As a result, the stock-item brackets cannot be used. These brackets must be custom-made by using CAD/CAM. It is necessary to take precise patterns of the lower and upper teeth, digitize them and input them into the CAD/CAM equipment. The lingual braces can be used by both teenagers and adults.

The following steps are involved in lingual braces which have almost the same function as conventional braces worn on the front of the teeth. There may be some complications, however, due to their placement on the lingual side of the teeth. lingual braces:

• Clinical Evaluation – Dr. Shah at Tustin Smile will perform a detailed examination of your teeth in order to determine how severely your teeth are misaligned. Dr. Shah will also review radiographic images and study models of your teeth in order to develop an individualized treatment plan. All of these steps will be taken, before deciding whether lingual braces are the proper course of treatment.
• Making Impressions of your Teeth -your teeth will be cleaned thoroughly before an impression is made. 3-D impressions will then be made of your upper and lower jaw using a special scanner.
• Cast and set-up- The lab technician will develop a cast that is based on these impressions. It will then be modified according to the dentist’s guidance in order to create a “set-up” for your case. It will show a mock-up of what your teeth will look like when they are perfectly aligned.
• Fabrication of Treatment Plan-The next step in the process is to digitize the mock-up dimensions using special 3-D software and input the information into the computer. The specific brackets for each of your  teeth are then custom-designed using computer aided design software.
• Production- The brackets are produced using  computer aided manufacturing (CAM) software (computer aided machining). This design data is  used by numerically controlled (NC) milling machines to make the brackets. The arch wire is prepared through the use of robotic bending under computer control.
• The applicator tray- Once the brackets are fabricated, they are then embedded into an applicator tray. This is  a stent that fits over your teeth perfectly. It keeps the brackets aligned exactly to allow the dentist to perform the bonding procedure. The hardware is then sent to the dentist who attaches the brackets to the teeth. The process involves the following steps.
  • Teeth preparation- The teeth are roughened and thoroughly cleaned to facilitate better bonding.
  • Cement application- The brackets in the applicator tray have cement applied to them.
  • Bonding- The bonding is performed by pressing the applicator tray  precisely against the teeth. The brackets of the lower or upper jaw are then bonded simultaneously.
  • Removal of the tray- Once the cement has hardened, the dentist breaks away the tray. This leaves the brackets securely attached to the teeth. The dentist then scrapes away the excess bonding.
  • The archwire- The final step in the procedure is the placement of the arch wire. No ligatures are needed.

The treatment period with lingual braces ranges between one and three years, depending on the individual case.  The braces are removed after the teeth have been realigned properly. Dr. Shah will then provide you with a fixed or removable retainer. The retainer is necessary in order to consolidate the new alignment. It may be necessary to use the retainer for an additional six months.

Due to the fact that lingual braces have an invisible, inward location, they require special care by the patient.  The following are the key points to keep in mind when caring for your lingual braces:

• Maintain Good oral hygiene- In order to prevent gum disease and tooth decay, it necessary to practice good oral hygiene. You should brush your teeth at twice daily, making sure that you spend at least two minutes evenly on all the teeth.The gum line should be cleaned with a soft toothbrush with rounded bristles the gaps should be cleaned using an inter-dental brush. It is also possible to use an oral irrigation device. You can also ensure excellent oral health by flossing after every meal or at least once daily.
• Protecting Oral Soft Tissues – If the tongue is irritated by the braces, the wax provided at the start of treatment should be used. It should be pasted on the inside of the teeth, especially in very sensitive areas where it hurts.
• Regular Visits – in addition to your regular monthly or weekly appointments for youngsters, children and adolescents who are undergoing orthodontic treatment at Tustin Smile, must also visit us after every six months for prophylaxis and teeth cleaning.
• Diet Management – During your orthodontic treatment, it is essential that you avoid chewy, sticky, and hard foods. This includes raw vegetables and fruit like carrots and apples. These foods can dislodge your brackets.

There are both advantages and disadvantages (and limitations) to the use of lingual braces compared to other types of teeth alignment alternatives.have advantages over other types of teeth alignment apparatuses. The following information is useful input into deciding on the most convenient and affordable orthodontic treatment for your family members.

• Advantages of Lingual Braces
  • Better Esthetics – The main advantage of lingual braces is the they visible by casual observation. They only be seen after careful examination. This is a major advantage from an esthetic perspective.
  • Comparison with Invisalign® and Clear Braces
    • Compared to clear plastic aligners, lingual braces are less visible.  The aligners can be discerned, because they give off a sheen.
    • Better control over individual teeth movement is achieved with lingual braces.

• Disadvantages
  • Potential for Tongue Irritation – Since lingual braces are placed on the inside of the teeth, the braces on the upper teeth can come between the teeth in the lower jaw and those in the upper jaw. The braces on the lower teeth can come into contact with the tongue. This can prevent it from moving freely, irritating it and causing pain when speaking or swallowing.
  • Speech Problems – Since the tongue must touch the teeth to produce certain sounds and the brackets are placed where the tongue used to touch, it can prevent you from making sounds properly.
  • Cleaning care – Since lingual braces are on the inside, they present difficult challenges for proper hygiene and care.
  • Application is complicated – It is difficult to accurately place the brackets behind the teeth, while maintaining limited visibility. It, therefore, requires more care and time. It is necessary for the dentist to have specialized training.
  • Getting used to – Lingual braces require more time to get used to than regular, visible braces.

The cost of lingual braces ranges from $8,000 to $10,000. The prices vary, depending on where you get the braces. This compares with Invisalign® which costs between $4,000 and $7,400 and traditional metallic braces which range from $3,000 to $7,000. Therefore, lingual braces are the most expensive type of dental aids for pediatric teeth alignment.

Although most dental insurance plans do not cover the cost of braces for those over eighteen,  some supplementary plans may be available. Fortunately, the cost of braces is tax deductible, if it is above a certain amount. It is recommended that you research the costs and coverage before deciding on what type of braces to purchase. It is important to determine the percentage of the cost that is covered and the total lifetime maximum. There is considerable variation in the types of coverage that are available. However, the usual policies include 50% coverage with a $1500 lifetime maximum per child.

It is also recommended that you maintain the same insurance plan throughout your entire orthodontic treatment. This is because many types of orthodontic coverage will not cover braces, if they were applied prior to the policy’s effective date. In this case, it would be considered a pre-existing condition and an out-of-pocket expense.

If the braces are considered to be medically necessary and you qualify for Medicaid, they may be covered by Medicaid. It is important to determine the lifetime maximum and the percent coverage. Additional information can be found at http://www.medicaid.gov/.

At Tustin Smile, we offer affordable, high quality orthodontic treatment for residents of Orange County and people living near Tustin. Don’t hesitate to contact us so that we can provide the best treatment options for your child’s teeth straightening needs. See more about orthodontic.