Lingual braces are one of the options if you're after "invisible braces". For all practical purposes, they are similar to traditional metal braces — except they are fixed on the inside of the teeth. They consist of brackets, an archwire, and rubber bands. They are almost invisible, meaning that they may be visible between teeth in case the teeth have gaps, or they may be visible on the inside of the lower teeth when the patient is talking, but they are much more inconspicuous than regular braces.
1. Are lingual braces for everyone?
Adults and young adults who don’t want their braces to be visible at their place of work or study may prefer these braces, as may musicians who play a wind organ, or sportspersons who are worried about blows to their face. Practically, though, lingual braces can be applied to people of any age and the only consideration is the kind of tooth movement a person and their orthodontist are seeking to achieve.
2. Advantages of lingual braces
The biggest advantage of lingual braces is that they are inconspicuous. They also offer an advantage over clear aligners, as they are in the complete control of the orthodontist as compared to aligners, where the patient must have the discipline of wearing them for 20 hours every day.
You can eat, and drink and brush your teeth with lingual braces — while aligners need to be removed for all these activities. The treatment time may be shorter to or similar to conventional braces and the treatment result is quite predictable.
3. Disadvantages of lingual braces
Lingual braces do take some getting used to. Speech may be a problem for some time, as our tongue touches the back of our teeth to make some sounds like S and T. Patients may temporarily suffer from a lisp, which usually eases out with practice.
Swallowing may be slightly encumbered as this also involves the tongue touching the back of the teeth. Softer foods initially help the patient get used to the lingual braces. The tongue may suffer some abrasions or cuts at first as well, due to the brackets present on the inside. An anesthetic gel can be used on the tongue to prevent pain until the tongue gets accustomed to the brackets, and orthodontic wax or silicone pads can be placed on the brackets to cover the edges.
The cost of lingual braces is significantly higher than traditional braces.
4. Types of lingual braces
Traditional lingual braces come with stock brackets, wires, and elastics. A thicker layer of cement is required to bond these brackets to the inner side of teeth, making the bracket cement assembly quite thick. The dentist then manually shapes the wire depending on the contours of the teeth. In traditional metal braces, the wire is usually a horseshoe shape, while in lingual braces it is more of a mushroom shape with bends. Traditional lingual braces were bonded one arch at a time. First the upper teeth and then the lower, usually during a separate appointment. The position of the brackets is also at the orthodontist’s discretion, so it takes longer to start the treatment and can be a bit less precise than newer alternatives.
Modern lingual braces are highly customized and use cutting-edge technology. After the initial impression, a computerized analysis is carried out to show the exact position on the teeth where the bracket must be fixed. As the brackets are customized to the shape, size, and contour of the patient’s teeth, the layer of cement required to fix them is very thin — making the cement bracket assembly thinner and lesser irritating to the tongue.
The wire is also bent in the required manner using robotics — so it is very precise. All the brackets in one arch are bonded using a custom tray, which only allows the brackets to be fixed in a precise position. This makes the process much quicker, allowing brackets of both arches to be bonded on the same day. A popular example of a brand of modern lingual braces is "Incognito".
5. How to clean your teeth while you are undergoing orthodontic treatment using lingual braces
Brushing your teeth will be difficult and challenging while the lingual braces are in place. You may use a brush with a smaller sized head so that you can reach all the areas concerned. Brushing after every meal and snack is recommended, as the brackets and elastics tend to trap food particles and this may lead to tooth decay. The use of aids like mouthwashes, interdental brushes, and dental floss may help to keep your teeth clean.
If you are after orthodontic treatment without it being obvious to everyone around you, lingual braces are definitely a great choice. The comparison is basically with the clear aligners, which are a removable option, hence your discipline and compliance are paramount. Lingual braces need a clinician with higher skill, and it is recommended to go for modern lingual braces as they promise more predictable and faster results with fewer breakages and failures.