Fixed Orthodontics

What is Fixed Orthodontics (Fixed appliances)

Have you ever thought about orthodontic treatment for misaligned teeth? Fixed orthodontics, a specialized area within dentistry, focuses on correcting misaligned teeth and addressing jaw bone issues. With the continuous evolution of orthodontic techniques and tools, traditional metal braces are no longer the sole treatment choice available today.

What Is Fixed Orthodontics?

Fixed orthodontics involves attachment of brackets to the teeth, which cannot be removed by the patient. Unlike removable orthodontic appliances, fixed orthodontics does not rely on patient cooperation.

The average duration of fixed orthodontic treatment is 2 years, but it can be extended based on the type and severity of the malformation. It is important to avoid consuming solid foods like scorched rice, corn, seeded fruits, and olives while undergoing fixed orthodontics to prevent bracket detachment and potential tooth damage. Patients must take extra precautions during this time to avoid tooth discoloration and decay.

Fixed Orthodontics Treatment Process

During fixed orthodontic treatments, teeth can be shifted approximately 1 mm per month, which may not be ideal throughout the treatment duration. In certain situations, a tooth extraction may be necessary based on the type of malformation. In such cases, teeth are guided toward the vacant spaces, and the movement of the tooth becomes noticeable in the initial sessions. Patients are advised to attend treatment appointments on a monthly basis.

Following the activation of elastic bands, wires, or springs during each session, patients may experience some discomfort that typically subsides within the first week. Occasionally, during examination sessions, a portion of the wire may protrude from the end of the teeth due to tooth movement, causing a sharp sensation for the patient. In such cases, an immediate emergency visit should be arranged to trim the protruding wire end.

What Are Fixed Braces for?

Fixed orthodontic treatment focuses on repositioning teeth, correcting overcrowding, and enhancing tooth alignment. Brackets are bonded to the teeth, with a wire threaded through them. Subsequently, small elastic bands are attached to the brackets. These bands, available in white or various colors, are changed during each appointment, while the wires may remain unchanged.

What Are the Types of Fixed Orthodontics?

What Are the Types of Fixed Orthodontics?

There are different types of fixed orthodontics available to you. They are:

Conventional metal fixed appliances

Appliances commonly used for children and often referred to as ‘train tracks’, are typically made from stainless steel and attached to the teeth using tooth-colored filling material. It is important to be cautious when eating hard foods to avoid breaking the attachment, which can disrupt the treatment. An orthodontic wire is tied into the bracket using colored elastic rings, which may discolor between visits.

These elastics can be silver to blend in with the appliance or brightly colored. As treatment progresses, thicker wires are used to apply greater forces to the teeth. Patients may describe this process as ‘tightening’ the appliance. At the end of treatment, the appliances can be easily removed, leaving the teeth intact.

Ceramic fixed appliances

Instead of using stainless steel, the attachments can be made from a durable ceramic material that matches the color of the teeth. This creates a more visually pleasing appliance, especially for adults. The orthodontic wires can also be tooth-colored to enhance the appearance further. Ceramic fixed appliances are just as effective as traditional fixed appliances in achieving tooth movement.

However, in cases where the bite is deep, ceramic appliances may not be recommended for the lower teeth as the hard material can potentially damage the opposing teeth that come into contact with the attachments. While ceramic appliances may be slightly more challenging to remove compared to traditional fixed appliances, they are unlikely to cause harm to healthy teeth.

Self-ligating fixed appliances

The major orthodontic manufacturers each make their own line of self-ligating appliances, which can be either metal or ceramic, and some may make significant claims regarding the benefits of their treatment. Instead of relying on elastics to secure the orthodontic wire in place, these appliances feature an integrated clip mechanism that securely holds the wire, allowing it to move more freely.

While there is no proof that this mechanism yields superior results compared to a traditional fixed appliance, there is evidence that the self-ligating mechanism reduces the time needed to change the wire and decreases the likelihood of the appliance becoming discolored between visits due to the absence of elastic ties.

Lingual fixed appliances

Lingual fixed appliances

In contrast to the previously mentioned appliances, lingual appliances are affixed to the inner surface of the teeth, rendering them undetectable to external observers. Numerous orthodontists provide these systems, which can yield exceptional outcomes. However, certain challenges may arise with lingual appliances, such as initial speech difficulties, discomfort of the tongue, and difficulties in maintaining cleanliness. It is important to note that the cost of treatment with lingual appliances is significantly higher compared to the previously mentioned appliances.

What are Fixed Versus Removable Braces?

In general, fixed appliances tend to be more efficient compared to removable ones, although they may come at a higher cost and cause greater discomfort in the oral cavity. On the other hand, removable appliances are typically more affordable and provide a higher level of comfort, but they may require a longer duration to achieve desired outcomes.


Removable braces offer a viable solution for orthodontic conditions that range from mild to moderate. However, it is important to note that they may not be suitable for all orthodontic needs. In addition to their potential cost-effectiveness, removable braces may also offer the advantage of shorter treatment duration compared to traditional braces.


How long are fixed braces on for?

Typically, the recommended duration for wearing braces ranges from 18 to 24 months. Changes in the alignment of your teeth may start becoming visible within four to six weeks of getting them fitted. On average, most individuals can expect to see significant improvements within 2-3 months.

How painful are fixed braces?

The majority of individuals may encounter discomfort for a brief period of time after getting braces or having them adjusted. On the other hand, some may only feel slight discomfort that dissipates within a short time frame. Braces serve as a form of orthodontic intervention utilized by orthodontists to address issues such as overcrowded or misaligned teeth.

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