Clear Aligners (Invisalign) vs. Traditional Metal Braces

While both clear aligners and braces can help create beautiful and healthy smiles, the day-to-day management of the appliances is different. From diet changes and keeping your teeth clean to appointment frequency and physical comfort, these appliances will impact your daily routine over the course of your treatment.

In this article you will learn how braces and clear aligners compare for each category below:

• Treatment Time
• Comfort
• Appearance
• Oral Hygiene
• Eating
• Compliance (Patient Participation)
• Scheduling
• Cost
• Daily management
• When are braces a better option?
• When are aligners a better option?

Treatment Time

There can be differences in how long treatment takes based on the use of clear aligners or braces, and the experience of your orthodontist.

In our office, mild to moderate cases treated with clear aligners finish six months faster and fewer visits than with braces. Cases with moderate to severe complexity take about the same amount of time to complete with clear aligners or braces. There are some more complicated situations where braces are more efficient.

Comfort

Aligners: Aligners are smooth and plastic, but occasionally, you may get an aligner with a rough edge. You can simply use a nail file to smooth the rough area or ask your provider to help. Most doctors will recommend using a new aligner every week or two which allows for gradual tooth movements. This slow movement applies mild pressure on your teeth resulting in minimal tooth soreness.

Braces: Adjustments to your braces are made every 4-10 weeks, which puts a larger amount of pressure on your teeth at one time as compared to aligners. This additional pressure can increase the tooth soreness you experience. Brackets and wires can poke into your gums and irritate your mouth, though this is usually more noticeable at the beginning of treatment. Orthodontic wax can be placed on braces to provide a barrier between the metal and soft tissues. Most people adapt to braces after a few days/weeks, though there is usually a bit of discomfort after each adjustment.

Appearance

Aligners: Aligners are less noticeable than braces because they are clear and molded to your teeth. However, most orthodontists use attachments (tooth-colored dental material that is glued onto your teeth) that help grab onto the plastic aligner to create predictable and efficient tooth movements. These visible attachments protrude from your teeth in varying amounts, though they are still less visible than braces.

Braces: Braces are generally metal, though some orthodontists offer tooth-colored brackets. Tooth-colored brackets may be less noticeable, but they are typically larger and more protrusive than metal brackets, making them more likely to get broken off. Many children like making their braces more lively by adding colored elastics.

Oral Hygiene

Aligners: To clean your teeth during treatment with clear aligners, simply remove your aligners and brush and floss your teeth like normal. To clean your aligners, remove them and then brush them with your toothbrush. If you need to wear an aligner longer than expected you can soak them in a denture or retainer cleaner to remove anything that has built up. Orthodontists typically instruct you to switch out your aligner every 1-2 weeks, so they generally do not get too dirty or discolored.

Braces: Cleaning your teeth with braces takes extra time and effort than before you had braces. Food is also likely to get stuck behind the wire and around your brackets, making it more difficult to keep your teeth clean. Move your toothbrush in small circular motions to clean your teeth and gums, while also making sure to brush around each bracket. Flossing requires a special tool that will allow you to weave the floss under the wire for each tooth. Poor oral hygiene can lead to puffy/inflamed gums and decalcification which can leave permanent white spots (decalcification) or even cavities in your teeth.

Eating

Aligners: Before eating, remove your aligners and put them in a protective case. Because aligners are removable, there are no food restrictions and you can continue to eat the same foods you did prior to starting treatment. After you’ve eaten, it’s good practice to rinse your mouth with water before placing your aligners back in your mouth. You do not need to brush/floss before putting your aligners back in after a meal as long as you thoroughly brush your teeth in the morning and the evening. Drinking beverages other than water with your aligners in is OK as long as you rinse your mouth with water frequently and understand that colored beverages will discolor your aligners and leaving your teeth soaking in sugary beverages can increase the chances of getting a cavity. Since you will be switching to a new aligner every week or so, discoloration of aligners is usually not a big issue.

Braces: Sticky and hard food can break brackets and wires, so you have to adapt your diet during treatment with braces. Popcorn, jerky, bagels, meat on the bone, and crunchy granola bars should all be avoided. Because food easily gets stuck between brackets, you may want to brush your teeth after eating.

Read more in our blog post: What Can I Eat with Braces and Invisalign?

Compliance (Patient Participation)

Aligners: Studies and experience show that teeth will not move predictably unless aligners are worn for an average of 21 hours per day (two weeks of wearing your aligners for 10 hours a day does not equal one week of 20 hours per day). Recommendations vary depending on your doctor, but it’s common to change to a new aligner every week or two. If you don’t wear your aligners enough or switch them out as instructed, your aligners may stop fitting your teeth which can lead to extended treatment time. If your aligners stop fitting, you’ll likely need to have a new scan of your teeth taken so new aligners can be created (which can lead to additional charges). If you misplace your aligners, you can try on the next aligner in your treatment. It will likely be a tight fit, but if you have diligently worn your aligners, you should be able to get the next aligner to fit.

Braces: One of the greatest benefits of braces is that they are glued on and you can’t take them out. As long as you stay on track with your appointments, your teeth will continue to move because the brackets and wires are putting continuous pressure on your teeth. However, if you miss appointments or have excessive breakage to your brackets and wires, your treatment can take longer. If you do a poor job of keeping your teeth clean, some orthodontists will pause or even end treatment, not wanting to risk the health of your teeth.

Scheduling

Aligners: The frequency of your visits will vary depending on your doctor, but visits are generally every 10-20 weeks, with rare unplanned/emergency visits. Routine visits are usually short, with only 20-30 minutes to check progress and to give you your next sets of aligners. If you have completed a series of aligners, your visit may be longer to accommodate a new scan of your teeth.

Braces: Appointments are usually every 4-10 weeks, with the possible need for unplanned visits for broken brackets and pokey wires. Routine visits are usually 30-50 minutes to allow for the manual adjustments that are needed for this appliance.

Cost

Treatment fees are unique to each provider/office. In our practice, clear aligners and braces are the same cost, however, there are a couple of things to consider:

Aligners: You may incur additional fees if your aligners stop fitting because you are not wearing them enough or you fail to follow your doctor’s treatment recommendations.

Braces: There may be extra charges if you have excessive breaking of brackets and if you extend beyond your treatment time by not complying with your doctor’s recommendations.

Read more in our blog post: How Much Does Orthodontic Treatment Cost?

When are braces a better option?

These are some cases where braces can be a more efficient treatment option:

• If you have a large space that needs to be closed
• A molar is tipped and needs to be uprighted

When are aligners a better option?

There are some cases where using aligners can be a more efficient treatment option:

• Your teeth have excessive wear from clenching and grinding and would benefit from having plastic between your teeth
• You’re sensitive to tooth pain and would benefit from the frequent, small movements of aligner treatment
• It is not convenient for you to make frequent visits, like if you are living away for college or a job

The Takeaway

When you come for a consultation at Garfinkle Orthodontics, we’ll review both appliances to help you determine which will fit best with your treatment goals and lifestyle. The choice of which appliance we use will likely be up to you.

Ask your doctor if he recommends one appliance over another for your treatment goals. Your doctor may be able to correct your child’s bite and alignment more efficiently with clear aligners, but braces may be a better option if your child does not think he can be responsible enough to keep track of aligners. Likewise, if you do not want to adjust your diet or you don’t want the visibility of brackets, then clear aligners may be a better option.