Q&A With Dr Emma
Hi Emma, I’ve noticed an increasing number of teenagers opting to have clear braces. Obviously this looks more visually appealing, however I was wondering if the clear braces such as Invisalign have any additional advantages compared to the conventional metal band braces? Thanks, Claire - Belmont (WA)
"Clear braces" can mean a couple of different things. As you mentioned, Invisalign is one system, which uses a series of clear plastic aligners to gradually straighten teeth. Another option is to go for traditional braces with bands and brackets, but have the brackets made out of tooth-coloured ceramic, or a clear material so they are far less visible than metal ones.
Clear plastic aligners have their limitations, but also some advantages over traditional metal braces. Not only are they much harder to see, but they can be taken in and out by the patient. This means they are taken out for eating, so you can still enjoy a hamburger without having to fish bits of bun out of every wire and bracket. Being removable also makes cleaning a breeze. Maintaining good oral hygiene around fixed metal brackets and wires is a big challenge, particularly for teenagers who have other priorities, while removable aligners mean you can brush and floss like normal.
Being removable is not always a good thing, though. If the patient is poorly motivated for treatment, they may be tempted to take their aligners out for occasions other than eating and cleaning. For optimum results, aligners must be worn for 22 hours a day, so leaving them out for extended periods will slow treatment down significantly. The other problem is that removable aligners can be lost, or damaged when outside the mouth. Dogs seem to have a particular affinity for chewing on things like aligners, dentures, and mouthguards, so the safest place for them is in your mouth!
Finally, there tends to be less irritation with clear plastic aligners than with traditional braces. There are no wires or brackets to rub on the cheeks or gums, and while breakages can still occur, a broken aligner is far less annoying than a broken wire poking out.
For the ever appearance-conscious teenager, clear plastic aligners can be a good option for orthodontic treatment. How effective they will be though depends on excellent patient compliance, and on the starting position of the teeth. Sometimes it's not possible to straighten certain teeth with aligners, and sometimes it's possible but would take longer than conventional braces. Like most things in life, the advantages and disadvantages need to be weighed up for the individual situation.