Why Do Braces Have Hooks? Types of Hooks Explained
The braces you have on your teeth are made up of many components, and you might have noticed tiny hooks that poke out toward the gums. Not all brackets have hooks, but most of them do because they’re so useful.
The hooks on braces are usually located on canine, premolar and molar brackets. They’re used to apply force through rubber bands, power chains, coils and metal ligatures. Bracket hooks are built in, while ligature (Kobayashi) hooks or wire hooks are separate accessories serving the same purpose.
If you’re reading this, you’re either curious or you might have a hook problem. Either way, we’ve got you covered, and we’ll explain everything in detail in this article.
Which brackets have hooks?
Most of the brackets on the market have hooks on them, even the clear ones, but some orthodontics opt to work without hooks and only attach them when necessary.
Some brackets, especially metal self-ligating ones, have a profile that stands out and it’s easy to wrap a rubber band, elastic chain, or ligature around them without the need for hooks.
Your standard set of brackets will have built-in hooks on canines, premolars and all molars. The hooks on the molars will be a little different though – you’ll always see them pointing toward the back. That’s because molars often need to be anchored or pulled forward, and if the hooks were pointing toward the gums, the elastics would slide or snap out easily.
You’re probably wondering why incisors don’t have hooks. Well, it’s mainly an aesthetic issue, and also, they’re really uncomfortable at first, and the frontal lip area is more sensitive. Hooks don’t need to be used on the incisors as often as on your back teeth.
A word on clear bracket hooks: ceramic and sapphire braces also have hooks on canines and premolars. The problem is, they’re much more fragile than your regular metal bracket, and often, they’re the first things that break. But we’ll cover that in a minute.
The three different kinds of braces hooks
Built-in hooks are a great invention, but they’re not the only type of hooks we have in our braces arsenal. For those brackets that don’t have hooks, any orthodontist can easily fashion one out of ligature wire.
These special wire ties are called Kobayashi wire ties, or Kobayashi hooks (they look like wire loops). I’m not a big fan because they bend easily, slide into the gum and the twisted part can poke the patient’s cheek. But some orthodontists are experts at using them and absolutely love them.
Kobayashi hooks are especially handy for incisors, when up-and-down rubber bands need to be applied.
The last type of hook is a very tiny accessory that goes on the wire, much like a Pandora bracelet charm. It can be either crimped to the wire so it doesn’t move or allowed to slide on the wire. Some orthodontists go a step further and solder hooks to the wire – it should look like the hook is coming out of the wire. Wire hooks are really handy for space closure in extraction cases.
What are hooks used for?
Now that I’ve convinced you that hooks are necessary, allow me to explain how they work.
Hooks are used for pulling certain teeth or groups of teeth in different directions: mainly forward/back or up/down. Gentle force can be applied on hooks through the use of:
- Rubber bands – you might be familiar with these, they’re round rubber elastics that patients place themselves on certain hooks and change them every day. The rubber bands are used to help settle the bite and/or close spaces faster, but more on that in another article.
- Power chain or closed coil – these accessories help close gaps between teeth and they’re placed by your orthodontist.
- Metal ligature – sometimes, a metal ligature is secured to the hook, although it’s more common to thread it around the entire bracket. Metal ligatures stabilize teeth and keep them from moving.
What to do if a hook breaks?
Hooks on metal brackets rarely break, and when they do, it’s a manufacturer issue. Hooks on clear braces are a different story – they break all the time. They’re the most fragile part of a ceramic or sapphire bracket.
Clear bracket hooks can break from hard foods, wearing rubber bands, tinkering with your braces, or for no reason at all (which is the number one reported cause for most ortho problems :).
If a clear bracket hook breaks and you’re supposed to have a rubber band on it, don’t worry. Call your orthodontist’s office and ask for instructions concerning your rubber bands. At your next appointment, your orthodontist will most likely change your bracket or tie a Kobayashi hook on it.
Kobayashi ties rarely break, but they may bend into unwanted positions.
What if the hook is hurting your cheek?
When you first get braces, the hooks on the brackets may feel strange and sharp, but your cheeks will get used to them in no time at all.
If a tooth is sitting in a very crooked position, towards the cheeks, that bracket may bother you a bit more than the others or even cut your cheek. Use orthodontic wax to cover the bracket, rinse with saltwater, and take something for the pain. Remember – this, too, shall pass.
Most of the time it’s not really the bracket hook hurting your cheek, but the pointy end of a ligature or the end of the archwire. Inspect the area to see what causes your cheek to be sore. If it’s a metal ligature sticking out, try to redirect the pointy end with a pencil eraser and tuck it toward the teeth. If it’s the archwire, there’s not much you can do yourself – your orthodontist will help you.
Kobayashi hooks are also a metal ligature, which means that they can irritate your cheek if they’re not placed in a neutral spot. Before leaving the ortho’s office, always check to see if anything is bothering your cheeks – when you get home it will be too late.
Conclusion
Hooks may not be the prettiest thing, but they’re a great tool. They come in many shapes and sizes, metal and clear, and can irritate your cheek sometimes. Hooks rarely break, but even if they do, it’s not the end of the world – it’s an easy fix for your orthodontist, so don’t be afraid to reach out for help.
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