Metal braces

What they are

Small stainless steel brackets bonded to the front surface of each tooth, joined by an archwire. The wire is held in place either by coloured elastic ligatures or by the bracket itself in a self-ligating design. Modern brackets are roughly half the size of those used in the 1990s, and the wires used in early treatment are nickel-titanium alloys that deliver gentle force over a wide range of movement rather than the stiff steel of older systems.

What they do better than the alternatives

• Bodily movement and root control. When a tooth must be moved through bone with its root following properly — closing an extraction space, uprighting a tipped molar — a rigid bracket-and-wire couple does it predictably.
• Impacted teeth. A canine stuck high in the bone is brought down by attaching a chain to it and pulling against a fixed appliance over many months. There is no realistic aligner equivalent.
• Severe rotations. A tooth turned ninety degrees is unwound and then held while the fibres around it reorganise.
• Compliance-proofing. They work while the patient sleeps, forgets, or argues. For many teenagers this is the deciding factor.
• Durability. Steel brackets rarely fracture. Ceramic occasionally does.

The honest downsides

They are visible, and for some patients that is genuinely the whole issue. They make brushing harder, and poor hygiene during treatment causes permanent white marks on enamel that no amount of straightening compensates for. They are uncomfortable for the first three to five days after bonding and for a day or so after some adjustments. Certain foods have to go for the duration — not most foods, but the hard and sticky ones people find hardest to give up.

Cost

Metal braces are the lowest-cost fixed option, which is a function of materials and chair time rather than a lower standard of care. The fee for any case depends on complexity and length, and is quoted in writing after examination and records. At this practice the quote includes retainers at the end and the first year of retainer checks, and monthly plans are interest-free through the clinic with no credit application.

Who they suit

Most teenagers. Anyone with a bite that needs real correction rather than cosmetic alignment. Anyone whose case involves extractions, impacted teeth, or jaw-relationship work with elastics. Anyone who would rather put the money into the result than into the appearance of the appliance. Adults choose them more often than people expect, particularly when treatment is short.