#4 AN ADULT CHOICE
Much has been said about the oral health benefits of a well-aligned set of teeth. For most patients, however, the primary reason to seek orthodontic treatment is to be able to smile with confidence, says DR LIM HONG MENG of Mount Elizabeth Orthodontic Clinic.
That’s especially true for adults. Many of those seeking orthodontic treatment now are professionals with busy careers; others are homemakers who have more time for themselves now that their kids are older. In fact, according to Dr Lim, many parents embark on orthodontic treatment after their kids have started theirs.
“Top of the list now is treatment with removable clear aligners,” he says, “pioneered and popularised by Invisalign. For fixed braces, the more aesthetic options are, firstly, ceramic braces, and, secondly, lingual or invisible braces bonded on to the inside surface of teeth. Lingual braces are offered by only a few orthodontists.”
Removable aligners or fixed braces?
“Given a choice,” says Dr Lim, “most adult patients will choose the removable clear aligners over fixed braces.” That comes as no surprise. But there are various important factors that must be considered here.
First is compliance and discipline. Ask yourself: am I disciplined enough to wear my removable liners for 20 to 22 hours daily for as long as it takes? If not, lingual braces may be the better option. Being able to remove the aligners at will is both an advantage and disadvantage, explains Dr Lim. “Tooth movement requires a sustained and directed force to result in cellular changes that produce bone remodelling.”
Second is the complexity of the malocclusion. Though Invisalign has been improved over the past two decades to the point where it can now be used to treat more complex cases, he says, patients with more complex malocclusion must be prepared to have a longer treatment duration and may need to end the treatment with a short phase of fixed braces.
A third factor is the patient’s expectations. For someone who is very particular, right down to the slightest tilt of a tooth, treatment might take longer and involve a number of additional “refinement aligners”. Again, a short phase of ceramic or lingual braces towards the end of treatment might be necessary to achieve the desired outcome.
Finally, there’s the dentist’s preference. “Some dentists prefer and offer only aligner treatment or fixed braces,” notes Dr Lim. “However, those who can offer both options should be able to provide you with a balanced opinion on what is the most suitable option.”
In the end, aligner treatment is still not able to replace fixed braces entirely, especially for children and in more complex malocclusions, he concludes. “But for adult patients it can be an alternative to not having any treatment at all.”