What are the differences between types of orthodontics?
“I don’t want anything on the outside. Will it still work the same?” Many people want to choose the appliance first. I first decide where and how far the teeth need to move, and then choose the appliance that does that movement best. Sometimes the same mouth can be treated with several appliances, and sometimes only one will work.
| Type | Visibility | Advantages | Things to check |
|---|---|---|---|
| Metal brackets | Clearly visible | Fine control of rotation, angle, and complex movements | Brushing around the appliance |
| Tooth-colored brackets | Less visible | Same principle as metal | Brushing around the appliance |
| Self-ligating brackets | Depends on the type | Less tying of the wire, so friction may be lower | Not an advantage for every movement |
| Lingual braces | Almost invisible | Not noticeable during conversation | Speech at first, brushing the inside |
| Clear aligners | Hard to see | Can be removed to eat and brush | Worn 20–22 hours a day |
When are bracket braces the right choice?
Wires and brackets are the longest-used method, so a lot of experience in predicting results has accumulated. They allow fine control of rotation, root angle, and complex bites, so they are often the better choice when the amount of movement is large or when teeth are extracted for orthodontics. Self-ligating brackets, in which a cover holds the wire, reduce the tying and untying, but I do not claim they hurt less. I have written about the differences in Why self-ligating brackets differ from conventional braces.
Food tends to remain between brackets and under the wire, so an orthodontic toothbrush and interdental brushes are essential. If inflammation around the appliance causes bone loss, the gums do not grow back.
Do lingual braces affect speech?
At first, the tongue touches the appliance, and sounds like “s” and “ch” often come out lisped; this usually lessens after a few weeks of adjustment. The inside is hard to see in a mirror and hard to reach with a toothbrush, so it takes more time to clean than an outer appliance. If the movement is hard to control from the inside, I recommend a different appliance. For the first few days, the tip of the tongue may rub against the appliance and sting, and applying orthodontic wax makes this much easier.
Who are clear aligners right for?
Clear aligners suit people who can keep to the wearing time. Apart from eating and brushing, they must be worn almost all day, usually 20–22 hours, for the teeth to move as designed. If you often take them out and forget, the plan goes off track. The range of possible movement is wider than before, and if anchorage is insufficient, a small orthodontic mini-screw may be added in the jawbone to help.
However, clear aligners are not a cure-all, so when a root angle must be uprighted a lot or the amount of movement is large, I suggest brackets. Conversely, I do not insist on wires for a mouth where the movement is simple. For detailed criteria, see How to choose clear aligners.
How we do it at Wonjin Dental
Wonjin Dental’s orthodontic appliances are Clippy C (self-ligating brackets) for full orthodontics, MTA for partial orthodontics, and Seraphin for clear aligners, with orthodontic mini-screws added when needed. Each price is published on the fee page. In consultations, rather than focusing on the appliance name, I ask together whether that appliance can make the movement needed, whether you can keep to the wearing time, and whether you can manage hygiene on the inside. If a movement is not possible, I tell you so first.
Frequently asked questions
Can I switch orthodontic appliances partway through?
In some cases a switch is possible, such as finishing large movements with brackets and then completing treatment with clear aligners. Cost and duration change, so we discuss the possibility when making the initial plan.
Which orthodontic appliance hurts the least?
The force applied at one time and individual differences matter more than the type of appliance. With any appliance, there is often soreness for 2–3 days after it is placed or adjusted, and it usually lessens as you adjust.
What foods should I avoid during orthodontic treatment?
Brackets easily come off with sticky foods such as rice cakes or caramel, and hard foods such as ice or meat on the bone. With clear aligners, take them out to eat, but brush before putting them back in to prevent cavities.
Can I exercise or play an instrument during orthodontic treatment?
In most cases, yes. Use a mouthguard for contact sports, and with wind instruments you may need an adjustment period at first because your lips rub against the appliance.
