Orthodontic treatment uses appliances to correct the position of the teeth.
The 4 main types are:
- fixed braces – a non-removable brace made up of brackets that are glued to front of each tooth and linked with wires
- removable braces – usually plastic plates that cover the roof of the mouth and clip on to some teeth; they can only carry out very limited tooth movements
- functional appliances – usually a pair of removable plastic braces that are joined together or designed to interact together, and fit on to both the upper and lower teeth
- headgear – this is not an orthodontic appliance itself, but can be used with other appliances and is usually worn at night.
In more severe cases, treatment may involve fixed braces together with surgery to move the jaw. This treatment is carried out in hospitals.
These treatments are outlined in more detail below. Further information can be found on the British Orthodontic Society (BOS) website.
Fixed braces are the most common type of orthodontic appliance.
A few days after a fixed brace is fitted, you’ll be able to eat a normal range of foods. But you should avoid certain foods and drinks, such as toffee, hard sweets and fizzy drinks, as they can damage the appliance and your teeth.
If you're using a fixed appliance and you play a contact sport such as rugby, you should wear a gum shield to protect both your mouth and the appliance.
Fixed braces are usually made out of metal, so will be noticeable on the front of your teeth.
Many private orthodontists now offer ceramic or clear braces, or metal braces fitted to the back of the teeth, although they're usually more expensive.
Removable braces can be used to correct minor problems, or as part of fixed brace treatment.
They can also sometimes be used to discourage children from sucking their thumb, but this is not available on the NHS.
These braces should only be taken out of the mouth for cleaning or as a precaution during certain activities. Your orthodontist can advise you about this.
Functional appliances can be used to treat problems with the position of the upper and lower jaw and teeth.
Most people need to wear them all the time. It's very important to follow your orthodontist's instructions about how and when to wear the appliance. If it's not worn correctly, the treatment will not work.
It may be necessary to remove your functional appliance for cleaning and while you're eating.
Headgear is used to correct the position of the back teeth or to keep them in position while the front teeth are being treated.
Most people only need to wear headgear in the evening and during the night. You will not be able to eat or drink while wearing headgear.
There are other types of braces available privately, such as aligners, or invisible or lingual braces that fit on the back of the teeth.
You'll need to talk to your orthodontist to see whether they can be used for your problem. The cost of these braces is usually higher.
Retainers are used at the end of a course of orthodontic treatment. They hold straightened teeth in place while the surrounding gum and bone adjusts to their new position, and can either be removable or fixed.
Under the NHS, your orthodontist is responsible for your care for 12 months after normal treatment ends. After this period, you'll have to pay privately for continuing care, retreatment, and any replacement or repair of retainers.
It's likely there will be some tooth movement if you stop wearing your retainer. Changes in the position of your teeth can continue throughout life and are part of the normal ageing process.
The only way to have permanently straight teeth is to wear a retainer on a part-time basis for life.
In some cases, it may be necessary to remove a tooth to correct the position and appearance of nearby teeth.
You're likely to achieve good results within 18 to 24 months of starting treatment as long as you:
- take good care of your teeth and gums
- wear your appliances as instructed
- follow your orthodontist's dietary advice
- wear your retainer every night to maintain the results – your orthodontist will talk to you about exactly how long you need to wear this