Orthodontic Treatment: Braces or Clear Aligners (Invisalign). Do I Need It? Is It Too Late To Start?

A frequently asked question that dentists often receive is: do I need to straighten my teeth?

A simulated Invisalign plan for an adult:

Almost always, the answer is, “it’s up to you.”

Save for very specific situations, orthodontic treatment in the form of braces (conventional metal/ceramic, Damon) or clear aligners (such as Invisalign) is entirely optional. It can be used to manage dental problems like:

• Aesthetic issues

  • Crowding

  • Spacing

  • Narrow smiles

  • Broad smiles

  • Small jaws

  • Large jaws

• Functional issues

  • Poor chewing

  • Inability to cut fine foods like noodles

  • Food trap

  • Poor dental hygiene

  • Certain speech issues

If done properly, orthodontic treatment will likely lead to improvement both aesthetically and functionally. However, it comes with a huge caveat: commitment. Orthodontic treatment requires utmost cooperation from the patient. Patient motivation is a key factor in the success of orthodontic treatment. Patients must not only keep up with orthodontic instructions, but also maintain their oral hygiene more rigorously than before.

Orthodontic treatment also takes time. There are no shortcuts to a good orthodontic finish! Be prepared for up to two years of treatment. Sometimes, more complex conditions take even more time.

Invisalign, Damon Braces or Conventional Braces?

Invisalign clear aligners

Conventional braces vs Damon braces

Whatever your choice, they are ultimately different means to the same end. Certain conditions may be better treated with clear aligners (like Invisalign), while others may be better treated with conventional braces or Damon braces.

Conventional braces and Damon braces both utilise brackets that are bonded to the surface of your teeth. Damon braces, however, have ‘doors’ that open or close to secure the metal wire. Conventional braces, however, utilize a module (rubber ring) to secure the wire to the bracket.

Damon braces are theoretically advantageous as they allow the wire to slide smoothly under the bracket door. It offers less resistance and therefore should be slightly more comfortable. Teeth are also supposed to move at a faster speed. Additionally, the rubber rings of conventional braces eventually lose their elasticity, therefore requiring more frequent visits to the dentist to be changed.

Anecdotally speaking, however, I see little clinical difference between Damon braces and conventional braces. Other clinicians, on the other hand, swear by the Damon system. If you wish to have fewer dental appointments and do not appreciate the aesthetics of the rubber rings, then Damon is for you. Otherwise, the conventional systems work just as well, and come at a lower cost.

Is It Too Late To Start?

The short answer: no.

Teeth can move at any stage in your life. While treatment may take slightly longer, many individuals undergo orthodontic treatment later in their life.

Starting young, however, does provide a host of advantages. If orthodontic problems are detected early (as young as 6 years of age!), interceptive orthodontic treatment can be carried out to reduce the complexity of treatment later in life.

Early treatment of a 9 year old child:

11 months later:

Early treatment in children can also correct the direction of growth of the lower jaw, thereby reducing the need for complicated jaw surgeries later in life. It also reduces the chances of having teeth embedded in bone, which would otherwise have to be surgically removed at a later time.

Many doubt their child’s ability to cooperate with orthodontic treatment. However, some children turn out to be even more cooperative than some adults! With the right motivation and environment, interceptive orthodontic treatment at a young age often proves to be highly effective to nipping orthodontic problems in the bud. Their future selves would thank them.