Orthodontics

Traditional metal braces are fixed to the teeth and joined by a wire. This is the most versatile approach: it allows movements the other techniques cannot achieve, and it does not depend on your diligence, since nothing comes off.

Clear braces work in exactly the same way, but the brackets are pale ceramic and far less visible. They are somewhat more fragile and call for a little more care at the table.

Clear aligners, of which Invisalign is the best-known brand, are a series of removable appliances that you change at regular intervals. They come out for eating and for brushing, which makes hygiene much simpler. They suit mild to moderate cases.

With aligners, the deciding factor is not the technology, it is the wear time: they need to be worn 20 to 22 hours a day. Worn less, they simply do not work. If you know you will struggle to keep them in, fixed braces will be the better choice, and we will say so.

It begins with a full assessment: X-rays, photographs, and impressions or a scan of the arches. These records show the position of the roots and the state of the bone, and establish what is achievable. A gum problem or active decay is treated before starting, never during.

Duration varies considerably from case to case — from a few months for a limited movement to more than two years for a major correction. You will know the estimate for your own situation, and the cost, before treatment begins.

Age is not a barrier. An adult with healthy gums and bone can be treated; the movements are simply slower than in a teenager.

This is the part of treatment most often underestimated. Once the appliances come off, teeth have a natural tendency to drift back towards where they started. A retainer wire bonded behind the teeth, or a clear retainer worn at night, holds the result.

Retention is worn long term, not for a few months. An orthodontic result achieved and then lost for want of retention is an entirely avoidable outcome. Results vary from person to person depending on the starting condition, oral hygiene and lifestyle. No result can be guaranteed in advance.