What are Separators, Spacers and Orthodontic Bands?

by Dr. Joseph Thompson

Spacers Separators in the mouthAn Orthodontist uses many different items to move teeth.  A lot of people have heard of separators or spacers. Yet, they don’t know what they are or how they are used.  Some of the items that an orthodontist will use during treatment are separators (spacers) and orthodontic bands.  Separators are used to create space between teeth.

An orthodontic band is the older style of braces that are usually used in the posterior part of the mouth.  An orthodontic band is a band of stainless steel metal that wraps around the tooth.  It is held in place with special dental cement.  A band can be used on any tooth however they are not very aesthetic in the front.  The band can be plain or have attachments welded to it like a bracket.

Orthodontic band in the mouthOrthodontic bands are able to take the chewing forces better than a bonded bracket on the posterior teeth.  Some orthodontists will start treatment by using bonded brackets on the molars.  If the patient knocks off the bracket a couple of times, then the orthodontist may switch to an orthodontic band.  It is more durable and has less chance of becoming loose. On the other hand, some orthodontists will just place bands on the back teeth from the very beginning of treatment and never use bonded brackets in the posterior region.

The reason some orthodontists like bonded brackets in the posterior region of the mouth is that they can visually inspect the tooth for a cavity.  Whereas with a molar band, an orthodontist cannot see if there is decay forming under the orthodontic band until it is removed.  That is the disadvantage of an orthodontic band.

Rubber Orthodontic separator & metal separatorSo, to place an orthodontic band, separators are placed first between the teeth to create space one week before the band is placed.  There are two types of separators.  The rubber separator is used the most.  The orthodontist will place the separator between the teeth by using some floss and some force.  The separator is stretched around the contact area of the tooth.  As the rubber separator returns to its’ original shape, it pushes the teeth apart creating space.

The metal separator is used when a rubber separator cannot be placed.  This is usually when the contact between the teeth is so tight, a rubber separator just can’t be placed.

Orthodontic BandsWith separators, a patient cannot floss around them or pick at them.  It is best to try to leave the separator in place until the next appointment.  If the separator falls out, it usually means that the space has been created.  If this happens, call your orthodontist to see if they want to place it back.  With a rubber separator, it is normal to feel it when you bite down.

Once the space is created by the separator, the orthodontic band can be placed.

Are separators necessary on baby teeth?

Sometimes not.  The contact point between primary (baby) teeth can vary.  An orthodontist could try to see if the band will go on the primary tooth before placing the separator.  Sometimes the contact is tight and needs a separator.  It just depends on the tightness of the contact.

There are different sizes of teeth so there are different sizes of bands.  The orthodontist will try different sizes of bands to find which one fits the best.  Once the size is determined, orthodontic cement is placed inside the band and placed on the tooth.  The excess cement is removed before it sets.  After about 5-10 minutes, the cement is hard and the rest of the appointment can be completed.

Separators and orthodontic bands are very common in orthodontic treatment and are used everyday.  Knowing the reason separators and orthodontic bands are used can defuse an apprehensive patient.

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