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Brace yourself

Published: January 12, 2013 Updated: March 13, 2013 at 08:55 AM

Adults considering dental braces often wonder whether one type is better than the other.There are basically three types of orthodontic braces, explains Dr. Steven J. Lindauer, professor and chairman of the Department of Orthodontics at the Virginia Commonwealth University School of Dentistry.Conventional braces come in metal and clear ceramic and go on the front of the teeth. Lingual braces are put on the back of teeth. And there are clear aligners such as Invisalign and Insignia Clearguide that go over the teeth.Adults seem to adjust better to the clear aligners, Lindauer said.He shared a 2011 research paper that compared the different types of braces in a small sample of adults. In the research, adult patients who got braces were asked to fill out a quality-of-life questionnaire, and 68 responses were tallied."My take on the study was that patients in conventional and Invisalign experienced about the same amount of soreness — pain — but overall the Invisalign patients adjusted faster. The lingual patients had the most pain and discomfort and took the longest to adjust — if they ever did," Lindauer said.The degree of crookedness or misalignment of teeth can affect whether one type of dental braces is recommended over another.Conventional braces are a lot more versatile, Lindauer said, allowing doctors to manipulate them to do what they want to accomplish.The Invisalign aligners are made in a laboratory before treatment begins. So there is some predicting of how teeth will move, and the prediction can be off, affecting treatment.Average treatment is about 22 months, according to the American Association of Orthodontists, which estimates that one in five patients treated by association members is an adult."Usually aligners are going to be used in simpler cases, so (patients) don't have to wear Invisalign as long. The lingual ones, in the study, they were the hardest to adapt to. Adults seem to find them the most uncomfortable. Orthodontists find them harder to work with."As for cost, Invisalign has a laboratory fee that can make them more expensive than other types.The other issue for aligners, he said, is patient compliance. They have to be worn all the time, except when eating or brushing teeth.Richmond (Va.) Times-Dispatch