Lingual Braces

By Catherine M. Fascilla, D.D.S.

Lingual braces are braces that are bonded behind the teeth. They were first introduced in the United States more than twenty – five years ago by a doctor in Beverly Hills. They gained instant popularity because they appealed to the patient that wanted straight teeth but did not want their braces to show. Many doctors tried the lingual braces but found them difficult to use and were not satisfied with the results they were getting. Patients were not pleased either because the large bulky brackets interfered with speech and caused tongue irritation. As a result, most orthodontists in the U.S. stopped offering them to their patients.

Until recently, aesthetic orthodontics offered either clear ceramic braces or the Invisalign aligner system. While each of these are good treatment options, each of these has its limitations.

Today’s technological advances have created an appliance system called iBraces. These are lingual braces bonded behind the teeth to meet the cosmetic needs of the patient and the technical demands of the orthodontist. iBraces Appliances are made using CAD/CAM (computer-aided design/computer-aided manufacturing) and robotic technology. After an accurate impression is taken by the orthodontist and set-up instructions are given, Lingualcare, the company that manufactures the iBraces scans the models into a computer. The brackets and wires are completely customized to adapt to the patient’s tooth anatomy and treatment needs. The brackets are delivered in a tray that allows for placement as a unit, as opposed to traditional braces, which are placed on one at a time. A sequence of precise, robotically bent arch wires is fabricated and sent with the brackets. These wires are designed to move the teeth into the ideal position minimizing not only the time spent making adjustments by the doctor but also the length of treatment for the patient.

Because these lingual braces are 100% customized and are low profile, they offer the patient superior fit and comfort. After an adjustment period of 7-10 days, most patients report little or no speech interference or irritation of the tongue. Orthodontists like this system because it allows them to treat a greater range of malocclusion than with the clear plastic aligners of the Invisalign system. There is almost no limitation to the type of patient that can be treated with iBraces as compared with only 25-35% of orthodontic patients with Invisalign. Compliance is critical with Invisalign. It is necessary that the aligners be worn at least 20 hours per day to achieve good results. Because iBraces are fixed in place, compliance is not an issue.

The iBrace System is the next generation of invisible orthodontic treatment. This new method is an excellent alternative for patients who want to straighten their teeth but do not want their braces to show.

The information in this article was provided by Seth Newman, D.D.S., a board certified orthodontist practicing in Roslyn Heights. He can be reached at 516-626-2060;

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