According to a study published in ResearchGate, malocclusion affects 39% to 93% of children and teens worldwide, as well as many adults. It’s so prevalent that the World Health Organization (WHO) even ranks it as the third “most important” oral health issue.
Also called a “bad bite,” malocclusion is when your upper and lower teeth don’t align even when you close your mouth. It’s more than just a cosmetic issue; it can also result in oral health problems.
So, if you have misaligned teeth or a bad bite, consider exploring the main types of braces available today. Otherwise, your condition can wear down your teeth, irritate your gums, and make your pearly whites more susceptible to tooth decay.
In this guide, we’ll explain your primary options for dental braces, as well as answer the following questions:
- How do braces work?
- How long do braces take?
- What is the best type of braces?
Let’s get started.
Traditional Metal Braces
Traditional metal braces, sometimes called “train-track braces,” remain the most common orthodontic device. They’re the first type of modern braces, consisting of several components, including:
- Metal brackets, usually stainless steel or titanium
- Metal archwires, often made of stainless steel or titanium alloys
- Elastic ligatures, tiny rubber bands that come in all sorts of colors
For some patients with severe jaw misalignment (e.g., a severe overbite or underbite), inter-arch elastics, which are rubber bands bigger than elastic ligatures, may also be necessary.
How Traditional Braces Work
Teeth straightening with metal braces involves gradually moving the teeth through controlled pressure. Each component plays a different role in these movements.
First, we have the metal brackets, which serve as anchors for the archwires. Depending on the severity of the malocclusion, your general dentist or orthodontist may affix one bracket to nearly every tooth (except the very back molars). They’ll use dental adhesive to glue the brackets securely to the middle part of the front of each tooth.
Next, your dentist will insert an archwire into the brackets. If you must get braces for the upper and lower teeth, you’ll also get an upper and lower archwire. The wires apply pressure and force to the teeth and move them to more ideal locations.
Your dentist will then secure the archwires to the brackets using elastic ligatures. The tiny rubber bands will help prevent the wires from slipping or popping out of place.
Your dentist may also connect the upper and lower braces with inter-arch elastics. The bands exert pressure on the jaw, moving it backward or forward, depending on the specific type of malocclusion.
You must visit your dentist throughout the treatment, usually once monthly. During these visits, the dental professional will clean your teeth and adjust the pressure and tension of your braces.
How Long Do Traditional Braces Take?
Treatment with traditional metal braces usually takes between 12 and 24 months. However, the length of treatment time still depends on the severity of the issue. For more severe or complex problems, expect it to take longer.
Patient adherence to monthly check-ups and visits also affects the duration of treatment, regardless of the type of braces placed. So, whether you opt for metal or clear braces, you must visit your dentist or orthodontist as directed and scheduled.
As mentioned, your dental professional will adjust the orthodontic devices during each monthly visit. The adjustments ensure your braces maintain adequate pressure and tension to move your teeth. Otherwise, the archwires may become too slack, extending the treatment time.
Are Traditional Braces the Best Type of Braces?
It depends, although traditional braces are usually best for children and teens as they typically provide the most practical and affordable option. Since they’re “permanent,” young patients are less likely to lose or misplace them than removable orthodontic appliances.
Traditional braces are also ideal solutions as they effectively treat many orthodontic issues common in children and teens, such as:
- Crooked teeth
- Crowded teeth
- Gaps between teeth
- Misaligned bites like crossbites, overbites, and underbites
- Rotated teeth
- Protruding teeth
If you’re an adult with a more severe or complex orthodontic issue, your dentist may also likely recommend traditional braces. A good enough reason is that your dentist will have better, more precise control over metal braces’ fixed brackets and wires. Other orthodontic treatments, such as removable clear aligners, may not provide the same high level of precision and control.
Variations in the Metal Used for Traditional Braces
Some metal braces for adults, teens, and kids have specialized coatings that make them more aesthetically appealing.
For example, rhodium braces work like traditional metal braces, except their brackets feature rhodium coating. As explained by Brilliant Earth, rhodium belongs to the platinum element family, but this silvery-white metal is rarer and more expensive than platinum or gold. In orthodontic brackets, rhodium coating gives them a more polished, aesthetic appearance that resembles silver jewelry.
Iconix braces are another variant of metal braces. They also use stainless steel brackets and archwires. However, the brackets feature a champagne-colored coating, which patients may find more elegant-looking than stainless steel.
Ceramic Braces
Ceramic or “clear braces” consist of ceramic brackets that are either clear or mimic the color of natural teeth. Like traditional metal braces, they also have wires and rubber bands, although you can get them in clear or tooth-colored options.
How Do Ceramic Braces Work?
Ceramic braces work much like traditional metal braces, with brackets, wires, and elastics all working together to place pressure on the teeth and move them to more desirable positions. They also require once-monthly visits to the dentist for adjustments. The primary difference is their appearance: ceramic braces are more subtle because of their clear or tooth-colored components.
How Long Do Ceramic Braces Take?
Ceramic braces typically take as long as traditional metal braces, considering they work similarly.
However, treatment with ceramic braces may take longer in some cases because the porcelain-like materials used in their brackets are less durable than metal braces. They’re more prone to chipping and cracking, which can reduce the force necessary to move the teeth.
Dentists must replace damaged ceramic brackets for the braces to work correctly again. So, if a patient takes too long to visit their dentist, it could prolong their treatment time.
When Are Ceramic Braces the Best Option?
Ceramic braces may be one of the best options for individuals who:
- Have a complex orthodontic case wherein traditional metal braces are the best option but want a more discreet, less noticeable alternative
- Are prone to tooth sensitivities, which metal brackets and wires can aggravate as they conduct heat (and cold)
- Are older (including teens) and can exercise more care over the ceramic brackets
Lingual Braces
Like traditional metal braces, lingual braces use metal brackets, wires, and elastics. However, instead of covering the front of the teeth, they go behind, hence the term “lingual,” which means “relating to the tongue.”
How Do Lingual Braces Work?
Lingual braces move teeth to better locations the same way traditional braces do. Monthly visits for adjustments are also a must. The key difference is their placement; since lingual braces go on the back of the teeth, they’re nearly invisible when you smile.
How Long Do Lingual Braces Take?
Due to their unique placement, lingual braces may take longer than traditional braces. Because of the limited space behind the teeth, dentists have to make more precise customizations and adjustments, potentially prolonging the treatment time.
A dentist may also need to use custom-made brackets for lingual braces. Customization is crucial for this orthodontic treatment, as it allows the braces to fit the unique contours of the backsides of a patient’s teeth.
Making orthodontic brackets from scratch and tailoring them based on unique factors takes time, which can add to the treatment’s overall length. For the same reason, losing or damaging the brackets of lingual braces can prolong treatment time.
When Does Choosing Lingual Braces Make the Best Sense Then?
Given the many drawbacks of lingual braces, you may wonder if it would even be the best option in any situation.
Lingual braces may be the best alternative for people whose orthodontic case warrants using traditional metal braces but want them to be as discreet as possible. They’re also ideal for individuals who play contact sports, as the brackets’ placement can help minimize the risk of accidental injuries.
Likewise, those who play wind instruments may find lingual braces to cause less discomfort than braces affixed on the front of the teeth. Lingual braces may also affect playing, especially those of brass instruments, to a lesser degree than traditional orthodontics.
Clear Aligners
Clear aligners, made of durable, see-through plastic, are the most recent additions and innovations to orthodontic treatments. Because they are transparent, they provide the most discreet teeth-straightening option.
Unlike the other braces discussed in this guide, clear aligners differ in that they’re completely removable. Their removability is a key component of the treatment, as the aligners, or trays, require replacement every week or two.
The removability of clear aligners also gives them an advantage over fixed braces, as they allow for better cleaning of the teeth and gums. You can brush twice daily and floss once daily like you usually do. Whereas if you wear fixed braces, you’d need to pay more attention to how you brush or floss to ensure you remove as much cavity-causing plaque from your pearly whites as possible.
How Do Clear Aligners Work?
When you opt for clear aligners, your dentist will create a highly tailored treatment plan involving wearing a series of trays with varying degrees of tightness. The aligners must cover all of the teeth and provide a snug fit. As you wear them, they should gradually move your pearly whites according to your treatment plan’s desired goals.
For clear aligners to be effective, you must wear them constantly, usually about 22 hours daily, as News-Medical.net explains. You need to have them on even while you sleep. You should only take them out when you eat, drink, brush, or floss your teeth.
Your dentist will inform you when you need to change your aligners, typically every week or two. Depending on your treatment plan, you should get several trays at once and then return to your dentist every six to eight weeks for the new ones. The dental professional will also use these visits to clean your teeth and monitor the treatment’s progress.
Once you’ve finished wearing all the aligners, you should have straighter teeth, a more optimally aligned jaw, or both. Your dentist will then give you retainers to maintain the new position of your teeth and jaw. You may have to wear it all day for the first few months and then just every night afterward.
How Long Do Clear Aligners Take?
As the U.S. FDA explains, treatment with clear aligners can take six to 18 months. However, this depends on the case’s complexity and patient adherence. For instance, more complex cases may take up to two years, and failure to follow instructions (e.g., not wearing the aligners for 22 hours a day) can prolong the treatment.
When Are Clear Aligners Your Best Option?
Clear aligners may be the best option for people with less complex orthodontic cases (e.g., minor to moderate overbites, underbites, crossbites, etc.) and:
- Want to get straighter teeth and a more aligned bite in a highly discreet way
- Have the discipline to adhere to the treatment’s instructions (i.e., wearing the aligners nearly all day)
- Looking for a more comfortable teeth straightening treatment
- Don’t want their diets restricted or modified, which can be the case when wearing fixed braces
Explore the Primary Types of Braces With Your Dentist
Clear aligners, metal, ceramic, and lingual braces are all types of braces that can help straighten your teeth and bite. There is no single “best” type, as each has pros and cons. The best way to determine which type to choose is to consult a dental professional.
So, if you want to say goodbye to crooked teeth or a misaligned bite, it’s time to say hello to a dentist or orthodontist qualified to provide orthodontic treatment. They can explain your best options based on your unique needs and preferences.
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