Clear aligners or braces? What to look at when deciding

The question most often asked at the start of orthodontic treatment is the choice of method. Both move the teeth; the difference is which movements they can carry out, and how precisely, and what the treatment expects of the patient.

According to the type of movement

Moving a tooth by tipping it is easily done with both methods. For movements such as moving the root together with the crown (bodily movement), rotating a tooth around its own axis, bringing an impacted tooth into the mouth or extruding a tooth in the vertical direction, fixed braces are more predictable. With clear aligners, small clear attachments bonded to the tooth are used for these movements; the plan is built accordingly.

According to patient compliance

Fixed braces work independently of the patient's decision — they are fixed in place. If a clear aligner is not worn 20–22 hours a day, the teeth do not reach the planned position; as the series progresses the aligners do not seat, and the treatment is planned again from the beginning. If there is doubt about compliance, this is a decisive criterion in the choice of method.

Hygiene and gums

Because aligners are removed, brushing and flossing are done normally; the risk of gum inflammation and white spot lesions is lower. With fixed braces an interdental brush and regular cleaning are essential; otherwise permanent discolouration can form around the brackets.

Duration and check-ups

In similar cases the total duration is largely the same; the real difference is in the frequency of check-ups. With fixed braces a wire change is needed every 4–6 weeks. In aligner treatment the check-ups can be spaced to once every 6–10 weeks — a practical advantage for patients living out of town or abroad.

Combined approach

In some cases the difficult part of the treatment is completed with fixed braces for a short time, and the remaining alignment is continued with aligners. The aim is not to defend a method, but for the tooth to move where it needs to go in the most predictable way.

The common point: retention

Whichever method is chosen, treatment does not end when the aligners or brackets come off. Teeth tend to return to their former positions; retention continues for a long time with a thin wire bonded behind the teeth and/or a night retainer. The most common cause of relapse is giving up retention.

Frequently asked questions

I am an adult — is it too late?

No. There is no age limit for tooth movement; the condition is that the gums and bone are healthy.

Will my speech be affected while using aligners?

There is a mild adjustment period in the first few days; in most patients it passes in a short time.

Is teeth whitening done during treatment?

It is generally left until after treatment; with fixed braces part of the tooth is covered, so a colour difference can occur.

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The information on this site is for general guidance only; diagnosis and treatment require an examination by a dentist.