hi it's dr amanda with straight smile solutions street smile solutions.com and today we're going
to talk about elastics with braces or rubber bands with braces specifically we're going to be talking
about class 2 and class 3 elastics these are two of the most popular configurations but there's all
kinds of elastics there's triangles there's box elastics there's anterior elastics there's cross
elastics there's z elastics and i have videos actually on all this already you can just go
into my um section and look under a little search bar and then put that in and it'll come up but um
i just wanted to go over a little bit more class 2 and class 3 because that's the most popular now
for me i don't start elastics on a patient until we've already finished the main steps would be
leveling and aligning and i've worked my way up to rectangular wires so if you are
an orthodontist or a dentist you know what this means you have to finish your leveling on the
lining i work my way through my round arch wires in nighttime my 14 my 16 my 18 and i get myself
into a nice heavy wire like 18 25 and that means and everything's straight at that point um i'm
happy about how straight everything is i'm happy about the bracket positioning all i need to do
next is maybe close some spaces if i have any and or fix the bite that's all that's left so you
shouldn't be working on class two and class three until you got to that point okay so it might take
six months it might take a year it might take three months it might take a year and a half
till you're ready so that comes more towards the end for me but let me show you how that works so
one great like hack that you can use for elastics um if you don't have nails or if you're really not
very dexterous is to get um an elastic placer and most orthodontists will have this and there's like
a curved end and then there's a little end that has a little pitchfork and whatever and works for
you so let me show that to you so here's how it works and remember elastics come in all different
sizes and strengths so they usually come in a certain amount of ounces so two ounces usually
light four ounces usually medium six to six and a half ounce is heavy those are intra or elastics
then they also come in diameters okay so this for example i think this is one quarter but it's
the diameter of the circle right so they come as small as 1 8 3 16 one quarter 5 16 and so on so
for class 2 or class 3 elastics obviously you want to have the smallest diameter that you patient can
comfortably take on and off by themselves and i never let a patient leave my office until they
can show me that they can take their elastics on and take them off properly by themselves without
my help because it's really easy for us to put them on but it's harder for them to put it on
and remember class 2 and class 3 elastics only work when you wear them 22 hours a day if you wear
them 16 hours a day you're probably gonna get zero results it doesn't work that way your body has
to get used to it the bone has to get used to it and intermittently wearing it is going to achieve
nothing except for just discomfort and frustration so if you aren't going to commit to wearing it
full time no sense in wearing them at all you should let your doctor know and your doctor can
perhaps modify your treatment plan accordingly and or maybe your doctor just can't fix your bite so
obviously we want to try to give you a perfect outcome so you need to try to follow the
directions i know it's frustrating i had class 2 elastics many many many times so but you know
what the more you wear them they actually won't cause any discomfort or soreness once you start
wearing them continuously and kind of get over that initial um hump of getting used to wearing
them so let me show you what class to elastics look like on a braces patient keep in mind that
you you may not look like this but this is just a typo not right so class two elastics are meant to
help to fix over jet or when the front teeth are more forward of the lower teeth okay so ideal bite
would be where your front teeth are pretty much almost touching your bottom teeth so if it's like
this you need you have over jet and we need to fix it so ah this one has wax on it so of course
this is a little more tricky oh no and i broke a bracket okay so i'll just show you on this side
so class two elastics normally go from the upper canine assuming you have it to the lower molar
like this can you see that upper canine to lower molar now as you can see my fake
patient here actually is missing some teeth so i might actually go with a smaller diameter
than this this is normally i use 3 16 heavy if i'm doing it on the proper wires this i think
is one quarter medium so this isn't really the right thing but you know like i said the smallest
diameter that the patient can comfortably get on and off so most of the time 3 16 heavy is going
to be my go to class 2 or class 3 elastic but sometimes if a patient has a really big mouth
and really big teeth i'm going to use quarter heavy sometimes they have a super tiny mouth
maybe they had some extractions i'm going to use 1 8 heavy that's 6 ounce or 6.5 ounce so
you need to possibly stock quite a few different diameters and sizes of elastics in your office
because not there's no like cookie cutter approach to this okay so you've seen what class two looks
like again upper canine to lower molar is class two now let's switch it around let's talk about
those underbite patients or negative overjet patients and what class three elastics look like
so class three elastics are gonna be the opposite they're gonna go from lower canine
to upper maller let me show you there you go class three okay lower canine to upper bowler
now usually patients like this configuration better because you can't really see it it's a
lot more discreet and it doesn't look like spit coming out of your mouth but you know we can't
pick which way our teeth are so this is meant to be for more edge to edge bites or under rights so
that's class three and remember if you're patient if you lose your elastics you need to give your
doctor a call because you need to continuously wear them or if you run out give them a call i've
always been cool about throwing elastics in the mail and mailing them out to my patients so they
don't have to come in and get more sometimes you're going to have asymmetric elastics or
you're going to have one elastic on one side and a different elastic on the other side so here is
class three on both sides as you can see okay um sometimes you're gonna have elastics in the front
sometimes you're gonna have triangles on the side you might have boxes on the side you might have
zigzag elastics at the end so so many different configurations check in with your doctor regularly
how often does it take to correct a bite with class 2 or class 3 elastics well it depends on
how if you're actually wearing them so assuming if they're sized correctly and you have the right
diameter i've always noticed that patients can usually achieve one millimeter correction per
month of continuous wear that means if you have a five millimeter over jet it should take five
months of continuous wear if you stop wearing them for a few days you're gonna slip and that's gonna
need a whole another month to catch up again so you need to wear them continuously and if you feel
like you're over correcting that happens sometimes so always check with your doctor if you feel like
you're over correcting so for example in a class 2 case i tell patients that once their front teeth
start to touch you know then they need to give me a call because you know without the elastics in
because we might need to discontinue the elastics earlier or pause them or just wear them at nights
and so good to know all right thanks so much hopefully that was helpful take care