The Pros and Cons of Invisalign® vs. Braces

Invisalign®: A Clear Option in Teeth Straightening
“Invisalign uses a series of custom-made, clear aligners which are specially fabricated just for you,” says Joseph Lattinelli, DDS, of New York City and Staten Island, NY. “With the Invisalign system of tooth movement, you can enjoy virtually invisible tooth straightening, while having the ability to remove the aligners to brush and floss your teeth normally.”

“People who are on-the-go and want to look and feel better, especially busy adults, love Invisalign,” adds Brian LeSage, DDS, of Beverly Hills, CA. “The trays are [practically] invisible and, in most case, our patients would like to be bracket-free for esthetic reasons and [for] maintaining healthier gums and mouth.”

• Pro: Invisalign is almost invisible and is removable.

Removable Aligners: Good or Bad?
“Invisalign requires the patient to wear the [aligner] trays throughout the day and remove them when you eat or to brush and floss your teeth,” explains Dr. Lattinelli.

“Approximately every two weeks, you will begin wearing a new set of aligners, advancing you to the next stage of your treatment,” he continues.

With Invisalign, says Jason Ingber, DDS, of Waterford and Pontiac, MI, “patients have complete control, because they decide whether to wear the corrective appliance or not on any given day.”

This is both an advantage and disadvantage, depending on the patient’s dedication to the treatment and observance of usage instructions. Says Dr. LeSage, “Invisalign, [when] one wears the custom clear aligners as directed, will accomplish the results, in most cases. The fact that you take your aligners out when you eat and perform normal oral hygiene is a huge plus.”

But, Dr. Stanley reminds, “the patient will have to put them in his mouth to work. If the patient is not compliant, Invisalign will not work.”

Michael Liberto, DDS, of Mountainside, NJ summarizes, “Aligners are only effective if worn by the patient who has the option of inserting them or not; brackets [of traditional braces] bonded to the patient’s teeth remove that uncertainty.”

• Pro: You can remove Invisalign trays to eat and brush and floss teeth properly.
• Con: You may forget to wear the aligners or choose not to wear them frequently enough because they’re easily removable.

When Invisalign Isn’t the Best Option
Lattinelli enthuses about Invisalign: “The entire process is pain-free [and] with various advances in the Invisalign technology, most people are candidates for Invisalign.”

With traditional metal braces, he notes, “you may experience some or all of the following: pain, discomfort, mouth sores or injuries caused by the brace wires, tooth decay (from inadequate brushing and flossing), plaque buildup, tooth discoloration, tooth/bracket breakage or difficulty eating.”

While definitely a great option, Dr. Ingber warns, “Invisalign can only be used for minor tooth movement. It may not be used for more major undertakings to straighten grossly misaligned teeth. Almost anyone who really wants major tooth and/or occlusal changes made should opt for braces.”

“The results [from braces] are dictated by the orthodontists and the treatment speed or accuracy can be changed at any time,” Ingber concludes.

Elizabeth Lowery, DDS, an AACD member dentist in Austin, TX adds, “The main disadvantages of Invisalign are that it can take a little longer to achieve the same result that you would achieve with traditional braces and that some complex cases can’t be ideally treated with Invisalign.”

Occasionally, even when Invisalign appears to be the right choice, results aren’t optimal. LeSage says, “In some [Invisalign] cases, you may not get the expected results.” But, he clarifies, “a second refinement phase can be performed to get a comfortable, long-term bite and excellent esthetics.”

• Pro: Invisalign is a pain-free treatment option for many patients.
• Con: More serious orthodontic issues may not be addressed by Invisalign.
• Con: Dentists aren’t as in control of the process as with traditional braces.
• Con: Results may take longer to achieve than with braces.
• Con: Patients may need secondary treatments to get expected results.

The Best of Both Worlds? Invisalign and Traditional Braces
Even when Invisalign isn’t recommended as the appropriate first course of action, dentists often find the aligner treatment useful in the completion or maintenance of a procedure or process.

Says LeSage, “Every individual who is considering orthodontics should inquire if they are a good candidate for Invisalign. Many find they are. [He or she also] might be a candidate for a hybrid case, completing part of your orthodontics in brackets and part in Invisalign.”

Dr. Lowery agrees, adding, “Some dentists will recommend Invisalign as an adjunct to cosmetic or restorative treatments, in order to be more conservative in preserving tooth structure and improving the final outcome of a case.”

• Pro: The Invisalign technology may offer a more appealing option after major issues have been resolved with traditional braces.
• Pro: Invisalign can help preserve and maintain cosmetic and restorative dental procedures.

This article was created by the Top Dentists editorial team.