Braces vs. Aligners: What’s Best and What’s Changed
Wondering whether braces or clear aligners like Invisalign are the right choice for your child, or even for yourself? In this episode of Not My First Rodeo, Dr. Hicks breaks down the real pros and cons of each option. From cost and comfort to maintenance and results, this is the no-fluff, mom-approved guide you’ve been waiting for. Whether your teen is just getting started or you’re exploring adult orthodontics, tune in for expert advice that’s local, practical, and easy to understand.
Because every great smile starts with the right choice—and a mom who does her research.
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For a transcript of the video, Click Here or read below:
Epic Ortho Moderator: Okay. Braces versus Invisalign, or aligners. I’m here with Dr. Joseph Hicks. This is not his first rodeo. So, Doc, okay, I see this out there — people are asking like, is this one better? Of course, I don’t want my kid to, you know, not take care of his teeth when they have braces, so I’m gonna choose this over this for convenience or quite frankly, what the kid wants. Um, so this is something I would love to hear you break down for me. Um, how’s this changed, you know the deal, this is not your first rodeo. (For sure.) So, what have you seen happen with technology in this whole area of braces versus Invisalign? Like tell me about Invisalign.
Dr. Hicks: Yeah, for sure. So, Jennifer, this is a great topic, uh, because there’s a lot of misconception in the community when it comes to Invisalign, braces. Technology is changing. And not always in a good way, but we do have the advancements with clear aligners. So, let’s kind of talk a little bit about aligners versus braces. So, I get a lot of people coming into the office because of what they may have seen (Yeah, a lot of marketing.) on TV or from friends. A lot of marketing, right? So, uh, they come in wanting aligners because aligners are cool, but there’s a misconception on what aligners can actually accomplish. So, here’s the analogy that I give. When we talk about aligners, we do a scan, which we’ll talk about as we move along. But we do a scan, and we make this hypothetical movement to go from A to Z. Think of it as jumping across a pond in one leap.
Epic Ortho Moderator: Like a simulator?
Dr. Hicks: Kind of, yeah, like a simulator. So, we’re making all these aligners. Let’s say there’s 25, 35 aligners that you have to go through to get across the pond. So, it’s a hypothetical movement. You always, it’s a very tough job to jump across the pond. But think about braces. Braces give you the ability to jump from one lily pad to the next, and at every lily pad, you make a decision on how to get to the next lily pad. So, it’s a bend in the wire. It’s a change in the wire. It’s elastics. You don’t have that ability with aligners. Okay. Now to back up a little bit, aligners have a place in orthodontics. It’s a great product and one that we really love because you have movement, right? You have, uh, change as we get older. So, these minor movements can be accomplished very well with aligners. Better hygiene, you can take ’em out to clean, brush your teeth. So, there’s a lot of advantages.
Epic Ortho Moderator: Okay. Yeah, it’s changed a lot. I mean, since you started school and started this journey, the traditional braces, like what do you still love about what traditional braces do?
Dr. Hicks: So, oh, a lot of things. I love traditional braces, but I wanna back up. I’m old enough now where, when I was in residency, I started my residency in 99′, and Invisalign got approval from the FDA, I think it was 98′. So, we were the first class that, they flew us out to San Francisco. I remember being in the basement of this hotel and there’s a room –
Epic Ortho Moderator: That sounds a little shady!
Dr. Hicks: Right! We all were thinking, “move teeth with plastic?” So, yeah. Robotic. Yeah, I don’t even know if it was called Invisalign at that point. It’s just aligners. So anyway, we take this little course and then we go back — and now here we are 20, whatever, 30 years later. Right? And so, the technology’s changed quite a bit. We have a lot of, more, a lot more advancements that allow us to move teeth better with plastic. But there’s still limitations.
Epic Ortho Moderator: Okay. I’m imagining all you guys flying back from that — nobody spoke, you know, we were kind of part of something that was, that blew your mind. So, um, so if you had to like, “I’m sorry Doc, you gotta go back in braces” and you’re like, “braces are Invisalign for a year?”, which one are you choosing for you?
Dr. Hicks: Well, knowing my teeth, I would go into aligners. Yep. I would, uh, there’s again, a lot of advantage of aligners and with the amount of movement that I would need for me, I would go into aligners. And that’s the case for a lot of adults. But still, a lot of adults come into the practice and there’s significant movements, where maybe they never had braces, or what I see on a lot of adult males, is we need to remove a lower incisor. That’s a common area for adult men to have a lot of crowding. So, we can’t make room for all these teeth, so we have to remove a lower incisor. Those are sometimes tough movements for aligners to accomplish. So, we do a lot of combination treatments as well, where adults are very concerned with aesthetics, right? They’re business leaders. They’re in front of people, they’re teachers, whatever the case may be. So, they’re looking for an aesthetic smile. So, we put them in upper clear aligners and lower braces. That’s a common, very common thing for us at our practice.
Epic Ortho Moderator: Well, I mean, I do see more people in Invisalign. I will say, personally, I’ve had Invisalign. One thing that I was surprised, and like I know this industry, the attachments. Like, if it’s too good to be true and you’re thinking about Invisalign, you gotta know — I think it’s important to tell patients they also get these kind of braces, like, things on their teeth, right?
Dr Hicks: Yeah. That’s a very, very important topic we have to discuss prior to them accepting our treatment plan, because there are attachments. Attachments are, they’re getting more advanced. There are companies now that are making these attachments that are 3D printed. So, the 3D printed attachments don’t have, uh, they don’t, they don’t discolor. The attachments that we used to use, and still do, are, uh, they’re tooth colored material, and they can discolor over time. And they are a little noticeable, even though they’re tooth colored.
Epic Ortho Moderator: Just different.
Dr. Hicks: Yeah. And sometimes we gotta put ’em right on that front tooth. Okay. And you, (Oh man!) you gotta be okay with that.
Epic Ortho Moderator: I’ve heard it said, it’s like the handles of a door, like we , sometimes you have to have a handle to move a tooth, so, yeah.
Dr. Hicks: Yeah. And these attachments aren’t for retention. They are for helping us move a tooth. There’s bevels, there’s eclipse, there’s circles, there’s horizontal. So, all these attachments mean something different.
Epic Ortho Moderator: Yeah. So super technical. And I’ve seen dentists and other practitioners doing Invisalign. So why? Why choose you? What kind of education, extra education, like tell me about that.
Dr. Hicks: That’s a great question. So yeah, any dentist can use Invisalign. And you see a lot of dentists now that are doing Invisalign. (Mm-hmm. Sure.) And I think if they’re minor movements, I certainly think there’s a place for that. But as an orthodontist, we went to school a lot, uh, beyond dental school to learn about moving teeth. Moving teeth, and understanding the concept of moving teeth, is critical when you’re doing aligner cases.
Epic Ortho Moderator: It’s good to know. Yeah. I think there’s a lot of people who would be like, “Okay, I just don’t see it, doc.” Like there’s this piece of plastic and you’re gonna gimme 30 pieces of plastic. Or there’s these brackets, right, that they’re gonna put their teeth. Um, I know what goes into it, but I think it’s important, like what goes into this expense that these parents prepare for, for their teenager to give them that self-esteem boost. What goes into the cost of braces?
Dr. Hicks: So, it’s the technology, I mean, and science. Those are the biggest drivers of cost in our industry. The most common thing, uh, our expense is the cost of the bracket. The bracket has a lot of technology in it. So that bracket that I use, it has a three-dimensional slot that moves a tooth. So, the bracket goes in on the tooth in a very specific position, to move the root and the crown of the tooth, such that it’s positioned for healthy, long-term prognosis. So that bracket is really expensive because of the technology that went into it.
Epic Ortho Moderator: Yeah, sure. Yeah. Does my kid go retrieve it when they lose it and it falls in the trash can? Do I send them after that bracket? Is it worth it?
Dr. Hicks: No. No. Um, we’re gonna replace it. We’re gonna replace it.
Epic Ortho Moderator: Okay. Add it to the bill. (Yeah.) No. Um, so what are people surprised about when they hear your treatment plan? I mean, ’cause I hope, and people should go get second opinions. When you come in, what do you feel like they should look for, um, in others and like, what do you see with those second opinions?
Dr. Hicks: So, the biggest thing I would say is a consumer needs to be comfortable with the entire office, (Yeah, absolutely.) because, not just the provider, because this is an experience. Let’s say you’ve got a one or two year treatment plan. You don’t only just see me as the provider. You’ll be seeing the front office staff. How are they answering the phone? How are the treatment coordinators? Your whole experience. What is the environment like? You know, we provide a different environment where we want everyone to feel comfortable. So, I think those are very important ’cause it’s a journey.
Epic Ortho Moderator: Epic, an epic journey.
Dr. Hicks: It’s epic. Yes. We try to provide an epic journey.
Epic Ortho Moderator: So, finances, I mean, moms are always gonna want to talk about this. Like how does it work, with, do you finance it for them? Is there down payments? Like what can a mom expect? ’Cause that’s important to know.
Dr. Hicks: Uh, great question. So, moving teeth, orthodontics, is expensive. And it, uh, it’s a lot for some, especially when you have two or three siblings that are coming in and ready for orthodontic care at the same time. So, what we do at our practice is we provide a payment plan. So, we allow the parents to pay for the braces, or the aligners over the course of treatment. There’s no, uh, there’s no finance fee. You just pay [on] a monthly basis, uh, we don’t increase the cost, it’s just you get to pay on a monthly basis from the start of treatment till the end.
Epic Ortho Moderator: So rapid fire questions. (Sure.) Does it always work?
Dr. Hick: So not every case that we treat can look like a type of don that sits on the table. I wish I could, but there’s a lot of other factors that go into straightening teeth, right? There’s jaw structure, there’s muscles, there’s the tongue. There’s so many other things that contribute to the end result.
Epic Ortho Moderator: Sure. And our culture is so, like, “I want results now.” Um, you have people come in and be like, “How long is this gonna take? Is this, I’ll be done in four months (Dr. Hicks: oh goodness.) right, by my wedding?”
Dr. Hicks: So, here’s a classic example. So, what happens is, there’s a lot of visual movement in the first two or three months. So, in, after three months, you know, the teeth are fairly straight after the beginning wire or whatever, and they’re like, “My teeth are straight. Can I get my braces off now?” Well, wait a minute. (Just, okay. There’s so much more to the story.) There’s still a lot to do. Yeah.
Epic Ortho Moderator: Okay. Well, yeah, so just, that you have some expertise there (Yeah, a little) that I think can a blend into that. What’s the weirdest broken bracket story you’ve ever heard?
Dr. Hicks: Oh, goodness. Uh, well, I hear a lot. Uh, I love it when kids come in and they’ve got three or four brackets off, right? (Ah, yes.) And you know, they’ve done something.
Epic Ortho Moderator: I’ve chewed ice.
Dr. Hicks: Right? Yeah. So, the kids will say, “I was just sitting in class, and they just popped off.”
Epic Ortho Moderator: They just popped off!
Dr. Hicks: Yeah! Or “I was drinking, I was drinking a glass of milk, and my brackets came off.” So, yeah. Okay.
Epic Ortho Moderator: There’s more to this story.
Dr. Hicks: Yeah. There’s more to the story.
Epic Ortho Moderator: Yes, absolutely.
Dr. Hicks: Love those though.
Epic Ortho Moderator: Um, okay. Personally, which of your two sons was the more difficult patient?
Dr. Hicks: Oh, that was Griffin. Without a doubt. Yeah. I’ll never forget.
Epic Ortho Moderator: Compliance.
Dr. Hicks: Yeah. Not only compliance, but after the first day he’s like, “Dad, just take these off.” Like, Griffin. I’m not taking your braces off!
Epic Ortho Moderator: Goodness. Well, what would you want a mom to know who’s deciding for herself, or for her child, or a parent out there, when they’re looking at the braces versus aligner — what questions do you think they should ask?
Dr. Hicks: Well, first off, I would say come in for a consultation. Come in. Let’s have that discussion. (It’s free!) It’s free. (Right cost.) Right. And so, I typically will sit down and break this into a couple different buckets. Let’s look at the pros and cons of each. And see which one may be best for you. Yeah so, I kind of lead patients down a path, but I let them make the decision. I’ll give ’em the pros and cons, and then we’ll make a decision together.
Epic Ortho Moderator: It really is a personal choice. Like, you know, you wanna make a relationship with them, know you can afford it, and all the things that we talk about. (Right.) About making that important decision. Well, thank you Dr. Hicks. This is not your first rodeo.
Dr. Hicks: Not my first rodeo.
Epic Ortho Moderator: So, thanks for talking with me today about braces versus aligners.
Dr. Hicks: Thanks, Jennifer. Yeah.