Orthodontic Digest

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Q&A with Orthodontist Adam Jowett: Part 2 - What’s the Difference Between Aligners, Retainers and Braces?

Award-winning writer Lisa Dawson received so many questions from her followers after announcing she was having treatment with Autograph Aligners, she decided to put them all together in an interview with her Orthodontist, Adam Jowett.

In this three-part blog series, we share the topics covered in that interview.

Part one covered all things aligners. Now, in part two, we answer the million-dollar question; What’s the Difference Between Aligners, Retainers and Braces?

Here, Adam explains the difference in simple terms, sheds light on some of the common misconceptions about clear aligners and orthodontics, and explains how covid-19 has made clear aligners more popular than ever.

Lisa: “What is the difference between a brace, a retainer, and an aligner?”

Adam: Your aligner is a clear, removable gumshield or similar in appearance to a retainer that sits over the teeth. It is transparent and you tend to get like a shine on the teeth but you can’t see the aligner as such.

 Lisa: Retainers are for holding teeth, not for straightening though? They are holding them once you’ve had them straightened right?

Adam: Yes, absolutely right!

Lisa: There are two types of retainer: fixed and removable. Could you explain a bit more about that?

Adam: Removable retainers are similar to what everyone is used to, they are similar to an aligner. You put them in, wear at night time, and they hold the teeth in the right position.

Adam: The other type of retainer is called a fixed retainer. They are little wires glued behind the teeth. Not everyone needs them. Not everyone has them. The little wires glued behind the teeth and they are usually an addition to the removable ones. They are an additional support to help reduce the chance of the teeth going back to where they were before. They are becoming more popular really. They are behind the top and the bottom front teeth. You don’t take them in and out, they are glued on, and you keep them on for as long as you can.

Lisa: So, is a brace the one that is stuck on every tooth?

Adam: A brace; people tend to refer to a brace as a fixed brace. Yes, so “metal train tracks,” are I suppose what people think of as braces. They are glued to the teeth and they have wires, and you change the wires about every 6 weeks. Each wire straightens the teeth a little bit more, and a little bit more again.

Lisa: Does it hurt when they move?

Adam: Fixed braces tend to be associated with a lot of discomfort. It is achy when you have them adjusted and it wears off after a few days. With aligners, because you change them every week, or sometimes a little longer, the discomfort is initially when you fit the aligner in, you get those days when it is a bit achy. Its not painful like sharp pain, its more kind of a bruising; discomfort. It’s not the kind of thing you need to take any paracetamol for. It goes away after a couple of days. Quite often, some people when they’ve got their aligners, say they’ve had up to aligner ten, they will say “it hurt at first, and then it went away, but more recently I’ve noticed it’s a bit tighter on this side. It’s not particularly painful; it’s just because the teeth are moving.

Lisa: Interesting!

Lisa: What are the pros and cons with normal braces - the fixed metal ones?

Adam: Metal braces have been around for forever. They are really efficient, and they are a little bit cheaper than aligners. There are different types: There are fixed metal braces that they tend to use on the NHS orthodontic services. There are also clear versions of them which are exactly the same but they look a bit nicer. They are quite popular with patients who are concerned about aesthetics.

Adam: The advantage of clear ones is they look a lot nicer but they’re really expensive to make. The metal ones, they work really efficiently, they just don’t look very nice; that’s the only disadvantage I suppose. Sometimes they are a bit sharp. It takes a while for the lip to get used to the metal being there, but other than that, they work really really well.

Covid-19 challenges

Adam: One thing that has become important in this recent pandemic, with fixed braces, you need to have them adjusted so you need to come in and see people like me as the orthodontist every 6 weeks to have the wire changed and the colours changed. With Covid around, it’s been more difficult to access those services and it has had an impact on the efficiency of treatment and how long it takes. Whereas with aligners, you have them sent out. So, you get a box with aligners: one to ten, or even more sometimes. And, you change them yourself, so one of the massive advantages is during this pandemic, people with aligners have been able to continue their treatment, whereas it’s kind of paused for people with fixed braces.

Lisa: Yes, that’s really interesting actually.

Adam: So just to summarise …

  • Braces tend to be the fixed ones.
  • The aligner moves the teeth by a sequence of clear “covers” that go over the teeth.
  • The retainer is needed at the end; they don’t move the teeth; they hold the teeth in the right position afterwards.

Adam: So, if you have fixed braces, at the end, you need some retainers, and they are clear covers that go over the teeth; holding the teeth in that corrected position.

If you have Aligners, you still need retainers. Your retainers you hold onto forever. We used to tell people that after 12 months you can stop wearing your retainers, and we had all these people coming back saying, “my teeth have moved”. We now know, because of all the research we have done, that if you want to keep your teeth straight, you need to wear your retainers forever. So, it is a lifelong thing.

Lisa: I wish my dentist had told me that 30 years ago!

Adam: We get that comment a lot!

Watch the full interview on Lisa Dawson’s Highlights page here

Award-winning writer, blogger, creator, presenter, and self-confessed story addict Lisa Dawson is currently undergoing aligner treatment with Autograph Aligners. Follow her on Instagram @ _lisa_dawson_ to see her aligner story in her highlights, featuring the full live Q and A with Orthodontist Adam Jowett at Honesty Dental, Baildon.

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