Orthodontic treatment is no longer just metal wires. Clear aligners are an attractive option for many people, but not the right option for every case.
How do the two methods work?
Braces are bonded to the surface of the teeth; the wire running through them applies a constant, controlled force. The wire is adjusted by the dentist at regular intervals. Metal or tooth-coloured ceramic brackets can be used.
Clear aligners are thin, transparent trays that fit exactly over the teeth. Each tray moves the teeth a little; every week or two you move on to the next one. The trays can be taken in and out.
Appearance
Clear aligners go unnoticed unless someone looks closely. Metal brackets are visible; ceramic brackets are tooth-coloured and draw less attention. For adults who do not want visible braces at work or socially, aligners have the edge here.
Comfort and daily life
- Eating: Aligners are taken out for meals, so there are no food restrictions. With braces you need to avoid hard, sticky and shelled foods.
- Cleaning: With the aligner out you brush as usual. Cleaning around brackets takes more care and an interdental brush.
- Irritation: Brackets and wires can irritate the cheeks and lips in the first weeks. The edges of aligners are smooth.
- Speech: Aligners can cause a slight lisp in the first days; it usually goes within a few days.
Discipline: the weak point of aligners
For clear aligners to work they must be worn 20 to 22 hours a day; they come out only for eating and brushing. While the aligner is out the teeth do not move, and may even move back. Braces are fixed in the mouth; there is no question of forgetting or neglecting them. So aligner treatment suits people who are sure they will wear them consistently.
Which cases suit which?
Mild and moderate crowding, gaps between teeth and many bite problems can be treated with clear aligners. In the following situations, however, braces usually give a more predictable result:
- Severe crowding and cases requiring extractions
- Teeth that need to be rotated or extruded significantly
- Bringing impacted teeth into place
- Skeletal jaw discrepancies
Which method suits you becomes clear after an examination and X-ray assessment. For general information see our orthodontics page.
Treatment time and check-ups
Duration depends on the case, not the method. For cases of similar difficulty the two take about the same time. With braces, check-ups are usually every four to six weeks. With aligners the intervals can be longer.
After treatment: the same rule for both
Whichever method is used, teeth tend to move back to where they were. Wearing a retainer after treatment is essential. Retention is at least as important as the treatment itself.
Frequently asked questions
Can clear aligners be used at any age?
They can be used by teenagers whose permanent teeth have come through and by adults. What matters is not age but the health of the teeth and gums and whether the aligners will be worn consistently.
Can I drink tea or coffee with aligners in?
Only water should be drunk with the aligner in. Hot drinks can distort the aligner; coloured and sugary drinks stain it and, trapped between tooth and aligner, raise the risk of decay.
Are braces more painful than clear aligners?
With both methods the teeth are moving, so pressure and tenderness are felt. With braces this lasts a few days after each adjustment; with aligners it is felt for a day or two with each new tray and is generally milder.
This article is for general information and is not a substitute for diagnosis or treatment. If you have a complaint, please see your dentist.