Train tracks, metal mouth, brace face: all creative nicknames for orthodontic treatment. Today more than ever, patients are trying to avoid that metal look by requesting something more aesthetic such as lingual braces or clear plastic aligners. To develop appropriate treatment plans and inform patients about the basics of braces, dentists should be aware of the patient’s aesthetic concern but also consider the indications and limitations of each method of treatment.
It’s important that dental students have a basic knowledge of the various forms of orthodontic treatment. It is a topic that comes up in everyday patient interaction and is found in a large portion of treatment plans. Even if you are not interested in specializing in orthodontics or providing orthodontic treatment in your office, this information is necessary to answer basic questions in a general practice setting.
Traditional labial/buccal appliances remain the best known and most commonly used orthodontic appliance. Today’s brackets are much smaller than the historically notorious “metal-mouth” braces. Nickel titanium wire used with these braces has revolutionized the mechanics of treatment, drastically reducing the time of care. Additionally, new heat-activated archwires are implemented, which use a patient’s body heat to help teeth move more quickly and less painfully.
Ceramic Buccal Brackets
Ceramic braces or “tooth-colored braces” are similar to metal braces but present a more esthetic option as the color mimics that of teeth. There are two types: plastic and ceramic. The plastic version is less expensive but has a tendency to fracture more. Tooth-colored braces work in an identical way to the conventional metal braces and therefore have a similar cost and treatment time.
Lingual brackets use the same material as traditional metal braces but are a more esthetic option than traditional buccal appliances as their placement is on the “tongue” side of teeth. They are the least visible as there is nothing on the buccal surfaces. The time required for overall treatment and each appointment is longer because the technique is significantly more complex. Also due to the level of technology required, there is a higher cost. These braces are best limited to adult patients, who are very esthetically concerned.
Clear Plastic Aligners
Clear plastic aligners or “invisible braces” such as Invisalign and ClearCorrect have become increasingly popular in recent years. This treatment consists of 18 to 30 custom-made, clear plastic aligners. The aligners are removable and replaced every two weeks. Patients often come and seek out Invisalign because they want orthodontic treatment but don’t want the unsightly metal brackets that come with traditional braces. They are a more affordable alternative to lingual brackets and more aesthetically pleasing than buccal. The clear aligners are virtually invisible and removable for special occasions, cleaning and eating, allowing patients to maintain their oral hygiene, diet and lifestyle. However, invisible braces are generally limited to less complicated cases and are greatly dependent on patient compliance as the appliance must be worn almost full-time to work best.
Did you wear braces or have orthodontic treatments done? Share your experiences in the comments below!
~Erin Fraundorf, Louisville ’16, District 7 trustee