Removable braces – why have they declined, and how to find them today
Last update of this part: 18.12.2006
See alternatives to „torture instrument“ style braces first

Many of the patient-friendly and economic types of removable braces, which are explained in these pages, have been driven out of the market by the more expensive fixed braces, or have difficulties to enter the market.
Even formerly established types of removable braces, the separate ones for both jaws as well as the „double-deckers“, have been reduced in their work-out and in their equipment with wires and screws such that they nowadays should appear unable to perform a full jaw orthopedic treatment without fixed appliances in addition.

These have now become widespread, with no regard how much pain and sores in the mouth they cause. Also injuries during sports occur, repair is needed more frequently, and the overall treatment is often not shorter than with removables, and the result is often not judged better. Maybe too many uniformized dental arches are generated by ready-made „one-size-fits-all“ wires. Moreover, fixed braces cause higher costs, by themselves and by measures against the artificially increased caries danger, and not to forget repairs. How easily can a bracket be bitten off – where in contrast, properly handled and stored removable braces rarely break.

The knowledge about the friendly treatment with modern removable braces is rare. Professional conferences and journals contain to 98% fixed braces, including contributions about how to prevent or treat the damages that they do. These are further sources of income, of course.
The attention to the causes of teeth and jaw disorders is overgrown by nowadays´ fascinating technical possibilities, and often children have to suffer for that. Keeping us healthy is not the real interest of medical industries. Because public knowledge about economic and low-risk methods could reduce their sales.
Even little children of 4 – 8 years are nowadays treated with brutal methods and / or fixed installations. These use often prefabricated parts (headgears, lip-bumpers, ..) and disturb speaking, swallowing etc. Nobody tells the parents that removables would work perfectly well in this young age. When they find out the disadvantages of „modern treatment“ themselves, it is horribly late to get out of there – that is the strategy here.

The mouth and dentition as an organ for chewing take damage not only by desequilibrated overload, but also by lack of exercise due to too soft food. At first, breastfeed, and later hard food is important for childrens´ jaw development, where space is a prerequisite of teeth alignment, and for keeping the tissues strong in older age! In contrast, fixed braces hamper this healthy act of chewing by pain or by hindering installations, like quad helixes and Herbst appliances – the dental arches then rather resemble a construction area than a part of our body.

For late / adult treatments economic partial solutions would be conceivable, e.g. limited correction of the frontal teeth, but with a painless jaw anomaly remaining. A rational technique to correct teeth which are slightly tilted in all directions is the silicone rubber setup technique: these teeth are corrected on the plaster model, replicated in silicone rubber parts of an otherwise quite conventional plate appliance ... see part A in chapter „braces“ for more details.
To correct jaw anomalies of adults, an evaluation of the „Dentosophy“ method (in chapter „Weitere Info“) would be of scientific interest. The above example seems impressive – but how many % of adult cases work equally well? Since the forces in these „chewing gum effect“ treatments (see also in part B and in „Weitere Info“, functional treatment) arise only from the partient´s mouth muscles, they bear no risk of pain or damage. Their result may not look perfect, but healthy like „naturally grown“. And not to forget, it self-stabilizes by healthy muscular functions, in contrast to a result of „artificial“ forces with no regard to the functioning of lip, tongue etc.
The risk of early wear that arises from jaw anomalies is rather statistical than unavoidable. Likewise, everyone who walks on just 2 legs bears an increased risk of backbone wear when aging, and every heavy person bears an increased risk of wear of knee joints.

Test questions for searching an appropriate doctor, who practises a particular method: in this example here, „We would like to obtain a jaw orthopedic / orthodontic treatment only with removable braces“,

1. Could you do this in appropriate cases? (for how many % approximately at which age)
2. Would a functional treatment be possible in appropriate cases, that means with appliances that only make use of the mouth muscles´ forces? (a riskless, quasi-natural therapy)
3. „Democracy“: can appropriate patients choose between different types of braces for their treatment? (one prefers hard but fast, another one slow but gentle)
4. In case that you already know the name of your jaw / tooth disorder, then ask by which methods / types of braces this is treated there in general (individual tele-diagnoses and treatment plans are not authorized).

Additional arguments: removables are NOT old-fashioned in general.
We would be satisfied with a treatment result below the most perfect possible.

With the disadvantages of the particular high-profit medicine in your (or your child´s) case in mind, you could be a mighty consumer. You should rather phone 5 – 15 doctors in advance, until you find the „right“ one, than take the risk that you, or your child, suffer under a treatment for years, and / or that you have to pay much too much.

Note well that the younger your child is, the more growth can be utilized and guided, so that more gain of space and greater corrections are possible with simple appliances. But beware of pre-fabricated stuff like headgears, fixed lip-bumpers or quad helices or even worse. Simple, individually-made small removables can often open the way to a healthy development of the dentition. They are inexpensive and are not such a punishment for children than the stuff mentioned before. See prototypes of „lightweight“ removables in chapter „Eigenentwicklungen“ (category „Angebote für Fachleute“). In contrast, the correction of crowded teeth in older teenagers and adults is always tedious, if by extracting healty teeth, which can give a concave mouth profile in addition, or if by fixed braces which then will probably need additional parts, or if by removable braces, which will take long when growth is lacking.

Success or failure of „removable“ treatment depends on 1. the details of the appliances, which are not always obvious (adhere to instructions of successful practicians!), 2. successful communication between doctor and patient, 3. good knowledge of jaw growth. It is e.g. often ignored that due to growth, childrens´ teeth have a tendency to stay upright, which facilitates proper gap closure / opening (mesialization / distalization) with removable appliances.

How many doctors to ask?
The more, the rarer the skills are which you are looking for, of course. Nevertheless you do best to stay friendly. Communication should be open-minded, and medical terms that concern you should be made understandable to you. Probabilities to find your specialist are calculated in the table below. Down along the rows, the abundance of the requested skills decreases. The columns give the number of 1-...25 experts you ask. The cells of the table give the probability in % to find just one with the requested skill among them.
Example: you look for a quite abundant method, that every second doctor offers, e.g. a simple removable expander for young children (I hope that I do not over-estimate its abundance). Then the first one you ask could already be the right choice with a probability of 50%. If you ask two doctors, you should find what you are looking for with 75% probability, that means just 25% remain for being unsuccessful twice.
In contrast, the search for rare skills and methods requires extensive search and survey. Regard the figures in the last row. If the requested method is offered by only every 20. specialist, which may be true for functional jaw orthopedics in South Africa, then the first doctor whom you ask arbitrarily will be the right choice for you with a probability of only 5%! To have 40% probability for success, you should ask 10 doctors, and for 64% probability, 20 doctors.
This tedious work can be reduced by getting doctors recommended by a headquarter of a requested technique. Some are in my link list, and www.orthodontic-outrage.com has adresses and is fighting against unnecessary, mutilating extractions. But CAUTION: DO NOT try to find help there in progenic cases! You can also suggest a physiotherapist to apply the Muscle force jaw shaper, see part B in the braces chapter, which would probably cost you less.

Last not least, regard that different techniques differ in their frequency of regular treatment sessions and of emergencies (urgent repairs / sores). By this, a farther away doctor does not necessarily consume more time and transportation – if he practises e.g. a functional treatment with rare sessions and low risks.

Go on to alternatives to „torture instrument“ style braces
HOME