Braces used to be a rite of passage for many teenagers, and also an essential solution to a variety of oral issues for adults as well. But, in recent years, Invisalign, a less obvious orthodontic treatment involving clear, removable aligners, has gained popularity. Advertised as more comfortable and quicker than traditional braces, the treatment has helped people who avoided braces for cosmetic and other reasons.
But is one better than the other? Experts weigh in.
How braces and Invisalign work
“In simple terms, braces and clear aligners work in the same fundamental way. Both apply gentle pressure to the teeth, slowly guiding them into better positions. Teeth do not know whether the pressure is coming from a clear plastic aligner or from brackets and wires attached to the teeth,” says Dr. Daniel S. German, founder and CEO of orthobrain® in Cleveland, Ohio. He notes that Invisalign is simply one brand of clear aligners that people have started using interchangeably with the phrase “clear aligners,” but it is not the only brand available. SimplyClear and Angel Aligner are among the other brands.
Consider the costs
Dr. Michael Durbin, president of the American Association of Orthodontists at Des Plaines, Illinois, notes that cost varies based on the severity of the case and the expected treatment time. Insurance will likely cover a portion of the price, which can be thousands of dollars.
“Clear aligners have a higher lab fee associated with their manufacture, so fees may be higher for clear aligners, especially when used for early treatment. Most orthodontic offices offer convenient and flexible payment options so cost difference between the two options is typically not a barrier in selecting treatment options,” he adds.
Differences in compliance, and outcomes
“The biggest difference is not the biology of tooth movement. It is patient compliance,” German says. Once braces are placed, patients cannot remove them, and don’t allow for any missed wear time. However, with clear aligners, patients have to wear them nearly full time, around 22 hours per day, removing them just for eating and drinking. “Clear aligners only work while they are being worn,” he says. “Perhaps the most important non-clinical factor is compliance. Patients who are unlikely to wear aligners as directed are often better served with braces, which remain in place and continue working around the clock.”
In addition, some patients have sensitivities or even allergies to metal, and are better suited to clear aligners, as even metal-free ceramic braces have some metal in the wires.
“The best choice depends on the specific type of tooth movements needed, the bite problem being corrected and the patient’s ability to comply with treatment instructions. Some orthodontic problems respond more predictably to braces, while others respond more predictably to aligners,” he adds.
It’s best to consult your dentist in this decision.