Braces on Teeth: Types, Treatment and What to Expect

Braces on teeth are one of the most recognisable dental treatments in the world, yet many people in Nigeria know very little about how they work, who should wear them or what treatment involves from the first visit to the day the braces come off. A survey of 123 patients and parents of children with clefts at a Lagos teaching hospital found that 43.9% knew braces could straighten teeth, but only 13.8% knew who an orthodontist was [1]. It is a small, specific group and not a national figure, but it shows how little some patients know when they first arrive with questions. This guide explains what braces are, what they can and cannot correct, how they move teeth, the main types, what treatment looks like step by step, how to live with them and what the risks are. It also covers what to check before you let anyone fit braces on teeth, because the person doing the work matters as much as the braces themselves.

What are braces on teeth?

The NHS describes braces as a treatment to help straighten your teeth [2]. In practice, braces on teeth are fixed appliances made of small brackets glued to each tooth and joined together by a thin wire. Cleveland Clinic explains that they use mild, constant pressure to move teeth into their proper positions over time [3].

A few terms are worth separating. Orthodontic treatment is the wider term dentists use for the whole course of care, which includes the assessment, the braces and the retainers worn afterwards. Brackets are only the small pieces bonded to each tooth, so the word is not another name for braces. The wire that links the brackets is called the archwire, and the small elastic rings that hold the wire in place are called ligatures or modules [2,3].

Bite problems also have specific names, and they are often mixed up in everyday conversation. Cleveland Clinic defines an overbite as a deep vertical bite in which the upper teeth overlap the lower teeth more than they should, and an overjet as upper front teeth that stick out further than they should [4]. Those are different problems with different causes.

An underbite means the lower front teeth extend beyond the upper front teeth. A crossbite means some upper teeth fit inside the lower teeth. An open bite means the upper and lower front teeth do not touch when the mouth is closed [4].

What braces on teeth can correct

The NHS lists several reasons someone might need braces: teeth growing too close together or sticking out, upper and lower jaws that do not meet properly, large spaces between the teeth, and tooth positions that make it hard to chew or to keep the teeth clean [2]. Cleveland Clinic adds that braces can also make your teeth easier to clean and help prevent cavities and gum disease [3].

Braces on teeth have limits, and a good clinician will tell you where they are. If the bones of the face and jaws are out of balance with each other, orthodontics alone cannot position the teeth to create a functioning bite, and straightening the teeth will not correct the imbalance between the jaws [5]. Where the jaws are out of balance, treatment can combine orthodontics with jaw surgery [5]. A tooth that has fused to the jawbone, a condition called ankylosis, can also prevent alignment [6].

Gum health sets another limit. The British Orthodontic Society states that active gum disease must be treated and stabilised before orthodontic treatment begins [6].

How braces on teeth move teeth

When fixed metal braces are fitted, brackets are attached to each tooth with dental glue, a wire connects the brackets and applies a small amount of pressure, and small elastic modules tie the wire to the brackets [2]. Over time, that pressure moves the teeth into the correct position [2].

The movement itself depends on the bone around each tooth. Nottingham University Hospitals NHS Trust explains that the wires exert a force through the bracket and tooth, that the forces are kept low to reduce the risk of damage, and that teeth move at roughly 1 mm per month because the jaw bone remodels, which happens slowly [7]. A review of the biology describes remodelling as bone being broken down by cells called osteoclasts, coupled with new bone being built by cells called osteoblasts [8]. On the side of the tooth where pressure builds, bone is cleared to make room. On the stretched side, new bone forms [9].

A simple way to picture this is a tooth sitting in a cushioning ligament, with bone clearing ahead of it and being rebuilt behind it. This also explains why harder pulling does not mean faster results. A review of orthodontic tooth movement reports that with light force, movement usually begins within 2 days, while with heavy force it usually takes 7 to 14 days to start [10]. Orthodontists keep forces light on purpose.

Braces types: metal, ceramic, self-ligating and lingual

The main braces types differ in appearance, comfort and how they hold the wire. No type has been shown to be clearly faster or less painful than the others, so the choice of braces on teeth usually comes down to appearance, budget and what your orthodontist recommends for your case.

Metal braces. These use stainless-steel brackets and wires held with elastic ligatures. They are the most visible type, and patients can usually choose clear or coloured ligatures [3]. The NHS notes that fixed metal braces are commonly used within the health service in the UK [2].

Ceramic braces. Cleveland Clinic says ceramic braces work the same way as metal ones and are less noticeable, but they are more fragile and more likely to break [3]. The British Orthodontic Society also warns that ceramic brackets in particular can wear the enamel of opposing teeth during treatment [6].

Self-ligating and lingual braces

Self-ligating braces. These use a built-in system to hold the archwire instead of elastic ligatures [3]. A 2013 meta-analysis found no significant difference between self-ligating and conventional brackets in pain after 4 hours, 24 hours, 3 days or 7 days, and no significant difference in the number of appointments or total treatment time [11]. A separate systematic review concluded that shorter chair time and slightly less tilting forward of the incisors appear to be the only significant advantages [12]. They are a valid option, but they should not be sold as faster or more comfortable.

Lingual braces. These are fitted to the back surfaces of the teeth so that other people cannot see them [3]. A meta-analysis found that, compared with braces on the front of the teeth, lingual braces were associated with more tongue pain, more difficulty with oral hygiene and more speech difficulty, although they caused less lip and cheek pain. The authors described the available evidence as limited [13]. A 2025 review of adults undergoing different orthodontic treatments also found that lingual appliances had a persistent impact on speech, despite some adaptability [14].

Clear aligners are a separate option made of removable trays, and they are covered in our guide to braces versus aligners. Which braces types a clinic offers varies, so it is worth asking at your first visit what is available and why a particular type is being recommended for you.

Treatment step by step

The first visit and records. The NHS says the assessment may include examining the teeth and jaws and taking X-rays, photographs or scans [2]. Records of this kind give the orthodontist a baseline to plan from. The British Orthodontic Society says patients should be told about the benefits, the expected duration, what will and will not be achieved, the alternatives and the consequences of having no treatment [6]. If you have ever had a front tooth knocked or damaged, tell the orthodontist [2].

Fitting. When braces on teeth are fitted, brackets are glued on, the wire is placed and the elastic modules are added [2]. Teeth may be sore for a few days afterwards, and patients may need soft food and painkillers [2]. Nottingham University Hospitals describe the ache as lasting roughly the first 24 to 48 hours [7], while the British Orthodontic Society’s patient leaflet says teeth are likely to be sore for about 3 to 5 days after fitting and after each adjustment [15].

Adjustments, duration and removal

Adjustments. Appointments usually come every 6 to 8 weeks [2,7]. At each one the orthodontist checks progress and adjusts the wire or other parts so the teeth keep moving.

How long it takes. Nottingham University Hospitals report that most orthodontic treatment takes 18 months to two years, with more complex cases averaging two and a half to three years [7]. Cleveland Clinic gives a similar picture: about two years on average, with some people finishing in under 12 months and others needing up to three years [3]. The British Orthodontic Society warns that an estimate may not always be accurate, because of individual biology, breakages or missed appointments [6].

Removal and retainers. After the braces come off, you will need to wear a retainer, and the orthodontist will tell you for how long [2]. This final stage is not optional, and the next section explains why.

Why braces on teeth need retainers afterwards

Straightened teeth tend to drift back. The Cochrane review of retention describes this plainly: teeth can become crooked again after being straightened with braces, which is called relapse [16]. The British Orthodontic Society states that relapse will occur after orthodontic treatment and that retention is needed in most cases. It adds that spacing, rotated teeth and an increased overbite have a high potential for relapse [6].

On how long to wear retainers, the Society’s patient leaflet is direct: the only way to ensure your teeth cannot move is to wear your retainers part time for life [17].

The evidence on which retainer is best is weaker than many patients assume. The 2023 Cochrane review included 47 studies with 4,377 participants, and concluded that the certainty of the evidence was low to very low, so no firm conclusion could be drawn about any one approach over another. Most studies measured effects for less than one year [16]. The practical message is to follow your own orthodontist’s retainer plan closely rather than looking for a universal answer.

Who can get braces on teeth

Children. The American Association of Orthodontists recommends that children have a first check-up with an orthodontist by age 7, and a check-up is not the same as starting braces [18]. The NHS says braces are often recommended for children and teenagers after all their adult teeth have come through [2]. The British Orthodontic Society says most children begin treatment around 12 or 13, once all their permanent teeth have erupted, and that in a few cases treatment is better started early [33]. Cleveland Clinic says the best time for braces is generally between the ages of 9 and 14 [3].

Adults. The NHS says adults can also have braces [2], and the British Orthodontic Society says age is not a barrier to treatment [33]. Cleveland Clinic says adult braces are just as effective but may take a little longer [3]. An orthodontist quoted by Cleveland Clinic explains that someone with a history of cavities or gum disease that has been treated and is now stable could be a candidate [19].

Oral hygiene as a starting point. An NHS trust leaflet says treatment will not begin unless you have an excellent standard of oral hygiene, because orthodontic treatment can increase the risk of tooth decay and gum problems [23]. The British Orthodontic Society warns that treating teeth in the presence of uncontrolled gum disease may cause bone loss, loose teeth or tooth loss [20].

Extractions. Many people assume braces always mean pulling teeth. The evidence says otherwise. A 2025 systematic review and meta-analysis found no statistically significant difference in relapse of overjet, overbite or crowding between extraction and non-extraction treatment [21]. A meta-analysis on the soft-tissue profile concluded that non-extraction approaches are a safe and effective alternative, while noting that extraction is often preferred for some bite patterns and for moderate to severe crowding [22]. Extraction is a decision made case by case, after examining your teeth and X-rays.

Living with braces on teeth

Cleaning. The NHS advises brushing with fluoride toothpaste in the morning, at night and after meals, and using an interdental brush every day to clean between the teeth and underneath the braces [2]. Cleveland Clinic adds a soft-bristled brush, daily flossing with floss threaders or orthodontic flossers, and an alcohol-free antibacterial mouthwash [3]. An NHS trust leaflet recommends fluoride toothpaste and a fluoride mouthwash to reduce the chance of early decay around the brackets [23].

Food. The NHS recommends limiting sugary food and drink, avoiding hard, crunchy or sticky foods and cutting food into smaller pieces [2]. Cleveland Clinic suggests soft foods for the first few days [3]. The NHS says not to chew gum because it can get stuck in your braces [2]. Ask your orthodontist whether the same rule applies to you.

Sore spots, everyday problems and what patients say

Sore spots and everyday problems. Cleveland Clinic suggests covering rough-feeling brackets or wires with dental wax [3], and the British Orthodontic Society notes that damage to the soft lining of the mouth is common and that patients should be advised how to manage it [6]. The NHS says to contact your dentist if pain lasts more than a few days after fitting or an adjustment, if your gums are very red, swollen or painful, or if your braces break [2]. Ask your orthodontist at the start which painkiller they recommend and what to do if a bracket comes loose or a wire starts poking, because the right answer depends on your case.

What patients say. A questionnaire survey of 75 patients aged 10 to 28 with fixed appliances at the Lagos University Teaching Hospital gives an honest picture of how demanding treatment can feel. About 73% had difficulty eating, 65.8% had difficulty with oral hygiene, 69.9% experienced pain from the teeth, and 64% said they had wanted to discontinue treatment at some point [24]. Knowing this in advance is useful. It means that the rough weeks are common, and that they are worth discussing with your orthodontist rather than simply putting up with them or stopping.

Risks and side effects of braces on teeth

Braces on teeth are widely used, but every patient should know the risks before starting.

Discomfort. The British Orthodontic Society states that pain and discomfort occur commonly after fitting or adjustment [6].

White spots and decay. The British Orthodontic Society lists demineralisation and caries as common risks of orthodontic treatment [6]. A 2025 meta-analysis found that about 55% of people wearing braces developed white spot lesions, compared with about 29% of people who had no treatment. The risk rose with longer treatment, and one analysis found rates were highest in African patients, although that finding came from a smaller subgroup and should be read with care [25]. Thorough cleaning around the brackets is the best defence.

Gum inflammation. According to the British Orthodontic Society, most patients experience some gum inflammation, which is usually reversible, but poor oral hygiene can cause irreversible damage [6].

Shortening of the root tips. Mild shortening of the roots, called root resorption, is an unavoidable consequence of tooth movement and is believed to occur in all patients, although in most cases the changes are insignificant. Extensive resorption is rare but significant, and it is linked to how far the root tip moves, the length of treatment and heavy forces [6]. A systematic review notes that severe resorption, affecting more than a third of the root length, has been reported in 1% to 10% of treated teeth [26].

Relapse. As covered above, teeth can drift back without retainers [6,16].

Other risks. The British Orthodontic Society also lists loss of vitality in previously injured teeth, nickel and latex allergy, and gum recession in a few patients [6].

Braces on teeth in Nigeria: need, specialists and fashion braces

How many people need braces. Studies of Nigerian schoolchildren using the same dental health index report a definite need for treatment in roughly 14% to 21.5% of children. In Ile-Ife, 14% of 250 schoolchildren had great need [27], and in Benin City 21.5% of 441 children aged 11 to 18 had definite need [28]. In that Benin City study, only 3.9% of the children perceived a definite need themselves [28]. Many children and parents may therefore not realise treatment is available or needed. These are regional studies from some years ago, so they show a pattern rather than a national figure.

Specialists are few. A paper on orthodontic training in Nigeria reports a ratio of about one orthodontist for every 3.86 million Nigerians, and notes that orthodontists represent only 1% of all dentists in the country [29]. Cleveland Clinic notes that orthodontists usually place braces, but some general dentists offer them too, and that severe malocclusion requires a specialist [3,4]. Reported counts of Nigerian orthodontists vary between sources, so the safest summary is that they are very few and mostly based in the big cities.

Fashion braces and what to check

Fashion braces. Fashion braces look similar to real orthodontic braces but do not treat anything. A published letter describes them as appliances that can cause damage to the teeth, gums, lips and supporting bones, and reports that some products were found to contain toxic heavy metals such as cadmium [30]. They are sold openly online in Nigeria [31]. No Nigerian peer-reviewed study of their harm was found, but the risks described elsewhere are reason enough to avoid them. In May 2026, the President of the Nigerian Association of Orthodontists urged Nigerians to avoid unqualified dental practitioners and to seek treatment only from certified professionals, a statement reported in the press [33].

What to check before you start. Confirm that the person treating you is a registered dentist or specialist with the Medical and Dental Council of Nigeria, which accredits orthodontic training in the country [29]. Ask who will fit and adjust your braces, how often you will be seen, what happens if a bracket breaks and what the retainer plan is. Be cautious of anyone who offers braces without X-rays, an examination or a written treatment plan.

Book a consultation

Braces on teeth are a long commitment, and the first step is finding out whether they are right for you. Ask The Dentist in Ibadan offers orthodontic treatment, including metallic braces and clear aligners. Book a consultation to have your teeth and bite assessed. To see what changes over the course of treatment, read braces before and after.

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