Question 1

What are lingual braces?

Accepted Answer

Lingual braces are similar to traditional metal braces for straightening teeth, with one key difference: the brackets, wires, and even the elastics of lingual braces are mounted onto the backs of your teeth, so they can’t be seen. They get their name from the lingual area (the back of the teeth).

Like all braces, lingual braces close gaps and resolve crowding by applying pressure that moves teeth into alignment. Your orthodontist can custom-fit lingual brackets to each tooth, to fix your unique issues. In some cases, your braces can be applied to just the top front teeth, to correct minor issues.

“The only real advantage of lingual braces versus traditional front of the teeth braces is the cosmetic advantage, since they are generally hidden behind the teeth,” says Dr. Steven Davidowitz, a dentist in New York City.

The authors of a recent article on lingual orthodontics noted that “with the increasing number of adult patients in orthodontic practices, the lingual orthodontic treatment has become a treatment of choice, due to its aesthetic appeal for most adults."

Question 2

What are the pros and cons of lingual braces?

Accepted Answer

Pros

People can’t see them when you talk or smile, making them one of the most discreet options for straightening teeth.
Lingual braces can fix most types of alignment problems. “Teeth move when force is placed upon them,” says Dr. Greg Jorgensen, an orthodontist in Rio Rancho, New Mexico. “They can’t tell where it comes from—the front of the teeth, the back, clear plastic aligners, or removable retainers.”
Unlike clear aligners, like Invisalign, lingual braces don’t have to be removed for brushing your teeth or eating.
You don’t have to worry about food getting visibly stuck in your braces, since they’ll be hidden.
They don’t get in the way of mouth guards for sports activities.
Lingual brace brackets need only a thin layer of cement, so they don’t stick out from the tooth as much as conventional braces or Damon braces.
Any discoloration or white spots that result from wearing braces will be on the back of the teeth, rather than on the front.

Cons

Treatment time can take longer than with traditional braces.
Lingual braces can interfere with your tongue movement, causing irritation, sore spots, and even speech issues when you’re first getting used to them. “Your tongue will play with the lingual brackets, and you could get a raw, sore tongue from them,” says Dr. Michael J. Thomas, a dentist in Beverly Hills, California.
Your cleaning routine may take longer, because it’s harder to see and reach the backs of your teeth.
Fewer orthodontists offer lingual braces, which require specific training that not all orthodontists opt to receive. “One reason not a lot of orthodontists offer lingual braces is because it’s more difficult to treat patients and get acceptable results,” says Dr. Jorgensen.
Because they require more time and expertise to place and maintain them, lingual braces can be significantly more expensive than traditional braces.

Question 3

How much do lingual braces cost?

Accepted Answer

Your cost will depend on your orthodontist’s level of experience, their practice location, how many brackets you need, and whether your braces are customized.

Your dental plan may cover orthodontic treatment—or at least a portion of it. Most major insurance companies offer coverage for limited orthodontic work. Medicaid will pay for braces in full, when medically necessary, in children under 21. Generally speaking, Medicare does not cover braces or other orthodontic care.

Financing is available specifically for orthodontic work, and most orthodontists offer payment plans as well.

Question 4

Do lingual braces take longer than traditional braces?

Accepted Answer

Yes, treatment time can take longer with lingual braces, “since tooth movement is generally slower,” says Dr. Davidowitz. Treatment with lingual braces takes 18–36 months, depending on the complexity of the correction, while treatment with traditional braces typically takes 18 to 22 months (though it can take much longer).

Question 5

Can anyone get lingual braces?

Accepted Answer

Lingual braces can correct most types of malocclusion, the technical term for when the teeth aren’t aligned properly. “Lingual braces can fix overbites as well as underbites, spaces, and overcrowding,” says Dr. Davidowitz. “However, someone with a severe deep bite may not be a candidate, since lingual braces will interfere with biting and chewing.”

People with a biting and grinding problem (like bruxism) may not be good candidates either. The braces can also be a hard adjustment for anyone who plays an instrument that uses the mouth, such as a clarinet.

On the other hand, lingual braces are especially popular with people who play contact sports and regularly use a mouth guard.

If you’re looking for a broader smile, lingual braces might be a good option. “Many orthodontists prefer lingual braces in adults for broadening smiles,” says Dr. L. Matthew Schofield, an orthodontist in Irving, Texas.

Question 6

How do lingual braces work?

Accepted Answer

Much like traditional types of braces, lingual braces apply continuous pressure to move teeth into alignment. This helps close gaps, shift overcrowded teeth, and improve your bite.

Some types of lingual braces use standard metal brackets and wires, while others are custom-made, which contributes to their higher cost.

Generally, non-customized braces are best suited to patients who need milder degrees of correction. More complex cases usually require bespoke solutions.

The process of getting braces usually begins with a comprehensive exam and X-rays in order to determine the stability of your teeth and gums. If you’re cleared for braces, your dentist will get a detailed digital scan or a putty impression of your teeth. They send this to your orthodontist and collaborate with them on your treatment plan.

Most dentists try to avoid extracting teeth, but if your mouth is very overcrowded, there may be limited or no room in the jaw for all the existing teeth. According to the Mayo Clinic, your orthodontist may recommend removing one or more permanent teeth, to allow room for the remaining teeth to fit comfortably. This allows the teeth to fit together better and also creates adequate space for cleaning.

Typically, your braces will be applied at an appointment four weeks after the first impressions were taken.

Question 7

How are lingual braces applied to the teeth?

Accepted Answer

Your orthodontist will prep your teeth for bonding by applying cement, apply the brackets, and put a tray over your teeth in order to hold the brackets in place as they bond.

Once the cement has completely set, the tray is removed, leaving the brackets bonded to the teeth. Then they’ll thread the wires into place and tighten them, to begin shifting your teeth.

Question 8

What are the most popular types of lingual braces?

Accepted Answer

Incognito is a brand of lingual braces that are customized to your mouth, to provide very precise tooth movement. They’re gold instead of steel, which may make them more comfortable. Incognito Lite braces are made for the front teeth only. Though Incognito is a brand name, it has become synonymous with lingual braces, much as Invisalign has for invisible braces.
The STb Light Lingual System is a line of self-litigating, or self-tightening, braces that are made with an emphasis on comfort. It can be more cost-effective than Incognito.
iBraces are clear, making them especially inconspicuous. They’re also highly customizable, with a similar price point to that of Incognito.

Question 9

Do lingual braces affect speech?

Accepted Answer

Yes, lingual braces can create speech challenges. For instance, you may develop a lisp. “When people speak, their tongue touches the backs of their teeth to make certain sounds,” such as the letter S, says Dr. Davidowitz. “Since the brackets are on the back sides of your teeth, you should anticipate that your speech is going to be affected.”

You may also make a whistling sound in place of the letter S, if your front teeth have been altered in some way.

Your tongue should eventually become accustomed to finding a new location to produce certain sounds, but a small percentage of people will continue to have speech difficulty through their treatment.

Question 10

Are lingual braces more painful?

Accepted Answer

“Dental literature and patient feedback show that lingual braces can be more uncomfortable, especially on the tongue, compared to traditional braces or clear aligners,” says Dr. Davidowitz. In fact, many RealSelf members rated their treatment “Not Worth It” due to the soreness. Your tongue hits the bottom of lingual braces, and you might develop ulcers, aches, and tiny cuts on the soft tissues of your mouth before you adjust.

Eating can also be difficult during this adjustment period. Your dentist can recommend methods to help, including rinsing your mouth with salt water. Pain-relieving gels, mouthwashes, and dental wax or soft silicone (to smooth out sharp edges) are also helpful while you’re waiting for your tongue to toughen up.

Question 11

What can you not eat with lingual braces?

Accepted Answer

“Unlike clear aligners, for which there are no diet restrictions, both traditional wire braces and lingual braces have many food restrictions,” says Dr. Davidowitz.

Foods you’ll be instructed to avoid include:

Tough-to-chew foods, like bagels, steak, and hard pizza crust
“Hard foods,” like popcorn, ice, pretzels, nuts, and hard candies
Foods that are “sticky,” such as caramels, gum, and soft candies: “They can debond and break the brackets and can also get stuck around the braces, leading to cavities,” says Dr. Davidowitz

To avoid damaging your braces, he recommends cutting up food into bite-size pieces and not “chomping” into foods like corn on the cob, carrots, or apples.

Question 12

How do you clean teeth with lingual braces?

Accepted Answer

Good oral hygiene helps to minimize your treatment time and contributes to a healthy result, so you’ll want to continue brushing with a regular toothbrush and fluoride toothpaste after every meal and using mouthwash or a fluoride mouth rinse, if your provider recommends it.

Many lingual braces wearers mention that flossing is a problem and food particles can be easily trapped in the brackets. Dentists recommend using a Waterpik or a special flossing device, like AirFloss. You can also try an interdental (aka interproximal) brush. These small brushes are specially designed to clean between your teeth and can take the place of floss.

RealSelf Tip: It’s critical that you continue seeing your family dentist during orthodontic treatment, according to the American Association of Orthodontists (AAO). Your dentist will provide professional cleanings and checkups and, like your orthodontist, will keep an eye on your oral health. Visit your dentist at least every six months (or more often, if recommended), during orthodontic treatment.

Question 13

How long do you wear lingual braces?

Accepted Answer

Everyone’s treatment plan is different, but most patients wear lingual braces for anywhere from 18 months to three years.

Once your braces come off, your dentist will instruct you to wear a retainer. According to the AAO, retainers allow the bone that holds teeth to rebuild after teeth have moved. They also maintain the healthy new positions of teeth after active treatment is completed.

Question 14

Lingual braces vs. clear aligners: What’s the difference?

Accepted Answer

Though both are the closest you can get to invisible braces, lingual braces can be more effective than clear aligners for fixing complicated teeth alignment issues.

“Not only are lingual braces just as effective as Invisalign, they actually give your orthodontist more control over the outcome of your final result than with Invisalign. I use both, and each has its own advantages and disadvantages. Invisalign doesn’t have wires and brackets, but some patients just don’t like having their teeth encased in plastic 24/7,” says Dr. Jorgensen.

“There is also the issue of compliance, with Invisalign,” he says. “If you don’t wear them, they don’t work at all. Lingual braces allow more complex movements, and there are no compliance issues."

Question 15

Sources & studies

Accepted Answer

“Life During Orthodontic Treatment.” Your Guide to Orthodontics. American Association of Orthodontists, 2019.

“Dental braces.” Tests & Procedures. Mayo Clinic, May 21, 2019.

Salloum RB., Al Rassan L., Almukhaizeem N., Albluwi A., Alfayez R., et al. “Lingual Orthodontics Appliance, An Overview.” International Journal of Oral and Dental Health, 2018.

LINGUAL BRACES

Karyn Repinski

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Karyn Repinski

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