Lingual braces: advantages, disadvantages and how they work

Lingual braces are a discreet orthodontic solution that allows teeth to be straightened without visible brackets on the front surfaces of the teeth. Discover how they work, who they are suitable for, and what the treatment involves.

Lingual braces are a type of fixed orthodontic appliance, with brackets attached to the inner surface of the teeth, making them very discreet when speaking and smiling. They can correct various alignment and bite problems, depending on the dentist’s recommendation. 

The main advantages are their aesthetic discretion and the fact that they do not need to be removed daily. 

Limitations include:

• more difficult to keep clean;
• discomfort affecting the tongue;
• possible changes in pronunciation;
• a cost that may be higher than that of traditional fixed braces.

“As it is positioned behind the teeth, the lingual brace is difficult to see when the patient is speaking or smiling. This feature makes it a suitable option for people who want orthodontic treatment that is as discreet as possible,” explains Dr Iana Dilă Luță, a specialist in Orthodontics and Dentofacial Orthopaedics. 

Lingual braces can be used to treat several types of dental and occlusal abnormalities. However, their suitability depends on the complexity of the case, the patient’s anatomical characteristics and the orthodontic system used.

Problems that can be corrected include:

• Crowded or misaligned teeth;
• Spacing between teeth (diastemas and gaps);
• Certain types of malocclusion (reverse, crossbite, open bite, deep bite).

The specialist in Orthodontics and Dentofacial Orthopaedics determines whether the lingual braces can provide the necessary control to correct the identified orthodontic problem. 

The main advantage of lingual braces is their aesthetic discretion, as the brackets are fixed to the inner surface of the teeth. As a fixed appliance, it applies the planned orthodontic forces without the need for the patient to remove and reapply them daily.

The effectiveness of the treatment depends on the orthodontic diagnosis, the system used and the treatment plan drawn up by the dentist, not just on the positioning of the brackets.

Key benefits:

• Aesthetic discretion. The components of the appliance are positioned behind the teeth, making them much less visible during social and professional interactions.
• Continuous action. As a fixed appliance, it works continuously and does not need to be removed or reapplied by the patient.
• Customisation options. Certain lingual systems allow brackets and wires to be tailored to the patient’s dental anatomy, enabling individualised control over tooth movement.
• Correction of a variety of orthodontic problems. Depending on the system used and the dentist’s experience, lingual treatment may be suitable for both alignment problems and certain bite abnormalities.

These advantages must be considered alongside each patient’s individual circumstances, as aesthetic discretion is not the only criterion when choosing a brace. 

Placing the braces on the inner surface of the teeth also involves a few specific considerations that the patient must bear in mind.

In the first few days, the tongue comes into contact with the brackets, which may cause irritation or a foreign body sensation. There may also be temporary changes in pronunciation, particularly for sounds that require the tongue to touch the teeth.

Oral hygiene may be more difficult, as the components of the braces are located in areas that are harder to reach. After fitting and following certain adjustments, temporary tooth sensitivity or discomfort may occur.

Another consideration is the cost, which may be higher than for conventional fixed braces, particularly for systems with customised components. 

Lingual braces, traditional fixed braces and clear aligners are all designed to correct the position of the teeth, but they differ in terms of visibility, how they are used and hygiene requirements. 

*Prices valid at DENT ESTET clinics

The choice of braces should not be based solely on aesthetic considerations. The orthodontic diagnosis, treatment objectives, the complexity of the case and the patient’s lifestyle are equally important.

Find out the differences between invisible braces and traditional braces

In certain situations, lingual braces may also be recommended for adolescents, provided that their dental development and clinical assessment allow for this. 

The duration of treatment varies from patient to patient and cannot be determined solely on the basis of the type of appliance chosen.

Factors influencing the duration include:

• the complexity of the orthodontic problem;
• the condition of the supporting tissues;
• the individual’s biological response.

Adhering to appointments and the dentist’s recommendations helps ensure that treatment proceeds as planned.

A realistic estimate of the duration can be provided following the orthodontic consultation and analysis of the necessary investigations. 

It is important to highlight certain aspects relating to the fitting of lingual braces

Speech and discomfort in the first few days

Initially, some patients may find it difficult to pronounce certain sounds or experience irritation of the tongue.

These symptoms are usually temporary and subside as the patient gets used to the braces. If persistent sores or significant discomfort occur, an assessment by the orthodontist is required.

Diet during treatment

In the first few days after the braces are fitted, soft foods may be easier to eat.

Throughout treatment, it is advisable to avoid very hard or sticky foods, which can damage the brackets or other parts of the braces.

Cutting food into smaller pieces and chewing carefully can help to reduce discomfort.

Recommended foods when wearing braces

Oral hygiene with lingual braces

Oral hygiene requires extra care, as bacterial plaque and food debris can build up around the brackets.

It is important to:

• Careful brushing of all tooth surfaces, including the inner surfaces.
• Using interdental brushes to clean the areas around the brackets.
• Cleaning hard-to-reach areas with the instruments recommended by your dentist.
• Professional cleanings and regular dental check-ups.

Proper oral hygiene helps prevent tooth decay and gum inflammation during orthodontic treatment.

See the Guide to Braces Hygiene

If the brackets cause rubbing or irritation to the tongue, your dentist may recommend the temporary use of orthodontic wax. Orthodontic wax protects the tissues, but does not replace an assessment of any components causing persistent discomfort.

The cost of lingual braces depends on the orthodontic system used, the level of customisation and the complexity of the treatment.

Lingual braces with custom-made brackets may be more expensive than conventional fixed braces, due to the design and manufacturing process.

When assessing the total cost, the duration of treatment, regular check-ups, any additional procedures and the retention phase must also be taken into account.