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What to Know About Ceramic Braces

Medically Reviewed by Dan Brennan, MD on April 13, 2021

Many people who wear braces to correct their teeth or jaws usually get them during their teenage years, but more adults are wearing braces too. 

It’s not easy to see ceramic braces from a distance. That’s why some adults choose to wear ceramic braces instead of metal braces, as it makes them feel less self-conscious about wearing braces.  

What are Ceramic Braces?

Ceramic braces were first introduced in 1987. They’re made of aluminum oxide, which, in its most common natural form of corundum, is rated 9/10 on the Mohs scale of mineral hardness, just under diamonds. 

The brackets of braces are glued to the surfaces of the patient’s teeth. Brackets can be made of stainless steel, ceramic, or other materials. An archwire controls the movement of the teeth and connects the brackets and the bands.

Ceramic braces are a popular choice because they’re less noticeable than metal braces. But they do have some disadvantages, which is why some people may choose to go with a combination of ceramic and metal braces. 

Talk to your orthodontist to learn if ceramic braces are suitable for your teeth.

Advantages of Ceramic Braces

Less visible. Ceramic brackets can be clear or tooth-colored. They come in different shades of off-white that can be customized to match your teeth. The archwires that connect the brackets are also available in less obvious shades like white. This makes ceramic braces less visible than metal ones. 

Less allergenic. An allergy to the nickel used in dental appliances like braces is the most common allergic reaction seen in dental practices. This leads to nickel-related contact dermatitis. Several types of metallic alloys are used in orthodontics, and most of these include nickel. For instance, stainless steel alloys can contain about 8% nickel.

Less plaque accumulation. A small study on 20 teens found that those who had ceramic braces had significantly less long-term plaque accumulation on their teeth and brackets than those with metal braces. Plaque is the sticky colorless film that builds up on your teeth and contains bacteria. 

But there is contradictory evidence on this, as some studies have found no difference in plaque accumulation between the two types of braces, while one study found that metal braces had less plaque accumulation. More studies need to be carried out.

Suitable for imaging tests. Metal braces can interfere with magnetic resonance imaging (MRI) scans of the head and neck areas and need to be removed before testing. Ceramic braces are MRI safe and don’t have to be removed. But if the ceramic brackets have any metal parts, like stainless steel slots, they may have to be removed before any imaging scans.

More uses than invisible aligners. Ceramic braces are like conventional metal braces and can be used for various complex dental treatments. Invisible aligners, such as Invisalign and other brands, have some limitations, and are more for those who have minor spacing problems.

Disadvantages of Ceramic Braces

More bulky. Brackets that are made of ceramic may be larger than metal brackets and may be less comfortable for some people.

Easily stained. Some studies have shown that ceramic brackets may stain easily when soaked in solutions such as red wine, coffee, and cola. This evidence was from lab studies and more studies should be done. 

Demineralization of enamel. In early studies, researchers found that, compared to metal braces, ceramic braces were more likely to cause the mineral content in tooth enamel to decrease. But this was a lab test and more studies are needed.

Less durable. Ceramic braces may chip or break. If you regularly play contact sports, you should discuss this with your orthodontist or dentist. Whatever type of braces you end up with, do wear a mouthguard when playing sports. 

Harder to remove. Ceramic brackets can’t flex, which means they’re more likely to break. Fragments of ceramic brackets may accidentally be swallowed or inhaled. Also, removal of these brackets requires more force compared to metal brackets. So it may cause more discomfort. 

The fracturing of ceramic brackets during removal may result in parts remaining stuck on the teeth, which means they have to be removed with dental burs. Metal braces are able to bend more, which means less risk of fracture when being removed.

WebMD Medical Reference

Sources

SOURCES: 

The Angle Orthodontist: “Comparative analysis of long-term biofilm formation on metal and ceramic brackets.”

Chemistry LibreTexts: "Aluminas."

Clinical, Cosmetic and Investigational Dentistry: “Enamel demineralization around metal and ceramic brackets: an in vitro study.”

Dental Press Journal of Orthodontics: “Color stability of ceramic brackets immersed in potentially staining solutions.”

Elekdag-Türk, S. & Yilmaz, H. (2018). “Ceramic Brackets Revisited.” In B. I. Aslan and F. D. Uzuner (Eds.), Current Approaches in Orthodontics. IntechOpen.

IP Indian Journal of Orthodontics and Dentofacial Research: “Clear Aligners.”

Journal of Orthodontic Science: “Allergy and orthodontics.”

Mayo Clinic: “Dental braces.”

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