How Lingual Braces Work: Benefits and Drawbacks

Lingual braces are a modern orthodontic approach for those desiring aesthetic correction without having braces that show. Unlike traditional braces placed on the front sides of the teeth, lingual brackets are placed at the back of the teeth – thus, nearly invisible. Through this unique design, patients can undergo orthodontic treatment without compromising their appearance, making it popular for adults and working professionals.

In this article, we will explore how lingual brackets work, highlighting their unique mechanics and effectiveness. We will focus on their advantages and disadvantages and draw a balanced perspective for anyone considering them.

Furthermore, we shall compare lingual braces with traditional options to help you choose the best one. Lastly, we discuss who is suited for this treatment, ensuring you have all the information you need to make an informed decision.

What are Lingual Braces?

Lingual brackets are oral appliances used to straighten and align the position of the teeth without making the wearer look noticeable. Unlike regular braces that are bonded on the front or labial side, lingual braces are bonded at the back side or lingual side of the teeth. Given that they are discreet , they are ideal for those who want to have their misalignment fixed without the stigma of typical braces.

The primary function of lingual brackets is to provide the same orthodontic benefits as traditional braces, but in a more aesthetically pleasing way. They are largely in demand by adults, working professionals, and celebrities – especially in the fashion and movie industry – who would want a treatment that does not mar their physical appearance.

Do lingual braces have contraindications?

While effective for many orthodontic cases, these braces do have specific contraindications that can affect their suitability for certain patients. Morphological issues with dental crowns are a primary concern; irregularities in the shape of the crowns can complicate the placement and effectiveness of the brackets. Additionally, patients with significant bite issues, such as severe underbites or overbites, may not be ideal candidates because these conditions can exert excessive pressure on the brackets, potentially leading to bracket failure or tooth damage.

Furthermore, individuals with poor oral hygiene may struggle with maintaining the necessary care for lingual brackets, as they require diligent cleaning to prevent complications like irritation or infection. Lastly, those with specific health conditions that impair healing may face increased risks during treatment.

Lingual Braces Options

There are two primary options for lingual brackets: stock and customized.

● Stock braces are prefabricated and can be placed on models of the patient’s teeth by a laboratory, either commercial or in-clinic. After fabrication, these braces are transferred directly into the patient’s mouth.

● Customized lingual brackets, on the other hand, are designed digitally based on the specific treatment needs of the patient. Such customization allows for a more tailored fit and potentially more effective treatment outcomes.

Lingual braces types

Modern lingual brackets come in three notable types:

● Incognito: These are fully customized brackets that are designed to fit each tooth precisely. They are known for their aesthetic appeal and effectiveness in treating complex cases.

● Suresmile: This system utilizes advanced digital technology to optimize tooth movement and treatment efficiency, providing a personalized approach to orthodontics.

● Aalias system: This type focuses on minimizing discomfort and maximizing treatment precision by using innovative bracket designs and materials.

Each of these systems offers unique advantages in terms of comfort, aesthetics, and effectiveness in achieving desired orthodontic results.

How do lingual braces work?

Lingual braces work like regular orthodontic braces but are bonded to the back of the teeth, making them nearly invisible. The treatment first involves making impressions of the teeth to make special brackets that precisely fit over each tooth. These brackets are cemented onto the teeth, using a specially designed tray, as there is not enough space on the back side to use individual placement.

Once the brackets are in place, wires are attached in a way that gradually exert pressure to move the teeth to their desired position. Wires and brackets are usually customized using CAD CAM software to ensure optimal fit and treatment efficiency.

Unlike traditional braces, patients have to visit their orthodontist every 6–8 weeks for adjustments. Custom-made lingual brackets can make the treatment time faster and relatively comfortable, owing to the product’s slim nature.

Lingual Braces vs. Traditional Braces: Key Differences

Positioning and appearance

Lingual braces are attached to the back of the teeth, making them nearly invisible, while traditional braces are placed on the front and are more noticeable. This gives lingual brackets a clear aesthetic advantage for those seeking discreet treatment.

Comfort and adjustment

Lingual brackets may cause initial tongue irritation and speech difficulties, which can persist for weeks or months in some cases. Traditional braces typically result in fewer speech issues, with most patients adjusting within a week. Over time, both options become more comfortable as the mouth adapts.

All types of braces may temporarily affect speech, but research from 2014 indicates that lingual braces may alter speech for a month or longer. The severity of speech changes will depend on the brand used. Some patients address lingual lisps with speech therapy, but as the tongue adjusts to the braces, speech typically returns to normal over time.

Cost

Lingual brackets are more expensive, running up to $10,000, due to their customization and specialized care. In comparison, traditional braces range from $3,000 to $7,000. Of note, ceramic braces and clear aligners priced between $4,000 and $8,000.

Are Lingual Braces Better than Clear Aligners?

There are key differences between lingual brackets and clear aligners that will influence the decision on which treatment is best. Below, we compare the most important aspects.

Key differences

● Lingual braces: These are fixed appliances attached to the back of the teeth, making them virtually invisible. They remain in the mouth throughout the entire treatment and cannot be removed.

● Clear aligners: They are removable, custom-made devices made of transparent plastic. They must be worn for 20 to 22 hours a day to be effective but can be taken out for eating, drinking, and oral hygiene.

Appearance for both cases

● Lingual braces: Since they are placed behind the teeth, they are completely invisible from the front, making them ideal for patients seeking maximum discretion. However, they may feel slightly bulky at first.

● Clear aligners: While nearly invisible, they may be noticeable up close due to the shiny plastic material or visible attachments on the teeth required for certain movements.

The possibility of removal

● Lingual braces: These remain fixed in place 24/7, ensuring that the treatment progresses without relying on the patient’s compliance.

● Clear Aligners: Their biggest advantage is that they can be removed for eating and brushing, making oral hygiene easier. However, this flexibility can be a drawback if the patient does not wear them for the recommended period of time, delaying results.

Effectiveness in both cases

● Lingual braces: They are highly effective for complex cases, such as severe malocclusions or significant dental movements. They allow for more precise control of tooth movements.

● Clear aligners: They work well for mild to moderate misalignments but may have limitations in addressing more complex orthodontic issues.

Cost

● Lingual braces: These tend to be more expensive due to their customized design and the expertise required for placement and adjustments.

● Clear aligners: While not inexpensive, they are generally more affordable than lingual braces, depending on the level of customization and the brand.

Both treatments have unique advantages; the choice between them will depend on the patient’s individual needs, budget, and commitment to the treatment.

Who is a Good Candidate for Lingual Braces?

Lingual brackets are an excellent choice for individuals looking for discreet orthodontic treatment. Positioned on the back of the teeth, they are virtually invisible, making them a popular option for those who prioritize aesthetics.

However, not everyone is a suitable candidate for this treatment. Given below are a few ideal scenarios compared to situations where they may not be the best fit.

Ideal candidates:

● Adults and teens prioritizing discreet treatment: lingual braces are suitable for individuals who want effective orthodontic care without the visible appearance of traditional braces.

● Patients with mild to moderate alignment issues: they work well for cases like spacing, crowding, and mild bite corrections.

● Individuals committed to maintenance: lingual braces require diligent oral hygiene and regular orthodontist visits to ensure effective treatment.

Not suitable for:

● Those with severe bite issues: complex bite misalignments may require orthodontic solutions better suited to address this challenge.

● Patients with small teeth: limited surface area on smaller teeth can make bracket placement difficult or ineffective.

● Individuals with certain dental conditions: excessive enamel wear or gum issues may complicate the placement and effectiveness of lingual braces.

● Budget-sensitive individuals: lingual brackets are often more expensive than other options, rendering them less feasible for all budgets.

Consulting with an orthodontist is crucial to determine if lingual brackets are the right choice based on individual needs and personal dental health.

Benefits and Drawbacks of Lingual Braces

Benefits:

● Invisibility: Lingual braces are mounted on the back of the teeth, making the brackets, wires, and bands hidden from view. They remain unnoticed unless the mouth is opened wide.

● Pain differences: Some studies suggest lingual brackets may cause less overall pain as compared to traditional braces, especially during the first month of treatment. However, they may cause more tongue pain.

● Fewer lifestyle changes: Lingual braces may require fewer adjustments to daily life compared to traditional braces. Initial challenges, like eating soft foods and learning new cleaning techniques, are common but typically manageable.

● Custom design: Lingual brackets can be tailored to each patient’s teeth using CAD/CAM technology. Customized brackets reduce issues like speech and chewing problems and minimize tongue pain compared to pre-made brackets.

Drawbacks:

● Limited orthodontist availability:

Applying lingual brackets requires specialized techniques not commonly taught in most orthodontic programs. Finding a trained practitioner may be challenging.

● Speech challenges:

Speech can be temporarily affected with any braces, but lingual brackets may cause longer-lasting issues. Speech typically improves as the tongue adjusts over time.

● High cost:

Lingual braces are more expensive than labial braces, particularly custom-made ones. To save money, consider combining lingual brackets for the upper teeth with labial braces for the lower teeth.

● Oral hygiene challenges:

Lingual braces make cleaning more difficult due to their placement and closely positioned brackets. Food particles may stick more easily, requiring extra care. A water flosser can help maintain oral hygiene.

● Longer appointments:

This is due to the precise adjustments required and custom arch wires needed.

Conclusion

Lingual brackets offer a discreet and effective solution for those seeking orthodontic treatment without compromising their appearance. While they come with unique advantages and challenges, consulting with an experienced orthodontist is key to determining if they are the right fit for your needs. With proper care and commitment, lingual braces can help you achieve a beautifully-aligned smile.