Yes, you can get braces behind your teeth; the treatment is known as lingual orthodontics. These appliances function exactly like traditional metal braces, using brackets and wires to shift teeth into their correct positions. Their placement on the lingual, or tongue side, of the teeth makes them virtually invisible from the outside. Lingual braces are a highly aesthetic solution for comprehensive orthodontic correction, popular among adults and professionals who wish to keep their treatment discreet.
The Mechanics of Lingual Braces
The primary difference between lingual and traditional braces is the necessity for extreme customization. The surface on the back of the teeth is highly irregular and varies significantly from person to person, unlike the relatively flat front surface. Because of this complex anatomy, the brackets cannot be mass-produced in a standard shape.
Orthodontists use advanced digital technology, such as 3D intraoral scanners, to create a precise virtual model of the patient’s mouth. This model is then used with Computer-Aided Design and Manufacturing (CAD/CAM) to fabricate brackets that perfectly match the unique contours of each tooth. The archwires are also customized, often being robotically bent to ensure they apply the correct force vectors for effective tooth movement.
Determining Patient Suitability
While lingual braces are effective, not every patient is an ideal candidate for this treatment. A primary concern is the patient’s bite depth, particularly involving a deep overbite. If the upper front teeth significantly overlap the lower front teeth, the lower teeth can repeatedly strike the brackets on the back of the upper teeth.
This constant contact creates excessive pressure that can lead to brackets repeatedly coming loose, interrupting treatment progress and requiring frequent rebonding appointments. Teeth that are exceptionally small may also not provide enough surface area for the custom brackets to bond securely. While lingual systems can correct a wide range of issues, some complex malocclusions may be more efficiently treated with traditional appliances. A consultation with a specialized orthodontist is necessary to accurately assess suitability.
Practical Considerations for Treatment
Patients considering lingual braces must factor in the practical realities of cost and daily maintenance. Due to the sophisticated technology and extensive customization involved, lingual braces are generally the most expensive orthodontic option. The typical cost range is often between $5,000 and $15,000, which is higher than traditional metal or clear ceramic braces.
Treatment duration may also be slightly longer compared to other methods because of the complexity of the adjustments and the specialized skill required to manipulate the wires. Initial discomfort is common, as the tongue frequently rubs against the brackets and wires, causing temporary soreness or irritation. This placement can also interfere with speech, resulting in a temporary lisp until the tongue adapts to the reduced space, which usually resolves within a few weeks.
Maintaining oral hygiene is difficult, as the appliances are harder to see and reach for thorough cleaning. Food debris and plaque can accumulate easily around the brackets, increasing the risk of cavities and gum inflammation. Patients must be diligent, often needing to utilize specialized tools such as interdental brushes and water flossers to clean all surfaces effectively. The entire process requires the expertise of an orthodontist specifically trained in this technique.