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Thomas P. Connelly, D.D.S. Headshot

Crooked Teeth? Exploring New Options For Adults

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INVISALIGN VS METAL BRACES
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Today I want to talk about a very common issue that in the last few years has gotten rather complicated. That issue is crooked teeth and braces.

We all know what braces are and we know what they look like. Basically, braces are metal bands affixed to the teeth, and their purpose is to straighten them over time. They are very effective at doing just that. However, braces do present a problem -- they don't really look all that nice. Usually, this isn't a huge issue, because the largest group that uses braces is young children. Not that we don't want our kids looking good, mind you, but children -- especially young children -- are definitely less self-conscious in terms of "looks". Plus, when they are young is the best time to tackle crooked teeth.

That said, many adults now opt for teeth straightening. And because adults are far more apt to be interested in their everyday appearance, technology has answered with a few options beyond the "silver railroad tracks" that are a part of many children's smiles. Available today are ceramic braces that are much like their metal cousins, the big exception being they are more in line with tooth color. But also available is a new technology of "clear" braces that goes by the name of Invisalign. Which is what we are going to talk about today: Invisalign braces vs. traditional metal braces.

I'll state here in the beginning that it is very difficult to find any real, objective studies regarding Invisalign. The reason for this is that almost any information available now is paid for by or slanted towards one or the other. Even sites that have a name that appears to be objective are generally just touting one side. Therefore, much of this post is my own opinion (however, as a NYC Cosmetic Dentist I am in a pretty good position to have one about this.)

Let's start by stating something somewhat obvious: The big advantage to Invisalign is looks. Because they are clear, plastic-like "slip on" devices, they detract very little (if at all) to one's physical appearance. I can state firsthand that they do look good (well, good as in "not being able to tell they are there.") So they are very popular with the adult crowd for this reason alone.

There are a few other advantages as well, such as being able to take them out when eating. This is not only great from a comfort standpoint, but also because you can eat just about anything. Also, food doesn't get stuck in odd places, so cleaning teeth is easier and the risk of plaque is lessened.

But here's the big question that everyone asks me: Does Invisalign really work?

From what I can tell, yes, Invisalign does seem to be a viable alternative to "regular" braces -- for the most part.

I say this because I have heard (and read) enough to state that for some situations, Invisalign may not work as well as regular metal braces, and may even need "regular" braces to finish the job.(1) This becomes especially true if you have severely crooked teeth. Also, it would appear that premolars have presented a bit of a problem for the Invisalign braces.(2) Again, there is a lot of information out there, but most of it is written by dentists who offer the Invisalign product, so you have to take what you read with a grain of salt.

Ultimately, I do think the product has merit, but I would advise any patient really to have a real discussion about this issue with his or her orthodontist before making any decisions.
] go to the professional who makes his or her living straightening teeth, meaning an orthodontist instead of a dentist. This won't make many of my dental colleagues happy, but I feel very strongly that we dentists should really stick to what we know and let the orthodontists do their thing. There's also an ongoing class action suit regarding the Invisalign company dropping professionals who did not meet a quota.(3)

Lastly, like I mentioned earlier, in many cases, it would appear that Invisalign doesn't do the entire job. A patient may need regular braces at the very end of his or her treatment anyway. I don't know about you, but I would be more comfortable with the professional who could do the entire job -- which most dentists cannot. And again, I say all of this as a dentist.

So there you have it. I do think Invisalign has merit and should definitely be explored if you want to look into straightening your teeth. But I would advise you to see an orthodontist in doing such. Tell them Dr. Connelly, D.D.S. sent you :)

Until next time, keep smiling.

References:
(1) http://www.archwired.com/ceramic_vs_metal_braces.htm#INV
(2) http://www.dentalcaresource.com/orthodontics/invisalign/
(3) http://www.ada.org/news/4228.aspx

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