Clear aligners or braces? How we decide

What aligners do well

Mild to moderate crowding, spacing, and teeth that have drifted back after previous orthodontic work. They are removable, so cleaning is normal and nothing is off the menu. For adults who would not accept fixed braces at all, that matters — treatment that happens beats treatment that is theoretically better and declined.

Where fixed braces still win

Large rotations, teeth that need bodily movement through bone, significant bite corrections, and cases where a tooth has to be moved a long way. Brackets are attached, so they work whether or not the patient is disciplined.

That is the real dividing line. Aligners only work while they are in. Twenty to twenty-two hours a day, every day, for the length of treatment. If that is not realistic, aligners will disappoint.

What we look at

We take photographs, X-rays and a scan or impressions, and look at how the teeth meet, not just how they look from the front. A case that appears straightforward from outside can involve a bite problem that changes the plan entirely.

Where a case is complex, we say so and refer to an orthodontist. We do not stretch a case to keep it in house.

Retainers are not optional

Teeth move for the rest of your life. Whichever method straightened them, they will drift back without a retainer. Anyone who tells you otherwise is selling something.

Budget for the retainer as part of the treatment, not as an afterthought.

Talking it through

A consultation is a conversation with photographs, not a commitment. See clear aligners, braces or orthodontics.