Which Type of Braces or Aligners Should I Use to Straighten My Teeth?

Getting your teeth aligned can change your life in so many positive ways. At Meadows Orthodontics we talk with new patients every day who are both excited and nervous about which type of braces (or invisalign) they should choose. We work with each patient individually to help decide what will be best for their bite, and what will fit best into their lifestyle. The most important thing to remember is that braces, invisalign, and orthodontic devices of any type are only as good as the orthodontist using them. We all have different preferences-in general it is the decisions we make and mechanics we use that determine the quality of your outcome, not the braces themselves! Here is a guide to the orthodontic choices that are currently available.

braces 22Metal Braces:  These are the “traditional” braces that most of us think of when we picture braces. Metal braces are very popular because of their small size and low profile, and the fact that kids (and some adults) love choosing the color ties that hold the wire part of the braces in. At every appointment with us, these color ties are changed, and there is an opportunity to “refresh” the look of the braces.

  • Effectiveness:  Braces of all types (metal, ceramic, and self-ligating) are usually the gold standard in getting the best results for most types of bite and misalignment problems.
  • Esthetics:  Metal braces bring the bold fun factor, as kids really look forward to the thousands of color combinations that can be used with the ties. Silver and clear ties can be used if you want a less colorful look. They are very noticeable though, and adults and older teens often will often opt for a less noticeable option.
  • Relative cost: Metal braces offer a great value as far the unbeatable result you will get for the relatively lower investment in the actual braces.

downloadCeramic Braces: Often called “clear braces”, these braces are made of ceramic, composite or crystal materials. They are usually clear or tooth colored, and look amazing.

  • Effectiveness: For the majority of patients, ceramic braces are usually just as effective as metal braces and the same great results are expected. There are some exceptions: For patients with deep bites (lower teeth that are largely hidden behind the upper teeth) or with patients that grind their teeth heavily we have to decide individually if ceramics can be worn on the lower teeth. The goal is to prevent wear on the biting edges of the upper teeth in these cases. Even these patients can usually wear ceramics on their upper teeth though.
  • Esthetics: Ceramic braces are know for their discreet, sophisticated look that adults and older teens often gravitate towards. These braces are the best option for a highly esthetic look, with all the mechanical advantages of traditional braces. Because they are clear or tooth colored, we have patients that often go for months before co-workers notice they are wearing them!
  • Relative cost: Ceramics braces usually cost more to manufacture than metal braces, and depending on the case may cost slightly more than traditional braces (although usually not as much as invisalign).

images (1)Self-ligating braces: Common brands of self-ligating braces include Smart-clip, Damon, Harmony, and Speed, among many others. Self-ligating braces use various types of sliding doors or clips to hold the archwire into the braces instead of the color ties, and can be made of metal, ceramics, or a combination of the two. Although these braces work just as well as traditional or ceramic braces, patients must be very wary of marketing claims made by the manufacturers and dental providers regarding the “advantages” of these braces. Most credible, peer-reviewed research (summarized by a recent article by the American Association of Orthodontists’ Council of Scientific Affairs in the American Journal of Orthodontics and Dentofacial Orthopedics), is showing that there is no statistical difference between traditional braces and self-ligating braces in overall treatment time, faster alignment, reduced forces, patient comfort, or improved hygiene- basically, all the important reasons these brackets have been marketed. However, these are all great brackets, and I offer these brackets in my practice- I am just very up front with my patients that they only differ by the way the braces hold onto the archwire, they cost more, and results are the same as traditional or ceramic braces (the vast majority of my patients choose traditional or ceramic after learning this!).

  • Effectiveness: Self ligating brackets are just as effective as traditional braces, and the same treatment time and results can be expected.
  • Esthetics: These braces can be metal, ceramic, or a mixture of the two, and the size varies depending on the manufacturer.
  • Relative cost: The moving parts within these braces make manufacturing them more costly, and this may be passed on to the consumer. Like always , this varies case by case.

imagesInvisalign:  Invisalign is a series of clear plastic trays that are changed at a prescribed period of time in order to make many incremental movements to your teeth. There are many things that invisalign does as well as braces, and some things that it struggles with in comparison. For the things that invisalign tends to have a harder time correcting, orthodontists must use adjuncts that would normally be used with braces: elastics, bite planes, in addition to what are called “attachments”, or composite bumps that are bonded to the surface of the teeth in order for the trays to “grip” onto. Also, patients and parents must consider that the ability to remove the trays at any time is both invisalign’s greatest advantage (for eating, brushing, special events such as playing an instrument in concert, etc…), and its greatest disadvantage (if they are not worn consistantly, they do not work!).

  • Effectiveness: After years of using invisalign and braces, I have a good sense which bites are corrected really well with invisalign, and which ones are not. Of all the treatment types described here, Invisalign is the most important for this early case selection and identification of limitations of treatment. I actually prefer to use invisalign on some cases, and on others would not attempt to use it. I will discuss the pros and cons at your initial appointment!
  • Esthetics: One of the advantages of invisalign is the clear nature of the trays, and often it is close to being undetectable to the public. However, it is very common to need the bonded attachments to your teeth. Some patients would rather have ceramic braces than these attachments, while others do not mind them at all. It is important to be comfortable with what they will look like before we get started, and I will review with you where each attachment will be, and if rubber bands will needed.
  • Relative cost: On the average, invisalign tends to cost more than the other options, and this reflects the relatively large fee we pay in order to use invisalign’s technology. Again, there is a large variation in cost due to case complexity and expected treatment time.

Alignment with retainers:  Minor movements are possible within retainers that are made by our office. The key word is “minor”, as retainers are designed to retain, or hold the teeth in place. Small areas of pressure, or even a spring-loaded wire  can be added within a retainer that can push an area of a tooth a small distance.

  • Effectiveness: Only for very minor movements, and the retainer must be worn steadily for the desired movements to occur.
  • Esthetics: It appears that you are wearing your retainer, whether it be a clear vacuum formed tray, or a Hawley type retainer with acrylic and wire across the front teeth.
  • Relative cost: The cost is usually proportionate to the minor movement that we are trying to achieve.

Call me at any time at Meadows Orthodontics, and we can discuss which option is best for you or your child!

Dr. Dan Rejman is a board certified orthodontic specialist, with two Castle Rock locations. Our original location in the Meadows right next to Einstein’s/Caribou, and our new location near Founders and Terrain, in the Founders marketplace.