How do orthos decide whether to use bands or brackets?

[braceface2b]

Another thread reminded me of one of my molar bands popping off during my first treatment as a teen, and made me wonder, how do orthos decide whether to use bands or brackets?

In my case, the two treatments couldn't be more different. Back then, I had 12 bands - 4 on top and 8 on bottom. This time around, I have none. Back then, I never had headgear, elastics or anything special that really attached to the bands. About the only thing I can remember is powerchains, but I'm assuming I'll have those again this time around.

I didn't get all of my bands at once back then. When I had my braces put on, they did the first four on my first molars, leaving some unbanded, unbracketed teeth between on the lowers. Then they banded my second molars at my next visit, upper and lower, then the teeth just in front of the first molars on bottom, and eventually the two teeth just in front of those. Eventually, only my front six were bracketed on bottom, the rest were banded.

For the most part, it wasn't that bad, but my spacers kept falling out for the two final bands that were put in, and at that appointment, I remember the assistant basically just jamming them in (with me biting down on the stick of course.) The two weeks following that were the worst pain I've ever experienced in braces.

Given my fully bracketed treatment now, in hindsight, that whole ordeal just seems like it was unnecessary.

Does anyone have any clue what criteria orthos use to determine whether they band certain teeth or bracket them? Listening to them in the office, I get the impression that my current ortho tends to not band adult patients, but apparently does band children and teens.

[jakesmom]

How interesting! I thought they only banded now when there was a large cavity or a crown that they feared the glue for the bracket would not attach to very well. But my husband, who had braces as a kid in the early 60s, had all of his teeth banded because that was just how they did it then.

[braceface2b]

Well, this isn't quite that long ago. The first time around, I got mine on in 1989 and got them off in 1993. No cavities, no crowns, etc. I was always a little surprised that they did 8 bands on bottom and 4 on top since my bottom teeth were basically straight when I got braces - it was my top teeth that really needed help.

[lilone]

On the flip side, I had no molar bands for my treatment in the mid 80's, but would have them this time if I had decided to do the full treatment (needed for tads and forsus spring).

[sadpanda]

I'm not sure how the orthos decide whether to use bands or brackets, but my ortho basically said that he doesn't use bands at all. I'm sure he must have someone with bands, but the staff and the ortho act like bands are old-fashioned or something. My last teeth have a bracket thing with a little tube the wire goes into and is somehow secured in there so it doesn't fall out. From what I've heard about bands, I'm glad my ortho doesn't use them.