What are lingual braces?

Braces can be fitted to the inside of the teeth as well as the outside, in order to be invisible. Braces fitted to the inside of the teeth are known as ‘lingual’ braces, those on the outside are known as ‘buccal’ braces.  Lingual braces  work in a very similar way to buccal braces and a good part of the information given for one type will apply to the other. Lingual braces really are invisible and can effectively treat most cases of irregular teeth. However there are some important differences which you must be aware of if you are considering lingual braces. These are explained in the following FAQs

I do not want anyone to know I am wearing braces. Are lingual appliances really invisible?

Lingual appliances are stuck to the inside of the teeth and really are invisible. They are the most effective way of straightening your teeth without anyone knowing that you have braces.

Can everyone have a lingual brace?

Lingual braces can effectively treat most types of problems as long as the teeth and gums are healthy. Lingual braces may not be suitable for people with very short or worn-down teeth, as your teeth are even shorter on the inside of your mouth than the outside and the teeth may not be high enough to provide enough room to stick the brace. For this reason, people in their teens, whose gums would not yet have matured and reached their adult levels, are not suitable for lingual appliances.

What can I eat and drink?

You will find lots of websites and videos giving lists of foods you should and shouldn’t eat. The main issues with eating and drinking are foods that cause tooth decay, which may permanently scar your teeth and breaking your brace by knocking one of the brackets (the metal squares) away from the tooth. In reality these lists are not practical. Everyone knows which foods are bad for the teeth. Sweet and sticky foods, fizzy drinks and other high sugar and/or acidic drinks all damage the teeth. However, it is not what you eat or drink that causes the problem, it is when you take it. The bacteria in your mouth take the first tiny bit of sugar that enters your mouth and convert it to acid, which remains protected in the plaque (the white sticky stuff that forms on your teeth) and eats away your tooth. The maximum amount of acid produced is in the first 20 minutes, so even if you brush your teeth after eating, a lot of damage will have been done. Once you stop eating and the sugar clears, your teeth use the  calcium in your saliva to repair the damage. The worst time to eat sweets is before you sleep, as you produce very little saliva, so the sugar is not swallowed and the teeth cannot repair any damage. Everyone has to eat and it is impossible to avoid all forms of sugar. So in order to keep your teeth healthy, you should remove the plaque from all surfaces of your teeth and starve the bacteria of sugar to ferment, while giving your teeth the maximum time to repair any damage done, in between meals.

• Brush your teeth thoroughly at least once a day. It is better to do it once and well. The less plaque you have, the less acid can be kept up against your teeth.
• Use fluoridated toothpaste and a fluoride mouthwash – fluoride is incorporated into the tooth surface enamel and makes it more difficult for acid to dissolve.
• If you must have a sweet or soft drink, take it with a meal, as dessert. The bacteria will be full of sugar from the meal and cannot use this extra sugar. Also your saliva will wash away the sugar as you produce extra saliva when eating, so it will clear faster.
• Do not snack sugary foods/drinks between meals, you are feeding the bugs.

Similarly, it is not what you eat that breaks the brace, it is how you eat it. The brace is glued on, but has to come off without pulling bits of your teeth with it, so it can’t be stuck on so well that it can stand rough treatment. Knocking one of the brackets with your teeth or a bit of hard food will detach it from the tooth, which will immediately start to go back to its original position. The bracket will have to be replaced, and the tooth brought back into place before treatment can progress, so both the treatment time and the cost will increase. In order to prevent this, you should cut your food in to small, bite-sized pieces, put the food on your back teeth and chew slowly and carefully. You will take a long time to eat your first meal, but this will improve as you get used to it. Listen to this guy, he’s got good advice This one mumbles a bit, but he shows how braces break and why treatment takes longer

Will lingual braces affect my speech?

As lingual braces are stuck on the inside, they will make the tongue sore initially, you will be provided with a special wax to cover up the sharp edges, however your speech may be affected for the first week to ten days. This will certainly improve, however it may be a good idea to avoid any talks, presentations or viva voce examinations for a few weeks after having a lingual brace fitted.

What happens if I break a lingual bracket?

If the bracket is detached and not lost, it can usually be stuck on again, though often it is never as strongly bound to the tooth. If the bracket is lost, then another will have to be ordered from the laboratory and stuck on when it arrives.

Why are lingual braces more expensive than ordinary braces?

There are two main reasons why lingual braces cost more than conventional braces. The first is that, while braces stuck to the outside of your teeth (buccal braces) are assembled and stuck on in the clinic by the orthodontist using stock brackets and wires purchased from a supplier, lingual brackets and each wire have to be custom made for you in a specialised laboratory and shipped to the clinic to be glued on. The other is that these braces are difficult to adjust, so an appointment for a lingual brace is considerably longer than that for a buccal brace.

How do I clean my teeth with lingual braces?

It is easy to clean your brace but you have to be systematic in order to clean all the surfaces of your teeth. Braces trap food and increase the buildup of debris and bacteria, so you need to take a bit of extra care. The toothbrush must not be too big or it will not be able to reach all the corners of your mouth. The bristles should be medium or soft. Never use hard bristles, they will wear away the teeth. Use a pea-sized piece (you don’t need more) of fluoridated toothpaste on the brush. The most important place to brush is between the brace and the gums. Start at the back of your mouth and use small backwards-and-forwards or small circular movements. If you have an electric toothbrush, it will do these movements for you. Clean all the way from one side to the other. Then clean the inside of your teeth the same way. After that

brush the tops or chewing surfaces of your teeth. To clean in between the metal squares (called brackets), use an interproximal toothbrush. This must be of the right size to fit in between, generally 8mm wide. You should floss in order to clean in between the teeth. You will need a floss threader or use Superfloss (floss lengths with a stiff end, to push underneath the brace. It is a good idea to start with your bottom teeth before you mouth fills with saliva and toothpaste foam and then move to the top. Once you’ve finished brushing, rise your mouth with water, take your fluoride mouthwash and move it around your teeth for a minute. If this is the evening/night clean, you should not eat or drink anything after this apart from water. The evening clean is the most important one as most of your mouth’s defences are in your saliva and you produce very little saliva when you are asleep, so it is easy for bacteria to grow in your teeth and mouth. This is a link to a Superfloss video.This is a link to a floss threading video. The techniques are the same for lingual braces.