Children and adults alike have dreaded the conversation with their orthodontist: Whether they’ll need to spend a few years with braces. (In fact, one in five orthodontic patients is over the age of 21.) While some are fortunate enough to have a straight smile, others need some assistance in the form of metal scaffolding, making their mouth look somewhat like a New York high rise in the 1920s.
But why metal? Why not use plastic aligners? What’s the reason for braces taking such an old-school approach to tooth-straightening?
According to Popular Science, metal braces remain the gold standard because of their effectiveness. When teeth are subjected to forces generated by metal brackets glued to teeth and steel archwires—the wires that can be slowly and periodically tightened to move teeth—orthodontists are able to exert very tight control over how teeth shift over time. (Braces are also made of carbon, aluminum, nickel, and chromium, the latter of which provides rust and corrosion resistance.)
The same isn’t always true of more costly plastic aligners (often just called Invisalign, a popular brand name), which are suitable in some—but not all—of orthodontic cases. Plastic aligners are worn over your teeth for up to 22 hours a day and move teeth incrementally; each top and bottom aligner is usually swapped out after a month for new ones that will continue shifting the teeth into the desired position. But the more teeth need to move, or the more complex the case, the better argument there is to be made for metal braces, which can move teeth as well as the surrounding bone with more precision.
For some, plastic aligners may have benefits that outweigh their drawbacks. Because the appliances are removable, it’s easier to clean the actual teeth. Cosmetically, they also tend to appeal to adult patients who don’t want “metal mouth.”
(Headgear, which refers to an appliance extending out of the mouth, is necessary when conventional braces won’t be able to apply the necessary force or resolve multiple teeth, bite, or jaw problems at once. And despite what many ‘80s movies have taught us, headgear typically only needs to be worn at bedtime.)
So when your dentist or orthodontist recommends metal braces, don’t think they’re stuck in the past. In all likelihood, they believe it’s the best way to keep you smiling.