Orthodontic Separators (Spacers) Before Braces — UK Patient Guide

Why separators are used

Orthodontic separators are placed between the back teeth to create a small gap so that a metal molar band can be fitted at the next appointment. Molar bands — metal rings cemented around upper or lower molars — are used when a fixed brace needs stronger anchorage than a bonded bracket can provide, or when attachments such as headgear tubes, expander arms, or inter-arch elastic hooks are required. Without a separator, the contact between teeth is too tight for a band to slip through comfortably. The separator gently moves the tooth surfaces apart by a fraction of a millimetre over a few days, making band placement quick and comfortable. If you are having a palatal expander fitted rather than standard fixed braces, separators are almost always needed first because expanders use bands on multiple back teeth.

What the fitting appointment feels like

Placing separators is a quick procedure, usually taking under five minutes. A small elastic ring — typically blue or yellow — is folded with a tool and flossed between the target teeth until it snaps into the contact point. Alternatively, metal pin separators can be used. The placement itself causes brief pressure but no significant pain. Within a few hours of leaving the practice, aching begins as the contact between the teeth starts to widen. For most patients this peaks on the first and second day and reduces significantly by day three or four. The sensation is often described as pressure rather than sharp pain — similar to a tooth that has been knocked. Ibuprofen or paracetamol taken at age-appropriate doses before the discomfort peaks (rather than waiting until it is severe) is the most effective management strategy.

Eating with separators

Soft foods significantly reduce discomfort during the separator phase. Soups, yogurt, scrambled eggs, mashed potato, pasta, rice, and soft bread are all well tolerated. Avoid chewing gum — it is the most reliable way to pull a separator out. Sticky sweets such as toffee, wine gums, and fruit pastilles can dislodge separators. Very hard foods such as crusty bread, raw carrots, and hard biscuits can cause pain on the tender molars and risk knocking separators out. You do not need to eat a restricted diet indefinitely — separators are only in place for a few days to a week.

How long separators stay in

Separators are typically in place for five to seven days before the band fitting appointment. Some practices fit separators at a dedicated appointment one week before brace fitting begins; others place them at the records appointment. The exact timing is planned so the space has developed when the orthodontist is ready to fit the bands. If your appointment is delayed for any reason, inform the practice so they can advise whether the separators should stay in or be replaced.

Cleaning and oral hygiene with separators

Continue brushing your teeth normally, including around the separator. You should not floss the contact point where the separator sits — doing so risks pulling it out. Interdental brushes can be used elsewhere in the mouth as normal. If the area around a separator feels very tender, a warm saltwater rinse can soothe the gum tissue. Do not probe the separator with your tongue, fingers, or any implement — it will feel unfamiliar, but interference increases the risk of dislodgement.

When to contact the practice

Contact the practice if a separator falls out more than two days before your band fitting appointment — there may not be sufficient space by the time of the appointment without it. Also call if a separator causes severe or worsening pain beyond what ibuprofen controls, if the gum around the separator becomes very swollen or bleeds persistently, or if you are unsure whether the separator is still in place. Do not attempt to replace a fallen separator yourself — the practice will advise whether to come in for a replacement or whether enough space has already opened.

Useful related pages

This guide is for general information only. It is not a diagnosis, treatment plan, or substitute for advice from a registered dentist or orthodontist.