[GTO]

Keen on fixing my crooked teeth more for longevity & functionality, rather than aesthetics (although that's a good bonus). Have already lost a few teeth and my bite is damn weird; the situation will only get worse with time.

Please share the pros & cons of each option, along with your recommendation.

Cost is not a consideration. The end result is. Thanks much in advance

[Tejas@perioimpl]

Ah!

I'm not an orthodontist, but we do have 2 top orthodontists visiting our clinic, Oris at Worli, Mumbai.

One is old school and one is exclusive new school. Both are considered the top orthodontists in the country, let alone Mumbai. So, it's great to hear them sparring.

Old school is basically wires and brackets. Brackets can be metal or ceramic (a little better aesthetically). They are time proven and give the best results in the correct hands.

New gen:

Lingual braces - basically the same brackets and wires, but applied from inside the teeth and therefore invisible. We did a few patients with 3M ones, but they all said that the feeling on the tongue is unbearable and had them removed. Now, we do not recommend them at all.

Then there are the Invisalign and clones. Basically, this is how it works in a layman's language.

Your measurement is taken and scanned and fed into a computer that would then use a software to determine the correct alignment and bite. Then it would generate these trays or aligners that you need to wear every month. So, on day one you wear one aligner for at least 20 hours at day. That would move the teeth slightly. You only remove the aligner for eating and drinking.

Then, at the end of one month, you take the next aligner, which would move your teeth a bit more. If you have not worn the previous aligner diligently, the next one will not fit. This goes on for a year or two depending upon your case.

The advantages of the new gen braces are that their are practically invisible. Your visits to the orthodontist are less.

The disadvantages are, of course, cost and that complicated cases still require a final finishing by standard wires and braces.

The biggest problem I've noticed is that old school orthodontia is exclusively practiced by orthodontists, but new gen aligners by some companies are given to all dentists and they do not have the eye to change the plan suggested by the software or understand that the final finishing may have to be done later.

What I would use in my mouth?

I'd go to the orthodontist. If my case is complicated I'd opt for old school. Else aligners with maybe, final few months of finishing by old school.

[condor]

GTO,
I tried to ask my dentist about this - but as I had expected, she said she needs to see the full mouth scan images before she can suggest which would be better. And in some cases, neither of these will work.

And Tejas has answered too !

Btw, my dentist is a Prosthodontist and Oral Implantologist.

[Researcher]

I got my braces back in February as my front lower teeth have been misaligned since the milk teeth gave away. Went old school as the dentist was known to my father from work (father himself is a retired government doctor). He suggested the braces as he said they were more reliable and since I travel a lot, more dentists will be able to attend to it in case of an emergency. You get adjusted to the braces (both discomfort and slight pain) mostly within a week of putting them on. I was suggested to change the wires every month. Cost was not an issue for me, but I did prefer reliability and ease of being attended to at remote locations.

I will still suggest to visit a dentist and get a thorough check before taking a decision because:
1. It becomes complicated if there are tooth fillings and have to be checked in person.
2. There is a chance that some teeth may have to be removed for proper alignment. In most cases its the canines, but luckily I am told that none will be removed in my case.
3. My dentist told me that it is easier to put braces when you are younger, especially in the 18-22 age bracket. The older the person, the longer it has to stay before being removed.
4. I will strongly suggest to put this on hold until the pandemic is over. My dentist had to get admitted last year for a month due to the virus. He has closed this office since a month, just before lockdown started in Odisha.

Wishing you a very good luck with this new adventure.

[rajeevsulu]

I am an Oral Surgeon. My advice to you is to postpone your dental visit for the time being what with this being an elective procedure. Later meet your orthodontist as every case is unique and treatment planning is very individual.

[Tejas@perioimpl]

Also another point I forgot to add:

For regular braces - there is lesser compliance required on part of the patient other than proper brushing and using elastics if needed.

For aligners, more compliance is required in terms of wearing the aligners all the time else the treatment gets prolonged. At times you may have to shift back an aligner rather than move forwards.

[kpkeerthi]

Isn't there an age limit on who can get braced or not?

[Tgo]

Losing your teeth due to them being misaligned is a huge setback. It took me a lot of time to realize the importance of properly set teeth. I was quite ashamed of my teeth for a while that I would restrict my smile to the point where the teeth would just begin to show. The treatment and some cosmetic follow up procedures have helped me overcome that misplaced embarrasing moment now.

I got braces for misalignment of upper incisors back in class 8. The overlap was making it difficult to clean resulting in caries.

• The treatment lasted 1.5 year.
• It involved extraction of a premolar so that some space could be made to accommodate for the rotation of the offending teeth.
• The Molars which are the strongest set teeth act as anchors in this procedure. The wire acts as a guide for the teeth. It is tensioned by attaching elastic bands to the brackets act as the tensioning mechanism.
• The initial 2-3 day after each follow up sitting where they tighten the braces hurts, you feel a slight play in your teeth all the while.
• The inside of the lips rubbing against the brackets is something one gets accustomed to. It is easier not where they give you some gels to help numb and soothe the pain.
• There is slight staining (yellowness) on the bands they put on the brackets after you have food.
• The food getting stuck is also a major irritant which can be dealt with by following up each meal with a light brush of your teeth.
• The initial sitting to place the brackets takes about 2 hours. Each bracket is placed on the tooth in a slightly different position based on what kind of rotation or movement is expected on that tooth. As a result the wire that goes through the brackets looks crooked initially but becomes straight by the end of the treatment.
• My wife is undergoing the same procedure. In her case, the upper teeth needed the setting. The dentist said that the lower teeth follow the shift of the upper teeth to some extent. But in a gap of 4-6 months she would need to have the lower teeth also aligned.
• Any immediate concerns, fillings, RCT, capping / crowning or extractions has to be done before you start the procedure.
• Cleaning the insides of the teeth is a difficult job in itself. For this reason, it would be better to go for braces on the outside of the teeth (visible side).

Your dentist would be the best guide.

While that was a relatively trouble free experience my negligence in not filling up the left over gap in place of the extracted premolar led to me sacrificing three more teeth and the result is still not perfect.

PS: I also was of the wrong impression of being against RCT treatment. I used to argue that a dead tooth (as a result of RCT) can never be as good as a live tooth. Didn't follow that advise and got two such teeth capped only to have them infected a few years down the line and getting them reworked.

[Fiestaboy]

Hi GTO,
I had put my braces on Jan-2020 & during initial planning it was told that we will complete the procedure by Feb-Mar 2021.
However with the COVID, myself & hospital aligned to skip few visits & hence my braces plan got extended to Jun-Jul 2021.
Takeaway:
Braces timeline is hence purely based on individual's dental condition & it will take a year or above. so you need to be prepared for this.

Key things which i will share on braces are:
1. You will not be able to chew hard foods (like meat, etc.) in this period because your tooth are effectively moving, although it depends on our body strength (few say they eat meat with bones), but I don't do.
2. Every 3 or 4 weeks a visit to orthodontist to revise the braces tightening.
3. In braces - small wounds will occur due to the metallic wires or structures used, but it will be bearable.
4. After every visit to the orthodontist & corrections, you will feel pain or stress for next 2-3 days as they tighten it during the visit. Hence strictly no hard chewable food in these days.
5. Brushing will be little difficult for first few weeks then it will be normal.
6. You will find need to use interdental brushes, because food particles will stay between braces & teeth. Usage of this brushes are very simple though.

In my case milk tooth didn't fall & new teeth has risen wherever it find space. So, 6 tooth are removed (including molar) & then all the tooth in different positions are brought to right positions. She was open to both Invisalign & braces but i allowed her to choose based on my condition & we went with braces. I am happy about it.

Hence, you can take the positives & negatives from the thread, but choosing braces or Invisalign is fully dependent on your teeth condition+ dentist recommendation & your choice as well.

Note:
One main benefit of braces is you will avoid taking junk food for sure either because of hard to chew or b/c of settling of those food in braces area.
So if you really look to have good eating habits as well, you can directly go with braces.

[drsnt]

I am a Orthodontist and been working for last 20 years now. In simple terms, Invisalign is esthetically better but technically more complex when it comes to finishing and getting refined result. Braces are old school but have come a long way in development curve and present day ones may look like the older ones but are fairly more advanced.

You can get treatment by any modality but Invisalign is not suitable for complex cases, takes more time compared to braces, plus requirement of fixing brackets for finer adjustment is added disadvantage.

Your Orthodontist can guide you in deciding after analyzing if your case is suitable for Invisalign or not.

I personally prefer brackets over Invisible aligners ( Yes there are many companies providing invisible aligners, Invisalign being the topmost brand).
Brackets have few drawbacks
1. Esthetics
2. Hygiene maintenance
3 More discomfort at initial stages.

Advantages of Brackets
1. You can get the best possible outcome.
2. Treatment time is usually very less compared to Invisible aligners.
3. Complex cases can be treated with relative ease.

Esthetics can not be changed mush except tooth colored brackets and wires. Hygiene drawback can be largely eliminated with proper care. Discomfort tends to go away as patient gets accustomed to braces.

As you have lost few tooth and with non existent details I presume your case will be better with brackets/ Braces. Your Orthodontist can decide better with model analysis of your dentition, Cephalometric analysis etc.

Brackets are like Thar, Old School, potent and usablity is more while Invisalign is like a luxury sedan. More comfort but may not be usable at every occasion.

Regards

Originally Posted by kpkeerthi

Isn't there an age limit on who can get braced or not?

Not really, I have treated patients upto 60 years, Outcome will be slow with advance age and chances of unwanted complication increase. More than age its the bone and tooth condition that decides the treatment decision.

Originally Posted by Researcher

1. It becomes complicated if there are tooth fillings and have to be checked in person.
2. There is a chance that some teeth may have to be removed for proper alignment. In most cases its the canines, but luckily I am told that none will be removed in my case.
Wishing you a very good luck with this new adventure.

Most points you mentioned are fine. Canines are rarely removed for orthodontic treatment. Tooth fillings do not pose much of issue. Caps or Crowns need to be analyzed as they cause issues to bonding of brackets.

Originally Posted by Tgo

While that was a relatively trouble free experience my negligence in not filling up the left over gap in place of the extracted premolar led to me sacrificing three more teeth and the result is still not perfect.

That is the reason why pre treatment planning is most important part, sometimes even more that treatment itself. It can reduce the unexpected outcomes by large margin. Its like the first step in right direction will decide the final outcome.

Note from Support: Please use multi-quote instead of posting back to back on a thread.

[Taha Mir]

I've undergone ortho treatment with conventional metal braces during my 3rd year in BDS. (In the same college I was studying in).
The orthodontist was my professor and was one of the best in Hyderabad. (He's also a total petrol head like us).
Coming to the treatment part, it involved extraction of lower wisdoms and it lasted 2 years. I suffered minor to no pain, it was helpful being a dental student as I knew exactly what was going on. The treatment got over 2 years ago and I'm still required to wear my clear retainers which helps prevent relapse. The only drawback I felt with conventional braces is that they require regular and diligent cleaning. If you're not able to keep up with keeping them clean, you might end up with post treatment caries/cavities.

It'd be helpful if you post/ DM pictures of your teeth. Major tooth movements might require conventional braces. Also, the farther your teeth move, the longer you'd need retainers. Your doctor could set you up with a combination of both, depending on the case.

[bracesdoctor]

I am a senior consultant orthodontist practicing in chennai as well prof & head of orthodontics at a dental school here . I have practising braces for more than 25 years now of which i been practising Aligners since 2007 and a certified Invisalign specialist for the last 5 years .

A few of my professional colleagues have listed the techniques involved in the threads .
From my experience any Aligner treatment is based on a simulation model be it manual or computer simulated . Therefore the actual results may not match the simulated ones shown in the beginning of the treatment in which case the patient would need further Aligner s reffered to as refinement Aligners to complete the treatment . In some cases especially adult patients , aligners could do a wonderful job and it has .

For most patients , it is prudent to find an experienced orthodontist with a passion to Practise only orthodontics , sit with them and work out a practical treatment plan which would include the amount of time you could give for the treatment and other factors .

Having crooked teeth or mal aligned teeth is a sure way to lose them sooner than they could last otherwise .

[SolidusSnake]

@GTO, thanks for starting this thread. I also have crooked/ misaligned teeths, my dentist had been advising me for many years to get braces, but I neglected them till now. But with age, I am getting more and more issues and as per my dentist I should still get the braces. Just wanted to ask the doctors/ dentist here, is their any age limit to it, like I am 36, so I am apprehensive whether getting braces now will be helpful and have the desired results?

[Sonubbsr]

I would advise Ceramic Braces, it is your best bet between aesthetics and function.

3 things to keep in mind before starting orthodontic treatment :
a. Be patient, the process usually takes around a year or more.
b. Time taken to clean your teeth would be more than what you normally spend now.
c. Certain foods have to be avoided(Hard candy, sticky food)

2 things to keep in mind during treatment :
a. Never miss an appointment (Usually, you shall be asked to visit once in a month)
b. Always maintain proper oral hygiene(Warm Saline Rinses, Flossing, Interdental cleaning is to be given top priority, along with regular brushing)


1 thing to avoid during treatment :
a. Smoking and other deleterious habits are to be avoided at any cost.(If you have any)

Also, its feels so good, to see so many dentists active on the forum!

[matchvan]

What an amazing place this forum is.
Not just Moving Cars but now we are talking about how to MOVE teeth.
As Dr.Tejas mentioned, it's better to go for an old school approach but I would take age related factors into consideration before starting the procedure.
Oh and god forbid any Periodontal problems arise you can always consult Tejas or yours truly.
Before the treatment starts, Brace Yourself!