Orthodontics goes by a lot of names: braces, fixed braces, wires, aligners. The variation in wording is not cosmetic. It reflects that this is not one treatment but several, and they differ a great deal in what they cost.
The four main types
Labial metal braces. Fixed to the outside of the teeth. This is the traditional method and still the most widely used. It works reliably, and well-made metal brackets are more comfortable than they used to be. The trade-off is appearance, and the friction: the brackets rub against the inside of the lips and cheeks, which is often uncomfortable for the first fortnight and can cause ulcers.
Labial ceramic braces. The same principle, in a translucent ceramic that blends with the tooth. Harder to see, and generally more expensive. Most orthodontists use ceramic on the visible front teeth and metal on the back, where the difference cannot be seen and ceramic adds cost for no benefit.
Self-ligating brackets are a refinement of both: the mechanism holds the wire without separate elastics, which may reduce chairside time for some adjustments, though it does not guarantee fewer appointments or a shorter overall treatment.
Lingual braces. Fixed to the inside of the teeth, so nothing is visible from the front at all. This solves the appearance problem completely, and introduces others. The brackets sit at the back of the mouth where the tongue runs over them, so speech is affected for the first weeks and the tongue gets used to it. Placement is also more demanding, and the brackets are made individually, which makes it one of the more expensive options.
Clear aligners. Removable trays made from flexible transparent material, which sit over the teeth like a thin film and apply pressure to move them. The computer models the intended tooth movements in advance and produces a series of trays, worn in order, with the last tray holding the teeth in their planned final position until retainers are fitted.
Common questions about clear aligners
Am I suitable? In most cases, yes. After around twenty years of development, the indications have widened considerably, and clear aligners now treat many of the same malocclusions fixed braces do. There are still cases where braces remain the better choice, usually involving complex tooth movements.
What is the advantage? Two things. They are close to invisible, which matters to a lot of adults. And they come out, so you can brush properly; a fixed appliance makes cleaning around the brackets and wire genuinely difficult.
Do they take longer? No, not really. Treatment length is broadly comparable, around two to three years for both, and is determined mostly by the complexity of the case and how consistently the aligners are worn. What differs is the number of appointments: aligners usually need fewer reviews, at longer intervals, which is a genuine advantage if you are travelling for treatment and cannot attend every three to four weeks.
What happens at the start
Your first appointment is a full assessment:
- photographs of your face and teeth
- X-rays to show the jaw structure
- a mould of your teeth, taken by biting into impression material
The orthodontist then plans the treatment and goes through the specifics with you: how long it will take, what it will cost, which appliance is proposed, and whether any teeth need to be removed. Teeth are sometimes extracted before braces go on, and a scale and polish or fillings are often done first.
After that preparation, the appliance is fitted, or aligners are issued.
Reviews are typically every month for fixed braces, while aligners usually need less frequent appointments. The wire is changed and tightened at each fixed-brace review. Total treatment runs one to two years for younger patients and more like two to three for adults, because adult teeth tend to move more slowly and the periodontal response differs.
Does it hurt?
Yes, at the start of each adjustment, but it is manageable.
The first few days after the appliance is fitted are often the worst. Teeth feel loose and aching, the roots feel like they are being pushed, and eating is uncomfortable. This settles within about a week. After each adjustment, a similar but shorter ache lasts a day or two.
What matters far more than the discomfort is brushing. With fixed appliances, food collects around the brackets and the wire, and cleaning properly takes real discipline. Patients who are not rigorous about it end up with staining around the brackets and, sometimes, decay.
The cost question
Orthodontics looks expensive until it is spread over two to three years, and then it is a figure most people can plan around.
Two things drive the price: the appliance you choose, and where you have it done. Cost tracks the cost of living in the area quite closely, so the same treatment costs considerably more in a large city than in a smaller one.
Ceramic, lingual and clear aligners all sit above the price of standard metal braces, commonly by a significant margin. Lingual braces are often the most expensive, and clear aligners usually cost more than standard metal braces.
Private clinics charge more than public hospitals for the same work, and the gap is often substantial rather than marginal.
If you are trying to get a sense of a realistic figure, the public orthodontic department of a hospital in your own city can be a useful reference point, though its fees may be subsidised and may not reflect private practice prices.
If you are travelling for braces
Two things need arranging before you commit to treatment abroad.
First, how the reviews will happen. Aligners need far fewer appointments than fixed braces, and that is one of the strongest arguments for travelling for aligner treatment specifically. With fixed braces, agree in advance who will make the adjustments when you are back home, and get that agreed in writing with the treating clinic.
Second, the end of treatment. Retainers are made at the end, and long-term retention is usually needed, often indefinitely. Ask whether the retainer can be made and fitted at home, and make sure you know who will do it before you leave.