Braces vs. Clear Aligners

If your child’s dentist has recommended braces, you’re probably wondering about the options. You may be familiar with traditional braces, but you’ve also heard about clear aligners, such as Invisalign.

“Clear aligners are a removable orthodontic treatment option,” says Jacy Papasikos, DMD, an orthodontist at Papasikos Orthodontics in Montclair and Pediatric Dentistry and Orthodontics of Midland Park. “They consist of a series of plastic aligners or trays. Each week a new tray is introduced to apply more pressure to the teeth.”

Clear aligner therapy appeals to some families for many reasons, especially cosmetic purposes. “Clear aligners are less visible than traditional braces so many kids, especially teens who are conscious of their appearance, prefer them,” says Richard Bloomstein, DDS, vice chairman of orthodontics at Rutgers School of Dental Medicine. “When they’re worn correctly, they work well.”

Here’s what you should know about traditional braces versus clear aligners, as well as the pros and cons of both types:

Traditional braces are glued to the teeth, so they may be

By Arricca Elin SanSone

irritating to the tongue, lips and cheeks at first. And because they’re put into place all at once, there’s lots of pressure, all at once. Most kids do adapt to the soreness and wires after a few weeks of wearing them, says Papasikos.

But nothing is adhered to the teeth with clear aligners, so there’s nothing poking inside the mouth. The plastic trays also are somewhat flexible. But it’s a misconception to think clear aligners are completely pain-free because they’re still moving teeth, says Bloomstein. Kids adapt but both types of braces involve some temporary discomfort, which can be treated with over-the-counter pain medications, such as Tylenol.

Because your child is always wearing traditional braces, they’re always working. There’s no break in treatment or forgetting to put aligners back in the mouth after eating. Many patients actually like the idea of not having to be bothered with taking the trays in and out or switching to the next tray, says Bloomstein. Traditional braces also may be a good option if kids tend to lose things, such as their glasses or books (though if your child loses an aligner, you just skip to the next tray).

“Braces and clear aligners can achieve the same outcome in the same amount of time, which is about a two-year process,” says Papasikos. Braces need adjustments from time to time, which means trips about every six weeks to the orthodontist’s office. Appointments for aligners usually are every three months, with fewer unplanned visits because there’s nothing to break, such as wires. Typically, kids spend less chair time with aligners with fewer trips to the office.

But—and here’s the kicker—clear aligners rely more on your kid’s willingness and ability to follow the treatment plan. The recommendation is that kids wear them 22 hours per day. “You know your kid best,” says Papasikos. “One of the perks of clear aligners is that there’s lots of freedom, but there’s also lots of responsibility. Nagging won’t work. If your child isn’t going to wear them, they’re not the best choice.”

Obviously, it’s more challenging to clean teeth with braces on; kids have to brush for a longer period of time to dislodge food, and flossing is essential, followed by a fluoride mouth rinse. “There are more areas for food and bacteria to hide with traditional braces, meaning kids can be more prone to cavities,” says Papasikos.

Aligners have another benefit because kids take them out to eat. Kids with traditional braces shouldn’t eat sticky, hard or crunchy foods such as carrots, whole apples or pretzels. But there are no such limitations with aligners. It’s also easier to brush, though the trays do need to be cleaned twice a day, too.

Every case is different, so your orthodontist must evaluate the child’s individual needs. “In general, we have less control over tooth movement with clear aligners,” says Bloomstein. “With traditional braces, we can push and pull so we have twice the mobility. But aligners just push against the tooth. That may not be appropriate for more complex cases, such as where there are large spaces.” In some cases, your orthodontist may recommend a combination therapy, starting (or ending) with traditional braces to achieve the type of correction your child requires.

Insurance coverage typically is the same for braces or clear aligners, with a lifetime maximum of whatever your insurance allows for orthodontics. Generally, braces run about $5,000 to $7,000 (less insurance coverage), with clear aligners usually costing about $500 more overall. In addition, many orthodontists will allow you to split the fee into no-interest monthly payments.

“where