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Read articleFixed brackets, removable braces, clear aligner trays – modern orthodontics offers a whole range of treatment methods today. We receive a particularly large number of questions about removable braces: What can they do, who are they intended for – and where are their limits?
Dr. Mohammad Hakim, specialist orthodontist in Frankfurt, explains in this article in clear terms which types of removable braces exist, how they influence jaw growth, and when a removable appliance reaches its limits.
The video accompanying this article
What are removable braces?
The name already says it: Removable braces – often also called a removable appliance or a plate – can be taken out of the mouth and put back in by the patient. That is the fundamental difference compared with fixed braces and their permanently bonded brackets.
But “removable” is not always the same as “removable”: there are a great many different models and designs. With the appropriate indication, some of these appliances are covered by the statutory health insurance, while others are private services. Which version makes sense in your case and how coverage works out, we clarify individually in a personal consultation.
Fixed vs. removable braces – the decisive difference
The most important difference lies not only in comfort, but in function:
- Fixed braces: Work around the clock and can move teeth precisely into almost any desired position – including heavily rotated or displaced teeth.
- Removable braces: Create space, hold gaps and above all guide jaw growth. For completely straightening the teeth, they are only suitable to a limited extent.
Precisely this point is often misunderstood – which is why we will now take a closer look at the individual types of appliance.
An overview of the types of removable braces
In principle, removable braces can be divided into two large categories:
- Appliances for a single jaw (upper or lower jaw) – these serve more to move individual teeth.
- Appliances for both jaws (upper and lower jaw together) – so-called functional orthodontic appliances for growth guidance.
1. The classic plate – the all-rounder
The active plate is the most typical form of removable braces that young children receive at an early age. It is used when, for example, baby teeth have been lost too early and crowding develops as a result.
Small expansion screws are built into the plate. By adjusting them regularly – usually once a week – they gradually move the teeth to the side, backwards or outwards. This creates space for the permanent teeth coming through. The colorful plates are available in many colors, which noticeably increases acceptance among children and teenagers.
2. The space maintainer
A special function of the same appliance is holding gaps: if a tooth is lost early, the space maintainer ensures that the space is preserved and does not narrow as neighboring teeth move in – until the permanent tooth erupts. A space maintainer that is only meant to hold space usually only needs to be worn at night.
3. Functional orthodontic appliances: activator & co.
These appliances apply to both jaws together and have a clear goal: to guide the growth of the jaw. The best-known representative is the activator.
It redefines the position of the jaw and sets targeted growth stimuli. Especially in children and teenagers who are still growing, developmental issues such as a retrognathic bite or a large step between the teeth can be favorably influenced in this way. The clever part: the patient’s own growth forces are actively used for the therapy. Besides the activator, there are many other designs, for example according to Fränkel.
4. Myofunctional therapy with silicone trainers
As an alternative – and, with the appropriate indication, in some cases likewise covered by statutory insurance – myofunctional appliances made of silicone are used. They work differently from the activator: instead of applying pressure to the teeth, they stimulate growth through exercises and movements of the lip and cheek. Progression is achieved not through screws, but by switching to a different silicone hardness.
5. The twin block plate (combination appliance)
The twin block plate consists of two plates for the upper and lower jaw that come into contact with each other via a ramp. It combines the movement of the teeth with an influence on the jaw position – a versatile combination appliance.
6. Clear aligners as a removable option
Transparent clear aligners also count among removable braces. They are changed regularly so that the teeth continuously receive the right pressure and the desired movement. Unlike classic removable appliances, aligners are designed to make teeth straight – the ideal removable solution when it comes to a truly straight smile.
What are removable braces intended for?
In summary, removable appliances mainly fulfill two tasks:
- Influencing growth: Functional appliances for both jaws (e.g. the activator) guide jaw growth in the right direction.
- Moving teeth to a small extent & creating space: Single-jaw plates move teeth and hold or open up gaps.
In both cases, one thing is decisive: the patient’s active cooperation.
The limits: what removable braces CANNOT do
As useful as removable braces are – they have clear limits. Complete orthodontic straightening of the teeth is not possible with a removable appliance. It can create space and support nature in bringing the teeth into a better position.
With heavily rotated or markedly deviating teeth, however, fixed braces or aligner treatment are usually needed afterwards. Anyone who wants a removable solution for truly straight teeth is therefore better served by aligners than by an appliance that is only worn in the evening or at night.
Wear time & cooperation: the key to success
This is where the most common sticking point lies. While a pure space maintainer is enough at night, active removable appliances – which open up gaps, move teeth or guide growth – require a wear time of around 16 hours a day.
Important: the appliance has to be in the mouth longer than outside it. Otherwise the dreaded yo-yo effect looms, in which the progress achieved gradually reverses. That is why, with any removable appliance, treatment success stands or falls with cooperation.
Care & cleaning of removable braces
One clear advantage over fixed braces: cleaning is considerably easier and more pleasant. Here is how to care for your appliance properly:
- Use cleaning tablets (special tablets for removable braces).
- Use a toothbrush gently – no abrasive toothpastes, as they can cause scratches.
- Even with the appliance, always brush your teeth thoroughly.
Course of treatment: appointments, pressure & getting used to it
- Check-up appointments: as a rule every two to three months for fine adjustments.
- Feeling of pressure: Slight pressure on the teeth is completely normal and intended – that is how the appliance works. Pain or sharp, stinging spots, on the other hand, are not normal.
- Getting used to it: At first, the appliance may occasionally fall out at night. With a little practice, it sits securely after a short time.
Who are removable braces suitable for?
Removable braces are particularly useful for children and teenagers who are still growing, where the aim is to create space, hold gaps or guide jaw growth. For the final, precise tooth position – in teenagers as well as adults – fixed braces or aligners are then often used.
Which path is the right one for you or your child can only be assessed individually. In a detailed consultation as your orthodontist in Frankfurt, we clarify the possibilities, the limits and the right treatment plan.
Conclusion
Removable braces are a versatile tool in orthodontics – ideal for guiding growth and creating space at a young age. Their limit lies in precise straightening; for that, fixed braces or aligners are the better choice. Decisive for success remains the consistent wear time of around 16 hours a day.
Do you have questions about removable braces for yourself or your child? Schedule your consultation appointment with Dr. Hakim in Frankfurt now – as an experienced orthodontist in Frankfurt, we will advise you in detail on all the options.
