Exploring Fixed Orthodontics and Clear Aligners

In the realm of modern-day orthodontics, many alternatives exist for patients who wish to receive treatments other than the convention of fixed metal braces. The demand for clear aligners has particularly been increasing, especially in the adult population, and rapid technological developments have allowed them to treat a variety of cases.

Traditional metal braces consist of brackets that get fixed to teeth, while aligners are clear trays that are designed to fit over teeth and are removable. Fixed appliances treat complex cases such as: malocclusion, a misaligned jaw, overbite, underbite, overcrowding, spacing, open bites, periodontal problems, problems with speaking/chewing, and dental midlines. Conversely, clear aligners tend to be more aesthetic and beneficial for patients who want to undergo modifications such as minor straightening treatment. 

Since the aligner contraption is removable, patients do not need to worry about getting food caught in it during mealtime and can properly maintain oral hygiene by brushing and flossing normally. Aligners also cause less pain and require fewer dental visits compared to the traditional fixed orthodontic appliances. However, wearing aligners requires discipline since patients must wear it for at least 20 to 22 hours per day. With fixed braces, patients do not have this “option.” For kids who may not have the discipline to consistently wear the aligners for this duration of time, traditional braces may be more ideal. 

A common clinical finding with fixed braces is the development of white spot lesions on teeth due to tubes, orthodontic rings, or brackets. These white spot lesions are areas of demineralization of tooth enamel albeit mouth rinse with sodium fluoride can diminish the demineralization process. With clear aligners, these white spot lesions are not an issue. It is also easier for patients to maintain periodontal (gum) health with clear aligners since conventional fixed braces invite bacterial plaque buildup and make it more challenging for patients to practice good oral hygiene. 

Ultimately, whether a patient receives traditional fixed braces or clear aligners will depend on the severity of the case and the desired outcome. Modifications to daily oral hygiene practices will be made irrespective of the type of appliance received for the duration of the orthodontic treatment.

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