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How Does an Orthodontist Determine Brace Placement?

Whether you are a parent with a child reaching adolescence or an adult who is considering options for teeth alignment, dental braces may be a good option. Before actually making an appointment with an orthodontist or signing a payment plan, you might want to know more about how braces work. The proper placement of braces is key to their success. Individual braces are adhered to each tooth with a special adhesive and then strung together with a wire that holds all of the teeth with their braces in place. Over time, the combination of wires and braces will pull teeth into a straight position.

  1. Palmer Notation

    • In order to denote which tooth a bracket is to be placed upon, orthodontists use a system called Palmer notation. In this notation system, all of the teeth in an individual's mouth are assigned a number identifying them. The teeth are divided into four main areas: upper right, lower right, upper left, and lower left. A lettering system rather than numbering system is applied to baby teeth, but dental braces are not an option until all permanent teeth are in and settled. Although there are a few variations on this system, Palmer notation remains the most common means of clearly deciding on braces placement.

    Placement of Brackets

    • Brackets are typically ceramic or metal, and they are the main thing that comes to mind when one thinks of dental braces. They come with a colored option if the patient desires. From one tooth to another, the placement of brackets is relatively uniform. Each bracket is placed on the front side of a tooth in its center. For different types of teeth, such as incisors and molars, orthodontists have different heights they associate with the placement of the bracket for perfect centering. The brackets are then glued to the tooth with a strong adhesive that will neither break down in the mouth nor cause damage to teeth.

    The Arch Wire

    • The principal thing involved with braces placement is the placement of the brackets, but brackets alone cannot straighten teeth. After brackets have been adhered to a tooth, two wires, one that runs across the front of the top teeth and one across the front of the bottom teeth, are strung through the brackets. Over the duration of time the patient wears his braces, the arch wire pulls the teeth into correct alignment. Periodic trips to the orthodontist must be made so that the orthodontist can tighten or loosen the wire according to progress.

    Retainers

    • While not all patients wear retainers after they have their braces removed, many orthodontists encourage them to do so. Retainers maintain the position of teeth over time once they have been perfectly aligned. If the patient chooses not to wear a retainer, teeth can gradually shift and become crooked again. An option that some people might want to consider is the built-in retainer. This is a small metal wire that is placed at the back of the top front teeth and the bottom front teeth and then glued into place. It stays in at all times and causes no discomfort to its wearer.

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