Traditional wire braces were once an adolescent rite of passage. (The colorful rubber bands! The poking wires! The ill-fated flirtations with popcorn, apples, and chewing gum!) These days, kids have another option: clear aligners, removable plastic “trays” fitted to the teeth and swapped out every one to two weeks to advance treatment. The “invisible” braces aren’t new, but area pediatric dentists and orthodontists say that in recent years they’re treating more young people with the trays versus mouthfuls of metal.
Some of the increased use can be attributed to improved choices and technology. A key shift began in October 2017, when 40 patents that had helped Invisalign dominate the market expired, paving the way for new brands offering treatment at lower prices. (Aligners can cost anywhere from $945 to upward of $7,000.)
More competition also begets better products—a key point for Maddy Goodman, an orthodontist at Harmony Pediatric Dentistry and Orthodontics in Bethesda. “The technology has gotten so much better, in terms of how effective aligners are, that it’s made us as dentists and orthodontists more comfortable treating with it,” she says Goodman. Currently, about 65 percent of her pediatric patients have opted for clear aligners over metal braces. In addition to improvements with the plastic trays, Goodman can use digital scans to customize the fit, making for a more accurate and comfortable process than in the past, when molds sometimes yielded errors. And because aligners don’t need tightening or emergency appointments to fix a broken wire, patients spend less time in the doctor’s office, skipping to the next tray if an aligner is damaged or lost. “I prefer [clear aligners] in a lot of cases because I think they can do some things that braces can’t, and can do them faster,” says Goodman.
Recent years have also brought products designed for younger patients, such as Invisalign First, aligners for six-to-ten-year-olds who still have baby teeth. Most often, clear aligners are used on permanent teeth in the second phase of a two-part treatment plan. Derek Blank, a dentist at DC Pediatric Smiles in Bethesda, says most of the kids in his chair with clear aligners are in that second phase. However, he has patients as young as eight wearing invisible braces.
Dentists do note that compliance among kids is a concern. The aligners are effective only if worn at least 22 hours a day. Invisalign Teen’s plastic trays are stamped with blue dots that fade with use, indicating to practitioners whether or not a patient is wearing the device the required amount of time. While traditional braces are constantly working, aligners force kids and teens to be responsible for their own progress—not an easy task for every child. “What we’re hoping is that [treatment] allows that patient to be excited seeing their teeth move position,” says Blank. “They’re motivated by each new aligner they get.”
Even though the technology is available, not every situation calls for the clear-aligner route. Jarrett Caldwell, a dentist and orthodontist at Ivy City Pediatric Dentistry and Orthodontics in DC, says the majority of young people requesting clear aligners are between 13 and 15, though most of his patients donning them are over 15. For specific misalignments that call for treatments such as growth modification, Caldwell typically opts for brackets and wires. “The technology with clear aligners is improving, and it is definitely a benefit for patients—it gives them another option,” he says. “But there’s always going to be a role for traditional braces.”
Top Pediatric Dentists
This list of dentists, voted best by their peers for treating children and teens, first appeared in our March 2023 issue as part of a list of top dentists in all specialties.
Melanie Acosta
Silver Spring; 301-989-8994.
Amy H. Adair
Burke; 703-440-9701.
Felix J. Aguto
Waldorf; 301-206-1993.
Angela L. Austin
Alexandria; 703-942-8404.
Girish Banaji
Falls Church; 703-849-1300.
LaToya M. Barham
Springfield; 703-455-1339.
Reza Beheshti
Silver Spring; 240-752-8822.
Karen Benitez
Chevy Chase; 301-272-1246.
Richee K. Berry
Bowie; 301-383-0959.
Derek Blank
Bethesda; 301-363-9026.
Sara E. Bunin
Burke; 703-978-0051.
Keith F. Camper
Laurel; 301-691-4620.
Robert D. Camps
Silver Spring; 301-989-8994.
Charlie O. Coulter
DC; 202-873-9742.
Liliana Cuervo
Montgomery Village; 301-869-5437.
Mina Dadkhah
Alexandria; 703-417-9722. Also Sterling.
Jeffrey P. Davis
McLean; 703-848-8444.
Jayne E. Delaney
Alexandria; 703-370-5437.
Shailja D. Ensor
Rockville; 301-881-6170.
Neda Etessam
McLean; 703-821-1633.
Jena Fields
Silver Spring; 301-989-8994.
Sarah Ganjavi
Vienna; 703-938-6600.
Tiffany Gavin-Walker
Silver Spring; 301-989-8994.
Roselyne N. Gichana
Falls Church; 703-533-5511.
Jessica Goodman
Silver Spring; 301-989-8994.
John Han
Fairfax; 703-348-4216.
Heidi A. Herbst
Sterling; 703-444-3710.
Avionne A. Hill
DC; 202-873-9696.
Andrew I. Horng
Rockville; 301-881-0220.
Gema Island
Tysons; 703-790-1320.
Rishita A. Jaju
Reston; 571-350-3663.
Debra L. Jeffries
DC; 202-584-3848.
Neda Kalantar
Reston; 703-435-1500.
Jonathon Konz
Ashburn; 703-687-1581.
Gary R. Kramer
Burke; 703-978-0051.
Alan K. Kuwabara
DC; 202-244-6111.
Naveen Kwatra
Gaithersburg; 301-977-2200.
Lauren Lewis
Rockville; 301-881-6170.
Sy Majidi
DC; 202-849-3292.
Peter Markov
Arlington; 703-962-7814.
Niloofar Mofakhami
Oakton; 703-255-3424.
Carlos H. Monsalve
Herndon; 703-481-1115.
Ricardo A. Perez
Chevy Chase; 301-718-1012.
Gina C. Pham
Woodbridge; 703-490-5050. Also Dale City.
Roya Pilcher
DC; 202-237-2833.
Christine M. Reardon
Arlington; 703-579-0367.
Jessica E. Rubin
DC; 202-545-7200.
Andrew Jason Shannon
Vienna; 703-319-8370.
Elizabeth Shin
Bethesda; 301-941-7374.
Heather Sholander
Bethesda; 301-664-4220.
Emmanuel Skordalakis
Sterling; 703-421-3000.
Rory N. Smith
Alexandria; 703-370-5437.
Carla Stephan
Sterling; 703-421-3000.
Adam H. Ta
Alexandria; 703-922-4000.
Ruksana Talaksi
Centreville; 703-266-9090.
Cris Ann Ternisky
McLean; 703-356-1875.
My Tran
Alexandria; 703-922-4000.
David M. Treff
Burke; 703-712-8077.
Jack Weil
Vienna; 703-255-2573.
Nahee Williams
Springfield; 703-455-1339.
Claudia N. Williams-Conerly
Silver Spring; 301-565-3536.
Valerie V. Woo
Ashburn; 703-729-7005.