ON ORAL CARE
All Your Teeth Straightening Options, Explained
Thinking about straightening your teeth? Here's a brief overview of your options.
Like many kids, Melissa Foster had braces in her teens. While they straightened her teeth, there was one thing about her smile that still bothered her after she had the braces removed.
“After 21, when I was told I could stop wearing my retainer, I still had a crooked front tooth that was really only noticeable in pictures,” Melissa, a freelance writer based out of Chicago, tells The Impression.
She let it go for a while because she said it didn’t bother her too much. But when she got engaged to her then-fiancé, Alan, she decided to look into clear aligners to try and fix that crooked front tooth before tying the knot.
“I decided to have it done before my wedding, since that's essentially a photo fest,” she said.
Melissa is far from alone in deciding to straighten her teeth as an adult. According to a survey conducted by the American Association of Orthodontists, the number of adults seeking orthodontic treatment increased 16% between 2012 and 2014, to a record 1.4 million patients over 18. In fact, some estimates now claim that half of all orthodontic patients are adults.
Dr. Chung How Kau, professor and chairman at the University of Alabama School of Dentistry, definitely sees the trend of more adults asking about teeth straightening options. “The smile is certainly a big part of one’s self-confidence, and makes an impression on the people who meet them,” he tells The Impression.
If you’re thinking of straightening your teeth, there are plenty of options to choose from. And searching for teeth straightening options online results in an overwhelming number of choices, ranging from traditional metal braces, to clear braces, to newer clear aligners that can be purchased online as a teeth straightening kit and shipped to your house.
But when it comes down to it, your options come in just two main types: conventional fixed appliances, also known as metal or ceramic braces, or removable clear aligners.
The traditional option: braces
Most dental braces are visible.
They’re a fixed appliance, which means they’re not removable.
Good oral hygiene is necessary to prevent cavities and other oral health problems.
Braces and all other teeth straightening options work by using pressure to move your teeth into the proper position. There’s a reason metal braces are still around after all these years: they work for everything from fixing teeth that are crooked, crowded or spaced out to correcting an overbite or underbite. But braces aren't all metal mouth and elastic bands anymore. The technology has evolved over the years, and there are now a number of options available:
Metal braces. These are what you normally think of when imagining braces—a metal bracket with wires held on by elastic ties.
Self-ligating (Damon) braces. Like traditional metal braces, but they use a sliding device to hold the wire instead of elastic ties.
Clear braces. Ceramic braces that are clear or colored to match your teeth.
Lingual braces. Braces placed on the back of the mouth, rather than attached to the front. Not offered by all dentists.
People who wear braces should practice good oral hygiene by brushing and flossing regularly. If you have a more severe malocclusion like a significant overbite or underbite, braces are likely the right option for you.
“All of the treatment options are effective and have their own place,” Dr. Ed Shaheen, of Shaheen Orthodontics in Ladue, Missouri, tells The Impression. “There are certain cases that can be best treated with traditional braces, and there are some cases that are actually treated best with aligner treatment.”
For Melissa, using clear aligners only became possible after first having had braces. “Braces were more medieval and uncomfortable, but I do think I had to have significantly more that needed to be done at that time,” she said. “I had a serious overbite and crowding,”
The removable option: clear aligners
For mild to moderate cases, clear aligners can most much less than braces.
Clear aligners are removable, making it easier to eat, drink, and maintain oral hygiene.
Clear aligners require significantly less time at an orthodontist's office than braces do.
They’re much less noticeable than traditional braces.
They carry less risk of root resorption than braces.
If not worn for the proper amount of time each day, they won't be effective.
Some brands of clear aligners can cost significantly more than braces.
Because they're removable, clear aligners can be lost.
Treatment time: Varies by person; 10 weeks to 2 years
Cost: Between $1,900 and $8,500, depending on the brand
In 1997, Invisalign came to market with the first clear aligner option for patients. Since then, over two dozen companies have followed. Clear aligners are plastic retainers that are custom-made after a dentist or orthodontist either takes a mold of your teeth or creates a 3D digital model using an intraoral scanner. Each set of clear aligners puts pressure on your teeth, gradually moving them into place. Although clear aligners are removable for eating, drinking, or brushing, they still need to be worn for most of the day in order to be effective.
One major way clear aligners differ from one another is in the method of delivery. Some companies allow you to purchase clear aligners online after a visit to one of their shops where a scan of your mouth is taken. Other companies let you take a mold of your mouth at home before sending your retainers in the mail. Invisalign works with orthodontists and dentists to provide their product in-office, while patients who choose direct-to-consumer clear aligners are monitored remotely by either dentists or orthodontists depending on the company they choose.
These direct-to-consumer options are attractive for people who don’t have the time for traditional in-office orthodontic appointments and are considering less expensive teeth straightening options, says Dr. Shaheen.
“The cost of traditional orthodontic treatment is simply out of reach for many patients,” he said. “This efficient treatment and cost-effective modality gives them an opportunity to receive orthodontic care that they may not have otherwise enjoyed.”
Clear aligners have been studied for decades, but information on how effective they are in specific cases isn’t yet available because there are no large-scale clinical trials available. However, more recent research has shown that clear aligners are effective at correcting slight and severe overbites in addition to more common crowding and spacing issues. And orthodontists continue to see excellent results.
“As technology improves, the early limitations of aligner treatment are lessening,” said Dr. Shaheen. “The orthodontic specialty is fast approaching the time that any case might be treated with any treatment modality.”
Everyone has different teeth straightening needs.
If you’re planning on straightening your teeth, how do you know which option is right for you? It depends, said Dr. Shaheen.
“The truth is that all of these ‘products’ work well in the areas for which they were intended,” he said. “For appropriate cases, the direct-to-consumer treatment is every bit as effective as in-office treatment or even traditional braces.”
In the end, don’t go it alone. Whether it’s at a traditional dental office, an appointment at a store offering direct-to-consumer options, or through a remote evaluation, an orthodontist will have the experience you need to develop your treatment plan after evaluating your bite.
“Consumers forget that teeth are part of the human biological system,” said Dr. Kau. “I would advise that all potential patients seek professional advice before embarking on a course of treatment.” ✧
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