Is the technology of braces outdated?

Medically Reviewed by
Dr. Todd Ehrler

DDS, MS

Table of Contents

  1. Teeth Move
  2. Ancient Braces
  3. Modern Braces
  4. Why Braces?
  5. Aligners
  6. References

Innovations happen all the time, and often, they lead to better medical care. Now, for example, we use antibiotics (not leeches) to heal infections.

Orthodontics is similar. For some people, the tools common in orthodontic offices represent outdated paths to a better smile.

Why do your teeth move?

Think of a Halloween skeleton, and you're likely to think of a head filled with teeth rooted to the jaws. Your molars, incisors, and other teeth shouldn't move, right? After all, they are connected to the bony parts of your head.

In reality, your teeth can move quite easily. But they need constant pressure to make the shift.

Experts explain that mild pressure, constantly applied, will change the position of your teeth. It happens in a step-by-step fashion:

Pressure Begins
The push is gentle. (Otherwise, your teeth will fall out!) But it's enough to make your body take notice.
Tissues Stretch
The ligaments that connect teeth to bone begin to bend and lengthen.
Bone Remodels
The bone around the roots of your teeth break down and reform.
Supportive Structures Adjust
Your gums reform around the new placement of the tooth, so no gaps remain.
Every system that applies pressure can move your teeth. For most of human history, the preferred system involved braces.

Ancient braces: crude and painful.

Archaeologists have uncovered mummies with teeth wrapped in wire and brackets. At first, experts suspected that these ancient people were wearing braces. Now, most suspect that tooth wrapping was part of the body burial prep process. Real braces, as we know them, were developed in the 1700s.

Researchers explain that Pierre Fauchard is the accepted father of orthodontia. He used a variety of tools in his work, including:

A Bandeau
Metal strips sat in front of the teeth with wires wrapping around each tooth root.
Forceps
A tool shaped like a bird's beak forcefully shoved a tooth from one place to another.
Connections
He tied teeth together after significant adjustments until the mouth healed.

As the years went on, other dental professionals built on this work. They began extracting teeth to ease crowding issues, and they used tools to expand the arch of the teeth.

Plates, screws, and other appliances crowded the mouths of early patients. Some had smiles cluttered with metal, but others had teeth covered with bone, fabric, wood, and other materials.

Are modern braces better?

Modern orthodontists don't whack at teeth with crude tools, and they don't cover up mouths with wood or catgut. But current orthodontic procedures might be very familiar to people living in the 1700s. The basic goals and methods are the same.

Until the 1970s, reporters explain, doctors wrapped wires around teeth to move them. Sophisticated and durable glues were made that allowed brackets to sit securely on teeth for the length of the treatment program. That main innovation changed braces, but the rest remains the same.

Sign up for braces, and your teeth will be connected by wires that shift about every 30 days. The braces apply constant pressure, and since they can't be removed, it's almost impossible for you to interfere with your doctor's treatment plan.

Your doctor might augment the wires and brackets with other tools, including:

Buccal Tubes
These metal pieces connect hardware at the back of your mouth.
Headgear
Bands attach to your braces and put special pressure on your molars to correct large overbites or underbites.
Spacers
These sit between molars and encourage teeth to move.
Springs
Coiled bits on the wires of your braces press teeth apart.
If you need all of these tools, and some people do, it might be hard to see your teeth behind all of the metal and rubber and springs. And you might feel a whole lot like someone wearing a medieval torture device.
The technology that supports braces is hundreds of years old and for some people, braces are the only way to improve their smiles, but for many others, aligners offer a better way to move teeth.

Why do people choose braces?

Some mouths need many adjustments to ensure an enhanced smile. It might seem cruel or unusual to wrap someone's entire mouth with wires and bands and springs. But honestly, some people need all of that help to feel healthy and comfortable in their smiles. But many people do not. And braces can be hard to live with.

Braces simply never come off, even if you want to remove them, and your teeth need care while your smile is moving. To care for your teeth, you must:

Brush
Every time you eat, bits of food can stick in the brackets and wires. Regular brushing, at least two times a day but recommended after every meal, helps you wipe the debris away.
Floss
Food and plaque can stick between teeth, so flossing is crucial. But you will need a special tool to do this job, as wires will interrupt traditional flossing techniques.
Avoid Dangerous Foods
Hard candy, popcorn, gum, and other common foods can damage braces.

Braces can also be painful. Wires can break and stab lips and gums until they bleed. Brackets can push and scrape on the inside of the lips and cause ulcers and sores. Those wounds can take a long time to heal, as the contact between the injury and the hardware remains until the braces come out. And moving teeth can also be inherently painful.

A man who wore braces for many years described how he felt when his hardware was removed. He says he felt as though a 10-pound weight had been removed from the front of his face. He struggled to walk upright, as his body felt so different.

Few people would choose to live with discomfort like this unless they absolutely have to do so. For some people, a very viable second option exists.

Aligners are a better route.

Moving teeth means applying subtle pressure to the root of the teeth. Braces aren't the only way to do that. Aligners can also help.

Aligners are clear plastic trays that pop on the surface of the teeth. Those trays are swapped out periodically for new pieces that are just a bit different than those that came prior. The pressure is similar to that exerted by braces, but aligners come with no:

Wires
There's nothing to poke the back of the mouth, and there's no metal wrapping around teeth.
Brackets
Nothing is glued to the front of the teeth, so nothing scrapes the lips.
Extreme Measures
Aligners aren’t combined with other things like headgear.

You can take aligners out for proper cleaning, both at home and in the dentist's office. And while they can cause discomfort, it's often considered mild when compared to braces.

Researchers say aligners are viable alternatives to braces for people with mild or moderate tooth issues. If your teeth need quite a bit of help to move in the right direction, aligners may not offer enough support. But if your smile needs less intensive work, this technology could be just right for you.

References.

Interesting Facts From the History of Orthodontics. Colgate.

Orthodontics in 3 Millennia. Chapter 1: Antiquity to the Mid-19th Century. (February 2005). American Journal of Orthodontics and Dentofacial Orthopedics.

History of Dental Braces. (February 2019). Medical Life Sciences News.

Clinical Effectiveness of Invisalign Orthodontic Treatment: A Systematic Review. (2018). Progress in Orthodontics.

Dental Braces and Retainers. WebMD.

Braces & Retainers. (May 2017). Cleveland Clinic.

The Basics of Braces. Nemours.

Braces, Pointless and Essential. (July 2015). The Atlantic.

Are You Too Old for Braces? Harvard Medical School.


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