What Do Steel Tie Ligatures Do in Braces? Expert Tips

When you think of braces, colorful elastic ties might come to mind. However, there’s another important component that plays a crucial role in your orthodontic treatment: steel ligature ties. These ties might not be as eye-catching as their colorful counterparts, but they’re essential for effective teeth alignment.

In this article, I’ll explain which situations call for steel tie ligatures, their pros and cons, how they’re applied and removed by your orthodontist, as well as what to do if a ligature breaks or pokes your cheek. Let’s get started!

What is the Purpose of Steel Ligature Ties?

Steel ligature ties, like the elastic ones, serve to connect the brackets on your teeth to the archwire. This connection is vital for achieving the necessary pressure so that the main arch wire fits into the bracket slot snugly.

The primary difference between steel and elastic ligature ties is that steel ties are more durable and less prone to stretching over time. This means that they can maintain a consistent force on your teeth throughout your treatment, ultimately leading to more precise results.

What Are Steel Ligature Ties

Steel ligature ties are small, individual pieces of steel wire used to secure the main archwire to your braces’ brackets, providing tension on the teeth and guiding their movement toward the desired position.

These ligature ties help your orthodontist apply precise pressure and control your teeth’ alignment throughout the treatment process.

Steel ligature ties should not be confused with long ties (or lace ties) that go on top of multiple brackets. To learn more about lace ties, check this in-depth article.

Steel ligature tie

Steel Ligature Ties Materials: Metal and Esthetic

There are two main types of ligature ties for braces: metal and esthetic. Essentially, the wire part is identical – medical grade steel – but the esthetic ties are coated with a layer of white teflon or epoxy resin. Here are their main uses:

  • Metal: Metal ligature ties provide greater durability and reduce the need for frequent replacement. They are ideal for situations where more force needs to be applied to the teeth, or when the patient goes away for a longer time between appointments.
  • Esthetic: For patients wearing ceramic braces, esthetic ligature ties are a no-brainer. They blend in with the color of your teeth, making them less noticeable. However, they may require more frequent replacement because the coating chips away, plus they’re softer and tend to break more easily.

My personal preference, whether I’m dealing with metal or ceramic braces, are metal-colored ligature ties, unless the patient specifically asks for esthetic ones. If you want to shorten treatment time, I suggest you sacrifice a little bit of the aesthetics for better functionality. You can still wear esthetic ligatures for certain events if you want to.

Tooth-colored ligature tie

How Your Orthodontist Places Steel Ligature Ties

During your orthodontic treatment, your orthodontist may place steel ligature ties to help secure the archwire to the brackets on your teeth. Here’s a step-by-step guide to this process:

  • Removing old ties: If you have old elastic ties, your orthodontist will remove them using a probe. If you have ligature ties on your teeth, your doctor will use a small cutter and cut each individual tie off your brackets.
  • Selecting the right ligature tie: Your orthodontist will choose the appropriate size and style of steel ligature tie to fit your braces. Some steel ligature ties have hooks on them, and we can also choose from multiple gauges to select the right thickness.
  • Placing the steel ligature tie: Your orthodontist will carefully place the steel ligature wire over the bracket and on top of the wire, pulling gently until the ligature is secure under the bracket’s wings.
  • Adjusting the tension: Once the ligature tie is in place, your orthodontist will start twisting the wire in order to secure it and adjust the tension. This is done to ensure the correct amount of force is applied to your teeth. You will feel your braces get tight at this point.
  • Tucking the tail away: What’s left is a long piece of twisted steel wire which your orthodontist will now trim and tuck away so it doesn’t hurt your cheek or gums. This tail is also called a pig tail and can cause issues if not tucked away properly or if dislodged by certain hard foods.

Some tips for maintaining your steel ligature ties:

  • Keep your braces and teeth clean by brushing and flossing regularly, being extra careful around the ligature ties to avoid damaging them or moving them.
  • Avoid chewing on hard, sticky, or crunchy foods that can cause the ligature ties to become loose or break.
  • If you notice any issues with your steel ligature ties, such as loosening or breakage, contact your orthodontist promptly to schedule a repair or replacement.

Remember, steel ligature ties are quite soft and bendable, so it’s easy to accidentally move them out of place when flossing, brushing your teeth or eating.

Steel Ligature Ties Pros and Cons Compared to Elastic Ties

When considering braces, you might wonder about the difference between steel ligature ties and elastic ties. Some patients complain about not getting colored ties, but certain situations ask for steel ties. Both types have their pros and cons, so let’s dive into them.

Pros of Steel Ligature Ties:

  • Durability: Steel ligature ties are more durable than their elastic counterparts. They are less prone to wear and tear, ensuring that you can go longer in between appointments if need be.
  • Easier to clean: Since steel ligature ties are less porous, they are easier to clean and maintain compared to elastic ties. This means that you will have fewer issues with plaque and food particles getting trapped around your brackets.
  • Precision: Steel ligature ties allow the main archwire to apply more force on selected teeth, resulting in more precise tooth movements.

Cons of Steel Ligature Ties:

  • Less colorful: For those who like to express their personality through their braces, steel ligature ties offer fewer color options compared to elastic ties.
  • Less comfortable: Some people find steel ligature ties to be less comfortable than elastic ties due to their rigidity and potential to irritate the cheeks and gums.

So now, you have a better understanding of the pros and cons of steel ligature ties compared to elastic ties. This information should help you make a more informed decision when discussing options with your orthodontist, but keep in mind that the type of ligature you’ll get depends on the orthodontist’s preference and style of work.

Steel Ligature Ties Troubleshooting

Experiencing issues with your steel ligature ties can be frustrating, but don’t worry, here’s some guidance on how to handle common issues like your steel tie breaking or poking your cheek.

Broken Steel Ligature Ties

If you find that your steel ligature tie is broken, try to schedule an appointment with your orthodontist as soon as possible. In the meantime, since it’s already broken, your steel ligature tie will no longer serve any purpose, so it’s best to remove it.

To do this, you can grab a tweezer, identify which wire is the steel ligature tie, and which is the main wire so you don’t pull on the wrong thing, and gently wiggle it away from your bracket so it doesn’t cause any further damage to your cheeks and lips.

It’s essential that you do not apply any force when pulling because you can easily debond brackets or cause other issues with your braces.

If you struggle to take the broken steel ligature tie off, it’s best to tuck it away using a pencil eraser, cotton swab, or another soft instrument, and apply a piece of wax on the area so the wire doesn’t come loose.

Poking Steel Ligature Ties

A steel ligature tie that’s poking your cheek isn’t necessarily broken – most of the time it’s the pig tail that’s out of place. This is incredibly common and often happens with long-ish pig tails that haven’t been properly tucked away or that have come loose because of hard foods or brushing.

  • Use orthodontic wax: Take a small piece of wax, roll it between your fingers, and apply it to the poking tie to create a cushion between the tie and your cheek
  • Bend the wire: Identify the twisted tail of the steel tie and try to tuck it back under the main archwire, where it belongs. This may require some bending, and for this purpose, you can use the eraser part of a pencil, an interdental brush, or even get crafty with some orthodontic floss threaders to thread the steel tail underneath the archwire.
  • Trim the wire: If you’re unable to see your orthodontist right away, carefully trim the poking wire with a clean nail clipper or small wire cutter. I suggest you only do this as a last resort since trimming the twisted wire can cause the steel ligature to come undone, or to become even sharper.

Conclusion

Some patients hate ligature ties because they can’t play around with colors on their braces, while others love them for being so discreet and hygienic.

This love-hate relationship with steel ties is equally common among orthodontists and ortho assistants. Some orthodontists swear by them and use them almost exclusively. I personally place steel ligature ties wherever they make sense, but limit their use due to the quite frequent accidents and sores they cause to some of my patients’ cheeks.

Ultimately, it’s up to your doctor to use whatever benefits your treatment plan in the long run!

Whether you’re new to braces or a braces veteran, taking care of your teeth and gums during orthodontic treatment is crucial. That’s why I’ve put together a list of orthodontist-recommended tools that will make caring for your braces a breeze:

  • An awesome mid-range electric toothbrush. Rotating electric brushes are much more effective, in my opinion, than sonic ones. You can keep your teeth white by using whitening replacement heads.
  • A countertop water flosser to blast out food debris between teeth. I know handheld models are tempting, but you’ll need a lot of water. You can almost replace flossing with this and your gums will be healthier.
  • Braces accessories to get into all the nooks and crannies: straight or angled interdental brushes, floss threaders, orthodontic wax or silicone. For pain management, have gel ice packs handy, Orajel, and Mouth Magic (a cool soothing solution for mouth sores).
  • For clear aligner patients, a tool like PUL helps both remove and seat your aligner or retainer. Don’t forget to use a cleaning product like crystals to keep your trays fresh and hygienic.

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