Principles of Operation

Traditional Braces

Traditional braces, or fixed orthodontic appliances, work through a system of metal or ceramic brackets bonded to the surface of the teeth and connected by a metal archwire. This device applies constant pressure to the teeth to gradually move them into their ideal position.

The orthodontist regularly adjusts the tension of the archwire to guide tooth movement. Braces remain fixed to the teeth throughout the treatment duration.

Clear Aligners

Clear aligners are removable plastic trays custom-made to fit the patient's teeth. Each aligner slightly shifts the teeth according to a precise digital treatment plan.

The patient changes aligners every 1 to 2 weeks, with each new tray gradually moving the teeth closer to their final position. Unlike braces, aligners can be removed for eating and brushing teeth.

Pros and Cons

Traditional Braces

Pros:

• Maximum effectiveness for complex cases (severe rotations, open bite issues, etc.)
• No compliance issues since the appliance is fixed
• Precise control of tooth movements by the orthodontist
• Less expensive than aligners for some treatments
• Wider insurance coverage

Cons:

• Highly visible appliance (even with ceramic options)
• Discomfort and irritation of cheeks and lips
• Food restrictions (sticky, hard foods, etc.)
• More challenging dental hygiene to maintain
• Frequent visits to the orthodontist for adjustments

Clear Aligners

Pros:

• Nearly invisible when worn
• Removable for eating and brushing teeth
• More comfortable, with no metal to irritate soft tissues
• Better dental hygiene during treatment
• Fewer visits to the practitioner (sometimes virtual follow-ups)
• Digital visualization of the final result before starting treatment

Cons:

• Limited effectiveness for certain complex cases
• Requires strict discipline (wear aligners 20-22 hours a day)
• Generally more expensive than traditional braces
• Risk of loss or breakage of aligners
• Less suitable for children and young teens

Visual and Aesthetic Comparison

Aesthetic appearance is often one of the main motivations for choosing between braces and aligners. Here's how they compare:

Appearance of Traditional Braces

Standard metal braces are the most visible, with their stainless steel brackets and colored elastics (which some teenagers enjoy customizing). For a more discreet look, options include:

• Ceramic brackets that match the color of the teeth
• Lingual braces placed on the back of the teeth (completely invisible from the front)

However, even these more discreet options are generally more visible than aligners.

Appearance of Clear Aligners

Aligners are made of very thin transparent plastic that fits snugly over the teeth. At normal conversational distance, they are virtually imperceptible. Some aesthetic considerations:

• Aligners may slightly shine under certain lights
• Dental attachments (small composite bumps matching tooth color) may be required on certain teeth
• Aligners can stain slightly if not cleaned properly

For most adults and professionals concerned about their appearance during treatment, aligners offer a significant aesthetic advantage.

Clinical Effectiveness and Cases Treated

The effectiveness of treatment is a crucial factor in choosing the orthodontic method. Each technology has its strengths and limitations:

Traditional Braces are particularly effective for:

• Correcting severe malocclusions
• Treating open bite issues
• Performing complex tooth movements (significant rotations, extrusions)
• Managing skeletal problems with auxiliary appliances
• Treating patients of all ages, including children

Clear Aligners excel for:

• Correcting mild to moderate crowding
• Closing minor gaps
• Rectifying certain simple occlusion issues
• Treating adult orthodontic cases, especially relapses after previous treatment
• Performing partial treatments or focusing on the aesthetic zone

Aligner technology has significantly advanced in recent years, expanding the range of treatable cases, but some limitations persist. An experienced orthodontist remains the best advisor to determine which method will best suit your specific case.

Comfort and Adjustment Period

Experience with Traditional Braces

The placement of braces is generally painless, but the first few days can be uncomfortable:

• Pain and sensitivity for 3-7 days after placement and each adjustment
• Irritations of cheeks and lips (usually resolved with orthodontic wax)
• Speech adjustment period of a few days
• Pressure sensations during monthly adjustments

Experience with Clear Aligners

Aligners generally offer better overall comfort:

• Gentle pressure when changing aligners (every 7-14 days)
• No irritation of soft tissues (no metal or wire)
• Slight initial lisp that usually disappears after a few days
• Temporary removal of aligners in case of extreme discomfort

A 2023 patient satisfaction study revealed that 78% of aligner users describe their treatment as "comfortable," compared to 45% of traditional brace wearers. However, comfort is subjective and varies significantly from person to person.

Hygiene and Daily Maintenance

Maintenance of Traditional Braces

Braces require special attention to prevent enamel demineralization and cavities:

• Thorough brushing after each meal (3-5 minutes)
• Use of interdental brushes
• Dental floss with special orthodontic threader
• Recommended fluoride mouthwash
• Avoid certain foods: chewing gum, caramel, hard or sticky foods

Maintenance of Clear Aligners

Aligners offer dental hygiene comparable to that without orthodontic treatment:

• Remove aligners for eating and drinking (except cold water)
• Brush teeth before putting aligners back
• Daily cleaning of aligners with specific products or mild soap
• Rinse with cold water after removal
• No food restrictions (since aligners are removed)

From a dental hygiene perspective, aligners offer a significant advantage, allowing normal cleaning of teeth and reducing the risk of stains or demineralization on teeth after treatment.

Treatment Duration

Treatment duration is an important factor to consider when choosing between braces and aligners:

Treatment with Traditional Braces

• Average duration: 18 to 36 months
• Simple cases: 12 to 18 months
• Complex cases: up to 3 years or more
• Appointment frequency: every 4 to 8 weeks

Treatment with Clear Aligners

• Average duration: 12 to 18 months
• Simple cases: 6 to 12 months
• Moderate cases: 12 to 24 months
• Appointment frequency: every 8 to 12 weeks
• Aligner change: every 7 to 14 days

The exact duration depends on many factors: case complexity, patient compliance (especially crucial for aligners), patient age, and individual biological response.

Factors Influencing Duration

Several elements can lengthen or shorten treatment duration:

• Patient discipline: wearing aligners less than 20-22 hours a day can significantly extend treatment
• Complexity of movements: significant rotations, vertical movements
• Growth in adolescent patients
• Adult age: tooth movements are often slower in adults

For some simple to moderate cases in adults, aligners can offer faster results than traditional braces, but this trend reverses for complex cases.

Costs and Reimbursements

Financial considerations play a major role in the decision between braces and aligners. Here's a comparison of average costs in France in 2025:

Cost of Traditional Braces

• Standard metal braces: $2,000 to $4,500 for a complete treatment
• Ceramic braces: $2,500 to $5,000
• Lingual braces (inner face): $4,000 to $9,000

Cost of Clear Aligners

• Aligners in orthodontic offices (like Invisalign): $2,500 to $6,000
• Teledentistry aligners (like SmileDirectClub): $1,500 to $2,500
• Touch-ups and refinements: sometimes included, sometimes charged extra

Possible Reimbursements

In France, coverage varies by age and conditions:

• Patients under 16: Health Insurance covers 70% to 100% of the conventional rate for traditional braces only
• Patients over 16: No coverage by Health Insurance
• Mutual insurance: Partial reimbursement possible for both types of treatments depending on contracts

Financing Options

To make these treatments more accessible:

• Installment payments offered by most practitioners
• Interest-free payment plans over 12-24 months (depending on providers)
• Loyalty programs for families with multiple treatments

Best Aligner Brands

The clear aligner market has significantly developed in recent years. Here are the main brands available in 2025:

Aligners in Orthodontic Offices

Invisalign

Historical market leader, Invisalign combines proven technology with an international network of certified orthodontists.

• Strengths: Mature technology, extensive practitioner network, treats almost all cases
• Average price: $3,500 - $6,000
• Feature: SmartForce attachment system for complex movements

ClearCorrect

Popular alternative to Invisalign, with a progressive treatment approach.

• Strengths: Thinner material, competitive pricing, American-made
• Average price: $3,000 - $5,000
• Feature: Flexible treatment plans (Flex, Mini, One, Unlimited)

Teledentistry Aligners (Direct-to-Consumer)

SmileDirectClub

Leader in teledentistry solutions, SmileDirectClub offers a fully remote process with the option of in-store appointments.

• Strengths: Affordable price, convenience of remote treatment, virtual follow-up
• Average price: $1,700 - $2,300
• Feature: At-home impression kit or 3D scan in-store

Other Notable Players

• NewSmile: Newcomers offering very competitive prices
• Spark: High-end aligners available only in offices
• YourSmileDirect: European solution in development

Patient Testimonials

Real patient experiences can provide valuable insights:

Conclusion: How to Make Your Choice

The choice between clear aligners and traditional braces depends on several personal factors:

Clear Aligners are ideal if:

• Aesthetic appearance during treatment is a priority for you
• Your case is mild to moderate (minor crowding, small gaps)
• You are disciplined and can commit to wearing aligners 20-22 hours/day
• Budget is not your main concern
• You prefer fewer appointments with the professional

Traditional Braces are recommended if:

• Your case is complex (significant rotations, bite issues)
• You prefer a "no-discipline" solution (no aligners to remove/replace)
• Cost is an important factor (generally cheaper for complex cases)
• You are under 18 years old (possibility of reimbursement)
• You want the most proven orthodontic treatment

Our Final Recommendation

Whichever technology initially attracts you, we recommend:

1. Consulting at least two different orthodontists to get professional opinions
2. Asking to see examples of similar cases to yours treated with both methods
3. Considering your lifestyle and ability to follow instructions (especially crucial for aligners)
4. Checking your insurance or mutual coverage before making your decision

Both methods can deliver excellent results when used for appropriate cases and followed correctly. The key is to choose the one that best matches your personal situation, lifestyle, and priorities.