According to the American Association of Orthodontists, the number of adult patients undergoing orthodontic treatment increased by 14% from the year 2010 to 2012.
A specialty branch of dentistry, orthodontics involves the correction of irregularities of the teeth and face. For most people, braces are a means to straighten crooked teeth or remove gaps in the teeth, so as to get a perfect smile. However, there's more to braces than improving the appearance of the teeth. Braces help correct the alignment of the teeth, as well as the upper and lower jaw. Malocclusion is a dental condition wherein the teeth in the upper and lower jaw don't mesh properly, thereby giving rise to problems such as crossbite, underbite, overjet, deep bite, overbite, etc. The use of braces accomplishes much more than aesthetics, as the correction of bite has a direct effect on a person's health.
The logic behind the use of these orthodontic devices is that the position of teeth can be changed, when they are subjected to constant pressure in the direction in which tooth movement is required. It is the periodontal ligament that holds the teeth in place, and when pressure is applied to this ligament, the space where the teeth were located earlier get filled, and space is also created in the desired location. However, there's a need to monitor the movement of the teeth, and make necessary changes every now and then. The use of rubber bands with braces is an essential part of the treatment, as it ensures the desired tooth movement.
Components of Braces and Their Functions
The most commonly used dental braces are the metal braces. For those who don't wish to wear metal braces due to cosmetic reasons, there are other options such as the ceramic braces, lingual braces, Invisalign clear braces, etc. The metal braces comprise the following components:
- Single elastic ligatures
- Ligature wire
- Coil spring
- Rubber bands
Wearing Rubber Bands with Braces
More often than not, orthodontists recommend the use of rubber bands with dental braces. While tiny elastic bands called elastic ligatures affix the archwire to the bracket, interarch rubber bands are large rubber bands that exert pressure on the jaw. Elastic ligatures are available in a wide range of colors. While single ligatures put pressure on individual teeth and connected elastic ligatures help close gaps between the teeth or move multiple teeth in the same direction, interarch rubber bands help improve the bite by moving the jaw forward or backward. The interarch rubber bands are attached to the brackets through hooks.
It must be noted that the elastics should be used as per the directions given by the orthodontist. Mostly, these elastic bands are made of latex, but in case of patients who are allergic to latex, bands made from a non-latex material will be used. It is essential to use the elastic of the recommended diameter and strength.
Arrangements of the Rubber Bands
The arrangements of the bands are categorized on the basis of the class of malocclusion, which includes:
Class I Malocclusion
In this class, the bite is normal as the upper and lower molars are positioned properly. However, the upper teeth slightly overlap the lower teeth. There might be issues involving spacing or overcrowding of the teeth.
Class II Malocclusion
This class is characterized by an overbite, wherein the upper jaw and the teeth in the upper jaw overlap the lower jaw and teeth. The lower jaw is in a backward position, which causes the chin to recede or draw in.
Class III Malocclusion
This class is characterized by an underbite, wherein the lower jaw protrudes and the lower jaw and teeth overlaps the upper jaw and teeth.
Placement of Elastics on Braces
The orthodontist will decide the placement of the rubber band that will help in the movement of the teeth in the desired direction. The bands might be arranged in any of the following configurations, depending on the placement of the teeth.
Class I Elastic
The rubber bands are attached to the hook of the canine or cuspid in the upper jaw to the first or second molar in the upper jaw. It can also be worn on the lower jaw. The purpose of wearing elastics in this manner is to close gaps between the teeth by pushing teeth together.
Class II Elastic
This configuration involves intermaxillary traction, which requires the elastic to be stretched between the upper and lower jaw. In order to move the teeth in the upper jaw backwards and teeth in the lower jaw forward, elastic bands are attached from the hook in the upper canine to the hook in the first or second molar of the lower jaw.
Triangle Class II Elastic
In this arrangement, the elastic is attached from the hook of the upper canine to the hook in the first premolar and first/second molar, thereby forming a triangle. This configuration reduces the problem of overjet, by moving the upper teeth back and bottom teeth forward. It also helps bring the back teeth together.
Class III Elastic
In this arrangement, the elastic is attached to the hook of the cuspid or canine in the lower jaw to the hook of the first or second molar in the upper jaw. The purpose is to move the teeth in the lower jaw backwards and the teeth in the upper jaw forwards. These help in the correction of an underbite.
The elastic is attached to the hook of the canine in the lower jaw, as well as the premolar and first/second molar of the upper jaw, thereby forming a triangular shape. This facilitates the forward movement of the teeth in the upper jaw and backward movement of the teeth in the lower jaw.
The box configuration involves the attachment of the rubber bands to hooks on two teeth in the upper jaw and two teeth in the lower jaw. In case of class III arrangement, the elastics are applied to the upper canine and upper first premolar and the lower canine and lower first premolar. In case of class II, these might be attached to the upper canine and first premolar and the lower first premolar and second premolar. The elastics can be attached to any configuration of teeth. These could be applied on anterior or the posterior teeth.
Anterior Box Elastic
In case of the anterior box elastic, the bands are attached to the left and right canines of the upper and the lower jaw. In case of a posterior box elastic, the elastic is attached to four teeth, two on the top and two on the bottom to form a box. This arrangement is often used for correcting anterior open bite.
Anterior Triangle Elastic
In this arrangement, the band is attached to the hook of the canines in upper and lower jaw, as well as the hook of the first premolar in the lower jaw. This triangular arrangement might help in case of an open bite, wherein the teeth in lower jaw don't align properly with the teeth in the upper jaw. The placement of the teeth in the lower jaw looks unnatural, as teeth in the lower jaw are far behind the teeth in the upper jaw.
The elastic is attached to three teeth, forming a V-shape. The elastic can be placed on the anterior teeth. The V-shaped arrangement involves placing the elastic on the hook of the first premolar in the upper jaw to the canine in the lower jaw, and then to the hook of the canine in the upper jaw.
In case of an anterior vertical elastic, the elastic is attached to the hook on the first premolar in the lower jaw to the hook on the canine in the upper jaw, and then to the hook on the canine in the lower jaw, thereby forming an inverted-V shape. This type of arrangement might help correct the anterior open bite.
The elastic is attached to the hook of canine in the upper jaw to the canine in the lower jaw. It can be placed from the upper left canine to the lower right canine, or from the upper right canine to the lower left canine.
The elastic in this arrangement starts from one side and crosses the midline to the other side of the mouth. This is recommended in case of a midline deviation.
This is an arrangement wherein the elastic runs from the inside of an upper tooth to the outer side of a bottom tooth. As the name suggests, it is recommended for the correction of a crossbite, which is a type of malocclusion wherein one or more teeth in the upper and lower jaw don't match on one or both sides.
Directions for Wearing Rubber Bands
It must be noted that these bands help move the teeth in the desired direction, and a lack of consistency in wearing them can have an adverse effect on the orthodontic treatment. In fact, the teeth could slip back in their old position, if these bands are not worn consistently.
- Though rubber bands need to be worn most of the time, these must be removed while brushing and eating solid food.
- These must be placed back after you have eaten or brushed your teeth.
- One must follow the directions given by the orthodontist regarding their usage. With time, the elastic might lose its strength, which is why these must be changed as and when needed. The old elastics must be replaced with new bands of the required diameter and strength.
On a concluding note, the use of rubber bands is an integral aspect of orthodontic treatment, and it definitely affects the outcome of the treatment. These bands create the right amount of pressure, which helps move the teeth in the required direction. This helps align the teeth in such a way that they can work in tandem with the other parts of the jaw. This not only helps improve the appearance of the teeth and the face, but also corrects the malocclusion, which can otherwise have an adverse effect on one's health. However, for the best results, one needs to religiously follow the directions given by the orthodontist.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of an orthodontist.