of gum problems and tooth decay during treatment. Invisalign and Smile styler, like all clear aligners do depend on the individual to comply and wear them as instructed to get a good result. If they are not worn 22-23 hours per day, if aligner trays are skipped, used out of sequence or lost then the desired tooth movements may not be achieved and this may result in having to start the treatment again or incur additional costs.
Crooked teeth are able to be moved using both traditional orthodontic braces and more discrete and comfortable clear aligner alternatives. It is essential to get the right advice and where possible, second opinions from dental professionals when it comes to your smile.