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Invisalign braces versus metal braces

Updated on September 20, 2009
an Invisalign tray
an Invisalign tray

Invisalign braces are a nice alternative to straightening your teeth. The thought of braces either make most teens and parents cringe or shout for joy depending on the severity of the need and the cost. One thing remains true though, once they are on, everyone lives for the day they are off. As a dental hygienist, I too even look forward to cleaning their teeth sans metal and wires.

To begin the process for all mouths a panorex(full mouth x-ray) taken from the outside is needed; a 3D picture if equipment is available; mouth impressions(a jelly like alginate is placed in the mouth to get an exact replica of the teeth), inside and outside photos of the teeth(front and side profile are the most common) and any other measurements the orthodontist needs. Consultations are usually free and give you the costs and options for different treatments. Invisalign can cost almost a thousand dollars more than regular braces. Many dentists are starting to offer this now in addition to their regular dental practices, but with adolescents growing and changing mouths (losing teeth, rapid jaw growth), I prefer to use someone who does braces as a full time occupation. This is your choice. I have seen many kids rushed into brushes in late elementary school, and then need braces again in high school once the permanent teeth come in. I was one of these parents pushing for braces on my sons. The orthodontist wisely encouraged me to wait until my oldest son was in the prime of his growth spurt to help pull the small chin he had out with greater ease and less "gear" than if we had started earlier. His timing was perfect, and my son's profile changed along with his braces for a more masculine outcome. With my younger son, he was slower getting his teeth in. An arch expander in his upper palate helped to widen his arch to make room for his larger permanent teeth to drop down, yet no braces. Finally as a senior in high school, once his 2nd molars(that normally come in around age 12) arrived, we were able to start the invisalign on him. All the normal dentition needs to be in before the invisalign treatment begins.

Invisalign braces are clear plastic trays that are exact reverse replicas of your teeth except in the areas that the orthodontist wishes to move. If you take your finger and push against your two upper front teeth firmly for about one minute, you can feel the amount of pressure and what that sensation of having your teeth pushed with braces is like. Theses trays are made to move certain teeth around and not necessarily the entire mouth which aids in comfort for the patient. Metal braces are wired onto the teeth and can be overtightened accidentally or intentionally, but here, all the teeth are affected and sore.

Major differences are:

Invisalign: can be removed when eating, for brushing, and briefly for say musical instrument playing(my son played trumpet). Teeth can be brushed as normal and gums and teeth stay healthier. Metal braces cannot be removed until they are done. Brackets and wires are very hard to clean around, and plaque left on teeth too long can cause white spots or decalcification of the enamel. Sometimes this is irreversible.

Invisalign has small clear "dots" applied to certain teeth to help them grip and stay in place. Metal braces are glued onto the teeth with large metal brackets around the molars and smaller brackets on anterior teeth and secured with wires and rubber bands, and sometimes brackets and hinges.

Invisalign has smooth rounded edges and is custom fitted onto teeth. Little if any gum irritation occurs while wearing them. They are clear and most people do not notice them in mouths unless they smile widely. Metal braces can cover an entire tooth if it is small in size and the brackets, wires and constant adjustments irritate the gums, cheeks and lips.

Invisalign is custom fitted and people get used to talking with them in fairly easy. Metal braces can be cutting the lips or digging into the gums in areas and mouths are generally more uncomfortable. Kids complain of food catching in them all the time, making it embarrassing to talk because of "stuff" clinging to their braces. Especially at school or work, it can be very difficult to find time to adequately clean your teeth between meals. As a hygienist, I even have difficulty manuevering around brackets with my polisher sometimes, so I can imagine the difficulty an uninspired kid might have. Add tarter buildup, excessive plaque, trapped food particles and gums become swollen, tender and bleed easily. This only makes one less likely to want to touch them, even if this will make them better.

It takes about 20-30 custom trays per arch to complete invisalign treatment. They are changed out every 6 weeks, and can be worn longer without permanent damage. This can take approximately 2 years to complete. Metal braces are in need of constant adjustment and patients must come in every 6 weeks as well. However, if a bracket comes loose, or a wire breaks, the patient must go in and have it repaired as soon as possible. It is very easy to break a bracket or a wire simply by eating the wrong food(something chewy or hard) or sometimes the pressure it is put on with simply makes it break. My son had a bracket loose and broken before we even got home from the orthodontist once. He had not done anything!

Adults can benefit from invisalign too and moving teeth in the older mouth can be a different process with metal braces. Kids mouths are growing and aveolar bone(around teeth) is changing with each tooth that is lost and each permanent one coming in. With adults, careful consideration should be made around teeth that possibly already have bone loss. When teeth are not aligned correctly, or have heavy overbites for example, bone loss may have already occurred. Movement of the teeth through this area may be cause for some periodontal treatment as well. Again, someone very familiar with the movement of teeth can be better suited for this.

One drawback to invisalign, you can place them in a napkin at lunch and accidentally throw them out. They are to be worn even while you sleep, but kids have been known to take them out at night, if their mouth is sore , among other reasons. Obviously they won't work unless they are in, so some dedication needs to be made on the part of the patient to wearing them always. Metal braces obviously are on whether you want them or not. Only the doctor can remove them, and leftover glue must be scrupulously pried from the teeth. A small metal retainer is usually left in the lower anterior arch permanently. A removal palatal retainer sometimes is needed as well. Invisalign wearers can usually just sleep in their last tray at night for retention of alignment. This differs as well for each doctor.

And finally smiling with a mouth full of metal braces is just well, not as attractive. Nicknames and ribbing occur commonly and kids can become self-concious. Invisalign mouths can smile knowing very few people will even know or notice that they are wearing braces unless they see them come out.

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