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Aligners vs Braces: Get It Straight

Today, fixing a smile can happen in one of two primary ways. You can go the more traditional route of brackets and wires, or opt for aligners. According to orthodontists Dr. Mark Coreil and Dr. John Warford, either option will get your smile back on track, but with slight differences when it comes to patient involvement and methodology.

While you can hear all these two industry experts have to say regarding aligners vs braces at our podcast, here are some of the key issues these two clinicians touched on when brought together. 

Aligners catch up to bracket and wires

When aligners first hit the scene, it’s true, they weren’t up to par when compared with traditional braces. The plastic back then was inferior, and aligners would only work for certain conditions. Most orthodontists only used them to treat a relapse case.

Today, it’s a totally different ballgame, and aligners are so much more comprehensive. They can do anything braces can do thanks to advances in the plastic they’re made from. Since both treatments fundamentally do the same thing — they push on teeth to shift them into place — the stronger aligner material functions the same as brackets and wires.

Aligners now utilize templates for attachments that allow clinicians to set anchor points on certain problem teeth to make a more direct impact. Also made of the same composite material used to glue braces to teeth, these attachments make it easier for the aligners to exert the right amount of force on all a patient’s teeth.

How they work is still different

What will continue to remain different, even though both aligners and braces can fix the same issues, is how they do it. Each method works completely differently to achieve the same goal.

Braces use a nickel titanium wire. Although brackets hold the wire in place, it’s the wire that’s really doing all the work thanks to its special composition. Just like we can have a muscle memory, where our body remembers to do something we haven’t done in a long time, this special wire remembers its original shape. It gets bent out of this shape when it goes onto teeth, and immediately begins to shift itself back to its natural form.

Luckily, the natural form of the wire is the same shape as a smile, making it easy for clinicians to predict how a patient’s teeth will move, and at what rate. This innovation has made it possible to decrease clinician intervention and even fewer office visits than used to be the case.

Aligners don’t work automatically. They’re programmed to do something specific 100 percent of the time without any give or leeway. This requires clinician’s to predict teeth movement throughout the entire treatment process instead of just seeing how things are progressing from appointment to appointment.

For this reason, having the ability to remotely check in on a patient’s progress is supremely helpful. Clinicians can catch issues very early on and make adjustments as necessary without derailing the existing progress a patient has experienced. 

The patient’s responsibility isn’t the same either

A primary difference between aligners and braces is where the responsibility falls in order to have a successful treatment. Yes, there are technical aspects to both treatments that aren’t entirely the same as well, but where they also differ in the responsibilities that fall to the patient.

Maintaining a program using aligners is much more labor intensive for the patient. On a daily basis, they have to remember to put their aligners in, take them out, and put them back in again. Forgetting to wear them can impact a patient’s progress, so it’s really all on them once they’re given the tools they need to fix their smile.

Braces are slightly less intense. Yes, a patient must watch what they eat, and remember to brush, but the consequences of forgetting, occasionally, aren’t nearly so severe. While nobody wants to go back in to have a bracket put back on, the wire is still working in the interim. And, while forgetting to brush your teeth all the time can lead to other issues, most people remember eventually.

What it really comes down to here is patient preference. Maybe they’re so busy, it’s easier to only remember to brush. Maybe they want a more discreet treatment so lean toward aligners. Maybe a parent would rather yell at their child about putting in their aligners every day instead of driving them into the office to get a bracket repaired. Asking what the patient really wants is essential to ensuring their treatment is successful.

Braces and aligners can co-exist

With a variety of differences between the two treatments, what’s important is to not lose sight of the fact that they should co-exist. It’s good to provide people with options, and since aligners have caught up to brackets and wires, why not give each patient a choice?

There are even situations where a patient’s treatment will require both. Sometimes aligners won’t completely do the job, and brackets end up on a few teeth to add a little extra strength to the treatment. Sometimes teeth shift again after braces and aligners can quickly get things back on track.

Combination treatments aren’t something to discount, even now as technology continues to change. There’s no winner in the battle between aligners and braces. 

What it always should come down to, regardless of treatment option, is what drives a patient to correct their smile. It’s about the aesthetic as much as the functional change. A patient must want both for the process to work. Only by looking at both pieces of the puzzle can a clinician help them make the best choice for enjoying their smile again.

If you’re a clinician looking for new ways to give patients easier access to aligner treatments, even if you’ve traditionally only worked with brackets and wires, visit On Demand Orthodontist. Our revolutionary process, complete with remote monitoring, is changing the oral health landscape. Contact us today to learn more.