Lingual Orthodontics: Indications and Advantages

We refer to Lingual Orthodontics when the brackets and arches used to move the dentition are placed on the inner side of the teeth, on the so-called “lingual side” of the teeth, hence the name Lingual Orthodontics.

Nothing is placed on the outside of the teeth, or only some aesthetic buttons or other small attachments that the orthodontist deems necessary to properly complete the case. Because the brackets are “hidden”, this type of orthodontics is also called “invisible”. It is the technique that provides the best esthetics.

Differences between lingual and invisible orthodontics

The term “invisible” in this case should be qualified. Invisible Orthodontics” is commonly called the technique of Orthodontics with aligners, a technique that is also very efficient and that we work with a lot in the clinic. But this term is not entirely correct since aligners are not completely invisible, in addition to the fact that they sometimes require the use of attachments in the anterior areas of the dentition that are somewhat visible. The appropriate term in the case of aligners would be “transparent orthodontics” or “practically invisible orthodontics”. Invisible Orthodontics as such is, as we said in the previous paragraph, Lingual Orthodontics.

Having clarified this slight confusion with the terms, we will now go on to detail some of the differences between the two techniques:

  • Transparent Orthodontics does not use brackets and archwires to place the teeth, but rather aligners (plastic splints) that are changed every approximately 10-14 days, thus moving the teeth progressively.
  • Lingual orthodontics is hardly visible, the brackets are placed internally and externally the patient wears nothing, or practically nothing. The transparent technique, on the other hand, almost always requires the use of so-called “attachments” (small composite beads cemented to the outside of the teeth) so that dental movements are predictable.
  • The planning carried out by the orthodontist in the case of transparent orthodontics is completely digital by means of software. In the case of Lingual Orthodontics we make a set-up (with the desired placement of the teeth) on which our laboratory in Germany carries out the manufacture of the brackets, tubes and arches that we will use to move our teeth, fully adapted to the patient’s dentition and with the arches bent by a robot with maximum precision.
  • In the case of aligners we depend a lot on the patient’s collaboration, while with lingual orthodontics we are not so dependent, fortunately.
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In what cases is Lingual Orthodontics recommended?

  • In patients seeking maximum aesthetics, since no other orthodontic technique is as aesthetically pleasing as this one.
  • In the case of patients who have retained canines for the palatal area, the traction of these teeth with Lingual Orthodontics is quicker and simpler.
  • In patients who have very crowded vestibular (external) sides of the teeth, since in these cases the adhesion of the brackets and/or attachments would be compromised.

What is the advantage of this type of orthodontics?

  • Of course, esthetics. Practically no one will notice that the patient is wearing orthodontics.
  • As they are custom brackets (made to measure for each patient), the placement of the teeth in the desired position is usually faster, more precise and totally personalized for each patient.
  • It avoids the decalcification of the enamel that occurs in cases of patients with external brackets who have very poor hygiene.

Does it require specific care for maintenance?

In general, care is similar to that of traditional vestibular orthodontics, taking into account that, as the brackets are on the inside, the patient may find it difficult at first to place the brush correctly to clean under the brackets. In these cases we like to recommend the use of water irrigators, as well as dental cleanings every 6 months with the brackets in the mouth.

We also strongly recommend not eating very hard foods or resting hard objects (such as pens, lipsticks, etc.) on the teeth to prevent the brackets from becoming detached and also to prevent arch deformation.