Types Of Braces

Introduction

Braces are tried and true orthodontic devices used to correct the appearance and alignment of teeth, to improve oral health.¹ They are very commonly available and have been in use for a long time, with braces evolving significantly with the rise of technology. For individuals considering orthodontic treatment, it is important to understand the different types of braces available, so that one can make more informed decisions about one’s orthodontic treatment. 

Fixed braces are the most popular type of orthodontic appliance, but there are other options such as clear aligners. From traditional metal braces to modern and innovative clear aligners, there is something to suit everybody. Currently, there are 5 main types available:

• Traditional metal braces
• Ceramic braces
• Lingual braces
• Self-ligating braces
• Clear aligners e.g. Invisalign

Metal braces

When one thinks of braces, the image that most often comes to mind is of traditional metal braces. Metal braces have been in use for a very long time, and are one of the most popular choices for orthodontic treatment due to the predictability and reliability of their results.³ They consist of small brackets made of stainless steel, which are fixed onto the front of the teeth and joined together using a thin archwire.

Elastic bands called ligatures or metal ties are then used to secure the wire onto the brackets, which helps to provide consistent pressure to move the teeth in a specific direction. Throughout the treatment, the wires are slowly tightened to move the teeth into a more appropriate position. 

There are many advantages to metal braces, which have allowed them to withstand the test of time and developing technology. They have been proven time and time again to be effective in treating a wide variety of orthodontic issues, ranging from overbites to gaps in teeth to crooked teeth.⁵

The strength of the braces, resulting from the stainless steel and wires used, provides them with the durability required to maintain the constant pressure that is needed to shift teeth into a more ideal position over time. Unlike other types of braces, metal braces are suitable for people of all ages, ranging from young pre-teens to older adults. 

Moreover, they may offer a more cost-effective and convenient solution, as they tend to cost less than alternative options. Treatment typically lasts for 1 to 3 years, with metal braces being fitted in one sitting. Further visits to the dentist are only required for adjustments, and braces are easily cleaned simply by maintaining proper oral hygiene. Additionally, they are non-removable, so there is no chance that you will break, lose or forget to wear your braces! 

However, there are disadvantages to metal braces which make them unsuitable for certain patients. The main disadvantage is their visibility, which can cause young people to feel self-conscious about their smiles. Metal braces may also be uncomfortable when they are first placed on, as they may cause friction between the gums teeth and oral soft tissues, causing irritation and difficulty eating certain foods.⁶

Ceramic braces

Ceramic braces work in a similar way to metal braces, with the main difference being the material they are made of. Ceramic, or clear, braces consist of ceramic brackets which are attached to the teeth and joined together using a thin archwire.⁷ 

One of the main advantages of ceramic braces over metal braces is their visibility. Ceramic brackets can be clear or tooth-coloured, which makes them much less noticeable.⁸ Similarly, the wire used is often metal but can be tooth-coloured to further increase their invisibility. Additionally, the ceramic used may be more comfortable for orthodontic patients, as the materials used are smoother and less abrasive so are much less likely to irritate the gums or sides of the mouth. 

However, ceramic braces also have certain disadvantages which may mean that patients would prefer to opt for something else. They have a tendency to discolour or stain over time, which will affect their visibility, particularly if the patient is fond of drinks known to cause staining. Additionally, although ceramic braces are suitable for most orthodontic patients, they may be less effective when it comes to more extreme cases, as the materials used are less durable. 

Another major disadvantage of ceramic braces is that they are almost always more expensive than metal braces. They are more fragile than metal, so may require more repairs due to broken brackets or smaller adjustments which will lengthen the time required for treatment. 

Lingual braces

Lingual braces are unique in that they attach to the inside of your teeth rather than the front surface.⁹ They work similarly to metal and ceramic braces, as they utilise metal brackets attached by a wire to correct the position of teeth. Their main advantage is that they are virtually invisible from the outside, making them ideal for people who want a more discreet option. Moreover, they won’t leave lasting damage to the front of your teeth and will allow you to see results as they happen. 

Additionally, lingual braces are specially designed and custom-made, due to the variability of the backs of the teeth.¹⁰ This means that your dentist can perfectly position the brackets to where they will be most effective and most comfortable, so there is minimal irritation and maximum effect. Similarly to metal braces, they are also fixed, making it impossible to lose or forget your braces. This makes them just as effective as a method of orthodontic treatment for people of all ages. 

However, the placement of lingual braces also means that they can be more challenging to keep clean than traditional metal or ceramic braces might be, meaning that proper oral hygiene is essential. They may also be more expensive and require a longer adjustment period, as there may be irritation to the tongue or speech difficulties initially.¹¹

Self-ligating braces

Self-ligating braces are a more developed version of traditional fixed braces and are available using metal or ceramic. Instead of using elastic bands to hold the archwire in place, self-ligating braces use a bracket system which is held together using built-in clips or doors.¹² This provides an easier and more comfortable alternative, but which are just as effective as metal braces. 

The absence of elastic bands allows the wires to move freely within the brackets, making tooth movement more efficient, which can in turn reduce treatment time and the number of appointments needed. Self-ligating braces may also be more comfortable, as they exert less friction and pressure on the teeth, resulting in less irritation.

Moreover, the absence of elastic bands can make self-ligating braces easier to maintain and keep clean. Elastic bands are often places where plaque and food particles accumulate, so removing them makes oral hygiene more straightforward. This can help to reduce the risk of cavities or other dental issues during treatment. 

However, self-ligating braces are similar to metal braces in that they may cause mild discomfort, especially initially. They are also still visible as they require a metal archwire to work, albeit less visible than traditional metal braces would be. They may also be more expensive, especially as there is a higher probability of the brackets or clips breaking. 

Clear aligners

Clear aligners are an alternative to traditional fixed braces, which provide a discreet and nearly invisible option. Instead of using a bracket system and wires, clear aligners use clear, flexible trays which are custom-made so that they fit snugly over the teeth and will slowly shift them into position over time.¹³

The main advantage is their discreet appearance, making them particularly popular amongst adults and people whose commitments make it difficult for them to wear braces. The fact that they are custom-made also reduces the possibility of irritation or discomfort which is associated with fixed braces, which is further enhanced by the smoothness of the material used. 

Clear aligners also offer a much more flexible option. They should only be removed when eating, drinking or brushing your teeth, meaning individuals can maintain their dietary and regular oral hygiene routine without any disruptions. As each aligner is only worn for a short amount of time, using clear aligners reduces the number of visits to the dentist which are required.

However, clear aligners may not be suitable for everybody. More severe cases may require traditional metal braces instead or additional orthodontic techniques. The flexibility also means that compliance is required for the treatment to be successful, as aligners must be worn for 20-22 hours a day.¹⁴ They are also often more costly than other treatments. 

Summary

Braces are very commonly used orthodontic devices, which aim to improve oral health by adjusting the alignment and position of teeth. There are many different types available, as not every type will be suitable for all orthodontic patients. Traditional metal braces are the most popular and most commonly used, due to their durability, effectiveness and cost, but have the disadvantages of visibility and discomfort.

Ceramic braces can be clear and come in different colours, which can help to reduce visibility, but are almost always more expensive and may not be suitable for patients with more extreme conditions. Lingual braces are an alternative which attaches to the inside of the teeth, which is ideal for those who want a discreet yet similarly effective alternative.

Self-ligating braces are a version of metal braces which utilise a sliding mechanism rather than elastic bands, which has been shown to improve comfort and may make treatment more effective. Additionally, clear aligners provide an alternative to traditional fixed braces, but may not be suited to those who have more severe problems or people who may forget to wear them.