First, let's talk about case selection, meaning which types of cases are better for braces versus aligners. In situations where there is a lot of crowding, like when one tooth is completely in front or behind the other teeth, there is a clear indication that braces are the better option. This is due to the fact that long-lasting, continuous forces are needed to help align the teeth. This is usually much harder to do when your aligners are constantly being taken off to eat/drink/snack throughout the day. In cases such as these, orthodontists can use springs and elastic chains to help move the teeth more efficiently. This efficiency saves you time in treatment. Also, in patients who have bite issues like crossbites or over- and under-bites, your orthodontist may need to use rubber bands to help the teeth move properly. Rubber bands were made to be used with traditional braces and are much easier to place and maintain on braces than they are with aligners. However, in patients with open bites, meaning the upper and lower teeth don’t touch all the way down, aligners have been shown to work beautifully. Also in patients that have spacing between teeth, aligners tend to work just as well as braces. Ultimately, it is up to your orthodontist to decide how to manage your concerns, but these are good rules of thumb to use to know what to expect.

Even though we, as orthodontists, try to select which cases would work better with braces or aligners, the patients themselves should know what would work better for their lifestyle. For example, with braces, you will likely need to be seen in the office every 6 weeks or so. With aligners, the appointments are less frequent and many appointments can be done virtually. Braces patients should also expect to spend more time on dental hygiene, as cleaning food particles out of the braces can take time. Flossing, in particular, does take getting used to and will involve more time and effort at first. With aligners, cleaning your teeth and flossing is the same as usual. However, with aligners, you must remove your aligners anytime you eat or drink anything. This is important to note, because for successful aligner treatment, you will need to wear your aligners for 22 hours per day. So for patients who like to spend 45 minutes drinking their morning coffee or tea, or for those that like to snack multiple times throughout the day, it will be almost impossible to wear your aligners enough for a successful finish. It is important to remember, when you decide to get clear aligners to straighten your teeth, you agree to wear your aligners as instructed. So this may significantly change the way you eat and drink throughout your day.

The main advantage of clear aligners is that they are almost invisible and more comfortable, but you will need to make sure you are wearing your aligners as instructed. The main advantages of traditional braces are that they can handle more complex cases, are generally more efficient, but you will need to visit your doctor’s office more, will have to spend extra time on hygiene, and the metal parts of the braces can sometimes cause irritation to your gums and cheeks.

Before 2020, this would have been the end of the discussion. But now that we live in a post-COVID world, we are all vigilant about what we put near our faces and in our mouths. With clear aligners, you must place and remove your aligners from your mouth many times throughout the day. We encourage all patients to wash their hands before doing this (which can become a chore). So please remember that if you choose clear aligner treatment you will have to coordinate a germ-free way of placing your hands inside your mouth.

Your orthodontic team should be able to help you answer all your questions, but this short guide may help you to have an idea of what to expect if you choose traditional braces or clear aligners to straighten your teeth.