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Traditional dental braces have improved the smile and oral function of many patients in the past decades.
Technological advancement and innovation have enabled clinicians to offer new aesthetic orthodontic treatment options, which has led to increased demand from working adults.
What other options are there now, apart from traditional metal braces? Are these modern aesthetic orthodontic options a new norm?
Apart from aesthetics, how do they differ from traditional braces? What are their limitations?
Dr Qian Li, Associate Consultant from the Department of Orthodontics at National Dental Centre Singapore (NDCS), a member of the SingHealth group, will address your questions regarding modern orthodontic treatment.
To post your question in this Q&A forum, please log in as a member. If you are not a member, you can register for a FREE membership here.
This Q&A forum is open from 1 May to 27 May 2021.
If you have problems posting your questions, please email your questions to marcom@healthxchange.com.sg
Kindly note: Your question will only go live / appear on this page after the doctor answers it
Posted by Jenny
There are metal braces and ceramic braces, then there is also Invisalign (are there other options of braces that I’ve left out?) I have the following questions:
Thank you for your advice.
Answered by Dr Qian Li, Associate Consultant, Department of Orthodontics, National Dental Centre Singapore (NDCS)
Hi Jenny,
In essence, different patients are suited for different types of braces based on individual needs. Metal braces and ceramic braces follow the same mechanical principles and produce identical results and effectiveness. Clear aligners are only suitable for specific cases, and can be less effective in correcting certain types of malocclusion..
The disadvantage of metal braces is that it is the most visible type of braces. Brushing and maintaining oral hygiene is also more challenging with fixed appliances (metal and ceramic braces). While clear aligners are removable when brushing and allow for easier maintenance of oral hygiene, they are also less effective in treating complex malocclusion. When using clear aligners, a high degree of compliance is required, and it needs to be removed when eating and brushing.
When it comes to treatment duration, the average duration for extraction cases is about 2 years, while non-extraction cases can be significantly shorter. Treatment duration varies between patients and depends on complexity of treatment, age, root length of teeth, bone density, rate of turnover of bone structure, etc. The choice of different types of braces has less of an impact.
Determining the best choice of orthodontic treatment involves identifying the option that best fits the individual’s unique preferences, priorities and treatment needs.
Most of the time, visibility of one’s braces is the strongest factor patients consider when choosing alternatives to metal braces. If you like to choose colors every month and don’t mind the traditional appearance of having braces on, then metal braces is usually the most cost-effective option.
Posted by Chris
Hi Dr,
Apart from correcting the gap between teeth and teeth protrusion, what are other reasons or benefits for getting braces? Will it last? Apart from braces, are there other ways correct teeth gap and teeth protrusion? Thanks.
Hi Chris,
Closing spaces and correction of protruding teeth are just two of the many indications of braces. I’ll state some of the common areas where braces can be recommended:
This list is not exhaustive, but shows the wide range of occlusal problems that braces can correct. Braces do not just improve the smile, they can also improve functions or prevent future development of dental problems.
Posted by Cindy
I’ve been going back and forth about whether to get braces for quite a while after hearing from others who done it that:
What do you think is the best option for me, based on what I’ve shared? Thank you.
Hi Cindy,
Most patients get used to the roughness of braces and wires after one to two months. Most are also able to eat normally after the first month of having braces on. Some adult patients are more prone to have ulcers and discomfort from braces than others. We advise a soft diet during the initial stage of braces treatment, and teach patients how to use wax and ulcer cream to relief discomfort from ulcers.
Extractions are recommended when there is crowding and lack of space for all teeth to fit within the patient’s jaws. Space created by extractions will be used to correct crowding (crooked teeth) or to reduce protrusion of teeth. Your orthodontist will discuss with you whether extractions are beneficial to your braces treatment.
Teeth tends to return to their original positions after removal of braces. That is why retainers must be worn after braces treatment for an adequate duration.
It is recommended to see an orthodontist for an initial assessment. During your visit, the orthodontist can advise on whether you will need extractions and what kind of discomfort you will likely experience during your treatment.
Posted by Alice
Hi Dr, my 7+ year old daughter has misaligned teeth and a slightly protruding upper jaw. Will wearing braces correct it? Is there a minimum recommended age for wearing braces? Is it better to wear braces at a younger age than later – does it mean a shorter wearing time but will it last to adult age? Having wisdom teeth will ruin the alignment, correct, what can be done then? Thank you for your advice.
Hi Alice,
Braces usually can be deferred until the age of 12 or older in most people, when baby teeth have all been replaced by adult teeth. However, some kids will require early braces at a younger age to correct problems that cannot be delayed further.
Alignment of teeth for aesthetic purpose is usually done after most permanent teeth have erupted. At the age of 7+, most adult teeth have not yet erupted, and it is too early to correct misalignment in most cases.
Jaw growth issues usually require early treatment and are best done between the ages of 9 to 12. Some patients will benefit from growth modification during this period, to help maximise the growth potential of the upper or lower jaw.
Severe protrusion of upper teeth may also require early correction at times to reduce risk of trauma and injury to the upper teeth.
Your daughter will most likely not require standard braces now, but may benefit from interceptive orthodontic treatment in the form of growth modification or removable appliances. It is a good idea to visit an orthodontist for an assessment.
Wearing braces during teenage years, compared to delaying until adult age, usually translates to faster treatment time, and less discomfort experienced during treatment. Wisdom teeth are not proven to ruin the alignment of teeth. As long as patient is compliant with retainer wear after braces, wisdom teeth removal is usually a separate decision from retention of braces alignment.
Posted by Mrs Ng
Hi Dr, I have the following questions:
Your advice is much appreciated.
Hi Mrs Ng,
Jaw growth issues usually require early treatment and are best done between the ages of 9 to 12. Some patients will benefit from growth modification during this time window, to help maximise growth potential of upper or lower jaw. Severe protrusion of upper teeth may also require early correction at times to reduce risk of trauma and injury to the upper teeth. It is a good idea to visit an orthodontist for an assessment.
The size of teeth and size of jaws in a child are affected by genetics. This in turn will play a part in the severity of a child’s crooked teeth. However other environmental factors such as thumb sucking habit, early loss of baby teeth, injury to teeth, missing teeth, all contribute to development of malocclusions as well. Even twins, who are genetically very similar, can have different presentation of crooked teeth.
Retainers are designed to retain the existing positions of teeth and not to move teeth. Clear aligners appear identical to retainers, but is designed to correct teeth alignment. Different brands of clear aligners have different limitations and effectiveness. There are some types of malocclusions that are not suitable for clear aligner treatment. An orthodontist can advise you whether you are suitable for clear aligner treatment.
The cost of braces varies for each individual. It depends on the complexity of your malocclusion, the type of braces you choose, and whether you are seeing a braces specialist (orthodontist). Some patients who have very mild crooked teeth may only require partial braces on several teeth and consequently the cost of treatment can be much lower.
Overall treatment cost of upper and lower comprehensive traditional metal braces in government hospitals is typically less than $5,000. Financial counselling can be done after you’ve visited an orthodontist to receive a more precise quotation.
Posted by Ren
Hi Dr, I had metal braces done 20 years ago and the procedure was like this – had to wear for about 2 years with monthly tightening of the wires. Then, after braces removal, had to wear retainers for about 6 months. Are the procedure and techniques still the same today? Thanks.
Hi Ren,
Traditional metal braces treatment has not changed very significantly from 20 years ago. Newer material technology allows for gentler wires and lower forces, which may translate to less discomfort experienced during initial stages of treatment. Newer ceramic materials for porcelain braces may also have better resistance to staining and fractures. However, overall treatment duration, fundamental principles of tooth movement, and the need for retainer wear has not changed.
Improvements in computer-aided design and manufacturing, intra-oral scanning and material science have allowed clear aligners to correct more types of malocclusions. Clear aligner treatment does not involve monthly tightening of wires and can be a lot more aesthetically pleasing. However, it demands a higher level of patient compliance in ensuring adequate hours of wear and has its own advantages and limitations.
Even though technology provided us with more choices, the biological principles and the need for an experienced clinician to co-manage the risks remain the same.
Posted by Freddy
My wife is a foreigner staying in Singapore under Long Term Visit Pass Plus (LTVP+). She wants to put on dental braces to correct the alignment of her teeth. I have questions regarding dental braces and theay are as follows:
Kindly advise on the above questions. Thank you.
Hi Freddy,
Here are the answers to your questions:
