For an ‘invisible’ treatment with results you’ll want to show!
With lingual braces, the brackets are on the back of the teeth, making this brace completely invisible. We use a CCLA, a Complete Customised Lingual Appliance, meaning that all the components of the brace are custom-made for each patient. Our supplier for the lingual brace is Lingualsystems in Bad Essen, Germany which uses the WIN system designed by Professor Wiechmann.
Everything is custom-made by hand
Each individual bracket and each individual wire is designed and custom-made by hand for the patient. Technological advances help us achieve a level of precision not seen before. For example, WIN’s customised brackets and wires are much more precise than brackets produced in a factory.
This quality is good for the patient and their treatment. The precision means the lingual device is even appropriate for more complex treatments. Because each brace is completely customised, this treatment method is suitable for everyone and all anomalies. We can treat every patient using this technology.
But we are not only concerned about the quality and precision. We also want to offer our patients the opportunity to undergo discreet dental correction.
Lingual brackets are not visible from the outside and therefore our patients can continue to show off their most beautiful smile. This invisible device is especially suitable for mid-career patients, for example, who are not interested in treatment with a traditional bracket brace.
All parts customised
A lingual device is made up of several parts, including custom-made brackets and wires. At the start of the treatment the teeth are not yet straight and often need space so that they can move into the correct position. To enable this, we often place small elevations on the back molars. These can be built into the bracket with a metal plate or we can make our own additional elevations from blue composite. These elevations often feel unpleasant, as if the teeth no longer fit snugly together and as if there are gaps between them.
Sometimes we use other components to make extra corrections. These include small drops of tooth-coloured composite on the outside of the teeth or transparent elastic bands called Lassos that wrap around the tooth. Both of these may be slightly visible. We need to use these elastic bands with the majority of patients treated with a lingual brace. The elastic bands can be applied and removed by the patient themselves. Depending on where in the mouth they are placed, these elastic bands may be more or less visible.
Getting used to the lingual brace
Simply wearing a brace is already a change in the dental situation. Patients often have to get used to this and may initially experience some discomfort. In the case of lingual devices, this discomfort may be caused by the brackets and possibly result in some speaking difficulties. The tongue may become irritated by the brackets. To deal with this, we give our patients a wax that they can put on the brackets if they feel sharp. The tongue needs to get used to the new situation after we have fitted the brace on the upper teeth. This may result in some lisping after the brace has been fitted, though this will cease after a period of acclimatisation. How long this takes varies from patient to patient. If necessary, a speech therapist can provide additional support.
Advantages of the lingual brace
The lingual brace has certain advantages, for example in terms of oral hygiene. With traditional braces, the brackets are on the front of the teeth. Inadequate oral hygiene may cause white stains (decalcification) or cavities (caries) to appear on the outer surfaces of the teeth around the brackets. These stains are not caused directly by the brackets, but are due to poor oral hygiene resulting in a build up of plaque around the brackets. These unsightly decalcifications/white spots are permanent and not treatable. Studies conducted by the ACTA in Amsterdam show that there is a higher risk of decalcification and cavities with traditional bracket braces. With lingual braces there is less risk of this as these decalcifications, if they occur, form on the back of the teeth and are therefore not visible from the outside.
Treatment with a CCLA is technically complex and therefore reserved for specially trained orthodontists. Dr Christina von Massow has followed a specialist course for this. In addition, she has also successfully completed a 2-year Master’s degree in Lingual Orthodontics at the University of Hanover, Germany. She is the only person in the Netherlands to have completed this course. Dr von Massow is the most experienced orthodontist in lingual orthodontics in the Netherlands.
Are you interested in lingual treatment? We will gladly provide you with all the necessary information
- van der Veen MH, Attin R, Schwestka-Polly R, Wiechmann D. Caries outcomes after orthodontic treatment with fixed appliances: do lingual brackets make a difference? Eur J Oral Sci 2010; 118: 298-303.
- Wiechmann D, Klang E, Helms HJ, Knösel M. Lingual appliances reduce the incidence of white spot lesions during orthodontic multibracket treatment. Am J Orthod Dentofacial Orthop 2015; 148: 414-22.
- Knösel M, Klang E, Helms H-J, Jilek T. Vollständig individuelle linguale Apparaturen vermindern das Schmelzentkalkungsrisiko bei einer Multibracketbehandlung um ein Vielfaches. Inf Orthod Kieferorthop 2015; 47: 149-157.