What to Consider When Choosing Braces

Get your teeth into all the options when choosing your braces

Broadly speaking, there are three main types of braces; conventional or labial braces where the brace is fixed to the outside (cheek side) of the teeth, lingual braces where the brace is attached to the tongue side and invisible braces where the aligners are clear, if not quite “invisible”. There are a number of reasons for choosing to go with a particular type of corrective alignment: some braces are more effective for different types of treatment and patients of different ages, and in those cases, the orthodontist might not provide options. However, for many patients, the starting point in choosing which brace to use is a balance between budget, aesthetics and the recommendation of the orthodontist. What some patients overlook when reviewing their choices is that there are practicalities to wearing the different types of braces, which can also be significant. In this article, we look at a research paper published in the European Journal of Orthodontics that compares the three types of braces for health-related “quality of life” factors such as pain and discomfort, problems eating and other oral symptoms. The research specifically compared the Invisalign™ brand of invisible braces with conventional and lingual braces.

Pain and Use of Analgesics

With all three types of braces, pain levels fell over the two weeks of the trial, with the highest levels of discomfort in the first few days. The research found that the highest pain levels on the first day of the treatment were with the Invisalign braces, but by the second day, the lingual braces were the most painful, and this continued for the 14 days of the trial. Conventional braces were consistently the least likely to cause issues with pain. Consumption of analgesics was at zero per cent by day 4 for those with conventional braces, day 6 for the Invisalign group and was still at 5.2% by the end of the trial for the Lingual brace wearers.

Oral Dysfunction

The researchers investigated oral dysfunction by measuring difficulties in speech, swallowing and opening of the mouth. While this was not a major factor across the three groups, the conventional braces were significantly more likely to cause issues compared to the other two groups.

Disturbances with Eating

Here the researchers looked at changes in taste and the enjoyment of food. Lingual braces had the most issues for these factors, with the Invisalign braces proving to be the best.

Oral Symptoms

The researchers also investigated if the brace wearers had any sores on the tongue, cheek, or lip, if there were any bad tastes and smells and if they experienced any accumulation of food. The Invisalign braces had the least problems related to these areas compared to the other two types of braces.

General Activities

A small number of people wearing braces can experience indirect problems when they first start wearing them, such as loss of sleep, missing time off work or school and problems concentrating. The researchers found that Lingual braces were the most likely to cause these types of problems.

Which Braces are Best for You?

Overall, the research presents a very mixed picture of the issues associated with the different types of braces. The most important thing is not to let any concerns about these issues put you off having corrective treatment! While this research was designed to focus on these issues, many patients do not experience any of the problems mentioned above. Also, the research only looks at the first two weeks of what can be a treatment lasting many months and for the vast majority of patients, almost all of the issues were resolved within that time frame. All good orthodontists will discuss with their patients the most suitable braces for the treatment they need. And if there are any issues, they will work with their patients to make the corrective adjustments necessary to solve any ongoing problems.