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What are self-ligating brackets & are they faster?

Self-ligating brackets (SLBs) have been around for many years. In fact, a gentleman called Charles E Boyd first introduced them in 1933. In this post, we explain what SLBs are and whether they do as claimed — offer faster treatment.

What are self-ligating brackets?

Standard metal braces consist of brackets that are attached to a patient’s teeth, and an archwire is threaded through the brackets using o-rings — little rubber bands — to hold it in place.  Self-ligating brackets, on the other hand, feature a small gate at the front that secures the archwire when closed. SLBs apply less friction to a patient’s teeth, and no o-rings are required.

The purported benefits of self-ligating brackets

Here are some of the benefits that manufacturers of SLBs claim:

  • Faster treatment because less friction allows teeth to move more freely
  • More comfortable due to less friction
  • Longer intervals between appointments
  • Better results

The benefits sound impressive — who doesn’t want faster treatment? However, many orthodontists, including us at Turner Lim, remain unconvinced that SBLs are any faster or better than other braces. In fact, a recent study suggests that SLBs could be slower than traditional braces by up to two months. Also, SLBs are not the most cost-effective option.

Should you avoid self-ligating brackets?

No. If fast treatment is important to you, SLBs are worth a try. Just be aware that the evidence to back up that they work faster is ‘thin on the ground.’

One of the better-known self ligating brackets is the Damon System. We have used this system in the past at our West Auckland clinic but feel it’s quite bulky — more compact brackets are easier for our patients. We do currently use a clear SLB  because it doesn’t have o-rings that discolour over time due to food. It also has a lower profile than the Damon System and so is more comfortable for our patients.

What determines the speed of orthodontic treatment?

It is claimed that SLBs apply less friction and, therefore, work faster than other braces because they allow patients’ teeth to move more freely. Yes, the initial alignment of teeth can be rapid, but the roots still require time to move into their correct positions.

In our experience, several factors determine the speed of orthodontic treatment, not least the skill of your orthodontist — her treatment plan, bracket placement and selection of wires and mechanics, etc. There are other factors, too, including:

  • Cooperation of patients — whether they wear the elastics as instructed.
  • Biology — every patient is different.

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Boy undergoing maxillary expansion.

The many benefits of maxillary expansion

Maxillary expansion is the orthodontic process of widening the upper jaw (maxilla) to align with the lower jaw. There are several benefits of this procedure that go even beyond orthodontics, which we discuss in this post. But, first, let’s look at why and how orthodontists use maxillary expansion.

In orthodontics

By widening a patient’s upper jaw, orthodontists can create space to correct crowding. The procedure also often eliminates the need for tooth extraction.

Why is expansion needed?

A narrow upper jaw won’t come right over time or as a child grows into an adult. Luckily, jaw problems in children are visible early. In fact, orthodontists usually carry out expansion on pre-adolescents because, at that age, their bones are not yet fused together, making it easier to widen the palate.

Crowded teeth because of a narrow jaw can cause the following problems:

  • Teeth are difficult to clean. As a result, food can become trapped and cause bad breath and gum disease.
  • Teeth can wear abnormally. Crowded teeth often don’t align correctly with their counterparts and touch tooth areas they shouldn’t.
  • It can be difficult to chew. The inability of teeth to make contact with each other can make chewing a problem.

How does maxillary expansion work?

The orthodontist will cement a custom-made appliance (expander) to the patient’s posterior upper teeth (bicuspids and molars). The expander has a small screw or spring that when turned, generates a force that gently separates the two palatal bones. The orthodontist will instruct the child or parent to turn the screw once a week, sometimes more often.

Beyond orthodontics

As mentioned in our introduction, there are other non-orthodontic problems maxillary expansion can address. Here they are.

Bedwetting

Yes, you read right. It is thought that expanding a child’s upper jaw can reduce or stop bedwetting. Now, you may be sceptical that maxillary expansion could cure for such a condition, but it makes sense. You see, many experts believe there is a link between bedwetting and breathing sleep disorders. The palate forms the base of the nasal airway, so widening it can improve airflow.

Sleep apnoea

Again, because maxillary expansion improves patients’ airways, it is thought to improve obstructive sleep apnoea in children — where the child stops breathing several times during the night. In adults, the lack of decent sleep can manifest in them falling asleep at inappropriate times. With children though, poor sleep can lead to hyperactivity, behaviour sometimes misdiagnosed as ADHD.

Hearing problems

Finally, several studies show that the hearing of hearing impaired children can improve from between two to 19 decibels after maxillary expansion.

There is still plenty of debate over the merits of maxillary expansion beyond orthodontics. If you feel, however, that the procedure may help your child, we recommend you consult a doctor to investigate allergies or adenoid problems first.

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A woman wearing lingual dental braces.

3 nearly invisible dental braces that adults love

These days, a growing number of adults wish to improve their teeth later in life. There could be a couple of reasons for this: orthodontics is more affordable and available than it once was, and baby boomers feel younger and want a look to match. One thing most adults are not too keen on, though, is visible braces

Yes, wearing braces can feel like being transported back to school. When you’re a teenager, they are a ‘badge of honour’ — a rite of passage. As an adult, though, they’re not so cool. After all, in the ‘grown-up’ world, we are, unfortunately, judged on our appearance. Looks are important — which, of course, is why you might be considering braces in the first place.

Well, we have some good news for you: If you want to get braces, there are less obtrusive options available, including lingual braces.

Lingual braces

Most dental braces fit on the outside of a patient’s teeth and are difficult to hide. Lingual braces, however, sit on the inside and are almost invisible, which makes them ideal for image-conscious adults.

Unfortunately, as many orthodontists are reluctant to fit lingual braces, they are not readily available. You see, compared to other types of braces, there is a bunch of stuff (like there being a smaller arc to work on) that makes fitting and maintaining lingual braces more mechanically tricky.

Anyway, in recent times — thanks to Alla, an old hand in the art, joining the team — Turner Lim has become more involved in lingual orthodontics.

Like many things in life, though, with lingual braces, as well as pros, there are a couple of cons to be aware of:

  • Mind your tongue. Because the braces are on the inside, they can affect tongue movement and take a bit of getting used to.
  • Your budget. Lingual braces are a premium product and, therefore, cost between 30% to 50% more than standard options.

Other discrete dental braces

Apart from lingual braces, there are two alternative non-obtrusive types to consider.

  • Invisalign®: With this system, there are no restrictions on what you can eat and drink. It consists of almost invisible computer simulation-generated templates (aligners), which are changed every 1 to 2 weeks. Your orthodontist will provide a new set at each check-up appointment (usually 8 to 10 weeks). For Invisalign®, the length of time between appointments is longer than many other treatments, which makes it easier to balance other commitments. Invisalign® isn’t effective for some bite issues — although advancements mean the bites types it isn’t suitable for continue to become fewer. In fact, for some bites, Invisalign® is the best option. For tricky work, and to make treatment as efficient, smooth and attractive as possible, we may first use a combination of fixed braces on the back teeth and Invisalign® on the front — there are so many options.”
  • Ceramic braces: Like standard types, ceramic braces have a small gate to hold an archwire in place and are not susceptible to the elastic ring changing colour with your latte or curry. Due to being made of a translucent material — some even come with tooth-coloured wires — ceramic braces are less visible than standard metal braces and even Invisalign®.

Read more about the different types of braces we offer.

We understand that aesthetics are particularly important for our adult patients, which is why we don’t charge adult patients extra for ceramic or Invisalign® braces. Also, with all ceramic and lingual treatments, we routinely use SureSmile on adults to achieve optimum results and treatment times.

So, there you have it: If you’re worried about what braces will look like, there are options available. If you enjoyed this post, please share.

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