The biggest difference would be compliance. I had some clear aligner patients who were like “I’m only going to wear this for 8 hours”. Then I’m like “okay cool, then you’d have to wear that aligner for one month instead of two weeks”. That’s the main difference. Because the tooth doesn’t know what’s pushing it. It’s just like something is pushing it so it’s going to move in the direction. Clear aligners are good at doing some things, like compared to braces. Braces are more precise, and there are zero compliance problems but of course, there are issues with hygiene, comfort. Patients tend to get ulcers very often. I just tell my patients if you’re getting fixed braces, just be prepared to get ulcers. But in the end, it’s not like they’re getting ulcers forever during the treatment, it’s just in the beginning. It’s like when you have a new pair of shoes rubbing you, you get blisters. Then after a while, the blister becomes a callus and then it doesn’t hurt you anymore because the skin there got tougher. It’s the same thing with braces.
And the biggest difference between the two, in our practice at least, would be the price. Because clear aligners are custom-made appliances, so it’s like the difference between you going to buy a shirt off the rack versus you going to a tailor to get something tailored. Clear aligners are like tailored stuff, so they do cost more. Fixed braces are like really cheap, so in the end, fixed braces—it’s not so much the brace itself, but the practitioner using it. I know really good orthodontists and they don’t care what braces you give them, they’re like—they know how to work it in their brain and still get really good results. That’s the main difference I would say is the cost of the appliance and also how long you take to get to the end result because the aligner is a piece of plastic in the end, so it’s not going to be able to push as hard as metal. You would get there in the end, it’s just going to take longer.
Another option would be lingual braces, where the braces are glued on the inside. This requires a separate kit just to do it. However, they do charge a lot because lingual is really a pain to do. It’s very difficult to reach and patients tend to get ulcers because the tongue is just rubbing on the braces all the time, but that is really invisible. It’s even more invisible than Invisalign because it’s totally hidden on the inside.
