In recent years, the British Orthodontic Society (BOS) has noted a significant increase in adults seeking orthodontic treatment. More than 75% of orthodontists reported an increase in patients in 2019. This increase is on top of the hundreds of thousands of children, teens, and adults who are already fitted with braces each year.
One factor behind the increase is an improvement in treatment options. Of course, standard metal braces remain an option. However, some individuals find that alternative orthodontic treatments better fit their needs.
Braces behind the teeth are an increasingly popular alternative to regular braces. Read on to learn more about this option and whether it’s right for you.
What Are Braces Behind the Teeth?
Braces behind the teeth are also called lingual braces. The term “lingual” references the tongue. So the lingual side of the teeth is the side that faces the tongue.
Patients with lingual braces have metal braces fixed to the back of their teeth.
Lingual Braces Versus Regular Braces: How Do Braces Behind the Teeth Work?
In structure, braces behind the teeth are similar to regular braces. Like regular braces, lingual braces use metal brackets and wires. An orthodontist applies cement to affix the braces to the back of the teeth. Over time, the braces gradually shift the teeth into proper alignment.
The treatment process for lingual braces is also similar to the process for regular braces. Whether a patient elects lingual or regular braces, the orthodontist first makes impressions of the teeth that require realignment. A dental lab then uses these impressions to make brackets customised to the patient’s mouth.
In fact, lingual braces can be customised to an even greater extent than regular braces. Depending on the options patients choose, orthodontists can customise lingual braces to each tooth.
With any orthodontic work, treatment time depends on the severity of the corrections. The average duration of treatment with lingual orthodontics ranges from 18-36 months. The higher end of this range can be slightly longer than regular braces. On average, treatment with regular braces ranges from one to two years. Again, though, the complexity of the case determines treatment time.
Ultimately, the key differences between lingual and regular braces are their placement and visibility. Placed on the backside of the teeth, lingual braces are essentially invisible. This makes them an appealing option for patients worried about the impact on their appearance.
Lingual Braces Advantages
Although they are similar in some ways, lingual braces offer significant advantages over regular braces. The cosmetic advantage is only one reason behind the growing popularity of lingual braces.
Lingual Braces Are Invisible
One of the most obvious advantages of lingual braces is that they are not obvious. Lingual orthodontics, like the Incognito system, are—as the name suggests—hidden. This means that others won’t know that a patient is pursuing treatment.
As treatment progresses, however, others will notice results.
Lingual Braces Are Highly Precise
Another advantage of lingual braces is their precision. All lingual braces, like regular braces, are designed based on impressions of the patient’s mouth. However, lingual braces can be customised to each individual tooth.
Because they are highly customised, lingual braces are ideal for correcting severely misaligned teeth. More complex orthodontic cases can include changing the heights of teeth. They can also involve closing gaps or correcting rotations. Braces behind the teeth can be more effective than regular braces in these complex cases.
Lingual Braces Protect Teeth from Decalcification
Decalcification means that the enamel of the teeth is stripped of calcium. As decalcification occurs, the teeth show chalky white spots. The impact on appearance is one concern with decalcification. However, decalcification can be more serious. If it is not treated, decalcified areas make the teeth more vulnerable to decay.
Patients with regular braces often experience decalcification. The braces themselves do not cause the loss of calcium. However, braces make good oral hygiene more important and more challenging.
Patients with regular braces may struggle to clean their teeth. Over time, improper oral hygiene practises allow plaque to build up. Plaque and the bacteria it contains produce acid. This acid, in turn, weakens the enamel of the teeth.
Studies show that patients treated with lingual braces experience a much lower incidence of decalcification.
Lingual Braces Disadvantages
Despite their benefits, lingual braces may not be for everyone. Choosing orthodontic treatments means weighing the pros and cons of all options.
Lingual Braces Can Take Longer to Apply
To apply lingual braces, an orthodontist must work in the relatively small space behind the teeth. The small space makes the process of applying lingual braces more delicate. It also means that the initial process of applying the braces may be more lengthy.
Lingual Braces Can Cause Discomfort
Patients who elect any kind of braces usually experience some discomfort during treatment. This discomfort is often greatest early in the treatment process.
When treatment begins, the teeth are significantly misaligned. Braces correct this misalignment by applying pressure. Gradually, this pressure shifts the teeth into their proper position. While gentle throughout, braces exert the greatest pressure at the beginning of treatment.
Most patients experience this pressure as a dull ache. Eating soft foods and taking over-the-counter pain relievers can help.
Patients with braces can also experience discomfort from the wires and brackets. These materials can feel sharp to the soft tissues of the mouth. Patients with regular braces experience more discomfort along the inside of the cheeks and lips. Patients with lingual braces can experience more discomfort on the tongue.
In recent years, lingual braces have made incredible advances in terms of comfort. Today, manufacturers use the smallest and smoothest brackets possible. Many lingual brace systems also use customisable brackets. These can be further adjusted to decrease discomfort.
Lingual Braces Can Alter a Patient’s Speech for a Time
Whether they choose regular or lingual braces, patients new to braces often struggle to speak clearly for a time. Patients with lingual braces may notice more significant changes to their speech.
Braces behind the teeth are closest to the tongue. The tongue, in turn, is responsible for forming the sounds of words. Lingual braces can interfere with the tongue’s movement. As a result, patients sometimes develop a temporary lisp. Usually, though, these changes diminish as the patient gets used to the braces.
Lingual Braces Can Make Cleaning the Teeth More Difficult
Patients who choose any type of braces are likely to find it more difficult to keep their teeth clean. With extra care, however, they can maintain good oral hygiene throughout treatment. In fact, doing so is essential to the success of their treatment and to their overall health.
When a patient has braces, food particles can become stuck in the wires and brackets. To protect the teeth from decay, the patient must regularly and thoroughly remove this debris.
Patients with braces must also avoid certain foods that can be more difficult to remove. Eating sticky candies, hard foods, like pretzels and nuts, and foods with small particles, like popcorn, is unwise while wearing braces.
How Can a Patient Maintain Good Oral Hygiene with Lingual Braces?
The following tips can help you keep your teeth and gums healthy during treatment and beyond:
- Brush all surfaces of the teeth at least twice a day for two minutes each time
- Choose a toothbrush that has soft, round bristles
- Carefully floss or use an interproximal brush at least once a day
- Use a fluoride mouthwash to flush loose debris from the mouth and strengthen tooth enamel
- Visit the dentist every six months for a professional cleaning and exam
- Abide by the food restrictions your orthodontist recommends
How Much Do Braces Behind the Teeth Cost?
When they first came out, braces behind the teeth tended to be more expensive than regular braces. Currently, a small difference in price remains. However, the cost of lingual braces is nearly comparable to regular braces.
Treatment costs for metal braces start at £3,100. Treatment with invisible, lingual braces from Incognito starts at £3,500.
Importantly, this cost covers the required orthodontic appliances and X-rays. It also includes the design, manufacture, and fitting throughout treatment. Finally, it includes two hygiene visits and an at-home bleaching kit to make your new smile shine.
Are Lingual Braces Right for You?
For patients looking to improve their smiles, lingual braces may be an ideal option. They offer many advantages over regular braces. Meanwhile, their cost and most of their disadvantages are comparable to those of regular braces.
Still, lingual braces aren’t the best choice for every patient. People with significant overbites, for example, may find greater success with other options, as the brackets on lingual braces may pop off more easily for them.
Whether lingual braces, regular braces, or Invisalign, patients should discuss the pros and cons of all treatment options with their orthodontists. An experienced orthodontist can help you choose the best treatment for you.
Invisible Treatment, Visible Results: Custom-Fit Braces Behind the Teeth
For people seeking a straighter smile, braces behind the teeth are an increasingly popular option. Lingual braces offer many advantages. Lingual braces are essentially invisible. They can also be highly customised to achieve more precise results.
If you think lingual braces or another orthodontic solution might be right for you, contact Ewell Orthodontics for a free consultation.
BDS FDSRCS MSc Morth
Faiza Lewis (nee Darugar) has been a Dentist for over 26 years and a Specialist Orthodontist for 17 years. She graduated from Birmingham Dental School in 1993 and from Guy’s Hospital in Orthodontics in 2002. She has had a variety of hospital jobs in maxillofacial surgery and working for the Wandsworth Community Dental Service before starting the 3 year Specialisation Programme in Orthodontics