Lingual Braces: Pros, Cons, Costs and Comparisons

What are Lingual Braces?

When you think of braces, you may think of the visible metal brackets and wires on the outside of the teeth. These are called labial braces. Elastic bands hold the wire in place on the brackets. The wire applies gentle pressure to the teeth, moving them incrementally over 6 months to 3 years.¹

Lingual braces have the same mechanism but are placed behind the teeth instead. Dentists can use computer aided design software (CAD) to fully customize these braces to the person’s mouth instead of using premade brackets.

Lingual braces work the same way as conventional braces but are much less visible. This makes them a popular choice for people who feel self conscious about wearing braces.

What Can Lingual Braces Fix?

Malocclusion refers to teeth that are not positioned correctly in the mouth. In Latin it means ‘bad bite’.² These misalignments can include overbites, underbites, crowded teeth, or protruding teeth.  

Crooked or crowded teeth can make it difficult to clean them effectively. If this is left untreated, it can cause a number of conditions, including:¹

• Abnormal enamel wear 
• Worsened speech 
• Gum disease
• Issues chewing
• Jaw problems
• Tooth decay
• Eventual tooth loss

Who can Wear Lingual Braces?

People who want straight teeth but don’t want to wear traditional braces might be good candidates for lingual braces. These people may feel self conscious or embarrassed about wearing traditional braces.

Because they are fixed to the teeth, you don’t have to worry about losing them, unlike with aligners. 

The best way to find out if you’re a good candidate for lingual braces is to consult an orthodontist. Many orthodontists offer initial consultations at little or no cost.³

Pros and Cons of Lingual Braces

Like any orthodontic treatment, there are advantages and disadvantages of lingual braces:

Pros

• Nearly invisible, as they are fixed to the back of the teeth
• Can correct almost any bite issue
• Can be customized to the person’s specific needs
• Potentially less painful
• No limitations on playing sports or wind instruments

Cons

• May take longer than traditional braces⁵
• Can cause a lisp for longer than conventional braces
• Typically more expensive than other types of braces
• Not offered by every orthodontist, so may be more difficult to find a provider
• Cleaning them can be difficult, as the brackets are closer together than with labial braces
• Must follow strict eating habits 
• White or brown spots or squares can form where the brackets are, although these will not be visible as they’ll be on the inside of the teeth

Are Lingual Braces Comfortable? Do They Give You a Lisp?

Lingual braces can take time to get used to. Your tongue may initially catch against the brackets. Your orthodontist can give you special wax to apply to the areas that rub against the soft tissues inside your mouth to minimize discomfort.

Like all other types of braces, they can cause a dull ache in the teeth as they begin to move the teeth. Over-the-counter (OTC) painkillers, such as ibuprofen or acetaminophen, can usually treat this pain. 

Some people develop a lisp. This should resolve within a few days. Because of this, many dentists recommend scheduling the fitting before a weekend or during  time off of work. This gives time to practice talking with the newly installed braces.

Some studies suggest that getting used to talking with lingual braces can take up to a month, compared to traditional braces, which can cause speech difficulties for a week.⁶ 

Other studies suggest that it can also depend on the type of lingual braces an orthodontist uses.⁷ However, most dentists agree that the more you practice speaking the quicker your lisp will resolve.

How Much Do Lingual Braces Cost?

Lingual braces tend to cost more than other types of braces. This is because they are a relatively new treatment, and the orthodontists who install them must complete special training.

The cost varies depending various factors, including:

• Where you live
• Your orthodontist’s expertise
• Insurance coverage, if and when applicable
• Treatment duration 

Be sure to speak to more than one orthodontist to find the best deal for your needs. Most orthodontists offer payment plans, some without a down payment, and some without interest.⁸ 

Does Insurance Cover Lingual Braces?

With your permission, your orthodontist can check your insurance coverage. Some insurance policies include orthodontic coverage, but most will only cover a portion of the cost. 

Alternatively, if you have either a flexible spending account (FSA) or health savings account (HSA), you can use those funds for orthodontic treatment, according to the American Association of Orthodontists.⁹

Some insurance companies only cover traditional braces and may make you pay the difference out of pocket. This is usually the case if you opt for a more expensive treatment plan, like lingual braces.

Most dental insurance policies will cover some part of the cost of orthodontic treatment for children under 18, as long as the braces are considered medically necessary.

Lingual Braces vs. Other Treatment Options 

According to the Canadian Association of Orthodontists (CAO), more than 4 million people across the United States and Canada are currently receiving orthodontic treatment.¹⁰ Everyone has different orthodontic needs, which is why there are many different types of braces.

Traditional Braces

Conventional metal braces are the most noticeable type of braces, and therefore tend to be the cheapest. They use brackets affixed to the front of the teeth, with a metal archwire running through the brackets. Small rubber bands called elastic ligatures hold the archwire in place .

Like with lingual braces, orthodontists replace the archwire at regular visits The archwire maneuvers the teeth into their proper placement. Because they are fixed in place, they don’t require you to do anything. 

Clear Braces

Unlike metal braces, clear braces have brackets made of a tooth-colored, ceramic material.

Other than their appearance, they are very similar to traditional braces. Clear braces still have brackets and wires, but the bands holding the wire in place are clear or white instead. 

Clear braces are also less obvious than traditional braces. They typically cost slightly more than the traditional braces with metal brackets.

Clear Aligners

These are clear, removable appliances used to straighten teeth. They are made of a plastic material that completely covers the teeth. They are typically worn all the time except for when eating.

Orthodontists create clear aligners by scanning the teeth and using a computer to customize them. Orthodontists recommend changing them every two weeks on average as the bite changes.

Benefits of clear aligners include:

• Virtually invisible
• Diet is not restricted
• Food does not get stuck in any wires, as there are none
• Fewer parts than traditional braces, so there are fewer things that can break or cause complications

Downsides of clear aligners include:

• Usually more expensive than other types of braces
• Not fixed to the teeth, so people might forget to put them back in after eating or may accidentally lose them or throw them away
• Might be slower than braces
• Potential to reverse treatment if you forget to wear them regularly
• Requires placement of a composite material on the teeth 

Summary

Like all types of braces, lingual braces have pros and cons. They are an excellent teeth-straightening choice for people who would prefer to keep their braces subtle.

Lingual braces aren’t the best choice for everyone. Speak to an orthodontist to find out if they’re a good fit for you.