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Braces or clear aligners? How do you decide?

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Dr. Justin Evans
T

he question at the top of many lists is which type of appliance to use to correct their orthodontic problem – braces or clear aligners? The fact is that there is no single “right way” for orthodontic treatment to be carried out and no one appliance is inherently better than another. What is used for an individual’s correction will be based on the goals of treatment, and the patient’s lifestyle needs, so following a detailed diagnosis by your specialist orthodontist, a personalised solution will be tailored for you.

Here are some common treatment factors to consider for both braces and clear aligners.

Traditional braces

There are many types of tooth straightening treatments available. Perhaps the most commonly recognised option is the traditional fixed metal brace. Metal braces consist of brackets that are carefully bonded to the front surface of your teeth. Wires are threaded through slots in the brackets. The brackets are typically made of stainless steel and the wires stay connected to the brackets by small rubber bands. The wires put a constant yet gentle force to properly align your teeth. It is important to know that braces have changed a great deal in recent years and are now more discreet. Clear brackets are now available (usually in ceramic form), along with coated or “aesthetic wires”. In recent years heat activated wires have become more common place, and these apply gentler forces to the teeth.

Benefits of traditional braces

Metal and ceramic braces tend to be more effective at adjusting teeth that have severe overcrowding. Metal braces may also cost less than aligners and you never have to worry about misplacing or losing them.

Aligners

Aligners are clear, thin, plastic-like trays, making them virtually invisible and allowing an individual to inconspicuously achieve a straight smile. Aligners are designed to minimize the appearance of the appliance to better fit any lifestyle. The key responsibility is wearing them as prescribed. That typically means a minimum of 20-22 hours a day and in the correct sequence. Because they are removable, aligners can be easily lost or damaged.

While there may be some initial discomfort when a patient switches to a new set of aligners, the discomfort can be easily managed. Removing aligners because they are uncomfortable defeats their purpose. Aligners can’t work unless they are in the mouth.

Benefits of Clear Aligners

The biggest benefit is that clear aligners are nearly invisible, meaning many people won't be able to tell you're wearing them at all.

Aligners allow for easier brushing and flossing since they're removed for cleaning. Plus, food won't get stuck like as sometimes happens with metal brackets. Because they don't have brackets or wires that can loosen, they require fewer repairs and fewer visits to the orthodontist. Current research ( O'Brien 2023) would suggest that whilst the outcome of aligner therapy has improved, treatment outcomes are still not as good as those of fixed appliances.