Metal braces are an orthodontic treatment that may help align crooked or overcrowded teeth. Braces also have an important role in improving oral health.

Malocclusion — the misalignment of a person’s teeth and bite — may lead to health problems, such as jaw problems, chewing or speech issues, or gum disease.

Braces help align a person’s teeth and bite. This orthodontic treatment helps teeth gradually move back into the correct position over time.

Other brace treatments have become increasingly popular, including ceramic, lingual, and Invisalign. A person should discuss these options with their orthodontist to determine the best strategy.

This article will explore metal braces, their advantages and disadvantages, and how to care for them to maintain good oral hygiene. It will also discuss the alternatives to metal braces and which treatment may be preferable.

Metal braces are a type of fixed appliance. An orthodontist works specifically with the bite and straightness of teeth. They recommend a dental brace to:

  • correct dental crowding and straighten teeth
  • correct bite so the front and back teeth meet evenly
  • reduce the chance of damage to prominent teeth

Orthodontics can also help in the treatment of other health problems, such as a cleft lip and cleft palate.

An orthodontist will either cement or bond the metal brackets directly to the teeth. A flexible wire fits through slots in the brackets to connect and hold the braces together. The orthodontist will then use small bands, known as ligatures, to hold the wire in place.

The braces apply pressure on the teeth to move and realign. An orthodontist may also tighten the wire to move the teeth and jaw during dental appointments.

They may also cement or bond a metal ring, known as a band, to one of the back teeth to provide anchorage and strength for the braces.

A person may also wear elastic bands between the upper and lower jaw to provide individual tooth realignment and movement during treatment.

Checkups with an orthodontist are usually every 6–8 weeks during the brace treatment to ensure correct alignment.

Read more about what to expect with metal braces.

Before a person considers using metal braces as their dental treatment, there are several advantages and disadvantages to consider.

Efficacy

As they are a fixed appliance metal braces allow for greater control and more precise teeth movement, especially in complex cases.

A 2019 study found that metal braces, in comparison with clear aligners, were more effective in treating teeth rotation, retention after brace removal, and certain types of malocclusions.

Dental health

Another benefit to braces is that they can improve overall oral health.

Misaligned teeth can cause swallowing or chewing issues. It can also make them harder to clean, making plaque buildup more likely and increasing the risk of gum disease.

Materials

The materials in braces are usually strong, and metal braces are highly durable.

In addition, as metal braces use darker materials, they are less likely to become discolored.

Variety

Orthodontic treatment also gives people the option to customize the color of their braces.

This can help people feel more comfortable with their smiles during the treatment.

Duration

Treatment with metal braces can last 1–3 years. After this time, a person will usually need a retainer that holds their teeth in their new positions.

However, this type of brace may not offer the quickest treatment.

Diet

Another disadvantage to metal braces is that a person needs to monitor their diet and oral hygiene more closely.

Eating foods high in sugar may lead to plaque buildup around the metal brackets. This buildup may eventually cause permanent damage or staining to the teeth.

Appearance

Additionally, some people may not like the appearance of braces.

A 2019 study notes that many participants preferred the comfort and aesthetic of clear aligners compared with conventional braces.

Costs

The cost of traditional metal braces ranges from $3,000–$6,000.

A person may be able to cover the cost of braces with health insurance, although this will depend on individual insurance providers. Each U.S. state may also offer varying levels of coverage.

Medicaid covers dental services for all children, referred to as the Early and Periodic Screening, Diagnostic and Treatment benefit.

While most states provide at least emergency dental services for adults, less than half of the states currently provide comprehensive dental care.

Learn more here about the Medicare hub.

Good oral hygiene and a balanced diet are vital when caring for braces.

Adequate brushing with braces is crucial to prevent plaque buildup and oral diseases such as gingivitis.

A person should do the following when they have braces:

  • brush at least three times a day
  • brush at least 1 hour after meals
  • brush above, on, and below the braces

An individual with braces should also clean between their teeth with other suitable tools, such as a floss threader or interdental brushes.

An orthodontist may provide a specialized toothbrush or cleaning tool to clean the teeth adequately.

Additionally, a person should avoid sticky, chewy, or hard foods, as they easily cause damage to the braces. These include:

  • popcorn
  • nuts
  • hard and chewy sweets
  • ice
  • chewing gum
  • whole hard fruits such as apples
  • raw vegetables such as carrots
  • corn
  • hard bread such as rolls or bagels
  • ribs

A person should also cut any hard foods into small, bite-sized pieces. They may also find it more comfortable eating soft food in the first few days after the brace fitting. These foods include:

  • yogurt
  • soft bread
  • pasta
  • cooked or canned fruit
  • mashed fruits and vegetables
  • scrambled eggs

Ceramic braces consist of ceramic material and can be transparent or tooth colored. A person may prefer the choice of ceramic braces over metal braces, as they are less visible.

A small 2020 study involving 20 patients found that ceramic brackets were less likely to detach than metal brackets. Further research notes that ceramic braces cause fewer problems, such as image distortion and signal loss, than metal braces in MRI scans.

However, as they cost between $4,000–$8,000, ceramic braces may be more expensive than metal braces.

Additionally, a 2019 study found that participants with ceramic brackets experienced more enamel demineralization than those with metal brackets. Demineralization occurs when there is a reduction in the hard minerals on the tooth’s surface.

Invisalign, unlike braces, are clear aligners and therefore less noticeable.

Orthodontists do not bond them to the teeth so are removable which resemble mouthguards.

Invisalign uses 3D imaging and mapping software to determine the right amount of force necessary for tooth movement. Following this, the manufacturer produces personalized, plastic-like aligners.

According to the Invisalign website, treatment using this approach usually takes up to 6 months, but in more complex cases, it can take longer. However, the treatment is typically much shorter than the 1–3 years with traditional metal braces and may suit a person who wants a quicker treatment option.

Invisalign treatment costs between $4,000 and $7,400, making it more costly than the most expensive metal braces.

A person undergoing Invisalign treatment must wear the aligners for 1–3 weeks for 22 hours every day before moving to another set of aligners. The option of removing the aligners when necessary may make them a more suitable choice for certain people. However, there is also a risk of the aligners being lost or damaged.

Treatment results using Invisalign may vary. A 2019 study notes that while Invisalign was effective in treating malocclusions, but the results were not as accurate as fixed appliance treatment options such as metal braces.

Lingual braces are similar to traditional metal braces. However, an orthodontist will instead bond the metal brackets to the back of the teeth rather than the front.

Lingual braces are hardly visible, which may be suitable for people wishing not to have noticeable braces. A 2019 study notes that participants chose lingual braces as the most preferred orthodontic treatment.

However, as they sit at the back of the teeth, they are also difficult to clean. This positioning also means that adjustments at checkups take longer.

However, lingual braces are also much more expensive than some treatment options, costing between $8,000–$10,000.

Additionally, a study highlights that lingual brackets may affect speech and increase difficulty in chewing. They are also more uncomfortable than other systems, as the brackets and wires are closest to the tongue.

Another orthodontic treatment option is self-ligating braces. These are similar to metal braces but do not require elastic bands to hold the brackets to the metal wire.

With metal braces, people usually experience pain or discomfort after each adjustment. In contrast, self-ligating braces constantly adjust at a much more steady pace.

This procedure is generally more expensive than metal braces but cheaper than lingual braces.

These appliances can also offer faster treatments than metal braces, are more efficient at moving teeth, and require fewer checkups with the orthodontist.

A 2017 study notes that self-ligating braces accumulate less Streptococcus mutans than metal braces. Streptococcus mutans is a bacterium that has links with teeth decay.

A systematic review notes no significant difference between the efficacy of conventional braces and self-ligating braces.

However, self-ligating braces are not suitable for all types of orthodontic treatment, so a person must consult their dentist before exploring this treatment option.

Braces are an orthodontic treatment option that may help align crowded or crooked teeth. Metal braces are the traditional treatment option to assist in teeth alignment.

However, other orthodontic treatments include ceramic braces, Invisalign, and lingual braces.

A person with braces should ensure that they regularly brush and ensure that they clean the brackets, wires, and each tooth individually. Regular brushing may help prevent oral diseases such as gingivitis and plaque.

Individuals should also monitor their diet to prevent plaque buildup and damage to the braces.

The choice of which braces option a person will be suitable for will depend on several factors, including the level of malocclusion and cost. They should discuss this with their orthodontist, who will advise them on the best option.