Metal or ceramic braces: how we help you choose

What are braces made of?

Brackets, small squares bonded to the front of each tooth.
An archwire, the thin wire that runs through every bracket and applies the light, steady force that moves teeth.
Ligatures, tiny elastic or wire ties that hold the wire in the bracket. Self-ligating brackets have a built-in clip instead.

Metal and ceramic braces differ only in the bracket. The wire, and the way it moves teeth, is the same.

How are metal braces different?

Metal brackets are stainless steel, an alloy that contains nickel; titanium brackets also exist. They are the smallest and strongest option.

They are visible, though smaller than the brackets most adults remember.
They rarely break.
They suit every kind of tooth movement.

How are ceramic braces different?

Ceramic brackets are made of polycrystalline alumina, a white, slightly translucent ceramic that blends with enamel. A nearly clear "sapphire" version, made of monocrystalline alumina, also exists. Many ceramic brackets have a metal slot inside so the wire slides smoothly.

They are much less noticeable. The wire still shows unless it is coated, and coatings can dull.
They are slightly larger and sit thicker on the tooth.
They can chip, and a chipped bracket is replaced.
Ceramic is harder than enamel. A lower bracket that touches an upper tooth in your bite can wear it, so on some bites we use ceramic on the upper teeth only.

Ceramic itself contains no nickel, but many ceramic brackets have a metal slot and most archwires contain nickel. If you have a nickel allergy, tell us before treatment so the brackets and wires can be chosen around it.

Is one faster than the other?

Not in a way you would notice. Early ceramic brackets added friction and could slow movement slightly; a metal slot largely removed that difference. Treatment time depends on your bite, not on the bracket color.

Is there a difference in care?

The daily routine is the same: brush after meals with a soft brush, clean under the wire with floss threaders, interdental brushes (small brushes made for the gaps between teeth) or a water flosser, and avoid hard, sticky and very chewy food. Ceramic adds one rule: the clear ties stain from coffee, tea, red wine, turmeric and tomato sauce.

How are braces placed?

Diagnosis. An examination, photographs, a digital scan, and X-rays. Decay or gum inflammation is treated first; braces go on healthy teeth only.
Bonding. Each tooth is cleaned and dried, and each bracket is positioned and set with an adhesive hardened by a blue light.
The wire. The first wire is light and flexible; firmer wires follow as the teeth align.

Placement takes one to two hours and needs no numbing. Teeth feel tender for a few days afterward.

Would Invisalign treatment suit me instead?

For many adults and teens, yes. Invisalign treatment moves teeth with a series of removable, nearly invisible trays, each worn for one to two weeks. It needs discipline, 20 to 22 hours a day of wear, and it is not the right tool for every bite. We compare all three options with you on the same records.

At our office the plan is made after full diagnostics, including how the bite and jaw joints work. Dr. Tetri plans and carries out orthodontic treatment himself, whether with aligners or braces.

Read more about Invisalign treatment and braces.

When to call us

Call us if a bracket comes off, a wire pokes your cheek, or a tooth becomes very painful between visits. A loose bracket is not an emergency, but it should be fixed within a few days.

Sources

About the author: Dr. Baruch Tetri, DDS, is a periodontist. He earned his DDS at NYU College of Dentistry in 2006, completed his Certificate in Periodontics in 2009, and is a Diplomate of the American Board of Periodontology.