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Goodbye Braces, Hello Aligners?

By Dr Abdul Rehman Rashid

You’ve been dreaming of well-aligned teeth, closing those gaps in between, getting rid of your buck tooth, or just to simply improve your smile, but confused on whether to go for traditional braces or to try the latest alternative today which are the clear aligners?

Twenty years back, patients wanting to straighten their teeth have only one option and that is to have braces placed on their teeth. Today, several dental devices and appliances are available which gives patients the opportunity to decide (with the help of their dentist) their preferred orthodontic appliance. One of these latest innovations is the clear aligner system.

Listed below are some of the major differences between braces and aligners to help guide you in making the appropriate choice. But first, here’s a short description of both:

As you might already know, orthodontic treatment with traditional braces uses brackets (usually metal), wires, bands, and elastics to move the teeth in the ideal position in the jaws. The brackets are bonded to the teeth surfaces and wires are held in place by small elastic rings. Monthly reviews or adjustments are required for this type of treatment.

Clear aligners are considered an alternative way to straighten the teeth. They are, on the other hand, transparent dental trays made of high grade plastic which are 3D printed with the help of a CAD CAM system. A series of aligners are fabricated using cutting-edge technology and each aligner is customized to fit in the patients’ teeth to gradually move each tooth until the desired outcome is achieved. 3-4 pairs of aligners are handed to the patient at a time and instructions are given on how to wear them.  It’s also important to note that some clear aligner brands use “attachments” or small bumps of composite resin attached to certain teeth all throughout the treatment time in order to aid the movements. Other brands however, don’t require these attachments and rely solely on the aligners’ material for tooth movements. Clear aligners, like braces, usually incorporate the use of elastics in correcting certain malalignments. 

Now, how do they compare in terms of effectiveness, aesthetics, comfort, dental hygiene relation, and cost?

1. Effectiveness

Believe it or not, both braces and clear aligners require the compliance of the patient to fully achieve the targeted final result, more so for the aligners, because they are in fact, removable. The required wear time for one pair of clear aligners for it to produce results is 17-22 hours for 1-2 weeks before moving onto the next aligner in the series. A very determined and compliant patient is the best candidate for this type of appliance. It is also a known fact that clear aligners are not suitable for all cases, which commonly suggests that severe or complicated teeth malalignment cannot be predictably achieved with this treatment alone. 

2. Aesthetics

Clearly, the aligners are the winners here. Gone are the “metal mouths” often associated with the metal brackets and wires. The transparent aligners are hardly noticeable in the patient’s teeth. Thus, they are the more appealing choice for adults, especially for those whose jobs involve a lot of social interactions and for personalities appearing on T.V. or film. Since they are removable, patients can remove them when necessary. They don’t interfere in special occasions (i.e. weddings, photo shoots, etc.) Although, a certain type of brackets made of semi-transparent ceramic are offered by many dental clinics which are less obvious than the metal ones, they are still not comparable to the "invisible" property that clear aligners offer. 

3. Comfort and Speech

Both braces and clear aligners offer some degree of discomfort, varying from patient to patient. This usually happens in the initial stages of treatment as well as during the monthly adjustments for braces. Every new pair of aligner will feel tight for the first few days of use. Though in terms of how the braces and aligners feel inside the mouth, most patients would vouch that the smooth thin plastic of the aligners are more tolerable and easier to adapt to compared to the bulky brackets and poking wires which are common issues for braces wearers.

Lisping is also a common thing to experience in the first few weeks of treatment for both treatment options. But as treatment progresses, the mouth adapts to these orthodontic appliances, just like breaking in a new pair of shoes, you get used to it after sometime.

4. Effect on Dental Hygiene

Your dentist cannot emphasize enough the importance of good dental hygiene during orthodontic treatment. Clear aligners have the advantage on this aspect as they are removable. Patients can easily brush and floss after every meal. Unlike with braces, patients get a tough time maneuvering in between the brackets and wires in order to brush all tooth surfaces. Flossing gets tricky as well while wearing braces. If you're serious about getting either braces or clear aligners, a reminder to live by is that dental hygiene should be impeccable during any orthodontic treatment, otherwise gum disease and other problems can arise which might lead to a worse teeth condition than before you started treatment.

5. Cost

Braces are generally more affordable than the fabrication of clear aligners. But since both are considered long term treatments, different installment plans are often offered by dental offices which patients usually appreciate.

Overall, there is no best orthodontic treatment in general. But there is one which is the most suitable for each individual patient. It’s always recommended that you talk freely and honestly with your orthodontist or dentist. All your concerns should be noted and with your dentist’s knowledge, he/she can devise the best treatment plan for you.

 

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