Fixed braces in Lugano

What fixed braces are

Fixed braces consist of attachments, also called brackets, bonded to the surface of the teeth and connected by an orthodontic archwire. The wire is adjusted at intervals and delivers the forces that move the teeth into the planned position. Unlike clear aligners, fixed braces cannot be removed by the patient and work continuously for the whole duration of treatment.

Metal or ceramic brackets

At Alpine Smiles we offer two types of bracket.

Metal brackets are made of stainless steel, are hard-wearing and suit all types of tooth movement. They are held in place with elastic ligatures available in a range of colours, changed at every appointment. Many children and teenagers enjoy choosing a new colour each visit, picking their team colours or something seasonal. Anyone who prefers a more discreet look can choose clear or grey ligatures.

Ceramic brackets are close in colour to natural enamel and are less noticeable at conversational distance, which is why adults often choose them. Compared with metal they are more brittle and can debond more easily, and clear ligatures tend to pick up staining from coffee, tea, turmeric and smoking, so they need changing regularly. Ceramic brackets cost more than metal ones.

Oral hygiene

Fixed braces call for a more careful oral hygiene routine, because cleaning around the brackets and archwire is harder. If plaque builds up along the edge of the brackets, gum inflammation can follow and, in neglected cases, enamel demineralisation, leaving white marks that remain visible after the braces come off. We recommend a toothbrush, interdental brushes and, where indicated, a water flosser, along with more closely spaced professional hygiene appointments during treatment.

Review appointments and repairs

Patients with fixed braces need regular appointments for adjustments and reviews, usually every six to eight weeks. On top of these come the unscheduled ones: a bracket that comes loose, or a wire that slips out and catches the cheek, needs sorting quickly, often within a few days. For a family with several children, or for anyone with a tight diary, these unplanned return visits are a practical point to weigh up before deciding. With clear aligners this side of things is reduced, as there are no brackets or wires that can break.

Sport and physical activity

In children and teenagers who play contact sports or play roughly, metal brackets can cause injuries to the lips and cheeks in the event of an impact. Anyone wearing fixed braces who plays sport should use a dedicated orthodontic mouthguard, replaced as the teeth move. Clear aligners have a smooth surface and cover the arches, so they do not carry the same risk of injury from brackets, but they are not a substitute for a sports mouthguard: for contact sports a mouthguard remains advisable in either case.

Eating and drinking

During treatment with fixed braces it is advisable to avoid certain foods, particularly sticky or very hard ones such as chewy sweets, ice, nougat and nuts, so as not to damage the brackets or the wire. Aligners are removed for meals and carry no dietary restrictions.

Making the choice

Compared with clear aligners such as Invisalign, fixed braces are more visible and ask more of you day to day. They remain an effective treatment method and in some clinical situations they are the more suitable option, for example where wearing aligners for the required number of hours a day is not realistic. The choice between the two depends on the clinical picture, age, lifestyle and patient preference, and is decided together after a clinical assessment.