Elastics with braces; if you haven’t had them yourself, you’ve probably seen friends or colleagues wearing these small rubber bands connecting several teeth. But what are they, what do they do, and why do I have to wear them?
When we refer to elastics, we are referring to the larger colourless, elastic rubber bands that run between the upper and lower jaws. These are different to modules – the tiny, often coloured, O-rings that sit around each bracket and hold the wire in. Almost all our patients will have to wear elastics at some stage during treatment. Generally speaking, we commence the use of elastics about 6 months into treatment once in suitable wires, but depending on what we are trying to achieve we may start on your first appointment. But don’t fret – we will always let you know when, where, how and why you are wearing them, all of which may change over time during the various stages of treatment.
The burning question here is why? We understand they can be fiddly, annoying or sore at times, and we don’t just have you wear them for our enjoyment, so why do we include this experience in treatment?
Essentially, elastics do things the braces can’t. The elastics are designed to place a small, but constant force on the teeth in order to correct the bite. Initially (like braces), the teeth they attach to may be a little tender, but (like braces) this will dissipate after a couple of days. Like all rubber products, they do tend to age and lose their stretch over time, so for this reason we advise changing the bands at least once (ideally twice) per day to maintain that small but constant force.
The most challenging issue for us is compliance – patients either not wearing elastics at all, or only wearing them a percentage of the prescribed time. Rather obviously, not wearing elastics is not going to allow any improvement in the bite. No improvement means extended treatment time. But what about partial wear? Unfortunately, wearing elastics for half the time is equivalent to not wearing them at all. Why? Well without getting too bogged down in the detail, say we asked elastics to be worn for 24 hours per day, but were only being worn 12. For those twelve hours they were being worn, there’s force on the tooth and subsequent movement. Great! One step forward! But then then following twelve hours there’s no force on the tooth and the tooth relapses in the direction it came from. One step back. So a net result of zero movement, bummer. And before the myth about wearing twice as many for half the time arises, there’s unfortunately no truth in that either.
The take home message here is that we want your teeth to look great, but also function well. The way we improve function is through occlusion. One of the ways we improve occlusion is with elastics. Hopefully this has provided some valuable insight into why those pesky little elastics which seem to find their way around the entire house are so valuable to us, but more importantly, to you.
Written by Campbell Watson