Braces behind the teeth

definition

Orthodontics continues to develop and tries to adapt to the aesthetic requirements of the patient. The internal braces or lingual technique is an innovative form of orthodontic therapy that appears invisible to outsiders. Individually adapted brackets are attached to the inner surface of the teeth so that the wire also lies behind the row of teeth and forms the teeth.

Especially with adult patients, the lingual technique is a popular variant to integrate an unnoticed therapy into their everyday life without the environment seeing anything of it. The lingual technique is a highly aesthetic therapy option that is rarely used in children and adolescents, as it is a private benefit from the health insurance company.

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Indications for braces behind the teeth

In general, braces behind the teeth have the same indications as external appliances and the results of both therapeutic approaches are the same. It differs in that the lingual technique is a highly aesthetic form of therapy which, through the positioning of the brackets, makes the therapy almost invisible to the environment. For patients who are in public, for example, the lingual technique is the perfect option for doing orthodontic work.

It should also be noted that language disorders can develop during the acclimatization period (6-12 weeks). In general, this form of therapy is particularly popular with adolescents and adults. Tooth misalignments such as a rotation of the teeth or a tilting of the tooth roots can be regulated by the lingual technique. Movement of the entire tooth body is also possible thanks to the internal braces. Therefore, there are hardly any cases that a lingual technique does not indicate.

What is the cost of braces behind the teeth?

The costs for the lingual technique are much higher than for external braces. In general, the health insurance company only pays for orthodontic treatments in childhood and adolescence; adult treatments are completely private. It should be noted that the health insurance company only provides basic care, other materials for the brackets and other techniques are not worn. As a rule, a cost increase of 30% to 100% must be expected, which means a price range of 8,000 - 16,000 euros, since the process and the time span are much more complex and longer.

Furthermore, this technique is only offered to orthodontists with certain training and a lot of experience, as it is much more complicated to plan and it is difficult to attach the appliance. These factors explain the difference in costs in order to achieve the planned dental situation. In general, it must be individually weighed whether the therapy, which is invisible to the environment, justifies the massively higher expenditure of time and money.

Wearing time

The length of time that braces are worn using the lingual technique cannot be compared to external braces, as they always last much longer. The reason for this is the more complicated treatment path. The application depends on the individual severity of the situation and position of the teeth and can vary widely. In general, a minimum period of use of around one year must be expected, which can, however, be considerably longer.

It is also possible that after the therapy with the lingual technique has been completed, a subsequent therapy with splints must be followed in order to achieve the result planned in advance. After the therapy goal has been achieved, a retainer is inserted after removing all brackets and splints. to maintain the position and prevent the teeth from migrating back to their original position.

Read more on the topic: Occlusion therapy

lisp

Because the individual brackets are attached to the inner surfaces of the teeth in the lingual technique, the original space of the tongue is reduced and thus restricted. In many cases, this requires getting used to, as the sound formation can also change. At first, those affected develop lisp, which, however, occurs very quickly after a short period of acclimatization and a few speaking exercises. If the patient is difficult to get used to the internal braces, a short speech therapy treatment may be necessary, which, however, quickly achieves the desired success. Pronunciation can be restricted for the first 6-12 weeks.

material

Internal braces are available in different materials. They are made to measure, as they are individually adapted to each tooth, in contrast to the external brackets, which are standard sizes. Common materials are metals such as gold or steel alloys. There are also ceramic brackets, but they are more expensive. Nowadays, the individual brackets can even be manufactured using CAD / CAM software, which enables very quick manufacture. CAD / CAM is a technique that scans the teeth and creates the brackets in three dimensions on the computer. These are milled from a material with the virtually created model. The wires fixed in the brackets are all made of nickel-titanium alloys and are very biocompatible. Only a few allergy cases are known in literature.

How do you clean this type of braces?

In general, internal braces are better cleaned due to their anatomical position, as the tongue constantly unconsciously cleans them. The tongue muscle scrapes and touches the internal braces permanently and thus removes leftovers. Scientific studies have shown that internal braces are better cleaned than external braces. However, it is more difficult for the user to clean the braces because they are difficult to reach. For cleaning, interdental brushes and regular professional teeth cleaning about 1-2 times a year are recommended.

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What is a permanent retainer?

A retainer is an orthodontic wire that is inserted after the straightening treatment has been completed. This wire lies on the inside of the teeth in the front area from canine to canine both in the upper jaw and in the lower jaw and is fastened with a liquid plastic. Functionally, it is there to maintain the position of the teeth after the treatment. This wire must be inserted because teeth always have a tendency to return to their original position, even after orthodontic treatment.

Therefore, the doctrine is to wear the retainer for a lifetime, but it does not represent any restriction. After a short period of getting used to it, it is barely noticeable for the patient. It is advisable to have the retainer checked every six months in order to ensure the optimal fit and function and to quickly notice any loosening of the plastic, as bacteria can multiply at this point without being noticed and as a result caries can form. It is therefore important to clean the retainer well and to have the tartar removed regularly by the orthodontist or dentist so that tooth decay cannot form in the first place. Regular professional teeth cleaning is also recommended.

Pain from the braces inside

The braces on the inside can irritate the tongue by reducing the size of the tongue space. The tongue becomes constricted and can also be painful during the acclimatization period as the wire scrapes the tongue and injures it. The tongue must first get used to the reduced space available. However, these pains and wounds disappear completely after a short period of acclimatization, as the tongue adapts and adapts to the new condition. If you have a very large tongue, the lingual technique is not advisable, as the wearing comfort cannot be adjusted and the pains to get used to it do not go away.