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Do Ugly Braces Work Better?

ALPHARETTA, Ga. – With advances in discreet options to straighten teeth like Invisalign, having your orthodontist recommend traditional metal braces can seem a bit outdated. What patients may not realize is that there are different pros and cons to each treatment and some options may not be the right fit or get the best results, even if they are more popular.

If “ugly” metal braces are recommended to a patient by an orthodontist, is it because they work better? The short answer is yes. But the patient may still choose to go with a less noticeable option, even if it costs more.

A study was published in 2009 by orthodontist Henry Fields and his colleagues to see what types of orthodontic appliances patients find more appealing. They asked 200 adults to gauge how attractive different images of teeth were with various appliances on them including clear aligner trays, ceramic braces and stainless steel braces. The results showed the less noticeable options were deemed most appealing.

The study participants showed a willingness to pay more for treatment that was seen as more attractive. A large number of the patients surveyed found the more common appliances like metal braces the least attractive and in many cases unacceptable. However, there are good reasons why orthodontists continue to use metal or even ceramic braces.

Stainless steel wires and brackets are considered the most durable and efficient, especially for more involved treatments such as rotating teeth. They are easy for the orthodontist to adjust for fine control of treatment results. While ceramic braces are bonded to the teeth like metal ones, they are more fragile and prone to breaking, making them a less reliable option though more aesthetic.

The most attractive treatment to the study participants were the clear aligner trays. They are hard to see when the patient is wearing them, easy to take out and clean and don’t cause the classic discomfort associated with wires and rubber bands. Even so, they are the most limited option in how much they can move teeth and not everyone is a candidate for aligner trays.

Kids and adolescents see braces differently than adults and are more likely to find traditional metal braces with colored ties or brackets in fun shapes like stars attractive. Fields and his colleagues performed a similar study in 2010 with 139 children and young adults in three age groups ranging from 9 to 17 years of age. They were shown images of 12 varieties of orthodontic appliances to see what appealed most to them from clear tray aligners to metal braces including ones with shaped brackets, colored and discolored ties.

The results were different for each age group, but the most popular choices were the clear plastic aligners, brackets with colored ties and shaped brackets. For children ages 12-14, brackets with colored ties were much preferred over brackets without colored ties. Another trend the study noted was for older participants to find clear appliances more attractive than younger children. Shaped brackets were rated higher by girls in the study then boys as well.

One thing to consider is that Field’s studies were done a few years ago and dental technology, especially for invisible treatment like the clear aligner trays, continues to advance.

When looking at what appliance type works best, it depends if you’re talking about the ideal end results on the patient’s teeth or their overall experience while in treatment. Orthodontists like Dr. Nima Hajibaik in Alpharetta work closely with each patient to determine the best treatment options, taking into consideration the patient’s preference for appearance, treatment time, cost and convenience.

If the patient prefers a convenient, discreet option and only needs minor adjustments to their teeth, Invisalign allows for them to remove the appliance while eating and is nearly invisible. If the orthodontist needs more control over moving the teeth, they might suggest clear or metal braces that are bonded to the teeth, allowing for more dramatic results to improve severe bite problems or if teeth are very crooked. Metal braces are the best choice if teeth are rotated, at different heights or if the back teeth need aligning.

While patients young and old show a preference for treatment that is hard to notice, they need to keep in mind they won’t be wearing the orthodontic appliance forever and the real goal is a beautiful, straight smile they can enjoy the rest of their life.

© 2014 Newpark Orthodontics. Authorization to post is granted, with the stipulation that Newpark Orthodontics is credited as sole source. Linking to other sites from this document is strictly prohibited, with the exception of herein imbedded links.

Dr. Nima Hajibaik
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