Ceramic braces were introduced as an orthodontic option for people looking for a more aesthetically pleasing alternative to stainless steel braces. Clear ceramic braces aren’t as obvious as metal braces.
About a decade ago, I went through a course of adult orthodontics. I decided to A/B test this for myself to find out the real story for my patients and readers, and the results were interesting…
After using ceramic brackets on my upper teeth and metal brackets on my lower teeth, I no longer recommend ceramic braces at all.
Let’s take a deeper look at what this type of braces is for, who might benefit from it, the pros and cons, and the costs to expect.
What are ceramic braces?
Ceramic braces are an orthodontic treatment designed to straighten teeth. They are very similar to traditional metal braces with one major difference: the brackets are made of composite material made to look like ceramic material. Usually, this either looks like clear brackets or tooth-colored brackets.
These types of braces use the same archwires and ligatures (elastic bands) as traditional braces. Unlike lingual braces (but the same as metal braces), ceramic braces are attached to the front side of your teeth.
The length of time this straightening process takes is very similar to metal braces, meaning the treatment time will last around 18-24 months for most patients. An orthodontist or general dentist may place these on pediatric or adult patients.
Braces work by pushing or pulling teeth into a more “functional” position and are intended to correct your bite. Correcting malocclusion (poor bite) will make oral hygiene more effective and may even reduce pain from TMJ.
Benefits of Ceramic Braces
The one main benefit of ceramic braces is aesthetics.
They’re not going to help your teeth move faster, they don’t eliminate any of the concerns associated with metal braces, and they don’t cost less.
That being said, the use of ceramic brackets does truly look less obvious on most people and may help relieve some cosmetic concerns.
There is some evidence that ceramic brackets lead to less accumulation of plaque than metal braces, but the research is very limited.
Cons of Ceramic Braces
In my experience as a dentist and patient with ceramic brackets, I see many drawbacks of this type of braces.
- Removal Procedure: First and foremost, the removal procedure for ceramic braces is alarming, in a word. Unlike metal brackets, which peel off gently, the removal process for ceramic brackets involves a loud popping. I’ve even seen it break off some natural tooth structure, which is definitely not ideal.
- Decalcification: Exactly like metal braces, after your ceramic braces are removed, you’re likely to have white calcifications on your teeth where the brackets were. These are difficult and often impossible to reverse.
- Inflammation & Oral Health: Braces, unlike clear aligners (Invisalign being the most common name), are notorious for causing disruptions in oral health. They’re more likely to cause inflammation, make oral hygiene (brushing, flossing, etc.) more difficult, and even damage the soft tissues inside your mouth. Braces also make you more susceptible to tooth decay, gingivitis, and subsequent progression of gum disease as well as root resorption.
- Teflon Toxicity: Ceramic brackets are a solution to stainless steel brackets, but the same metal wires (archwires) are used during the straightening process. Many archwires are coated with Teflon, which is associated with hormone disruption, thyroid problems, and more.
- Cost: Because this treatment option is considered a “step-up” cosmetically, ceramic braces are more expensive than traditional braces. Insurance companies don’t cover this delta and this can limit your dental insurance’s lifetime limits for orthodontic treatments and leave you paying more overall.
Should you get metal or ceramic braces?
In my opinion, ceramic braces aren’t the right option for most people. Invisalign is more effective with a much more aesthetically pleasing look (minus the cons!), while metal brackets are less likely to damage your teeth during removal and are more cost-effective.
How long does it take for ceramic braces to straighten teeth?
Like metal braces, ceramic braces will take about 18-24 months for the entire treatment process for most people.
This may differ in your particular case, so ask your dentist/orthodontist for a more specific answer.
Costs & Insurance Coverage
Ceramic braces cost about $4,000-$8,000 for total treatment.
This is about $1,000 less, on average, than metal braces. It’s about the same as Invisalign (clear braces) treatment.
Dental insurance companies usually cover orthodontic treatment at 50% with a lifetime (not yearly) maximum of $1,500.
Most of the time, there is an age cap of 18 (meaning they cover 0% of the cost of braces past the age of 18).
Other Types of Braces to Consider
There are 4 basic types of braces:
- Metal braces
- Ceramic braces
- Lingual braces (braces on the back of teeth)
- Clear braces/aligners (Invisalign or ClearCorrect)
This traditional kind of braces can achieve powerful, effective pushing and pulling of teeth. As discussed above, they also cause significant discomfort, make dental hygiene harder to accomplish, and come with other significant risks.
Metal braces are the least expensive type of braces.
As we’ve talked about, the major difference between metal and ceramic braces is aesthetic: the brackets are made of a composite that looks like ceramic material.
Ceramic brackets are also less durable than stainless steel brackets. If you go for this treatment option, it’s recommended you use a mouthguard if you’re involved in sports, physical exercise, or any regular activity that means your mouth moves a lot to protect your braces.
It’s more likely ceramic bracket removal will break off enamel than removing metal brackets. Processes such as laser-aided ceramic bracket debonding seek to lessen this risk.
Some sources report that they straighten faster than metal braces, but there’s little to no clinical evidence to support this.
They are about $1,000 more expensive for total treatment than metal braces.
Lingual braces are metal braces attached to the back, rather than the front, of teeth.
They are more likely than front-facing braces to cause longer-term speech impediments, such as a lisp.
They share characteristics and risks with metal braces and cost significantly more (up to $13,000 for treatment).
Invisalign-style aligners are an incredible alternative to traditional braces, which is why I recommend them often. There are no rubber bands, brackets to remove, Teflon-coated archwires, or many of the other more concerning factors involved in metal, ceramic, or lingual braces.
There’s no disruption in using a toothbrush or toothpaste as you can remove them briefly, as needed. You don’t risk enamel loss during removal, and they’re a much more aesthetically pleasing alternative to even ceramic braces.
Invisalign (or ClearCorrect) will cost about $3,000-$8,000 during treatment with your dentist, which is similar to the cost of ceramic braces. At-home clear aligners (SmileDirect and similar companies) are often less expensive, between $1,500-$3,000.
Q: Is it possible to stain ceramic braces?
To avoid staining ceramic braces, try not to eat many staining foods/beverages and don’t use a whitening toothpaste or other whitening treatments. Smoking will also quickly discolor your brackets, as well as cause major oral health problems. Stay away from cigarettes, all forms of tobacco, vaping, and any smoked THC/marijuana products to protect your oral health.
Q: What is the removal process like for ceramic braces?
- Lindel, I. D., Elter, C., Heuer, W., Heidenblut, T., Stiesch, M., Schwestka-Polly, R., & Demling, A. P. (2011). Comparative analysis of long-term biofilm formation on metal and ceramic brackets. The Angle Orthodontist, 81(5), 907-914. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/21542722
- Azaripour, A., Weusmann, J., Mahmoodi, B., Peppas, D., Gerhold-Ay, A., Van Noorden, C. J. F., & Willershausen, B. (2015). Braces versus Invisalign®: gingival parameters and patients’ satisfaction during treatment: a cross-sectional study. BMC Oral Health, 15(1), 69. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4478712/
- Farronato, G., Maijer, R., Carìa, M. P., Esposito, L., Alberzoni, D., & Cacciatore, G. (2012). The effect of Teflon coating on the resistance to sliding of orthodontic archwires. The European Journal of Orthodontics, 34(4), 410-417. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/21478301
- Fei, C., McLaughlin, J. K., Lipworth, L., & Olsen, J. (2009). Maternal levels of perfluorinated chemicals and subfecundity. Human reproduction, 24(5), 1200-1205. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/19176540
- Melzer, D., Rice, N., Depledge, M. H., Henley, W. E., & Galloway, T. S. (2010). Association between serum perfluorooctanoic acid (PFOA) and thyroid disease in the US National Health and Nutrition Examination Survey. Environmental health perspectives, 118(5), 686-692. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2866686/
- Jena, A. K., Duggal, R., & Mehrotra, A. K. (2007). Physical properties and clinical characteristics of ceramic brackets: a comprehensive review. Trends Biomater Artif Organs, 20(2), 101-15. Full text; https://pdfs.semanticscholar.org/0ad7/99ba830bad98b760f2d3dafbf20309034755.pdf
- Ghazanfari, R., Nokhbatolfoghahaei, H., & Alikhasi, M. (2016). Laser-aided ceramic bracket debonding: a comprehensive review. Journal of lasers in medical sciences, 7(1), 2. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4908986/
- Rai, A. K., Rozario, J. E., & Ganeshkar, S. V. (2014). Comparison of speech performance in labial and lingual orthodontic patients: A prospective study. Dental research journal, 11(6), 663. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4275635/