Cosmetic orthodontic braces Brooklyn, New York, Invisalign, Lingual braces, Ibraces, Invisaline braces, Clear transparent braces  Cosmetic orthodontics:

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Index to help navigate this page

Traditional braces...the "train tracks"  (ancient history up to about 1980)

Clear braces

    SmartClip Clarity clear braces

Invisalign

Lingual braces

    Lingual

     STb

     iBraces  and even better photo documentation of a case started July 12, 2008

Microimplant orthodontic treatment

Self-Ligating braces

    Damon

    Smart-clip straight wire (a "pre-programmed" prescription bracket: a product of 3m Unitek
                    introduced July 4, 2007 into Dr. Rothstein's practice

and now Microimplant Orthodontic

Our patients want/need to /should  know the best instruments orthodontist have to properly deliver treatment personalized for them.
The following "comparison" chart  is intended to help both patients and colleagues aware of  the benefits and disadvantages of different kinds of cosmetic braces. In this manner, the doctor can fashion/tailor  an appropriate "cosmetic" orthodontic treatment: 

[GO TAKE A LOOK AT THE OLD FASHION TRAIN-TRACK BRACES AND THANK YOUR LUCKY STARS YOU WERE BORN AFTER THEY WERE PHASED OUT IN THE MID-80'S]

    OK, NOW GO SEE THE NEW 8TH GENERATION OF LINGUAL BRACKETS THE "STb" (BRACE YOURSELF FOR A MIND-BLOWING EXPERIENCE).

NOW GO SEE THE 7TH GENERATION OF LINGUAL BRACES TO SEE THE CHANGES IN THE PROFILE AND FLATNESS OF THE BRACKETS vS THE STb BRACKET    (see also below information on iBraces)

FINALLY, CAN HAPPINESS BE FOUND IN "CLEAR" BRACES? GO SEE FOR YOURSELF.

Ted Rothstein, DDS, PhD
Specialist in Orthodontics for Adults and Kids since 1973
35 Remsen St.
Brooklyn, NY 11201
718-852-1551; Fax: 852-1894
Email: drted35@aol.com

Dr. Ted's Home Page     Site Additions     Invisalign Info Menu   Orthodontic Jaw Wiring   Arrange a Consultatation    Lingual braces

A  PATIENT'S GUIDE TO UNDERSTANDING THE DIFFERENCES BETWEEN BRACES
 See also Braces and Services in a nutshell.

Let us assume that the orthodontist you choose is capable of expertly providing all the types of braces listed above (the likelihood of that is very slim). Let us assume that the orthodontist is practicing in his own office or with an associate and provides “quality” in a “nice” office. In other words, the office is not a “clinic” like a hospital or some other kind of teaching institution. Now, let us assume you can choose from all three possibilities. Here is a helpful hint: Use  your "Page Down" key to first  see all  the questions that are answered...they are in bold letters.

Special note: In January 2004 Dr. Ted  introduced into his practice the ''Damon System" of modern orthodontic treatment. At present this tested treatment method has been shown to significantly reduce treatment time and discomfort, as well as the number of office visits. Alas, the bracket is not as yet clear-transparent. However, that factor is currently in development. [See the bracket] and then  See the poster Dr. Ted created to inform his patients of a the new choice IN ADDITION to ORTHOCLEAR (introduced 2004), INVISALIGN, LINGUAL and  CLEAR braces: Here is the big question... Would a would-be adult patient be willing  to pay about $200 more for
DAMON (metal showing braces) if they could have their teeth straightened in 25-30 % faster time?? WITH 25%-30%  FEWER VISITS?

What are iBraces?

July 4, 2007  Learn about IBraces:  Dr. Ted becomes certified in Ibraces   on July 3, 2007 by completing the online course for doctors at  www.lingualcare.com.  (See also  http://www.lingualcare.com/doctor/info.php)  and http://www.lingualcare.com/index.php. Ibraces are a unique version of lingual brace  whose virtues rely on the facts that  they are constructed by use of  proprietary software digital imagery; thus uniquely adapted to fit to the inside of the individuals teeth resulting in fewer detached braces. Moreover, they have a low profile so as to minimize or eliminate initial speech difficulties and tongue soreness. (See  below STb brackets, even smaller). The pluses for the doctor are that the inventor's laboratory has developed an archwire bending machine which precludes the doctor from having to do the  tedious and difficult work of bending the patient's arch wire himself. The disadvantage  to the doctor and the patient the  cost   ($1500-$2200) ouch. Ibraces have come into  their own  over the past 3-4 years.  [DOCTORS learn how you can become an iBraces certified doctor.] Sept. 1, 2006  STb is the new look and feel in  lingual braces. See the latest innovation in lingual brackets the STb. You dont's see them that's for sure; now  you may not even feel them because the 8th  generation of  lingual brackets are that low and flat. STb REMOVES THE "OUCH" FROM  LINGUAL BRACES.  DOES THE "ST" IN STb STAND FOR  STEALTHY?  [Be on the cutting go see them now].  

What is Microimplant Orthodontics?

In the last 3 years much attention has been paid to this subject as witnessed by an ever increasing number of journal articles and presentations by multiple speakers who have given  a host of presentations on the subject at the international meeting of the American Association of Orthodontist from during 2004, 2005 and just recently in May 2006 in Las Vegas. Like a forest fire burning out of control orthodontists are coming to use them more and more to enable them to move teeth in ways they never could before. It will not be long before the use of the microimplant  (miniscrew, TAD) is being taught and used in every post graduate orthodontic school in the country here and abroad. [Learn more about microimplants].

What are Lingual braces?

            Lingual braces consist of “brackets” which are bonded/glued on to the backside of your teeth and wires that attach to the brackets that allow an orthodontist to move your teeth into straighter positions. [See a picture of lingual braces.]  [See a photograph of Lingual braces 5X normal size]  [Read what patients who wore lingual braces had to say about them.]   This technique was introduced to the Orthodontic profession in 1983. Orthodontist who have expertise are difficult to find because this kind of brace requires much technical skill to master. [See the “official” list of  orthodontists who are members of ALOA (the American Lingual Orthodontists Association). Lingual braces are the orthodontists first choice under certain circumstances and for certain kinds of bite problems [. [Read the list of problems you will encounter with them.]

 What are the problems of Lingual braces:

            They are very expensive [See below].

            Finding an orthodontist who has expertise may be very difficult. [See list.]

            When they are first put on they may impair speech and make your tongue sore for 2—3 weeks.

            Because they are bonded on to the back of the upper front teeth, they sometimes prevent the back teeth from coming together until they are removed (which is why they are so useful to correct deep vertical overbites).

            Frequently, in the last 2-4 months they are replaced with clear transparent braces to rapidly achieve the perfection that braces placed on the front of the teeth can achieve.

            They cannot be used on very short/small lower anterior teeth.

            They must be ordered from the lab which takes 2-3 weeks.

Some may become detached/unglued if you eat crispy, crunch and crusty foods. (must eat a mushy diet).

            The length of the appointment is generally 30 minutes not 15 minutes.
           
            You must have your braces adjusted once each month after which your teeth will be sore for 2-4 days.

            Getting an appointment that suits your schedule may be more difficult.

            A detached bracket stays on the wire and can be very annoying to the tongue (“frantic tongue”) until it is removed and the wire can poke your tongue.

            Just about every emergency needs the skill of the orthodontist.

            The overall length of treatment time can take 3-5 months longer.

            Sometimes during treatment a temporary space will appear in your front teeth which would be largely ignore if you were showing clear braces on your front teeth.

What are the benefits of Lingual braces:

            Your natural teeth show all the time. The braces cannot be seen. No one need ever know that you are having orthodontic treatment.

            They are very effective in cases where you have very crowded teeth and a “deep vertical overbite.”

            You can have lingual braces on top and a different kind of brace on the bottom.

What is Invisalign (Invisaline)?

            Invisalign is a “revolutionary”  new way of straightening teeth without using brackets or wire.  See Dr. Ted Video 3(2703kb).  Invisalign was introduced by  “Invisalign Technology in 1988.  The “Aligner” is clear, transparent, and removable in an instant. The aligners are made from a single impression of your upper and lower teeth. It takes between 10 and 25 aligners in sequential order (a new one every two weeks until your teeth are straight) to complete treatment. [See a picture of an aligner]   [See another picture] [Read what patients had to say about their treatment with Invisalign.]   [Read the list problems you will have them.]  [See our nomination for the Invisalign poster child: Jill Nicolini]

What are the problems of Invisalign (Invisaline) braces:

            They have limited use: In general, your problem must be one in which your teeth are “mild-moderately spaced or “mild-moderately” crowded. If teeth are “very”  crowded or “very” spaced or “very rotated” Invisalign is not a choice.

Even if your teeth have a problem that fits for Invisalign treatment, if you do not have your 12 year molars your case will generally not be accepted by the company.

They provide the least amount of overall control over the corrective movements of individual teeth: In-out, up-down, right-left, twist (two kinds).

They will cost at least $1,800-$2,400 more than Clear transparent braces.

The laboratory makes them and presently (as of 4/8/02) it takes 4-6 weeks before they arrive once they are ordered.

They cannot be used in cases where 2-4 teeth need to be removed. 

            If the first aligner does not fit right, the entire set of them may need to be remade (4-6 weeks wait).

            Sometimes  tooth-colored  “attachments” ("small raised bumps") need to be added to some (2-8) of  the teeth for the aligners to be most effective in moving the teeth in the right direction.

            The orthodontist must plan ahead every movement of the teeth at the inception/design of the case.  There is no room for error.  Any errors that may arise may require intervention with  typical braces to correct.  A doctor who is not an orthodontist specialist may be unable to complete the case to the rigorous standards that an orthodontist can.

            It has now been reported to me that at least one patient may have experienced an allergic reaction to the material that the "aligners" are made of (read her letter). (Patients are sometimes allergic to the Nickel in stainless steel braces.) 

The clear transparent shell ("Aligner") that covers and moves the teeth. In this photo the aligner is on the top teeth only.	Ditto.

What are the benefits of Orthoclear (formerly Invisalign):

            They are very comfortable, almost totally invisible,  and removable.

            They are very easy to put on and take off.

            They can be used in cases where only one lower front tooth needs to be removed.

            You need not have your braces adjusted once each month and teeth soreness is minimal.

            There are no brackets to become detached so there are no dietary restrictions at all.

            If your case is one of mild-moderate crowding or spacing, the chance of ending up with a good result is excellent.

            Appointments are fewer, over all, shorter (5-10 minutes), and spaced at greater intervals 5-7 weeks.

            There are no “emergencies”: no detached brackets and no wires to poke you.

            If an "aligner" is lost it can be reproduced at Align Technology with comparative ease at minimal or no cost.
 

What are Clear transparent braces:

            Clear Transparent braces consist of “brackets” which are bonded/glued on to the front side of your teeth. They are made of a variety of hard, clear, and transparent (like cellophane) materials. Similar to lingual braces, wires need to be attached to the brackets that allow an orthodontist to move your teeth into straighter positions. See a picture of Sabrina's clear transparent braces just below.  Most often the wires are silver-colored, however orthodontists can provide “tooth-colored” wire.  Clear braces are a substitute for metal braces which an orthodontist can offer  would-be patients who want the very best looking braces available at an “affordable “cost and who would refuse to have braces it all if they were made of metal. [Read the problems you will encounter with them.]

What are the problems of clear transparent braces:

            They may be more easily detached if you eat crispy, crunch or crusty foods.

            They are bonded on to the front of your teeth.

            They “show” some.

            Certain kinds may be very difficult and sometimes uncomfortable to remove.

            The adhesive that is used to bond them on may become a bit straw-colored over a long period of time(17-25 months)

            Some of them can chip, deteriorate, or wear down and need to be replaced.

             You must have your braces adjusted once each month after which your teeth will be sore for 2-4 days.

            Some of them loose their strength toward the end of a long treatment and either need to be replaced or changed to metal to accomplish the final movements of the roots of the teeth.

Sabrina Brown is a professional hair stylist and make up artist: 718 638 3775...She is wearing clear braces and tooth-colored wire.	Joseph Nemeth 1//2/03

What are the benefits of clear transparent braces:

            They are the orthodontist’s most commonly used instrument with best overall control over the corrective movements of individual teeth: In-out, up-down, right-left, twist (two kinds).

            They are the least expensive of all the braces.  Most orthodontists (not Dr.Ted) offer them at a surcharge that varies from ($200-$700) over and above the cost of standard metal braces.       

Adolescents and teenagers accept them happily.

Emergencies are generally easier to take care of removing detached brackets and cutting off poking wires.

The patient/parent can take care of most emergencies at home with a wire cutter.

If you are away and have an emergency any orthodontist can take care of it.

Clear transparent braces on the “front faces” of the teeth can be used to take care of almost any problem of crooked teeth.

In general:

            Cost:

Lingual braces range in cost from $8,500-$11,800

            Invisalign: $5,500-$7,800

            Clear braces (with tooth –colored wire): $4,500-$5,800

            How much do braces cost the orthodontist

                        Lingual: $400 -$500  for 12 upper teeth and 12 lower teeth

                        Invisalign:  $1800 to treat the upper and lower teeth

                        Clear  transparent:  $75 - $250 for 12/12

            How to find an orthodontist who does:

                        Lingual [List American Lingual Orthodontic Association]

                        Clear transparent [See photos of Dr. Ted's patients with clear braces]

           Overall comfort:

                        Invisalign most comfortable

                        Clear transparent: Moderately uncomfortable

                        Lingual : most uncomfortable to the tongue especially when placed on the lower teeth

            Likelihood of affecting speech:

                        Lingual: most for 10 20 days

                        Invisalign: slight probability for 5-10 days

                        Clear transparent: Least likely

The number of times you must visit the office:

If no teeth need to be removed:

                        Lingual:  17-20 office visits

                        Clear Transparent: 14-18

Invisalign: 11-14

If 2-4 teeth need to be removed

Lingual:  22-26

Clear Transparent: 18-24

Invisalign: (can be used when treatment requires that
only one lower front teeth need to be removed.) 14-18

The average amount of time you must stay seated in the dental chair
 at each visit to the orthodontist

            Lingual:  30 minutes

            Clear transparent: 15 minutes

            Invisalign: 5-10

Overall “average” treatment time in months:

            Lingual: No teeth removed: 17-22 months. Teeth removed 24-28

            Clear Transparent: 14-18 months.  Teeth removed 23-26 months

            Invisalign:  12-14 months

Removability (ease):

            Invisalign: in an instant

            Clear transparent: To remove only the wire: less than one minute
            To remove the wire and 12 brackets 3-4 minutes
            To remove the wire and 12 brackets and the left over
            adhesive: 6-10 minutes
            To remove the wire, 12 brackets, adhesive, and polish teeth
            10-15 minutes

            Lingual:  Same as clear

Removability discomfort:

            Invisalign: No discomfort at all

            Clear transparent:  If 10 is very uncomfortable then 3-5

            Lingual: If 10 is very uncomfortable then 3-5

Which technique controls teeth movements the most

            Clear transparent …the most

            Lingual…the next most

            Invisalign…the least

Which technique is hardest for the orthodontist to treat with

            Lingual by far is the hardest

            Clear transparent is moderately hard

            Invisalign by far the easiest

Which technique requires the most initial planning

            Invisalign the most

            Lingual and Clear the same

Which kind of braces are the easiest for the orthodontist to put on?

            Lingual: takes more about an hour to put the braces on  (brackets and an arch wire on 12 teeth)

            Clear transparent takes about 30 minutes to put on (brackets and an arch wire on 12 teeth)

            Which problems are "best" for each technique?
             "best" means the treatment goals are reached with the fewest problems in the the shortest amount of time.  [See the common orthodontic problems]
                       Lingual:
                            Deep "vertical" overbite.
                            Moderate- severe crowding where teeth do not need to be removed.
                            Mild-moderate cases of teeth show spaces.
                            Cases where the front teeth are very crowded and lean forward and go past the lips.
                     
                        Invisalign: (The 12 year molars must be present)
                            Cases where the corrections require closing "mild-moderate" spaces between the teeth.
                            Cases where the patient complains of mild-moderate "crowding" of teeth
                            Most cases where it is reasonable to remove one lower front tooth.
                                                          
                       Clear transparent:
                            Moderate to severe cases of spaced or crowded teeth.
                            Cases where 2 upper or 2 upper and 2 lower teeth need to be removed.
                            Cases where the teeth are severely rotated/twisted.

Which braces are best for kids children?
            Boys 12-13, and girls 11-12 nowadays are thankful that clear braces are available to them at no additional charges. My experience is that before the ages of "self-consciousness, B12-13 and G 11-12"  "durable" metal braces are the best...especially for boys who tend to indulge in activities that cause the braces to become "detached" from the teeth leading to additional surcharges for rebonding the braces back on to the teeth.

Which braces are  best for adults?
            Adults may choose according to the specifics of their problem and their budgetary limitations. One combination that I find is commonly chosen is lingual upper braces with clear transparent lower braces. Another more frequently occurring combination is Invisalign upper and clear lower.  Seasoned orthodontists should take into account the kinds of braces the patient want as well as what the patients needs and can afford.

Who should choose lingual braces?
        Since lingual braces are the most expensive, those patients who can afford them and whose case profile includes those characteristics listed above. Also patients who prefer to have nothing cover their natural teeth or refuse to have brackets added to the outside of their teeth and patients who are in the public eye:  excellent for actors and actresses, models,  public speakers and above all those persons who are very shy and self conscious or who come face to face with a variety of different people in their
daily work lives, such as in interviewer.

Who should choose clear transparent?
        Those patients who prefer the most affordable braces with the widest applicability. Clear transparent braces the general all-purpose tool of the orthodontist.

                        Who should choose Invisalign?
                                Those patients whose problems fit the criteria for case selection (see above) and who are able to
                                pay an additional fee to cover the cost of having Align Technology manufacture them. Invisalign
                               (now sometimes known as Pop Out braces) is excellent for actors and actresses, models,
                               public speakers and above all those persons who are very shy and self conscious.

What is the SmartClip straight wire orthodontic system?

                    DR. TED PROUDLY INTRODUCES THE SMARTCLIP-STRAIGHT WIRE orthodontic system into his practice. See
                   SmartClip™ Self-Ligating Appliance System Patient Video Macromedia Flash, 6.6mb  [click on "Interactive media"]

                    Click Here to see powerful SmartClip™ Self-Ligating Appliance System CASE STUDIES

                    In clear and transparent: see Clarity™ Metal-Reinforced Ceramic Brackets

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