Lingual braces are an orthodontic treatment fixed to the posterior, or tongue-side, surface of the teeth. This option allows teeth to be straightened without the visible metal or ceramic brackets of traditional braces. Lingual braces use the same mechanics as conventional braces, applying continuous pressure to guide teeth into correct alignment over time. Their discreet placement makes the appliance virtually invisible to others, providing a significant cosmetic advantage.
Understanding Lingual Braces
Lingual braces function similarly to traditional braces by utilizing brackets, wires, and elastic bands to achieve tooth movement. The major distinction is the engineering required to position the hardware on the highly irregular and variable surfaces on the back of the teeth. The fabrication of these appliances relies heavily on advanced digital technology, such as Computer-Aided Design and Computer-Aided Manufacturing (CAD/CAM).
Each bracket is custom-made to fit the unique contour of the patient’s individual tooth surface using 3D imaging and printing. This customization is necessary because the lingual side of the teeth is not flat like the front, ensuring the appliance sits flush and is comfortable. The specialized brackets and robotically bent archwires incorporate the entire treatment plan, allowing the orthodontist to execute precise tooth movements. This technology enables lingual orthodontics to achieve the same high standards of treatment outcome as traditional braces.
Living With Braces on the Inside
The initial adjustment period for lingual braces often involves unique challenges related to their internal placement. The biggest initial discomfort typically stems from the brackets rubbing against the tongue. This irritation can cause temporary soreness or minor ulcerations as the tongue repeatedly encounters the new hardware. Patients often use dental wax to cover sharp edges and smooth the surface of the brackets during this initial phase to improve comfort.
A common temporary side effect is a speech impediment, often manifesting as a lisp or difficulty articulating certain sounds, particularly those that require the tongue to touch the back of the front teeth. The presence of the brackets physically obstructs the tongue’s familiar path for sound formation, forcing it to find a new position. This speech change is usually transient, with the tongue naturally adapting to the appliance within the first few weeks to a month. Practicing speaking, such as reading aloud, can accelerate this adjustment process.
Maintaining oral hygiene with lingual braces presents obstacles compared to traditional braces. Because the brackets are hidden behind the teeth, they are much harder to see, making it challenging to ensure all food debris and plaque are removed. Patients must be extremely diligent in their cleaning routine and may need specialized tools, such as interdental brushes, floss threaders, or water flossers, to thoroughly clean around the brackets and wires. The placement of the braces near the salivary glands can also increase plaque accumulation, making meticulous cleaning essential throughout treatment.
Determining Eligibility and Treatment Timeline
Not everyone seeking invisible orthodontic treatment is a suitable candidate for lingual braces, as candidacy is determined by specific clinical factors. Patients with a deep overbite, where the upper front teeth significantly overlap the lower front teeth, may not be ideal candidates because the bite can exert excessive force on the lower brackets, causing them to dislodge. The size and shape of the teeth are also considerations, as very small teeth may not have enough surface area to accommodate the bracket base securely. Consultation with an orthodontist experienced in lingual techniques is necessary to determine if the bite and anatomy are appropriate for this method.
The duration of treatment with lingual braces is generally comparable to that of conventional braces, typically ranging from 18 to 36 months, depending on the complexity of the case. While the treatment mechanics are similar, the custom nature of the appliance can sometimes lead to more efficient tooth movement, potentially reducing the overall time. The total treatment time is always an estimate and depends heavily on the patient’s specific needs and the extent of tooth correction required.
The cost of lingual braces is notably higher than that of traditional metal or ceramic braces due to the specialized nature of the appliance and the technique-sensitive placement process. This higher investment is a direct result of the sophisticated technology required for digital scanning, 3D printing, and customization of each individual bracket and wire. Costs typically range between $4,000 and $15,000, with final pricing dependent on the complexity of the case and the geographic location of the provider.