Braces have long been used to correct various defects in one’s smile. Orthodontic Braces are primarily used for teeth straightening and to close gaps in between. They are used to correct minor problems of underbite, overbite, or even cross-bite of teeth in the upper and lower jaw. A headgear may also be required to treat severe orthodontic problems in growing kids.
A prime motive for wearing lingual braces is their invisibility for esthetic reasons. They are considered to be the least conspicuous of all orthodontic devices used to straighten. They are like the normal wire braces worn on the outside. The difference is that all the hardware, that is the arch wire, ligatures and the brackets, is worn on the inside (tongue-side) of the teeth. One obvious requirement is that there is not enough space in the bite to accommodate the braces.
For this and other reasons, the brackets used are not stock-items. Rather, custom-made brackets are prepared by CAD / CAM after taking careful patterns of upper and lower teeth, digitizing them, and feeding to CAD / CAM equipment. They can be worn by adults and teenagers alike.
The function of lingual braces is almost identical with the conventional braces that are worn on the front surfaces of the teeth. However, their placement on the lingual side of the teeth may create some complications for both the orthodontist and the patient. The following steps are involved in applying lingual braces:
- Clinical Evaluation – before deciding whether they are best for your treatment, one of our expert dentists will first perform a detailed examination of your mouth and evaluate the severity of misalignment of your teeth. He will also examine study models and radiographic images of your them in order to create a customized treatment plan for each patient.
- Making Impressions of your Teeth -before making an impression, we will thoroughly clean. Afterward, we will use a special scanner to record 3-D impressions of teeth of both the lower and upper jaw.
- Cast and set-up- From these impressions, the lab technician produces a cast, and modifies it according to the dentist’s instructions to produce a ‘set-up’ for your case. The set-up is a physical mock-up of your teeth when in perfect alignment.
- Fabrication of Treatment Plan-The mock-up dimensions are digitized in 3-D using special software, and fed to the computer. Special CAD (computer aided design) software is used to design the brackets specifically for your teeth. Bracket for each tooth is custom-designed separately.
- Production- A computer aided manufacturing (CAM) software (computer aided machining) in the computer uses this design data to produce the brackets using numerically controlled(NC) milling machines. Robotic bending is used, again under computer control, to prepare the arch wire.
- The applicator tray- The fabricated brackets are embedded into what is called an applicator tray, a stent that should fit over your teeth perfectly and hold the brackets in exact alignment for the dentist to perform the bonding procedure. This hardware is sent to the dentist. Attachment of the brackets onto the teeth is done in the next appointment, and it involves the following steps:
- Preparation- The teeth are thoroughly cleaned and roughened to permit better bonding.
- Cement application- A cement is applied over brackets in the applicator tray.
- Bonding- The applicator tray is pressed precisely against the teeth and all the brackets of the jaw (either upper jaw or the lower jaw) are bonded simultaneously.
- Removal of the tray- Once the cement has cured, the dentist will break away the tray leaving the brackets firmly attached to the teeth. Excess bonding can be scraped away.
- The archwire- The archwire can then be placed. Ligatures are not needed.
The length of treatment will vary from case to case, but will normally lie between one and three years. After the braces have done the realignment properly, they are removed. Your doctor will then give you a removable or fixed retainer to consolidate the newly achieved alignment. This may another six months.
Because of their inward, invisible location, demand special care. We recommend the following points to remember during your treatment:
- Maintain Good oral hygiene- Good oral hygiene is essential to tooth decay and gum disease. This involves. Brushing twice a day spending at least two minutes evenly over all the teeth. Use of a soft toothbrush with rounded bristles to clean gum line and the teeth and an inter-dental brush to clean the gaps. An oral irrigation device may also be used. Daily flossing, preferably after every meal will also go a long way in ensuring excellent oral health.
- Protecting Oral Soft Tissues – If the braces irritate the tongue, ask your kid use the wax that we provided you at the start of your treatment, and paste it on the insides of the teeth, especially where it hurts.
- Regular Visits – in addition to your weekly or monthly appointments, children, adolescents and youngsters who are undergoing orthodontic treatment must visit us after every six months for teeth cleaning and prophylaxis.
- Diet Management – Avoid sticky, chewy, and hard foods, including raw vegetables like carrots and apples. Sticky and hard foods can dislodge your brackets.
They have advantages over other types of teeth alignment apparatuses. They also have their specific limitations. Here is a brief discussion of both, which may help in choosing the most affordable and convenient orthodontic treatment option for your children.
- Advantages of Lingual Braces
- Better Esthetics – The main, and probably the biggest advantage of the invisible braces is that they are not visible to a casual look. Only a close examination will reveal their presence. This is a major aesthetic advantage.
- Comparison with Invisalign® and Clear Braces
- Lingual braces are less visible than the clear plastic aligners, because the latter may sometimes disclose their presence by giving off a sheen.
- Lingual braces give the dentist a better control over individual teeth movement.
- Potential for Tongue irritation – They are placed on the inside of the teeth. Braces on the upper come between the teeth in the upper jaw and those in the lower jaw. On the lower, they come in contact with the tongue and reduce the freedom available to it for free movement. The tongue may be irritated, which can lead to pain in the area while swallowing or speaking.
- Speech Problems – The tongue needs to touch against the teeth to produce certain sounds. With the brackets placed where the tongue used to touch, you may not be able to produce certain sounds properly, at least initially.
- Cleaning care – Being on the inside, lingual braces pose special demands on regular hygiene care.
- Application is complicated – Placing the brackets accurately behind the teeth with limited visibility is a problem, and demands more time and care. Specialist training is required on the part of the dentist.
- Getting used to – It takes more time to get used to lingual braces than to the normal visible braces.
Prices depend on where you get the braces, but as general rule, lie between $8000 to $10000. In comparison, traditional metallic braces cost between $3,000 – 7,000, and Invisalign® from $4,000 – 7,400. Thus, lingual braces have the biggest price tag of all the three major types of dental aids used for pediatric teeth alignment.
Health insurance plans normally do not include braces for those over eighteen, but supplementary plans may be available. However, expense on braces is tax deductible if the total amount exceeds a certain limit. These matters need to be checked before the braces are bought. For any plan, be sure to ask about the percentage they cover and the lifetime maximum. The amount of coverage varies greatly, but a common figure is 50% coverage with a $1500 lifetime maximum per child.
We also recommended that you keep the same insurance plan during your entire orthodontic treatment. Most orthodontic coverage will not cover braces if they have already been applied to the teeth prior to the effective date of the policy. This would be considered a pre-existing condition and becomes an out-of-pocket expense.
Let us provide you with an excellent orthodontic experience at our dental office. Our dentists are experts in the placement of lingual braces and we are confident you will love the results. If you qualify for Medicaid and braces are deemed medically necessary, Medicaid may cover them. Be sure to ask about the percentage of coverage and the lifetime maximum. To learn more, visit http://www.medicaid.gov/