What Is the Purpose of Power Chains on Braces?
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If you’re currently wearing braces, you’re probably familiar with power chains. You may be wondering what power chains do for braces, and how they feel on your teeth.
Power chains are an orthodontic accessory that’s used on all types of fixed braces to achieve certain tooth movements: closing gaps, alleviating crowding, and even bringing down impacted teeth.
Whether you have metal, ceramic, or self-ligating brackets, you will most likely receive power chains at some point. Chances are you won’t like them, none of my patients do. That’s why it’s so important to understand how they work and know what to expect.
What do power chains do on braces?
A power chain is a string of round elastic rings that are connected to each other so that they look like a chain. The rings, similar to the O-shaped rubber bands you often see on braces, are placed over the brackets. As they stretch, they exert considerable pressure on the teeth.
Power chains have shape memory. When pulled and stretched, these elastic chains snap right back into shape. For this reason, power chains are used to bring teeth together toward the center.
There are many different ways orthodontists can place power chains on braces, either on a segment of teeth, or the entire arch. Some of your brackets may have power chains, while others may have normal elastic ties.
Thanks to their versatility, power chains can be used to fix a multitude of orthodontic issues. Here are just a few ways I use power chains in my practice:
1. Closing gaps
Many people seek orthodontic treatment for gapped teeth. While I find gaps charming, I can understand why my patients want to get rid of them. So how do we do that? We put braces on, get to a thicker wire, apply power chains for several months, and voilà – the gaps are closed!
Another situation that requires the use of power chains is when gaps open up between your front teeth during orthodontic treatment. Few patients know that braces can, and most likely will, cause small gaps to appear. This happens because we switch to broader arch wires to widen your smile.
So, before you panic at the sight of your gaps, know that they’re a quick fix with power chains.
2. Closing extraction spaces
Extraction spaces are more than just gaps that need closing. Typically, extractions create 8mm of space on both sides of the mouth that needs to somehow disappear.
As orthodontists, we have many tools in our arsenal to help teeth migrate into extraction spaces. The most popular method of closing extraction spaces is using pieces of power chains connected to certain teeth.
3. Fixing midlines
In the Facebook support groups that I’m part of, I often see patients worried about their midlines and how they’re off to one side.
Midlines can be a hard thing to correct. We can try to center them with extractions, rubber bands, and even surgery.
When correcting midlines with extractions, we use power chains to move specific groups of teeth to one side, often one by one. This can take a long time, but the results are worth it.
4. Fixing tooth rotations
To fix rotations, we can play around with how we place power chains on brackets. If placed on just one side of the bracket, we can correct certain rotations faster than just using braces and wires.
Another clever way to correct rotations is to create a force “couple.” The rotated tooth is engaged with power chains from two sides, both the cheek and the tongue side. This setup corrects the rotation much faster.
5. Fixing crooked teeth
You might be puzzled about how power chains work in this scenario. They close gaps, so it seems like they would just make crowded teeth more squished together, right?
It’s all about the technique. Crowded, crooked teeth need room to straighten out, and without space, it’s a slow-going process. That’s where power chains come in. We use them, along with open coils, to gently guide those crooked teeth toward open spaces, making everything line up quicker.
6. Aligning impacted teeth
If you have a tooth that’s stuck inside the bone, you know firsthand how difficult is to bring it where it belongs. Impacted teeth, particularly canines, can take a long time to align.
Pulling impacted teeth with elastic threads and power chains is the only way to exert the amount of force we need to bring these powerful teeth into alignment.
7. Fixing gummy smiles
Orthodontists can now correct gummy smiles without surgery and lift teeth inside the bone. Fixing gummy smiles has become possible in recent years thanks to the development of mini-screws.
Your orthodontist will install the mini screws high up in the gum and use small pieces of power chain to secure the archwire to these mini-screws. The power chains will pull on the archwire and lift the front teeth.
The processes described above take a long time and frequent replacements of the power chains. Consult with your orthodontist to learn when it’s time to get power chains and how to care for your braces once you have them.
Types of power chains for braces
There are three main types of power chains on the market. Your orthodontist will select the right one depending on how much force they want to apply to your teeth.
To sum it up, the tighter the power chain is, the stronger the force it exerts. Teeth move best with gentle intermittent forces, so overstretching power chains or using smaller sizes can do more harm than good.
Do power chains cause tooth pain?
Unfortunately, power chains do hurt when you first get them. During your periodical adjustment, your orthodontist will remove the ligatures (or tighten the self-ligating brackets) and place the power chain.
While you won’t experience any pain immediately, the power chains will feel very tight. Expect some pain and discomfort to start a few hours later and last for a couple of days to a week. You can manage the pain with over-the-counter medication like acetaminophen.
Over time, the power chain will weaken and stretch, and you will no longer feel them. This stretching gives teeth a break, which gives the bone time to remodel and help with gap closure.
The amount of discomfort you’ll experience will depend on the type and tightness of power chains, and whether you’re getting them for the first time. The more you wear power chains, the more your teeth will get used to the amount of pressure and stop hurting.
When can you expect to get power chains?
Just like rubber bands, power chains are very strong accessories. We want to use them sparingly. The consensus is not to use them on thin NiTi round wires because they can cause some unwanted tooth movements that are difficult to correct.
I like to place power chains on NiTi wires that are at least 17×25 thick, or steel wires. In translation, this means mid-treatment, or toward the end of treatment, as needed. Some patients receive power chains as early as 6-8 months in, while others get them at a later stage.
The important thing to know is that you’ll already be well-adjusted to your braces, and power chains will be just one more thing to get used to.
Are power chains the last step to braces?
No, power chains are not the last step to braces, but they do help complete the orthodontic treatment. Power chains help close gaps, but once those gaps are closed, your teeth will need a rest period.
To keep spaces closed, orthodontists use long ties, which are long thin wires woven around the brackets. The last stage of braces works on detailing and finishing up the treatment which can take three months or more.
Potential risks of power chains
Power Chains and Braces Emergencies
Even though power chains are reliable parts of braces, emergencies can happen. Here’s what to do if you face a problem.
What to Do If Your Power Chain Breaks?
It’s uncommon, but a power chain can break since they are made of materials like latex or polymer that can degrade over time. Orthodontists usually replace power chain spools every 12 months to prevent this.
If yours does break, contact your orthodontist. Without the power chain, some teeth may not stay in line. You may need to have it replaced before your next scheduled appointment to avoid misalignment.
What to Do If a Power Chain Ring Slips Off the Tooth?
If a ring comes off, often due to eating hard or sticky food, aggressive brushing, or an old, stretched power chain, you can usually fix it temporarily.
Use a toothpick or tweezers to carefully slide the ring back onto the bracket. Still, let your orthodontist know so they can check if it needs a replacement.
What to Do If the Power Chain Falls Off?
Full arch power chains rarely come off completely. However, smaller segments used for closing gaps can fall off if they’re too stretched and lose their tension.
If this happens, it’s not usually urgent, but you should inform your orthodontist. They’ll likely address it at your upcoming appointment.
Best power chain colors
When it’s time to pick the color of your power chains, your orthodontist will most likely have many spools on display. Remember, these will sit alongside the color ties on your brackets, so think about whether you want them to match or stand out.
Power chains contain more material than regular elastic ties, so they will be more visible on your teeth. You could go with a discreet silver or pearl that matches your braces or choose a pop of color instead.
Keep in mind that light-colored power chains can discolor over time, while clear ones will turn yellow. We have a full article on power chain colors to help you decide.
How to care for your braces with power chains
Keeping fixed braces clean is tough enough, and when you add power chains to the mix, it gets even tougher. Power chains can be plaque magnets, collecting all sorts of gunk before it’s time for them to be replaced.
Follow this oral hygiene guide every night to keep your braces in top shape, and brush during the day as much as you can:
- Initial Rinse: Begin by swirling water in your mouth to loosen any particles around your braces and power chains.
- Thorough Brushing: Use an electric toothbrush with a soft head to methodically clean around each bracket and power chain, paying extra attention to brush from all angles.
- Interdental Brushes: Use interdental brushes around the bracket edges and under the wire to dislodge any stubborn plaque or food. Use these brushes in the gaps between your teeth as well.
- Flossing Technique: Employ a floss threader to guide dental floss beneath the wire and between your teeth, ensuring you clean gently to avoid disturbing the chains.
- Water Flosser Advantage: Follow up with a water flosser, which uses a stream of water to remove any remaining particles. Blast any areas where the power chain may interfere with cleaning.
- Inspection and Touch-Up: After your cleaning routine, inspect your braces in the mirror. If you notice any leftover plaque or food, use the water flosser or brush again to target these areas. Don’t forget the back of your teeth.
- Fluoride Rinse: Conclude your routine with a fluoride mouthwash to help protect against cavities and strengthen tooth enamel.
- Regular Dental Visits: Maintain scheduled visits with your dental hygienist for professional cleaning, which is especially important for areas difficult to maintain with at-home care.
