Invisalign® vs Braces

Are you unhappy with the way your teeth look and think you need some sort of orthodontic intervention to straighten them out? Then you’re probably wondering about what kind of braces you might need. It wasn’t too long ago that there was no decision to be made because the only option available was traditional metal braces. However, over time, the dental community developed ceramic braces to give the patient a less conspicuous look compared to metal. They’ve also come up with lingual braces that are placed on the tongue side of teeth rather than the cheek side. But perhaps the most comfortable and commercially successful option of them all came with the advent of clear aligners, the most well known being Invisalign.

By now, most people have already heard about Invisalign or even other companies’ versions of it. Invisalign has become very popular as an alternative to conventional braces mostly due to the lack of unsightly metal that is needed to achieve straighter teeth. But what are other differences between the two types of orthodontic treatment and who qualifies for clear aligners?

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What are Invisalign aligners?

Invisalign uses a series of customized clear semi-rigid trays and tooth-colored tabs or attachments that are bonded on to the teeth. Together, they apply force onto the teeth, causing orthodontic movement. Invisalign treatment starts with a consult with a dentist or orthodontist to determine if the patient is a good candidate for Invisalign.

Once the doctor determines that the patient is a good candidate, a series of x-rays and photographs are taken followed by a set of impressions of the patient’s teeth either by traditional trays and polyvinyl siloxane (silicone) material or by a digital scanner. The dentist then fills out an online prescription form that will be sent to Invisalign lab technicians who then run the case through their software. The software generates the treatment sequence and 3D progression of teeth movement for the patient that can be seen by the dentist and the patient. Once the aligners are given to the patient, they are worn for at least 20 hours a day for 1-2 weeks per aligner before they’re replaced by the next set. The number of aligners needed depends on a case by case basis.

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What are braces?

Orthodontic braces use brackets, wires, and bands to move teeth through constant force and pressure applied to the teeth. It is still the preferred method by most orthodontists to correct more complex alignment issues that clear aligners may have a difficult time accomplishing. Much like the first steps of Invisalign, the dentist or orthodontist will perform a full diagnostic work-up to determine if the patient is a good candidate for braces followed by a treatment plan. The brackets, wires, and bands are then attached to the teeth. The patient is then regularly and frequently seen by the dentist or specially trained dental assistant to change out the wire bands according to the treatment plan.

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Invisalign vs Traditional Braces

1) Oral hygiene:

Since Invisalign is removable, brushing and flossing can be performed without special tools or modifications to a patient’s normal oral hygiene routine. This is especially crucial for patients who are prone to dental cavities and gum disease. With traditional braces, a special instrument called a floss threader needs to be used in order to pass the floss through the wires. Needless to say, because of all the added surfaces that food can attach to with traditional braces, the patient will need to be extra vigilant with oral hygiene during treatment to prevent cavities.

2) Teeth health:

With traditional braces, food debris gets trapped between the tooth and the brackets. These debris can be challenging to remove even with excellent oral hygiene. Over time, the food becomes a breeding ground for bacteria that release acid, softening the enamel around the brackets. Once the braces are removed, patients may notice these weakened spots by its chalky white spot appearance. Over time, these white spots may remineralize and the enamel may re-harden, but the irregular white spot appearance may never go away. With Invisalign, the chance of forming white spot lesions is drastically reduced.

3) Esthetics:

Apart from the more recently developed lingual braces, Invisalign is barely noticeable to others. There may be minor speech impediments that might be apparent during the beginning of treatment, but patients tend to get used to the aligners and over time learn to speak normally with the aligners in place.

4) Comfort:

Let’s face it, if you’re placing an appliance in your mouth, no matter how thin and soft it is, it won’t be as comfortable as having nothing there. However, compared to traditional braces, Invisalign aligners provide a more comfortable experience for the patient since there are no metal brackets sticking out that can cut your cheek and tongue.

5) Cost:

Depending on the type of Invisalign package that you and your dentist agree on for your treatment, the cost will vary. However, for a comprehensive upper and lower teeth case, the cost of Invisalign will range between $5000 to $8000. With Invisalign recently raising prices on their service and products, it’s likely that pricing for Invisalign by your dentist will slightly go up as well. The price of traditional braces may vary greatly depending on difficulty of the patient’s case and the doctor, but roughly it runs anywhere between $2500 to $6000.

6) Invisalign may not be appropriate for complex cases

Due to the nature of tooth movement, there’s only so much that clear aligners and buttons can do compared to traditional braces and wires. When it comes to extreme rotations, uprighting leaning teeth, or closing open bites, Invisalign may not be appropriate. However, there are orthodontists and dentists who specialize in complex movements with Invisalign that may be able to perform more complex movements.

7) Invisalign can’t guarantee patient compliance; braces can!

Since they are easily removable, there’s no real way for dentists to ensure that a patient is wearing the aligners every day for at least 20 hours. Invisalign does have an option to place a compliance indicator on the patient’s tray so that the dentist can get an idea of the patient’s compliance level. With traditional braces, unless the patient cuts off the wires with wire cutters (which happens from time to time), sticking with the treatment is a non-issue.

Making the correct decision

The decision to go with either Invisalign or traditional braces depends on the patient’s oral conditions and the skill of the dentist. For simple movements like closing small gaps, aligning several teeth with mild to moderate crowding, correcting simple bite pattern (occlusion) issues, Invisalign is an excellent choice. However, if the teeth are severely rotated or misaligned, or if there is a pretty noticeable open bite (upper and lower teeth are not touching together when biting), traditional braces may be a better option. Always consult with your dentist and don’t be afraid to ask questions and get a second opinion!

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Invisalign®, the Invisalign logo, and iTero®, among others, are trademarks and/ or service marks of Align Technology, Inc. or one of its subsidiaries or affiliated companies and may be registered in the U.S. and/or other countries.

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