Types of braces available in the USA

“A smile is a curve that sets everything straight”.This saying probably holds true for most of us.

A beautiful smile is something that can lift up your confidence and brighten up the lives of those around you. Yet, not everyone is fortunate to have a beautiful smile.

With the advancement in technology and medical science, nothing seems impossible, and having perfectly-aligned teeth is no exception. That’s the good news. The bad news is that it may take time to straighten teeth – anywhere between six months and two years, depending upon the severity of your condition.

Fun fact – Although forms of teeth straightening devices have been around for thousands of years, did you know, modern braces were invented in 1819 by Christophe-Francois Delabarre?

Usually, when the term orthodontic treatment is mentioned, we immediately think about unsightly wires and metal brackets. And while dental braces help us create beautiful smiles, most people want to avoid anything that will further put us in an embarrassing situation.

Thankfully, we’re already in 2021, and technology has moved on from the clunky metal-clad braces of old. Nowadays, braces are lightweight, sleek, and even invisible.

Before you decide to implement braces, it is essential to understand the different types of braces available and how they can benefit you.

Prior knowledge is always helpful while making the right choice. So let’s dive in and take a closer look.

Choosing the perfect type of braces

Generally, people choose to get their braces done at an early age but nowadays, even adults opt for braces to correct their crooked teeth.

Widely speaking, orthodontic braces can categorized as follows:

• Removable braces and
• Fixed braces

Removable braces are designed to be taken out by the patient regularly, while fixed braces remain on the teeth for the duration of treatment and should only be removed by a dentist or orthodontist,

One fun fact about fixed braces — the type of wire used in braces (a nickel-titanium alloy) was invented by NASA

Should you opt for fixed or removable braces?

Making any form of dental decision is hard without knowing all the facts. So let’s take a closer look at the types of braces and the pros and cons of each one to help you make the best choice for your needs, requirements and budget.

Fixed braces include:

• Traditional metal braces
• Lingual braces
• Ceramic braces
• Self-litigating braces

Removable braces include:

• Clear aligners

Traditional metal braces

These are the most commonly used and the oldest type of braces, but they have had a makeover in recent times, becoming more lightweight and with smaller brackets and thinner wiring to improve aesthetics.

In terms of cost, they are among the (1) cheapest form of orthodontic treatments averaging around $5000. Moreover, they can fix just about any orthodontic problem ranging from mild to moderately severe cases.

The brackets are manufactured from stainless steel, while a nickel-titanium alloy gives the wiring its strength. Rubber bands are attached to the brackets and wires, assisting them with the tightening process. Some teens enjoy wearing metal braces because the bands can be customized in various colors for a unique take on orthodontic treatment.

However, they can be uncomfortable until you get used to wearing them, and because they consist of visible metal brackets and wiring, they will be visible when you smile.

Pros:

• Among the cheapest orthodontic treatments
• Robust materials mean they won’t get damaged easily
• Helpful in treating more severe orthodontic issues

Cons:

• Extremely visible
• Can be uncomfortable and may take some getting used to
• Needs regular follow-ups by the orthodontist to tighten the bands
• Wearing them may involve dietary restrictions

Ceramic braces

People who don’t like the thought of sporting a mouthful of metal may want to consider ceramic braces as an option. Ceramic braces are similar to metal braces but contain ceramic tooth-colored brackets and clear wiring to blend in with the teeth. This makes them

significantly less visible than their metal counterparts and are ideal for those needing more complex orthodontic treatment but prefer the process to be discreet.

On the downside, these types of braces cost more than metal braces – somewhere between (2) $4000 and $7000 on average. Moreover, because the brackets are clear, they can be prone to staining.

Pros:

• Cannot be easily noticed
• Ceramic braces don’t demineralize tooth enamel
• Smaller rounded brackets and ceramic material means they can feel more comfortable than metal braces

Cons:

• Not as durable as metal braces
• Prone to staining
• Dietary restrictions may be required for the duration of treatment

Lingual braces

Unlike traditional metal braces, lingual braces are fixed to the back of the teeth. This makes them completely invisible. Often referred to as invisible braces or incognito braces, they remain a solid option for those who don’t want people to know they’re undergoing orthodontic treatment.

The disadvantages, however, are that treatment can take longer, and because they are fixed behind the teeth, they can affect speech, particularly in the early stages of wear.

In addition, lingual braces require a specially trained dentist to fit them, so they are not always readily available. As a result, costs remain high. So expect to pay somewhere (3) between $5,000 and $13,000

Pros:

• Not visible at all, unless the mouth is wide open
• Custom-created by specially trained professionals
• Can fix a wide variety of bite alignment issues

Cons:

• Expensive compared to other orthodontic treatments
• Takes a longer time to treat teeth
• Harder to adjust and fix
• Causes discomfort and irritation in the mouth and may hinder clear speech too
• Needs regular follow-ups by the orthodontist to tighten the band

Did you know that around 25 per cent of people who wears braces are adults?

 

Self-litigating braces

These types of braces are becoming more popular and look similar to standard ‘bracket and wire braces’ except they utilize a sliding mechanism rather than rubber bands. As a result,

they are self-tightening and therefore negate the need to visit the dentist every 4-6 weeks for tightening. Self-litigating braces such as (4) Damon braces are known for efficient tooth movement, making treatment faster in most cases.

On the downside, self-litigating braces don’t wholly avoid the metal-mouth look, and they cost more than metal braces – (5) typically around $5600 on average. And, like other forms of fixed braces, you may need to avoid sticky or overly crunchy foods that can wreak havoc with braces.

Pros:

• Typically a more comfortable treatment
• Can be attached easily without much pain and discomfort to the patient
• Teeth are more adaptable to movement
• Self-tightening, so fewer visits to the dentist.

Cons:

• They can take some getting used to
• They don’t altogether avoid the metal-mouth look
• Cost more than traditional braces
• May need to adapt the diet

Removable braces

So, that’s fixed braces. Now let’s talk about removable types of braces – in essence, that’s clear aligners.

Clear aligners

Clear aligners are unlike any other form of orthodontic appliance in that they do away with brackets and wiring altogether in favour of customized clear plastic aligners (known as trays). The trays are worn over the teeth like a mouthguard.

Because each tray is made from flexible clear BPA-free plastic, they are virtually invisible. Moreover, because there are no brackets and wires to contend with, they are more comfortable in the mouth. Also, no dietary restrictions are necessary because the aligners are removed every time you eat and drink.

On the downside, aligners aren’t suitable for all misalignments, working best on mild to moderate cases. Also, because treatment success is patient-dependent, compliance is key. If aligners aren’t worn for between 20-22 hours every day, treatment could be delayed.

You can find out more about (6)  how clear aligners work here.

Pros:

• Invisible and comfortable
• Easily removable
• Because aligners treat mild to moderate cases only, treatment times are minimal (typically 6-12 months)
• As trays are removed when eating and drinking, no dietary restrictions are necessary.

Cons:

• Top brands like Invisalign can be pricey, although there are other cheaper brands available
• Not suitable for complex or severe orthodontic cases
• Needs patient compliance

 

Braces and teeth movement – how does it work?

Your teeth are not directly connected with your jaw. Instead, there is an elasticated membrane below the gums that roots your teeth to the jaw. This membrane, known as the periodontal ligament (PDL), is responsible for the positioning of the teeth. When the braces exert sustained and gentle pressure, the teeth move accordingly, and over time, they become aligned into position.

Do braces hurt?

You shouldn’t feel any discomfort when your braces are being installed. But it might get a little uncomfortable in the following days when they are being tightened, or when you insert a new aligner (tray). This is normal and is a sign that the teeth are on the move. After a few days, however, your teeth should settle down.

The pain of braces is similar to that of throbbing or soreness. The good news is that over-the-counter medications like Tylenol or Ibuprofen should be sufficient to ease any discomfort. If you do experience any significant or long-term discomfort, call your dentist for advice.

How to take care of your braces

Irrespective of the types of braces you choose, it’s essential to follow a strict oral hygiene regime. Here are a few tips you might want to consider:

• Brush your teeth after every meal
• Never forget to floss your teeth at least twice a day
• Check yourself in the mirror and see if there are any food particles.
• Use a good quality mouthwash
• When necessary, use an interdental toothbrush to clean the brackets and archwires of the braces
• Visit your orthodontist regularly for check-ups.

Apart from cleaning, it is also important to know the kind of food you can and shouldn’t eat with your braces on.

Check out the table below to see food do’s and don’ts.

Food items you can eat	Food items to avoid
Dairy – soft cheese, puddings, milk-based drinks	Chewy foods like licorice and toffee
Seafood – salmon, tuna, crab-cakes	Sticky food like chewing gum
Pasta and soft-cooked rice	Hard foods like hard candies and popcorn kernels
Cooked vegetables – spinach, green beans, mashed potatoes etc.	Nutty and crunchy food like nuts

Treatment plan  – What to expect

Once you and your orthodontist have decided which treatment is best for you, it’s time to get your braces or aligners. Here’s a breakdown of how each process works.

Fixed braces process

1. Dental cleaning— During your first appointment, the orthodontist will clean your teeth thoroughly, check for cavities and fill if necessary, and remove any plaque.
2. X-ray and Impression— Next, an X-ray of the whole mouth and individual teeth is taken.
3. Creating a mold– The next step is to create an accurate mold by taking an impression of the teeth.
4. Placing the Brackets— After cleaning and drying, the brackets are glued onto the teeth with a dental adhesive. Once the brackets are in place, the archwire is threaded through and tightened.
5. Placing molar bands—Finally, the dentist attaches the molar bands. You’ll need to visit your orthodontist regularly to tighten the bands.

Removable aligners

The process for getting removable braces is different. Check out the process below for getting (in-clinic) aligners.

1. Initial consultation– A visit to your dentist or orthodontist will determine whether you’re a good candidate for removable aligners.
2. Intraoral scanning– If successful, a digital intraoral scan is taken to create a 3D mockup of your mouth.
3. ClinCheck– Intraoral scans are uploaded to a virtual assimilation tool that then portrays your smile before undergoing treatment. Any adjustments can be made virtually at this stage.
4. Aligners are custom-made– Once the virtual mockup is agreed upon, it’s sent to the lab where your aligners are custom-made.
5. Follow the plan– After several weeks, you’ll be called back to the dental office to receive the first batch of aligners. The dentist/orthodontist will show you how to put the first one on, and the rest is up to you. Aligners should be worn for 20-22 hours a day until treatment completion.

To sum up

Braces in the 21^st century no longer carry the stigma they did in the past, and orthodontic treatment, particularly in adults (7), is on the rise. So, If you are considering orthodontics as an option to straighten teeth, you’re not alone.

It’s essential to check out the types of braces available and compare the pros and cons before making an informed choice. While some treatments are ideal for some, they aren’t for others, so it’s good to do your homework to see what’s best for you.

Whatever you decide, remember to follow the treatment plan and take care of your braces because, in return, they can provide you with a straighter, healthy, confidence-boosting smile that can last for many years to come.