In a blog post today, Prof. Kevin O’Brien reviewed a study that looked at whether Invisalign aligners were more comfortable than conventional fixed braces. This started me thinking about the whole concept of braces and comfort and can you ever be comfortable whilst wearing braces?

Your mouth is a very sensitive area and any orthodontic appliance whether that is a fixed brace, an aligner or other removable appliance or a retainer is going to be felt in some way by the soft tissues in your mouth or your tongue. Let’s start by looking at the various elements of braces and aligners and how they may lead to an increase or decrease of comfort.

Conventional fixed braces usually consist of small brackets attached to the outside or inside (lingual) surfaces of your teeth. These are connected by a wire of varying thickness and stiffness which is usually held in place by some form of elastic O ring or metal wire. The brackets although quite smooth, can rub the inside of your cheeks or irritate your tongue but in my experience, you soon get used to this and spend most of the day with very little awareness you actually have braces. Brackets come in different sizes so presumably the larger the bracket the more the discomfort? Well I guess that depends on where the bracket is placed and the material it is made of but in my experience, I can’t say any one bracket was any more or less comfortable than any other.

If you need elastics to correct any discrepancies or to close or open spaces, you again may find these rubbing and the more taught the elastic, the sharper the edges become and therefore the greater the discomfort. Elastics that go between your top and bottom teeth can be, at times, a little annoying but did I ever find them uncomfortable, no, not really. And as before, after a few minutes you forget about them and any discomfort is soon a distant memory. I know others have found elastics to be a constant source of discomfort so guess I was just lucky (or very insensitive!)

So what about other appliances? Any appliance that takes space in your mouth such as an expander or an Inman Aligner is likely to cause some discomfort as it will get in the way of your tongue and in doing so, may affect your speech and eating. But once you are used to it, could it be considered uncomfortable? From what I have read, people with appliances like these do soon adapt and although they may still have some issues with speech, don’t appear to describe the appliance as uncomfortable.

That brings us on to aligners. I have never had aligners but have been regularly wearing my ‘Essix’ retainers since my braces were removed and if you can accept that there may be some minor differences, can honestly say they have never been uncomfortable. Yes, I have been aware I have been wearing them, yes, I can feel them and they give me a slight lisp but apart from the sensation of tightness, can’t really be described an uncomfortable.

When talking about braces, I wonder whether the description of the feeling of having an appliance is often mistaken for discomfort? You will feel the brackets, wires and elastics on the inside of your cheeks and with your tongue and at times this will lead to soreness which could be described as uncomfortable. This soon heals and then it simply returns to the feeling of having a brace. Teeth moving after an adjustment creates some sensitivity or soreness and again, this soon returns to normal so any discomfort is short lived.

If you consider the amount of time you will be wearing your braces against the time you will be aware of any discomfort, you should be reassured that the vast majority of the time you will either be asleep or have no awareness of your brace as you go about your day to day life. For those times when you are aware, it’s usually due to some short term soreness so can you ever be comfortable wearing a brace? Yes, I think you will be pleasantly surprised.

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