Competencies
Fixed braces - brackets for children & teenagers
Misaligned teeth are often not only an aesthetic problem, but can also affect health. Fixed braces are a proven solution for correcting misaligned teeth and thus supporting the patient's overall health.
At JUST KFO, we adapt fixed braces to the individual needs of our patients.
How do fixed braces work?
The exact orthodontic movement of teeth in the jawbone can only be achieved with fixed braces (multi-bracket appliance) or an aligner system(e.g. Invisalign). The fixed braces can be attached to the inside (lingual technique) or outside of the teeth. The externally attached visible and new braces can be made of metal or less visible ceramic.
Click here to go directly to the frequently asked questions / FAQs about fixed braces!
Fixed braces for children and adolescents
Fixed braces are often the treatment of choice for children and adolescents. If the permanent teeth are in the process of erupting and space is needed for them, we often treat this with fixed braces. The same applies if the upper and lower teeth do not fit exactly into each other when biting together (occlusion). Aligner treatment is often also possible.
Fixed braces / braces for adults
We can also incorporate fixed braces for adults if treatment with aligner therapy is not an alternative. This includes the straightening of tilted teeth or orthodontic treatment in conjunction with osseointegrated anchorage.
Fixed braces - before & after
Comparison of the different bracket systems:
Standard metal brackets
Ceramic brackets (Ormco)
Self-ligating metal brackets (Damon, Ormco)
Self-ligating ceramic brackets in the upper jaw, metal brackets in the lower jaw (Damon, Ormco)
Fixed braces as a multi-bracket appliance
Treatment with multi-bracket appliances
Newly developed wire materials and brackets (e.g. the Damon bracket) allow fast, gentle and comfortable treatment with fixed braces. After the bracket (fixed brace) is placed on the tooth, the tooth surface can be sealed.
Self-ligating brackets
The Damon system is one of the so-called passive self-ligating systems, the first generation of which was launched on the market by Ormco in 1996, and since then has constantly set new standards for the efficiency and quality of self-ligation.
In orthodontics, the term "ligation" refers to the connection between the archwire and bracket, which is created using elastic rubber bands or thin metal ligatures, for example.
Self-ligating brackets for fixed braces
contain a small flap that can be closed to hold the bow in position. The use of elastics or ligatures can therefore be completely dispensed with. This greatly improves oral hygiene.
This method has decisive advantages: The locking flap allows the archwire to slide freely in the bracket, resulting in less friction and reduced effort compared to conventional brackets. Self-locating brackets therefore offer remarkable advantages over traditional fixed braces. The brackets are available in metal and ceramic.
For the patient this means
- Significantly shorter treatment time
- Significantly better oral hygiene capability
- High-quality results
- More biological forces on the teeth and therefore gentler treatment
- If there is a considerable lack of space, the removal of teeth can often be dispensed with.
Treatment of temporomandibular joint disorders (CMD) with fixed braces
In patients with temporomandibular joint disorders (CMD), orthodontic treatment with fixed braces (multi-bracket appliance) or the Invisalign system is often necessary after orthopaedic adjustment of the functional position of the temporomandibular joint and physiological adjustment of the lower jaw position. With the help of fixed bites, the orthopaedic joint adjustment is fixed and the teeth are moved in individual segments with the braces. The fixed bites are gradually removed. This can be accompanied by manual medical or osteopathic treatment.
Frequently asked questions / FAQ about fixed braces
Table of contents
- Fixed braces - before & after
- The fixed brace
- How much do fixed braces cost?
- Which fixed braces are the best?
- How many days do fixed braces hurt?
- Which is better - fixed or loose braces
- What are the benefits of fixed braces?
- When do you get free braces?
- How much do fixed braces cost without health insurance?
- How much do braces cost per month?
- How much do AOK braces cost?
- Can you pay for braces monthly?
- Which braces are the cheapest?
- How much do braces cost for 14 years?
- How long do teeth shift after braces?
- When are braces not possible?
- How do I get the money back for the braces?
- How quickly do braces work?
- Classification system of orthodontic indication groups (KIG)
- Proper care of braces - Our care instructions
- Palatal suture expansion (GNE)
- Distalizer according to Carrière
- Anchoring technique orthodontics
- Positioner
The fixed brace
Fixed braces are a proven and effective method for correcting misaligned teeth. It consists of brackets that are bonded to the teeth and wire arches that move the teeth into the desired position.
The duration of treatment with fixed braces varies depending on the type and extent of malocclusion and can last from several months to several years. During treatment, the braces must be adjusted regularly by the orthodontist in order to monitor progress and optimize the correction of the malocclusion.
It is also important to maintain good oral hygiene during treatment and to avoid certain foods and habits that can damage the braces or affect the teeth. These include hard or sticky foods, chewing ice or biting nails.
Fixed braces can be a better option than other correction methods such as Invisalign in many cases, especially for more severe misaligned teeth. An experienced orthodontist can recommend the best treatment method and provide personalized advice to achieve the best possible results.
How much do fixed braces cost?
The cost of fixed braces can vary depending on the type and duration of treatment and the region in which the treatment is carried out. As a rule, the price for fixed braces is between 3,000 and 8,000 euros.
However, it is important to note that the cost of fixed braces can be covered by health insurance in many cases, especially in the case of more severe malocclusions. However, the exact conditions and reimbursement rates may vary depending on the health insurance company and individual situation.
An experienced orthodontist can provide personalized advice and cost estimates and recommend the best treatment method to achieve the best possible results.
Which fixed braces are the best?
There are different types of fixed braces, and which one is best for a patient depends on their individual situation and treatment needs.
Traditional metal brackets are a common and proven option for correcting misaligned teeth. They are robust and effective, but can be visible and unaesthetic.
Ceramic brackets are a more aesthetic alternative to metal brackets and have a color that better matches the teeth. However, they are less robust than metal brackets and can come loose or break more quickly.
Lingual brackets are attached to the inside of the teeth so that they are invisible from the outside. However, they are more complex and time-consuming to fit and oral hygiene can be more difficult.
Self-ligating brackets are an innovative type of bracket that do not require rubber bands. They enable faster treatment and reduce the number of appointments required with the orthodontist.
There is no "best" type of fixed braces, as each option has advantages and disadvantages and may be more suitable for different patients. An experienced orthodontist can offer personalized advice and recommend the best treatment method to achieve the best possible results.
How many days do fixed braces hurt?
It is normal for it to take a few days to get used to fixed braces and you may experience some discomfort or pain during this time. This is due to the pressure that the braces exert on the teeth to move them into the desired position.
Most people experience some discomfort in the first few days after braces are fitted, such as pain, sensitivity to pressure and rubbing on the inside of the cheeks and lips. However, these symptoms should subside within a few days once the oral mucosa has become accustomed to the braces.
Painkillers such as ibuprofen or paracetamol can be taken to alleviate the discomfort. It is also helpful to eat soft foods and avoid hard or sticky foods to minimize the strain on the braces.
If the pain or discomfort lasts longer than a few days or is very intense, you should see an orthodontist to check the braces for possible problems or complications.
Which is better - fixed or loose braces?
Whether fixed or loose braces are better depends on the patient's individual situation.
Fixed braces are a good option when it comes to correcting severely misaligned teeth. They consist of brackets that are bonded to the teeth and wire arches that move the teeth into the desired position. Fixed braces must be worn for the entire duration of treatment and cannot be removed.
Loose braces can be used to correct minor misalignments or as a retainer after fixed braces treatment. It consists of a removable plastic part that fits over the teeth and can be removed while eating or cleaning.
In some cases, both types of braces can be used together to achieve the best possible correction.
Ultimately, it depends on the severity of the misaligned teeth, the age of the patient and other individual factors as to which type of braces is the best option. An experienced orthodontist can provide personalized advice and recommend the best treatment method to achieve the best possible results.
What are the benefits of fixed braces?
Fixed braces are an effective treatment method for correcting misaligned teeth and jaw anomalies. It consists of brackets that are bonded to the teeth and wire arches that move the teeth into the desired position.
The advantages of fixed braces are
Improving the position of teeth and jaws: Fixed braces can help to correct malocclusions such as overbite, underbite, crossbite, open bite and misaligned teeth.
- Improved aesthetics: Corrected tooth alignment can improve the appearance of the smile and increase self-confidence.
- Improving dental health: correcting misaligned teeth reduces the risk of gum disease, tooth decay and tooth wear.
- Improving jaw function: Correcting the position of the teeth and jaw can help to improve speech problems and reduce jaw problems such as TMJ pain.
- Long-term results: Fixed braces can provide long-lasting results when used in conjunction with proper aftercare and regular dental visits.
However, it is important to note that fixed braces are a long-term treatment that requires time, patience and commitment. Good oral hygiene and regular visits to the orthodontist are also important to achieve the best possible results.
When do you get free braces?
In Germany, statutory health insurance companies generally cover the costs of braces treatment for children and adolescents up to the age of 18 if there is a medical necessity and certain conditions are met.
These requirements are:
- A severe misalignment of the teeth or jaw that requires correction
- A functional impairment of the jaw or teeth that can lead to health problems
However, health insurance companies usually only cover the costs of conventional fixed braces. If the patient or parents want a more aesthetic alternative, such as invisible braces, they must bear the additional costs themselves.
It is important to note that even in Germany, the guidelines and conditions for covering the costs of braces treatment can vary depending on the health insurance company and the patient's individual situation. A consultation with an orthodontist in Cologne Rodenkirchen can be helpful in this case to determine whether there is a medical necessity and which treatment options are available.
How much do fixed braces cost without health insurance?
The cost of fixed braces without health insurance coverage can vary in Germany depending on the patient's individual situation and the type of braces used.
As a rule, however, the cost of fixed braces without health insurance coverage is between €3,000 and €8,000. The exact costs depend on various factors, such as the type of braces used, the duration of the treatment, the experience of the orthodontist and the region in which the treatment is carried out.
It is important to note that in some cases it may be possible to make an installment agreement with the orthodontist to spread the cost of braces treatment over several months or years.
How much do braces cost per month?
The monthly cost of braces treatment depends on various factors, such as the type of braces used, the duration of the treatment, the experience of the orthodontist and the region in which the treatment is carried out.
As a rule, the monthly cost of fixed braces in Germany is between €50 and €200, depending on the factors mentioned. However, it is important to note that these costs are only an approximate estimate and that the actual costs may vary depending on the patient's individual situation.
It is also possible to spread the cost of braces treatment over several months or years by making an installment agreement with the orthodontist. However, it is advisable to speak to the orthodontist before starting treatment in order to obtain a personalized quote and clarify the payment arrangements.
How much do AOK braces cost?
Statutory health insurance companies, including the AOK, generally cover the costs of braces treatment for children and adolescents up to the age of 18 if there is a medical necessity and certain conditions are met.
The costs for fixed braces, which are covered by the AOK, are usually between €3,000 and €8,000. However, these costs only cover the basic treatment with conventional fixed braces.
If the patient or parents want a more aesthetic alternative, such as invisible braces, they must bear the additional costs themselves.
It is important to note that the exact costs and conditions for covering the costs of braces treatments may vary depending on the patient's individual situation and health insurance provider. A consultation with a dentist or orthodontist can be helpful in this case to determine whether there is a medical need and what treatment options are available.
Can you pay for braces monthly?
Yes, it is often possible to pay the cost of braces monthly by making an installment agreement with the orthodontist.
The exact conditions for payment in installments depend on various factors, such as the type of braces used, the duration of treatment and the total cost. It is therefore advisable to speak to the orthodontist to make an individual agreement.
It is also important to note that an installment agreement may entail additional costs for interest or fees. It is therefore advisable to check the conditions and fees carefully before entering into an installment agreement.
Which braces are the cheapest?
The most affordable braces are usually conventional fixed metal braces. This type of brace has been in use for many years and is still a proven and cost-effective option.
Compared to other braces, such as invisible braces like Invisalign or ceramic brackets, fixed metal braces are usually the cheapest option. However, the exact costs can vary depending on the region, orthodontist and individual treatment.
For children and adolescents up to the age of 18 who have a medical need for braces, the statutory health insurance usually covers the costs of fixed braces. However, the exact conditions may vary depending on the health insurance company and individual situation.
How much do braces cost for 14 years?
The cost of braces depends on various factors, such as the type of braces used, the duration of the treatment, the experience of the orthodontist and the region in which the treatment is carried out.
For children and adolescents up to the age of 18, statutory health insurance companies generally cover the costs of medically necessary braces treatment. However, the costs may vary depending on the patient's individual situation and the type of braces.
For adults and patients who want a more aesthetic alternative, such as invisible braces, the costs usually have to be borne by the patient.
In Germany, the cost of braces is usually between €3,000 and €8,000, depending on the factors mentioned. However, it is important to note that these costs are only an approximate estimate and that the actual costs may vary depending on the patient's individual situation.
It is advisable to speak to the orthodontist before starting treatment in order to receive an individual offer and to clarify the payment modalities.
How long do teeth shift after braces?
After braces treatment, teeth can continue to shift naturally. The speed and extent of the shifting depends on various factors, such as the patient's individual build, the quality of the orthodontic treatment and post-treatment care.
It is important to follow the recommendations of the orthodontist in Cologne Rodenkirchen regarding aftercare and the use of retention appliances to reduce the risk of teeth shifting again.
Retainers, such as fixed or removable braces, are used after the actual treatment to stabilize the teeth in their new position. As a rule, retainers must be worn for at least six months to a year to stabilize the realigned teeth.
In some cases, retainers may even be required permanently to prevent teeth from shifting again. It is important to follow the orthodontist's recommendations regarding aftercare and the wearing of retainers in order to maintain the long-term results of braces treatment.
When are braces not possible?
In most cases, braces treatment is possible for patients of all ages. However, there are some situations where braces may not be recommended or may even be contraindicated. Some possible reasons why braces may not be possible include:
- There are severe jaw anomalies that require surgical correction.
- There is insufficient bone structure or too little space for the teeth.
- The patient has advanced gum disease or other serious dental problems.
- There is a severe allergy to the materials of the braces.
It is important to note that these factors do not automatically rule out braces treatment, but can merely be a factor that is taken into account when deciding on treatment.
Before starting braces treatment, the orthodontist will carry out a comprehensive examination to determine whether braces are possible and recommended. The orthodontist in Cologne Rodenkirchen will also inform the patient about alternative treatment options if braces treatment is not possible or not recommended.
How do I get the money back for the braces?
Reimbursement of the cost of braces treatment depends on the type of health insurance the patient has. If the patient has private health insurance, they will need to check the terms and conditions of their insurance to see if the cost of braces for children will be reimbursed.
If the patient has statutory health insurance, this usually covers the costs of medically necessary braces treatment for children and adolescents up to the age of 18. However, there are individual regulations of the individual health insurance companies. The costs are not normally covered for adults unless there is a medical necessity.
In order to receive reimbursement for braces treatment, the patient must carefully check the terms and conditions of their insurance and apply for reimbursement if necessary. It may also be helpful to speak to an insurance representative or the orthodontist Cologne Rodenkirchen for further information and assistance.
How quickly do braces work?
The effect of braces depends on various factors, such as the individual condition of the teeth, the type of braces, the severity of the malocclusion and the duration of treatment.
As a rule, braces treatment begins with a phase in which the teeth are prepared for the presence of the braces. In this phase, the teeth can already move a little, but a significant effect is not yet to be expected.
The duration of treatment depends on the severity of the misaligned teeth. In some cases, braces treatment may only take a few months, while in other cases treatment may be required for several years. During this time, the teeth must be continuously put under pressure to achieve the desired effect.
It is important to note that the effect of braces is not immediate and patience and perseverance are required to achieve the best possible result. The orthodontist will regularly monitor the progress of the treatment and inform the patient about the expected time frame and the success of the treatment.
Classification system of orthodontic indication groups (KIG)
The classification system of orthodontic indication groups (KIG) is used in Germany to assess the need for orthodontic treatment based on findings.
Orthodontists use the system to classify tooth and jaw misalignments into five different categories. Depending on the category assigned, the treatment costs are covered by health insurance or offered as a private service.
The KIG system helps to ensure a clear structure in the treatment of misaligned teeth and jaws and to determine the corresponding benefit claims against the health insurance company.
Proper care of braces - Our care instructions
What do I have to consider with the new braces?
1) Removable braces / Invisalign splints:
It is important that removable appliances are kept clean and stored correctly. This means that the appliance, just like the teeth, should be cleaned with a toothbrush and toothpaste or, if desired, with special cleaning tablets from the pharmacy or drugstore. The brace should always be kept outside the mouth in the brace box. If the braces are not stored carefully, they can bend or break and, in the worst case, no longer function properly.
2) Fixed braces:
With fixed braces, brackets or bands are bonded to the teeth and connected to an archwire.
This can lead to temporary tension after inserting the brackets or new archwires. This feeling of pressure usually sets in the following evening and then subsides within the next three to four days. During this time, it is advisable to eat slightly softer food and avoid biting down hard. In principle, however, sticky or particularly hard foods should be avoided during the entire treatment period with fixed braces so as not to cause the bracket to become detached.
Sore spots may occur on the gums or on the inside of the cheek. Covering with dental wax usually provides relief, but here too the mucous membrane needs a few days to get used to the new situation and form a kind of callus. However, if the symptoms do not improve, you should visit the dental practice again.
The components of the fixed braces/appliance are very sensitive, and therefore the archwire may break or the brackets may come off. Please contact our practice so that we can repair the fixed braces. If the archwire sticks into the back of the cheek, you can simply shorten it with a small pair of pliers. In any case, you should come to the practice so that the orthodontist can replace the lost components.
Care instructions for braces:
Fixed braces require particularly intensive care. This is more difficult and time-consuming than without brackets or with Invisalign treatment. However, thorough tooth cleaning after every meal is essential with fixed braces, as bacterial plaque can build up around the fixed elements, increasing the risk of tooth decay.
We recommend the following for care with fixed braces:
- Oral B Indicator 35 Orthodontic
- Oral B interdental set
- Oral B Interspace (pharmacy)
- Oral B Superfloss (50 threads)
- Oral B Ortho (attachment for electric toothbrushes)
These special toothbrushes and dental flosses make it possible to clean areas of the teeth that are more difficult to access and should definitely be part of daily dental care with fixed braces.
Furthermore, additional care with mouth rinses is sometimes indicated.
With an electric toothbrush, e.g. Sonicare from Philips, optimum cleaning of the teeth is also possible with fixed braces or during treatment with the Invisalign system. In addition, AirFloss (Philips) can be used as a substitute for dental floss to clean the interdental spaces.
Palatal suture expansion (GNE)
Palatal expansion is a fixed brace for skeletal widening of the upper jaw. It was first published in 1877 by Angell in the USA. Rediscovered after 1945 by Haas, Timms and Derichsweiler, the GNE has since secured its irreplaceable place in orthodontics.
The braces are usually attached to the 1st molars and 1st premolars with bands. Today, the appliance can also be used as a plastic splint that covers all posterior teeth. The appliance is fitted with an expansion screw in the middle, with which the two halves of the upper jaw can be pushed apart by up to 10 millimetres in two to four weeks. New bone then reliably forms in the middle.
The use of palatal expansion is useful for patients with an excessively narrow upper jaw. The widening achieved with the GNE is skeletal, i.e. caused by newly formed bone.
The palatal expansion has many health side effects, all of which are based on the improvement of nasal breathing: fewer colds, fewer sinus problems, improved ventilation of the inner ear via the Eustachian tube with improvement of ear symptoms, improved sleep quality. Palatal expansion is often a good preparation for subsequent treatment with orthodontic appliances, the Invisalignsystem or fixed braces.
In rare cases, there may be possible side effects such as slight loosening of the teeth, a feeling of pressure and possibly pain in the head area as well as reddened or slightly inflamed gums.
The palatal expansion is a fixed brace
Distalizer according to Carrière
The Carrière Distalizer is an absolutely passive appliance that only becomes active through the use of Class II elastics. The nickel-free appliance is applied to the lateral tooth area, leaving the visible front area largely free.
A transparent retaining splint in combination with small buttons in the opposing jaw provides the anchoring point for the elastic rubber bands. The joint, the key component of the distalizer, enables targeted distalization of the canine and simultaneous distalization and derotation of the molar.
We like to use the Distalizer for Class II dentition before Invisalign treatment.
Patient example
Anchoring technique orthodontics
Very difficult tooth movements have become possible thanks to an anchorage that is attached to the bone. Anchoring means that we get the support we need to move a tooth from this point.
Example cases
Intrusion of an elongated molar with mini screws and Invisalign
The following pictures show the intrusion of an elongated upper molar using Invisalign treatment in combination with mini implants and elastics. The placement of two small screws buccally and palatally of the tooth to be intruded provides an optimal point of contact for the Invisalign splints and the additional force component from the elastics. The treatment created an optimal starting situation for the implantological restoration of the opposing jaw.
Comparison before intrusion and after treatment with the Invisalign system and miniscrew. Implantological treatment by Dr. Schuppan
Positioner
After removal of the brackets and bands, the period of fine adjustment and retention begins. The retaining apparatus of the teeth is not yet fully consolidated and can therefore be perfected using the so-called positioner and the teeth brought into the ideal position.
This requires various steps in the laboratory. Individual teeth or groups of teeth are removed from the plaster model and individually repositioned in the ideal set-up of the dental arches. The positioners are then fabricated over this ideal arch using a special thermoforming technique.
After removal of the brackets and bands, the period of fine adjustment and retention begins. The retaining apparatus of the teeth is not yet fully consolidated and can therefore be perfected using the so-called positioner and the teeth brought into the ideal position.
This requires various steps in the laboratory. Individual teeth or groups of teeth are removed from the plaster model and individually repositioned in the ideal set-up of the dental arches. The positioners are then fabricated over this ideal arch using a special thermoforming technique.
Sources:
- Chen, S.S., Greenlee, G.M., Kim, J., Smith, C.L., & Huang, G.J., 2010. Systematic review of self-ligating brackets. Am J Orthod Dentofacial Orthop, 137(6), pp.726.e1-726.e18; discussion 726-7. https://doi.org/10.1016/j.ajodo.2009.11.009
- Fleming, P.S., Dibiase, A.T., Sarri, G., & Lee, R.T., 2009. Pain experience during initial alignment with a self-ligating and a conventional fixed orthodontic appliance system. A randomized controlled clinical trial. Angle Orthod, 79(1), pp.46-50. https://doi.org/10.2319/121007-579.1
- Rosvall, M.D., Fields, H.W., Ziuchkovski, J., Rosenstiel, S.F., & Johnston, W.M., 2009. Attractiveness, acceptability, and value of orthodontic appliances. Am J Orthod Dentofacial Orthop, 135(3), pp.276.e1-12; discussion 276-7. https://doi.org/10.1016/j.ajodo.2008.09.020
- O'Brien, K., Wright, J., Conboy, F., Appelbe, P., Bearn, D., Caldwell, S., Harrison, J., Hussain, J., Lewis, D., Littlewood, S., Mandall, N., Morris, T., Murray, A., Oskouei, M., Rudge, S., Sandler, J., Thiruvenkatachari, B., Walsh, T., & Turbill, E., 2009. Prospective, multi-center study of the effectiveness of orthodontic/orthognathic surgery care in the United Kingdom. Am J Orthod Dentofacial Orthop, 135(6), pp.709-714. https://doi.org/10.1016/j.ajodo.2007.10.043.
- Pandis, N., Walsh, T., Polychronopoulou, A., Katsaros, C., & Eliades, T., 2013. Split-mouth designs in orthodontics: an overview with applications to orthodontic clinical trials. Eur J Orthod, 35(6), pp.783-789. https://doi.org/10.1093/ejo/cjs108.
- Papageorgiou, S.N., Gölz, L., Jäger, A., Eliades, T., & Bourauel, C., 2016. Lingual vs. labial fixed orthodontic appliances: systematic review and meta-analysis of treatment effects. Eur J Oral Sci, 124(2), pp.105-118. https://doi.org/10.1111/eos.12250.
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Orthodontics Cologne Rodenkirchen Our competences
Aligner Invisalign
Discover aligners such as Invisalign Cologne - the invisible solution for a radiant smile without braces at your orthodontist in Cologne.
CMD pain therapy
Find out more about craniomandibular dysfunction (CMD) - diagnosis, causes and our modern treatment approaches.
Snoring / sleep apnea
Improve your quality of life - discover our effective solutions against snoring and sleep apnea such as the snoring splint.
Sports mouthguard / mouthguard
Find out why a sports mouthguard is essential for sports and how it can help to prevent injuries in the mouth area.
Loose braces
Discover treatment with removable braces such as the Bionator - the practical and flexible solution for effective tooth correction.
Fixed braces
Find out more about fixed braces - the proven solution for precise and effective tooth correction at your orthodontist in Cologne.
Retention / Retainer
Secure your perfect smile with retention and retainers - find out more about this important phase after tooth correction.