How do braces actually move my teeth?

December 25th, 2022

Orthodontics is a branch of dentistry that focuses on the alignment and straightening of teeth, as well as correcting bite problems. One of the most common treatments in orthodontics is the use of braces, which are devices used to apply constant, gentle pressure to the teeth in order to move them into the desired position.

But how exactly do braces work, and what is the biology behind orthodontic-facilitated tooth movement?

When teeth are subjected to constant pressure, they will naturally try to move in the direction of that pressure. This is because the teeth are held in place by a group of specialized cells called periodontal ligament cells, which are found in the periodontal ligament (PDL) that surrounds the tooth. These cells are responsible for anchoring the tooth to the jawbone, as well as allowing for movement of the tooth when subjected to force.

When a tooth is subjected to pressure from a brace, the PDL cells on the side of the tooth facing the direction of the pressure will become stretched and elongated. At the same time, the PDL cells on the opposite side of the tooth will become compressed and shortened. This creates tension in the PDL, which prompts the cells to divide and multiply in order to maintain their ability to hold the tooth in place.

As the cells divide and multiply, the tooth is slowly moved in the opposite direction of the pressure. This process is called orthodontic facilitated tooth movement. It occurs in small increments over a period of time, with the rate of movement determined by the amount of force applied and the duration of treatment.

The biology behind orthodontic facilitated tooth movement is a complex and fascinating process that involves the interaction of various cells and tissues in the mouth. By understanding how braces work and the role that the PDL plays in tooth movement, orthodontists are able to effectively straighten and align teeth to improve the overall health and appearance of their patients' smiles.

NOTE: The author, Dr. Graydon Carr, is a board-certified orthodontist who is in the private practice of orthodontics in Chico, California with his partner Dr. B. Scott Hood. Dr. Graydon Carr was trained at the University of the Pacific, Arthur A. Dugoni School of Dentistry in San Francisco, California, and the University of Nevada at Las Vegas School of Orthodontics and Dentofacial Orthopedics. Dr. Graydon Carr & Dr. B. Scott Hood’s are experts in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems. This blog is for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. B. Scott Hood & Dr. Graydon Carr are licensed to diagnose and treat patients in the state of California. They cannot diagnose cases described in comments nor can they select treatment plans for readers. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.

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