Metal dental braces are still the most common type of dental braces used in orthodontics today. Despite an overload of advertisements for clear aligners, metal braces are still found on about 90 % of all orthodontics patients. This is mostly because the braces of today are not like the bulky braces of the 1950s and 60s. For patients that simply do not want metal braces, lingual braces and tooth-colored clear braces deliver orthodontic treatment with a maximum amount of disguise.
Stainless steel braces
While stainless steel metal braces are the kind of braces most people think of when they think of braces, they have certainly changed in the last 50 and even 20 years. For traditional metal braces in which the brackets are cemented to the front of the teeth, there are two main options: twin brackets and self-ligating brackets.
Twin brackets are the older of the two choices and require ligatures to hold the archwire to the brackets. While this main sound tedious, it actually gives the wearer the option to customize their metal braces in ways they could not previously. Want your braces to reflect your school colors or your favorite shoes? Ligatures come in virtually every hue. Another advantage of twin brackets is that they are among the least expensive orthodontic treatment option in terms of dental braces.
Are colored ligatures not something you care about? Newer metal braces have brackets that have a latch to hold the archwire in place without ligatures. These self-ligating brackets (like the Damon bracket) promise to shorten orthodontic treatment time since they can apply more pressure to the teeth than twin bracket designs. Despite this increased pressure on the teeth and jaws with self-ligating brackets, patients report less pain than with traditional metal braces. This is presumably because the forces applied to teeth are more “biologically sensible” according to the manufacturers.
If kids were looking customizable colors with self-ligating brackets, they will be disappointed. Another possible drawback is that self-ligating brackets can be more expensive than twin brackets, which will increase the cost of braces overall.
Lingual braces are metal braces as well but instead of brackets cemented to the front of the tooth, they are customized to hide behind the tooth. The archwire is hidden behind the teeth as well. This means that the casual observer (and even most careful observers) will not see the lingual braces.
While they are hidden from view, there are several drawbacks to lingual braces. First, they can be much more expensive than traditional metal braces and even clear aligners. Not all orthodontists offer lingual braces and those that do offer them usually charge more. Also, since lingual braces are on the inside of the tooth (tongue side), the tongue can become irritated by the archwire and metal brackets. Lingual braces may also interfere with normal speech.
Clear braces are the term given to braces that are very near the color of the patient’s natural teeth. In this context clear braces refer to ceramic brackets, which, when placed directly on a white tooth, appear clear or translucent. NOTE clear braces discussed in this article are installed and perform like metal braces and should not be confused with clear aligners like Invisalign. Clear aligners are actually clear.
“Clear” braces are usually made of ceramic or tooth-colored composite material. While the composite or ceramic brackets in clear braces do blend in with the natural color of the tooth, the metal archwire is still visible.
There are advantages and disadvantages to clear braces. On the one hand clear braces are certainly less visible than metal braces. On the other hand, composite materials and even porous ceramics can stain –just as tooth enamel will—from things like coffee and curry. This staining of the ceramic brackets occurs to a different degree than the staining of teeth. This means that the brackets may become more noticeable with time as the brackets and teeth stain at different rates. Further, clear braces, whether ceramic or composite, are more expensive than metal braces (though clear braces are usually less expensive than lingual braces). Also overall orthodontic treatment time may be longer with clear braces than with stainless steel brackets.