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Clear Aligners vs. Traditional Braces

Clear Aligners vs. Traditional Braces

This week we went live talking about the difference between clear aligners and traditional braces. People ask me all the time which one I recommend so I decided to create a discussion Live on Instagram about it! We had questions flooding in once the topic started rolling and so I wanted to post the Q&A on our blog! Even though we went live and answered a lot of questions on the spot, we wanted to do some follow up research just so it wasn’t a biased opinion what we were putting out there. Here are the questions we received and the answers we came up with:

Will you get better results with braces or clear aligners?  

There is an anecdotal way to look at this and an academic way to look at this.  On the academic front, there has been a new study that got published in the  EJO and then written about on Kevin O’Brien’s blog.

Dr. O’Brien did a great job of summarizing the article for other orthodontists.  I’d like to summarize it for non-clinicians into more bite size pieces. 

The systematic review looked at several articles and then ran numbers on those studies to combine them all to each other so there is more statistical evidence of the result.  After they ran the statistical analysis, the authors made a bold claim, according to Dr. O’brien, that braces have better outcomes as judged by the ABO standard (PS. Yes, Dr. Cooper is board certified by the ABO).

Long story short, there are discrepancies in the data like a different number of articles being categorized as serious risk and critical risk in the article compared to a chart on the EJO website.  There were serious concerns for bias with the articles chosen to run the statistical analysis on in the original study.  Then it came out that the EJO retracted the article due to plagiarism.  Maybe not the best source of information, huh?

So now what?  We are back to anecdotal evidence, at best, to try to figure out if there are differences between treatment results if you choose braces or clear aligners.  Since there are no strong peer-reviewed articles on clear aligner outcomes compared to braces, what can you use to make your decision.

Well, there is lots of advertising by clear aligner companies direct to patients.  There are many “KOL” (aka: Key Opinion Leaders) which influence orthodontists to treat with clear aligners more and tout their results as just as good or superior to braces.  There are many orthodontists – many of whom rarely treat cases with clear aligners that tout that nothing is as good as braces at creating the best smiles.

Really, there is not a “magical” appliance that guarantees results.  You need to  talk to the orthodontist that you want to treat your case (or maybe 2-3 orthodontists) and see what they are most comfortable with.  If they treat cases with both or hybrid treatment* then you can go through the pro’s and con’s of both types of appliances without as much concern for bias from that orthodontist.  If you talk to your orthodontist and they treat most of their cases with one appliance or another, then you should have that orthodontist treat you in the type of appliance they use the most.  I believe that you can get great results with either appliance, but the orthodontist programming the appliance should be very familiar with the appliance they are using to get the best results.

If you would like me to look over your case and give a recommendation, contact us and we can go through it on an IG Live for free.  Alternatively, we can schedule a virtual conference in private for a small fee.  I would especially like to do this for those of you who are not in Houston so that I can help you without any concern on your part that I am trying to “sell” you orthodontics. 

*hybrid treatment means starting with one type of appliance and then swapping to another appliance to finish

Here are several more questions that were asked throughout the Live:

– How do aligners move your teeth?

Aligners move your teeth gradually by having the plastic push your teeth and having the space for your teeth to move into that spot. Small clear attachments that we put in place give more surface area for the aligners to push on.

– Do braces hurt more than aligners?

Overall the amount of discomfort is probably about the same for an entire treatment, but the way you experience the pain is different.  In addition, each person has different pain tolerances and may describe the experience with trays or braces differently than another person.  

With braces you get sore right after an adjustment and then it subsides until another adjustment at the orthodontist’s office.

With the trays you may get a little sore with the change of a tray, but it won’t be all your teeth and it won’t be as much as a braces adjustment.  Patients change trays more often, so there are smaller doses of discomfort more frequently.

– Do aligners cost less than braces?

This totally depends on your orthodontist, the lab fee they are charged by a third party for appliances or clear trays – or the lack-there-of, the volume they do with either braces or clear aligners.  At Cooper Orthodontics, this has shifted a couple times already, but currently we have our clear tray process in-house and we charge less for clear tray treatment compared to braces treatment.  This really could change depending on the cost of supplies or availability of supplies.

– Do you get to choose if you get aligners or metal braces? Or do you have to have a certain type of case to qualify for one or the other?

At Cooper Orthodontics, most people get to choose.  If there is a strong preference by the dentist or other specialists that we are working with then we will let you know what the requests of those providers are before you make your decision.  Otherwise, there are advantages and disadvantages in each case and Dr. Cooper goes over those with you before you commit to an appliance for your case.

– Does CO use invisalign brand aligners or are you one of the few ortho practices that makes them in house? 

We make them in-house.  See this blog on the advantages of in-house aligners. 

– Can I do DM (aka: Dental Monitoring) even if I get clear trays?

Absolutely, DM is an at-home monitoring system.  When you scan and all your teeth have moved enough, then the AI built in will let you know to move to the next aligner.  This way, you have custom aligner changes at customized time intervals rather than guessing if you are doing it right.  

For example, before DM you might be put on 10-day aligner changes.  This would mean that you changed your aligner every 10 days no matter what.  You  just put it on your calendar and changed whether or not all your teeth had moved into place.  You also may have had all your teeth in the right place and ready to move to the next aligner by day 7, but you didn’t change your tray until day 10.  Now you scan at day 7 and if you are ready to change, you can.  If not, then you keep scanning at regular intervals until all the teeth  are ready and voila – you have customized tray changes to the rate of your own tooth movement!

– Are aligners available for teens?

Absolutely! They are actually some of our best clear aligner patients. 

– What is the oldest and youngest age someone can have clear aligners?

 The youngest I would recommend would be about 5 after they have had their expanders. They just need to understand what it means to keep those trays in.

I have had a few late 70’s in clear aligners and have one 80 year old thinking about doing it.. So just as long as your mouth is in good health theres not really an age limit!

– How do aligners fix bite correction?

There is an appliance called a carrie and you connect a rubber band from it to a button and that shifts your bite and then once your bite is adjusted then we go into clear trays and fix everything else. 

– Why would someone older in age want aligners and what is the benefit?

Most people who are older in age want to keep their teeth in line so they can clean between their teeth, keep their gums healthy, and helps them to keep all their teeth the rest of their lives. They want to make sure they can keep gum recession under control also! 


What if I don’t like having braces and want to switch to clear aligners?

Once we get your treatment underway it is definitely possible to switch any time. It is completely up to the patient but we will warn you that treatment will take a little longer! 


How do you maintain your aligners?

Since you are switching them out every 3-4 weeks you don’t have to worry about them too much but it is important to brush them and rinse them daily!


That wraps up the Q&A session that we had! If you have any questions you’d like to add or have answered feel free to find us on social media on Instagram and Facebook. We hope that this information is helpful to you and helps answer any questions about the topic you may have. We love being a resource for the people!



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