Today’s orthodontic patients have a choice of five basic types of braces, with variations in design and brand.
While most adults want to minimize their time in treatment, some seek to minimize the impact on their appearance, and others want to save money.
In some cases, a combination approach is possible—for example, starting with metal braces to achieve significant tooth movement and switching to Invisalign for fine tuning. The free patient evaluation that most orthodontists offer is a good opportunity to ask questions.
Here are the types of braces available, in order of popularity among adult patients, with an approximate cost range for adult treatment around Washington. Fees can run higher for a complex case—for example, if surgery is required.
The amount of time spent in treatment varies: Some patients spend six months in braces, others three years.
A series of plastic trays that fit tightly over teeth, Invisalign works for straightening teeth but not for bite correction or significant tooth movement. A treatment plan is established up front, and patients can go a long time between orthodontist visits. Trays should be worn most of the time but can be removed for short periods.
Treatment time tends to be shorter than for other braces, not because the technology is faster but because cases are simpler.
Cost: $4,500 to $12,000.
These tooth-colored brackets are less visible than metal, although rubber rings can become stained.
Traditional ceramic brackets are slower than metal at moving teeth and require more visits to the orthodontist. New ceramic brackets that are self-ligating and cause less friction—the arch wire slides in the brackets as teeth move—should help solve both issues, although they’re not as invisible as the old style because the bracket gates are made of metal.
Cost: $4,500 to $8,200.
Self-ligating, reduced-friction metal brackets don’t need elastic or metal bands to hold on the arch wire. Brackets slide along the wire as teeth move, and treatment takes 30 percent less time than with other types of braces. Although the stainless-steel brackets are small, they are visible. Choices from several manufacturers are available, including the Speed brand the author wore.
Cost: $3,500 to $13,000.
Gold-alloy brackets adhere to the inside of teeth, so are not visible. Linguals are good at correcting an overbite, in which the top front teeth come down too far over the bottom teeth. Self-ligating, reduced-friction lingual braces are newly available. Lingual braces can be painful on the tongue and may affect speech. Not many US orthodontists are trained in lingual braces.
Cost: $10,000 to $13,000.
The tried-and-true approach uses metal brackets, with the arch wire attached to each bracket by an elastic or wire ligature. The hardware is less expensive than self-ligating, reduced-friction metal, but it requires more time from the orthodontist, so costs even out. Without the sliding brackets, treatment takes longer.
Cost: $3,500 to $13,000.