Metal vs. Ceramic - how did you choose?

[Rangers]

Hi -

Wondering what affected your choice in metal vs. ceramic brackets BESIDES cost? I've had orthos tell me it is $1200 more for ceramic upper and lowers, others say it is $400 more, others say there is NO difference in price. I've had some say I can have ceramic on top AND bottom and others say ceramic ONLY on top and metal on bottom. One point an ortho made was that given the profile size of the ceramic both my top and bottom lips will protrude so if i have metal on bottom it will be more inconspicuous.

I've been told ceramic will slightly slow down my treatment time, others say no difference.

I can't obviously make sense of the price difference, nor change it and I also can't possibly know IF ceramic will take longer then metal - NO ONE can, unless we have a crystal ball.

BUT I know what I see - - - and at my most recent consult, the ligating metal brackets by GAC that I saw that one ortho offers are CONSIDERABLY smaller in actual size (I think we call that footprint) and CONSIDERABLY lower in profile - as in they protrude farther out from the tooth.

The ceramic brackets offered were by Unitek - I am guessing they are called Clarity but I will call to confirm. They are by far the largest ceramic bracket I've seen to date - so for me and my mouth I don't think it would be worth it to get them. They will cause my lip to protrude and I also have concerns with ligs staining - they told me i can come in for changes as often as i like - even every 2 weeks, but i'm just not sure about them.

Anyway - I'm wondering if she offers one of the smallest metal brackets, sure looked that way and they were very smooth and tiny. And the ceramics -well the ortho said she has tried many many kinds - in her residency and in her practice (she has a huge practice with her dad) and she feels these work best.

I still have to confirm which GAC metal bracket she uses - - I know for sure they are ligating and require ligs. She also told me that self ligating brackets are very bulky as well.

Any feedback on how you made your choice is appreciated!

[Candymomof3]

I am happy with my decision to go ceramic on top and metal on bottom. You can not see the bottom unless I point it out as you don't see my bottom teeth when I talk or smile. The ceramics are bigger than the metal though. The metal are very small and compact. The ceramics do seem bulkier and I am unable to close my lips all the way. Doesn't look so bad though. Looks better in pictures and from far away. You can obviously see up close though. I don't know what color my ligs are. He asked what colors I wanted and I shook my head, he said "natural for now?" and I said yes! So far, not too much staining, they are almost a pearl color so doesn't look bad. I still drink my coffee, but I do hold back on dark juices though.
I did not get a quote for metal only, he brought up ceramic top and metal bottom first and it sounded reasonable....$5200 ($4850 after family discount and 7% paying in full discount).

[Rangers]

Hi Candy and thanks!

My quote was $4550 for either metal or ceramic top and metal bottom. I get $1800 from insurance and if I pay in full it is a 5% discount. Or I can take $1800 off the $4550 and pay $2750 upfront or split it up in monthly payments. So far I am pleased with that price quote and I liked the ortho - a little freaked out at the look of their ceramics tho so I might go with the metals. I have a very small mouth - she said the ceramics will push my lip out and will always be visible.

[Candymomof3]

I tend to think though that as my teeth are straightened, and the little overbite I do have goes back...that they will not always show, as they only show slightly now.
I wish my insurance would have paid some though, but they only pay on my kids. On my daughter's they paid $1500 and we paid the rest. It's a lifetime max though so if she needs phase 2 I may add dental to mine instead of my husbands so I can get them to do it again! It's definitly expensive but oh so worth it. I have 3 kids and no doubt that the other 2 will need braces(genes!!!) so we will be paying the orthodontist big money for the next few years. It's so important to me though, that all 3 have beautiful straight teeth, and while it may sound shallow on the outside, my biggest reason is that I know it affected my confidence in school, and even in the military after...I was always quiet, and seemed shy, but the real reason was that I hated to smile or show my teeth---all those years wasted--makes me sad. I was not given the chance for braces when I was younger. I want all 3 of my kids to smile BIG, smile PROUD and never hold back. My daughter blossomed when we got her teeth straight, she was 8 when she got them on and then got them off 2 days before 5th Grade started. what a different child!!! She was loving it, and beamed every day. Anyway, sorry to get off track, but I am so passionate about braces!!!!!!

[Rangers]

I need to read your posts more often - i am not passionate about them, for ME. I think it is great for kids and very important for them to have a healthy bite first and foremost. Straight teeth are great too -especially for cleaning issues, and a nice smile doesn't hurt either.

I have quite a bit of crowding -- my teeth are reasonably straight and i would never agree to the inconvenience and 'look' of braces at my age unless it was necessary. The ortho told me my teeth will continue to migrate in and forwards - and get worse. She said she does not think she can give me a perfectly aligned bite but it will be an improvement.

She said I have a very narrow upper arch - and she will do her best to widen it but there is only so far they can go. I will also need rubber bands, impossible to say how long - she said some adults where them their entire treatment.

She told me maximum treatment time is 18 months but if my teeth move fast it could be shorter, but if shorter all the better. She also said she will NOT keep me in braces for more then 18 months. I never heard that statement before but if I go ahead with this - i like the sound of it!

Sorry to be negative - but i am dreading this entire process. Hopefully it won't be as bad as I fear.

[Candymomof3]

LOL! I know what you mean, believe me---I am only doing this because I have to also!!!! My front tooth will continue to turn in and I am not going to be any more snaggly that I am. I have negatives too---I miss my food, well..I miss enjoying it. It's such a chore to eat now...small bites, taking it slow, having to get it all out of my teeth after....takes the joy out of it for me. I don't feel pretty, or cute, or even close to it...it's taking stabs at my confidence...I just feel like plain jane every day. It's okay though....it'll all be over one day! I can hang in there for that day! I am in for 18 months too, but I tend to think 2 years...just don't want to be disappointed in June 0f next year
My upper teeth are crowded, my canines stick out higher and I have the slight overbight...my bottom are straight as can be---I always wished it was the opposite!! He is using bands eventually, with the possibility ot 2 teeth extracted...but trying not to, as he doesnt want the teeth to go it too much.
When are you getting braced? I was counting the days before, just to get started and get it over with!!! First week is the hardest!

[Rangers]

Hi there - welll as I recall you are WAY younger then me. So KUDOS to you for doing this so much sooner then me. Then again when i was your age my bite was just fine! But the last few years it shifted.

I haven't chosen an ortho yet - so not sure when I will get braced.

I still might chicken out! lol

[Candymomof3]

aww---- do not chicken out...because the time is going to go by anyway, and in 18 months you'll be kicking yourself!!!! I wanted to have perfect teeth by 30, will miss my goal by a couple of years, I will be 32 or 33. I just couldn't do it $$$ before now.
You won't regret it!!

[Zoso]

If you orthodontist knows what he or she is doing, and is happy to use either for your case, then you'll get the same results regardless of the brackets used. So it really comes down to being nothing more than a subjective, personal choice.

One note about ceramics: because of their typical bulk, and because the ceramic is such a hard material, if placed on the lower teeth, they can present some significant risk of chipping the upper front teeth. For this reason, some orthodontists will not place ceramic brackets on the lower teeth.

Any way, my bottom line advice is just to pick whichever you prefer.

[Stephanie]

i've had both.. ceramics the first time, and metal the second time.. Trutfully i would save themoney and get metals.. that is becuase I was comfortable wearing them very shortly after having htem on...

[acmbraces]

In regards to your first question about finding a ligating bracket -- There is no such thing as a "ligating bracket" per se. Self Ligating refers to the mode in which the wire is secured into the bracket. A Non self ligating bracket is the counterpart to a self ligating bracket. That simply means that the clinician must ligate the bracket manually with either a polyurethane module or a stainless steel metal tie. GAC has a wide selection of “traditional” or “non self ligating” brackets available. Omni-Arch, Micro Arch, Ovation, and Mini-Ovation are the most popular examples.

[Rangers]

i've had both.. ceramics the first time, and metal the second time.. Trutfully i would save themoney and get metals.. that is becuase I was comfortable wearing them very shortly after having htem on...

Hi and thanks Stephanie - for me there is no price difference in metal vs. ceramic - with one of the orthos I saw who I particularly liked. She is a part of my dental plan - she charges $4500 for metal or ceramaic and I get $1800 from insurance.

[Rangers]

In regards to your first question about finding a ligating bracket -- There is no such thing as a "ligating bracket" per se. Self Ligating refers to the mode in which the wire is secured into the bracket. A Non self ligating bracket is the counterpart to a self ligating bracket. That simply means that the clinician must ligate the bracket manually with either a polyurethane module or a stainless steel metal tie. GAC has a wide selection of “traditional” or “non self ligating” brackets available. Omni-Arch, Micro Arch, Ovation, and Mini-Ovation are the most popular examples.

Thanks for the explanation on the proper terms to use. You are correct in your list of products by GAC for traditional brackets - she uses GAC Micro Arch.

[Zoso]

They also offer Allure and Mystique - traditionally tied ceramics. I don't think "non self-ligating" is really a term

Rangers - $1800 from insurance is tasty (more than most), and the ortho you are looking at seems to have very reasonably pricing indeed.

[Sunny]

I allowed my ortho to choose the brackets for me, as I'd consulted with many ortho's over a period of 20 years and this was the first person I felt ready to have treatment with. I had six 3M Clarity on my uppers and the rest were InVu metal brackets. The cost was the same with or without the ceramic brackets, so that wasn't a consideration. I found the 3M Clarity to be great brackets, especially since I was self conscious, mostly due to not knowing any other adults who had braces.

Over the next couple of years, I had quite a few brackets moved, to assist with tooth movement, and this has included the top six. I'd gotten over feeling self consicous within a few weeks of treatment beginning, so I was happy to try both InVu and Nu-Edge. I now have one Nu-Edge ceramic bracket and the rest are InVu. I found the ceramic brackets to be smoother, and the smaller Nu-Edge brackets were more pokey ... and still are, if I neglect my hydration.

I now work for my ortho and two other's, who've joined to make a three person practice. One other ortho assistant has braces and she has all Nu-Edge. She says they feel fantastic compared to the metal brackets she wore about eight years ago ... she now understands about retainers for life! In our team photos, it does look as if I'm the only one with braces, as her brackets don't show, plus I think she had a teflon coated white archwire at the time, making them even more difficult to see.

I'm a firm believer in choosing an ortho you trust, as it's the archwire that does the work, and a skilled ortho will get it to do that job, no matter what type of brackets they use.

The media can be confusing with 'promises' of this and that, but without these sites, we'd find the WWW a tad boring. It's about using the information available wisely and remembering that if someone is advertising a product to encourage you to use it or buy it ... then they won't be telling you anything that might turn you against that product.

[Rangers]

Thanks Sunny. So both Invu and NuEdge are ceramic right? Yet a smaller NuEdge bracket was more pokey? Or is that because it was metal? I am a bit confused.

The ortho I saw last April when I almost got my braces used Invu ceramics - they looked to me to be very similar to the 3M Clarity brackets I saw the other night at my consult. When you had the metal invu's on the bottom did they feel smaller and more comfy then the top Invu ceramics?

I know I need to compare apples to apples and the metal brackets the ortho I saw uses are by GAC, but I am just curious. If I opt to go with this ortho I still need to make a choice as to whether i go with ceramic on top and metal on bottom or all metal. I go back and forth between which i think will be easier for me (staining, profile of bracket based on the SIZE of my mouth and lips, etc.)

Thanks for all your feedback!

[Zoso]

Now I thought that Nu-Edge are all cobalt-chromium (nickel-free) metal bracket. Don't see reference to a Nu-Edge ceramic on their site? And they sell kits to bond a mixture of Nu-Edge and InVu. I think you transposed your bracket names, Sunny. (Although the statementthat the Nu-Edge are the smaller and more pokey fits with them being the metal brackets)

[Sunny]

Ranger I apologise if I confused the bracket names ... sadly I seem to be doing a bit of this since my hubby's health has deteriorated further.

InVu are the ceramic brackets and Nu-Edge the metal ones. Here's the website! The footprint of InVu is smaller than the 3M Clarity, but I found the 3M Clarity easier to get used to, as the bracket leans back towards the tooth, making them even smoother. I think this is a reason why the Clarity is still so popular.

About the staining ... this can be annoying if you want to use the clear, tooth coloured and most light shades of ligs. Where I work, we also offer teflon coated wire ties that are white and they look great with ceramic brackets. I think the plain wire ties do also, and as long as you don't eat too many foods that stain 'yellow', the silver ligs are quite discreet with ceramic. Many of our professional adult clients have wire ties and I've found with practise they're nearly as fast to remove and replace as ligs. It's a bit different if we're using wire ties to apply pressure in a certain way to have the archwire engage differently in the bracket slot ... then the orthodontist ties the wire tie, as that's a skill they qualify for. We also allow for appointments to have ligs changed between adjustments. These are short appointments where the client does not see the orthodontist, but has a few minutes to get fresh ligatures. This happens with clients who like the light colours, as some shades can stain easily compared to others.

[Rangers]

Thanks so much Sunny!!! It's great to have you on here as it is clear you are a great source of knowledge and have learned SO much from the orthos you work with!! Too bad I can't get my treatment at your office!!

Don't worry about the typo with the Invu vs. Clarity - I knew what you meant!

I hope we can remain in touch as time goes on!

All the best - Rangers

[Zoso]

One point to bear in mind and clarify up front, if you want to have wire ties instead of ligatures, is whether your ortho is willing to do this, as some do reserve this for clinical not cosmetic need.

Teflon coated ties are nice, but I did read once (can't speak to the veracity) that they are sometimes not suitable, as the teflon can make it hard to have them apply the necessary forces in cases where they are being used to apply increased pressure. Why? Teflon's slick - it's what is used for non-stick coatings in cookware, and is a component of some of those rain-proofing prays you can get for shoes - I once used such a spray forgetting to remove the laces and they became quite a nuisance to keep tied. No joke.

[browneyedguy]

Rangers - I've been lurking on these boards for a long time now and have learned so very much about orthodontia from my own ortho and my brother who is also an ortho but unfortunately not located near me. All Sunny says is right on the money- hang in there, you will find the right ortho for you!! Keep us posted!

[browneyedguy]

In addition I'd say you are VERY VERY wise to do such thorough research in deciding which treatment plan to go with. It does NOT take a rocket scientist to understand what all is involved in orthodontia and having a general understanding of the various approaches. I know of many people who have indeed learned about all treatments available to them and made their decision on which treatment plan based not only on the ortho themselves but also which treatment plan suited their general needs! It is a wise thing to do! In this day and age many of us can learn - just take a look at this board and Arch Wired and see how many people DO indeed make informed decisions on their orthodontic care, and yes the TYPE of braces does and should influence our decision - along with the actual ortho's skills, personality, office hours, location etc!!

You are a wise lady!

[coconut]

In addition I'd say you are VERY VERY wise to do such thorough research in deciding which treatment plan to go with. It does NOT take a rocket scientist to understand what all is involved in orthodontia

I expect that an orthodontist may disagree with you on this. We, as consumers, can certainly learn much from research, but I don't think we can approximate the level of skill and competency that comes from years of training and practice in a specialist field.

and yes the TYPE of braces does and should influence our decision -

If what you mean by the "type of braces" is metal vs ceramic vs lingual, then yes, this can influence one's decision. Whether it should, is debatable.

[mikeg]

I am another who went with ceramic on top and metal on the bottom. When i talk and smile you can't see my bottom teeth anyways... The ceramics look better to me and less BLING BLING than the metal ones. But as others have said, you get so used to them that if I had to do it again, I'd get metals to save some money in this economy

[Rangers]

Thanks for the response Mike! So far the ortho i am leaning towards does not charge more for ceramic - so I can have my choice between the two. I agree in this economy, I'd prefer to save where I can!

Thanks again!

[Rangers]

Thanks for the feedback brown eyed guy.
Yes i am a lady! I think I mentioned it in one of my posts!

[Zoso]

It doesn't take a rocket scientist to understand what is involved in orthodontic treatment - it takes an orthodontist

It's absolutely appropriate to be an informed consumer, and that means choosing a treatment plan that meets our needs. It's no good if it involves extraction and we do not want that, or if it involves headgear or other appliances if we are unwilling to wear these, or if it involves a surgery that we have no means to afford, or ... well, any other number of practical concerns like this. And it's no good if the results that will be reached do not meet our goals for treatment.

But we can run ourselves ragged, and to no useful end, if we get too deeply worried about aspects of the treatment where we can't hope to understand enough to make any genuinenly useful judgement. That's a path that could easily lead to a paralysis of indecision, and not moving forward with treatment at all.

I'm sorry if my saying so bends a certain few people out of shape.

[Rangers]

Taking offboard members advice - - the doc who emailed me yesterday please contact me