Fixed appliance

Fixed appliance
8 October 2018 Articles orthodontics
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For most of the orthodontic patient, covering fixed appliance (generally called brace) is the most important part of the treatment. These appliances mostly are silvery metal type. Today there are different type of appliances such as ceramic appliance, lingual appliance and self-ligating rather than traditional looking metal ones.

Initially we should consider the difference between fixed and removable appliances. Fixed appliance are attached to the teeth by metal bands or special cement that they are not taken off until end of the treatment period. Removable appliances same as clear aligners should be kept at mouth about 22 hours per day, it can be easily taken off as needed by the patient. While clear aligners are useable for treating little or moderate problems, fixed appliance can be effective for more complicate and general problems.

Different types of Braces ( Fixed appliances )

Fixed metal appliance

Today stainless steel fixed metal appliance are light weight structures. Metal appliance contain of metal brackets which fix on each tooth by a special wire and these brackets also attach to each other by orthodontic wire. These brackets gently push teeth to the head to a proper position.

Fixed appliance wire attach to the brackets by elastic rings. These elastic rings will be replaced by new ones when the appliance are fixed by orthodontist. Those appliances with no orthodontic ring called self-ligating.

Fixed appliance

Although fixed metal appliance has the same function as the other metal appliance but their brackets are made of bright ceramic. Since ceramic appliance are hard to notice, it is well known among adults. According to special orthodontist, in some cases the orthodontic rings are discolored and it may leave trace on the teeth.

Fixed appliance made of bright ceramic


Self-ligating fixed appliance

Orthodontic manufacturers produce metal or ceramic self-ligating appliance; this appliance has many treatment advantages. This appliance not only has elastic ring to hold the orthodontic wire in position but also it has an integral mechanism that help the orthodontic wire to move comfortably. Although there is no proof that this kind of appliance has much better result than the other ones but there is evidence that this mechanism takes less time to change the orthodontic wire and since no elastic are used to tie the wires, there is less possibility of discoloring.

Self-ligating fixed appliance

lingual appliance

Unlike the other types, lingual appliances are placed to the inside surface of the teeth which is hidden of view. Most orthodontist suggest their patients this effective appliance. On the other hand, lingual appliance may cause some problems for patients such as difficulty in speaking, tongue soreness and problem for keeping the braces clean. This kind of treatment is much more expensive than the other ones, due to the high laboratory fee for producing the lingual appliance and time consuming surgery in the adjustments.

lingual appliance

Which type of appliance is suitable for me?

Fixed appliance advantages

  • Can be used generally for all teeth
  • Applicable for any correction aimed at an ideal arch form
  • Treatment period is partly short even in severe cases and also is manageable for patient
  • All the required instruments are prefabricated and can be placed directly in the patient’s mouth.
  • Amendments can be done in the follow-up sessions directly and quickly
  • Patient assistant is not required to ensure treatment procedure
  • No damage or harm to appliance because of inconvenient or incorrect handling by patient
  • Straightforward procedure is run by treatment process

Fixed appliance disadvantages

  • The amount of force is not manageable objectively
  • appliance function is unceasing
  • There is possibility of tissue damage, like root resorption and shortening of the alveolar ridges
  • There is high risk for caries due to limitation in cleaning ability
  • Continuous radiographic checks are obligatory
  • Fixed appliance appearance is unpleasant especially for adult.


Teeth brushing and flossing is the most important act after appliance surgery. You need take care in the area between space of band and gums. Collecting food around the bands and wires leads to stains and cavities in addition it causes unpleasant odors. So you should brush after each meal correctly and properly. You can ask your dentist about the proper toothpaste and tooth gap cleaners. Orthodontic appliance would be affected on your food type.

You should avoid to eat the following foods

  • Hard, crunchy foods

    • Ice: although you can have it in your drinks, but shouldn’t chew and crunch on it.
    • Hard edges of pizza
    • Crispy French fries
    • Chips: avoid to eat chips and replace it by cheese puffs that are more soft
    • Pecans, peanuts and popcorn: They can get caught in your appliance space area.
    • Hard candies.
  • Sticky foods

Avoid sticky candies like caramels, taffy and bubble gum.

Some fruits and vegetable such as apple and carrot should be cut off in small piece to eat. Avoid to suck on lemons or lime, they damage to your teeth enamel. Keep objects out of your mouth such as pencils and fingernail, because lead to loosing appliance. Generally, you should take care of your teeth appliance

and cooperate with your orthodontist to get better result. Inform your doctors for any problem detection.

tooth brush

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