Lingual Braces

lingual-brackets.preview.JPG What are lingual braces?
Lingual braces are custom made fixed braces bonded to the back of the teeth making them invisible to other people.  Braces in general are formed of two components:

• The brackets – The small metal pieces that are attached directly to the teeth
• The arch wires – that connects the brackets together

In lingual braces the brackets are cemented onto the backside of the teeth making them invisible while in standard braces the brackets are cemented onto the front side of the teeth.  Hence, lingual braces are a cosmetic alternative to those who do not wish to have the unaesthetic metal look but wish to improve their smile. 
How are lingual braces different from standard braces?
The main differences between the conventional braces and lingual braces are summarised in the table below:

Lingual Braces Standard Braces
Brackets are cemented onto the backside of the teeth Brackets are cemented onto the front side of the teeth
Metal work is invisible, hence are a cosmetic alternative to standard braces Metal work is visible making them less aesthetic
Brackets have to be custom made as back side of each teeth are unique in its shape Brackets can be mass produced as all front teeth are quite uniform in shape
Only suitable for adults and teens who can wear braces on the front of their teeth while it is not suitable for people with very small teeth or with certain bites Anyone can use standard braces
Lengthy and more difficult adjustment time Lesser adjustment time
More expensive Less expensive
Not all orthodontists are trained in fitting in lingual braces All orthodontists are capable of carrying out the treatment

What is the function of lingual braces?

Like the standard braces, the lingual braces help to correct

• Bad bite occurring as a result of misaligned teeth
• Gaps, crowding, rotated teeth, hence improving the cosmetic appearance of the teeth
• Braces apply continuous and gentle pressure on the teeth causing them to shift back to their proper position.

Who are ideal candidates for lingual braces?

Adults and teens who wish to improve their smile but do not want the metal work to be visible to others.

Who cannot use lingual braces?

• It is not suitable for people with very small teeth or with certain bites
• Smaller children who still retain some of their milk teeth

Can lingual braces be worn in combination with standard braces?
Lingual braces can be worn for both the upper and lower teeth. However, since the lower teeth are less visible, one can go for a combination of lingual braces on the upper teeth and standard braces for the lower teeth.

How are lingual braces fitted ?

It takes 2 visits to fit in the lingual braces at 3 to 5 days interval:
During the first visit

• Impression of the teeth are taken by the dentist using a plastic mould
• The plastic mould is sent to a laboratory where customized brackets for each tooth are made based on the mould
• The brackets are removed from the mould, set in wax and placed into a small plastic applicator.  This helps to keep the brackets aligned at the time of application.

Second visit

• Cement is applied to the back side of each bracket by the orthodontist
• The entire set is then pressed into place
• The plastic applicator is broken off once the cement sets in.  The custom made lingual brackets remain in their place
• Next the orthodontist installs the arch wire by threading it through the brackets behind the teeth.  The arch wire has been shaped for the ideal position of your teeth, and therefore tries to shift back into its original position pulling the teeth into place in the process

What can be expected after the lingual braces are fitted in?

• The patient may experience some temporary soreness of tongue and speech impairment such as lisping initially.  The braces have been designed such that the tongue gets easily adapted to them.
• Mild discomfort in the form of a mild ache or tenderness of teeth during chewing may be experienced.
• Tongue thrusting for swallowing would not be possible initially and you may have to learn some new swallowing techniques.
• You may require 1 to 4 weeks to get comfortably adjusted to the lingual braces.

What are the aftercare instructions for lingual braces?
• Rinse the mouth using salt water to help avoid initial discomfort.
• Learn to swallow without tongue thrusting by adopting new swallowing techniques.
• Speak more and over enunciate to aid in speaking more clearly
• Eat soft and soothing foods for the first few days.
• Maintain good oral hygiene – Brush after every meal.  Use a water pick or electronic toothbrush
• Regular dental check ups – Have regular dental examinations to monitor the health of your teeth and development of plaque.  Follow the instructions given by your dental hygienist to the T.

When will the positive results of lingual braces be seen?
They take typically the same time as traditional braces to show the positive results, generally 1- 3 years.
What are the disadvantages of choosing lingual braces?
• Food caught in between the brackets or wires are often hidden from your view.  Hence in the absence of a thorough dental routine, the chances for plaque formation and subsequent dental damage are higher for lingual braces.
• Longer time to adjust to than traditional braces
• Since lingual braces make use of customized lingual brackets designed using CAD/CAM technology in the lab, they are more expensive.
• Since the procedure requires specialized training in the development of customized brackets, orthodontists who are familiar with the procedure are often difficult to find.

Does the placement of lingual braces require the extraction of teeth?
Only in severe cases will teeth extraction be required; extractions are avoided in more than two-thirds the patients.