Conventional orthodontics: braces

Metal or ceramic

The principle is identical; only the bracket material changes. Metal ones are the most robust and the cheapest to replace if one comes off. Ceramic ones, matched to the tooth, are far more discreet but more fragile.

On back teeth, invisible when you smile, metal brackets remain the rule even in aesthetic cases.

Why braces remain the reference

They act in three dimensions on each tooth: rotation, uprighting the root, extrusion, intrusion. An aligner applies overall pressure to the crown; a bonded bracket transmits a precise couple to the root.

For severe crowding, a bite correction, or a case needing extractions, this is the appliance that keeps control.

Hygiene during treatment

This is the only real risk. Brackets trap plaque, and inadequate brushing leaves white demineralisation marks around them — permanent, and visible once the appliance comes off.

• Brush after every meal, interdental brush around each bracket
• Floss with a threader, or a water flosser
• More frequent scaling throughout the treatment
• Avoid very hard and sticky foods, which pull brackets off

Retention

When the appliance comes off, the fibres attaching the tooth to the bone still hold a memory of the original position and tend to pull it back. A wire bonded behind the teeth, a retainer worn at night, or both, hold the result.

That phase runs for several years, sometimes indefinitely at night. Treatment abandoned at this stage gives up part of what it achieved.