Back in "the day" metal braces were the only option for straightening teeth. Orthodontics has come a million miles since I had my braces back in middle school (early 70's). At that time I had metal bands on every single tooth! Headgear was how overbites were fixed. Luckily dental materials and technology have improved a bunch and so has the way that we straighten teeth. Although metal braces are still by far the most common way of straightening teeth (with much smaller, more attractive metal brackets that is), your orthodontist can now offer you clear braces, lingual braces (braces on the inside), and Invisalign. While most orthodontists were trained with good old fashioned braces in school and feel they still provide the most control, these other treatment techniques can provide excellent results in the right hands. Each methods has its own strengths and weeknesses and your doctor should be able to explain what they are. Some movements may be too complicated for Invisalign. Ceramic braces may not be the best thing to use on very deep bites. While most orthodontists (and oral surgeons) still prefer regular braces for surgical orthodontics where the jaws are moved, there are now innovative doctors using Invisalign with their surgery patients. In short, I don't think there is a single type of malocclusion where metal braces are your only option.
What Circumstances Are Metal Braces the Only Option for Getting Straight Teeth?
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When are braces needed?
The causes of tooth misalignment are quite varied, and so are the approaches to correcting it. Aligning teeth is nearly always possible with removeable aligners such as Invisalign. If there are bite problems which are due to skeletal jaw misalignment then some type of fixed appliance treatment is usually needed. Or, if there is extreme crowding which requires tooth extractions and large amounts of tooth movement then fixed appliances may be called for. The best approach is for you to get a consultation with an orthodontist who is highly experienced in using a variety of appliance systems (eg braces, Invisalign, etc). He/she will be able to recommend the best tool for the job and explain reasoning behind the choice.
Invisalign can solve almost all problems that braces can
Invisalign can solve almost all problems that braces can. The exception for braces being needed involve correcting impacted teeth that can't be aligned with just aligners. If there are significant skeletal problems, then Functional Facial Orthopedics can enlarge bone structures prior to Invisalign, but these types of problems can not be handled with just braces anyway, without the removal of some teeth or surgery.
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When are metal braces required?
There is always an option to using metal braces.
If the orthodontist thinks removable appliances are an option, Invisalign is one possibility. Clear braces made of ceramic are another option. SimpliClear clear wires with ceramic clear brackets are the treatment of choice when removable appliances are not an option.
When are metal braces the only option?
Almost never are regular braces the only option! With experience, even complex cases can now be treated with Invisalign (sometimes we do need to add partial fixed appliances for a limited time however). For Cases that cannot be treated with Invisalign, there are clear ceramic braces that can be used (the wires are still metal)
To get ALL your orthodontic options, make sure you see an orthodontist who has a LOT of experience with Invisalign (Elite Provider)
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.