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If you’re curious about how rubber bands work on braces, you’re probably already familiar with them. Orthodontic rubber bands, also called elastics, are small but powerful latex rings that go on top of the hooks of your braces. Their purpose is to move teeth or groups of teeth and settle your bite.
What you’re probably wondering is how exactly these rubber bands are moving teeth. Rubber bands work on braces in many different ways, depending on what we need to achieve, and there are certain patterns in which we can hook them to braces.
It’s these patterns, or combinations, that we’re going to focus on today. Depending on what type of malocclusion or bite problem you have, you can easily recognize which types of elastics you’re supposed to wear, and why they’re so important.
How Rubber Bands Work: 7 Patterns To Look Out For
Before we dive into the different types of elastic bands, let’s learn a little bit about malocclusions. To correct bite problems, we often use what we call “class” elastics. These class elastics borrow their name from the three basic types of malocclusion clasifications:
Aside from these 3 major classes we also have other types of bite discrepancies:
Here’s a visual representation of what we discussed so far:
For every situation described above, there’s a certain type of rubber band pattern that works in a specific way. We’re about to go into much more detail, and I’m sure you’ll learn a lot about the type of elastic bands you’re supposed to wear.
1. Class I Elastics
Class I elastic bands are rarely used by orthodontists, because we have powerchains and other methods of applying force in this manner that doesn’t require the patient’s compliance.
These rubber bands run from the 1st or 2nd molar to the canine bracket hook, either on the upper jaw or the lower jaw. Their purpose is close gaps or extraction spaces.
2. Class II Elastics
Class II elastics are used for correcting overbites. They work by pulling the top teeth back and the bottom teeth forward, settling the bite into a class I.
These rubber bands run from the bottom 1st molar to the top canine bracket hook on both sides. You will need to wear them 24/7 and your orthodontist will usually give you 3/16″ Light, Medium or Heavy rubber bands to wear for a few months, until your bite is corrected.
3. Class III Elastics
We use Class III elastics to correct underbites. They work by pulling the top teeth forward and the bottom teeth back until the bite settles in class I occlusion.
Similarly to class II elastics, these rubber bands need to be worn long term, 24/7, and you’ll be getting 3/16″ Light, Medium or Heavy rubber bands. Class III elastics run from the top 1st molar to the bottom canine bracket hook on both sides.
4. Vertical Elastics
Vertical elastics are used for bringing teeth that aren’t touching together. These rubber bands can be either individual teeth that are away from the occlusion plane, or groups of teeth in the case of open bites.
Here are some examples:
Box elastics are used for lateral open bites, or for settling the occlusion when it’s nearly time to take the braces off. They work on multiple teeth, usually the premolars and molars, and are typically worn on both sides.
Triangle elastics are great for bringing down a high canine, or closing a front open bite if used on both sides. Think of the tip of the triangle as the target for the area we want to correct with these rubber bands.
5. Crossbite Elastics
Crossbite elastics are used for correcting upper teeth that bite inside the bottom teeth. This often happens with narrow maxillas, and the molar region is usually a target for crossbite elastics.
Crossbite elastics are smaller in diameter and run from top buttons placed on the inside of the top molars to the bottom hooks of bottom molar tubes. They are used to correct individual teeth that sit in crossbite.
The smallest diameter rubber bands you may receive for crossbite correction is 1/8″. These might be annoying because they keep popping off, since they’re so tiny, but you have to be persistent.
6. Front Or Midline Elastics
Crossbites and bite discrepancies often cause what we call a midline shift. This is when the line between the top central incisors doesn’t match the line between the bottom central incisors, as it should.
Midline shift is often challenging to correct, and may require extractions or even surgery. Rubber bands are used to correct minor to moderate midline shifts, and they can be used either in a class combination (class II on one side, and class III on the other), or as front elastics, to guide the bite into place.
As with all rubber bands, you need to wear front or midline rubber bands exactly as prescribed, even if it may be confusing at first. Worn long term, these elastic bands can induce some canting or asymmetries of the occlusal plane, which is why they are used sparingly.
7. Z (Or Zig Zag) Elastics
Also called finishing elastics, this tight rubber bands pattern is used at the very end of orthodontic treatment to achieve maximum intercuspidation before braces come off. We want the bite to be perfectly settled before offering the patient an Essix retainer which doesn’t allow the teeth to naturally settle.
Z or Zig Zag elastics run from the back molars all the way to the canine bracket hooks in a zig zag pattern. Your orthodontist will typically prescribe a large stretchy elastic for this, and you’ll feel your mouth really close.
Some patients complain about not being able to talk with this types of elastics, and I can see why, but keep in mind you’ll only have them for a few weeks, and then the braces come off!
Elastic Bands Combinations
Your orthodontist may decide to give you multiple rubber band patterns to wear all at once. You may be getting class elastics and vertical elastics all at once, on one side and both sides.
What matters most is that you do EXACTLY what your orthodontist tells you to do. Your bite is unique, and so your treatment will be unique too. If you’re worried about getting too many rubber bands, remember this is all temporary, and the better you are at wearing them, the faster you’ll get your braces off.
Lastly, stop wearing your elastics if you have any broken brackets, loose or poking wires, or if you feel like you TMJ hurts or your elastics are causing a headache.
How to wear rubber bands for maximum effect
Wearing rubber bands on your braces is not everyone’s cup of tea. Most patients hate, but for those who wear elastics rigorously, the rewards soon follow.
So how can you maximize the effect of wearing elastic bands? If you’re having a hard time putting your elastics on, I recommend using an orthodontic elastic placer. In time, you’ll get used to getting them on your teeth using your fingers.
Should you add extra rubber bands on your braces to shorten treatment time? I strongly advise against it, as your upper and lower teeth require a precise dose of force which actually causes them to move properly.
Too much pressure would hinder your treatment plan, so don’t be tempted to add extra elastics or fresh elastics too often. We touch on this topic in this article about rubber bands dos and don’ts.
The bad news is there’s no way to speed up the effect of rubber bands or braces, and the best thing you can do is wear them 22hrs/ day and don’t skip days.
Anything less than that, and your teeth will start to hurt or move back and forth because of the inconsistency in wearing elastics.
Hopefully, I’ve been able to shed some light on the most common elastic configurations. Class elastics, vertical elastics, crossbite and midline elastics and a combination between them are the main ways we use this tool in orthodontic treatment.
As always, consult with your orthodontist if you have any questions, and in the meantime, don’t forget to check our other resources on rubber bands: