Are Ceramic Braces Better Than Metal? Pros and Cons of Each

If you’re getting braces later in life, you might be tempted to choose something less noticeable. You could go with clear aligners, or the next best thing – ceramic braces. Ceramic braces are quite pricy, and you may be wondering if they’re worth it. No worries, we’ll help you decide.

Ceramic braces aren’t necessarily better than metal braces. The only thing better about them is their aesthetic appearance. Aside from looking better, ceramic braces work the same way metal braces do, although they’re more fragile and not suited for all orthodontic cases.

In this article, we’ll debunk a few myths about ceramic braces – questions like are they slow, are they comfortable, do they stain, and much more. You’ll also learn about who is best suited for these types of braces, and my honest recommendation as an orthodontist.

How are ceramic braces different?

Ceramic brackets are shaped just like a normal, metal bracket, but what’s different is the material. They’re made up of polycrystalline alumina, or dental porcelain – a material similar to what you would find in dental crowns and veneers.

Ceramic braces price tag

Because producing ceramic brackets is more expensive and complicated than metal braces, their cost is higher, which reflects in the final price as well. All braces are expensive, to begin with, but ceramic braces come at a higher price tag.

Ceramic braces can reportedly cost between $4000 and $8000 per total treatment, although much of that cost is the treatment itself, depending on its difficulty, and not the type of brackets. However, aesthetic braces are still more expensive than metal braces by about $1000.

Ceramic braces used to be cheaper than clear aligners since aligners like Invisalign were using cutting-edge technology. As the competition grew, the price of clear aligners started going down. But the price of both clear braces and clear aligners has a lot to do with treatment complexity, so it’s hard to estimate how much your treatment will cost.

Ceramic braces aesthetics

Ceramic brackets have been processed to be tooth-colored and translucent so that they match every tooth shade, which makes them very aesthetic. Depending on the brand, ceramic brackets can be quite discreet, which is the main reason why adults often go for ‘clear’ braces.

But not all ceramic braces will stay beautiful and pristine. Some can stain or become yellow with time. This depends both on the quality of the porcelain material and how well the patient is caring for them.

To better understand staining, we’ll describe the two types of materials that get stained inside the ceramic braces: the elastic tie and the bracket itself.

The elastic ties that go on all ceramic brackets are transparent and unnoticeable at first, but they’re just simple medical rubber. Clear elastic ties rarely last longer than a week or two before they become stained with food and bacteria. Fortunately, they get changed every month or so, but in those last two weeks, they won’t look so attractive, no matter how hard you brush.

• PRO TIP: To avoid stained elastic ties, go for self-ligating ceramic brackets that don’t have any rubber components and are more hygienic.

The ceramic brackets themselves can also become stained, which is a bigger problem than staining the elastic tie, because stained ceramic braces will remain stained until the end of the treatment, or until the brackets are changed. Even changing one bracket can look weird because the new ceramic bracket will be white, while the old ones will still be yellow.

• PRO TIP: To avoid staining your ceramic brackets permanently, avoid smoking, and stay away from red wine, coffee, black tea, green tea, curry, and other staining foods and beverages. As an alternative, sip your favorite drinks through a straw.

If giving up all these foods and drinks is a deal breaker for you, maybe clear aligners are a better option, since you can take them off when eating.

What makes clear braces truly aesthetic and less visible is using a white archwire in conjunction with ceramic braces. This wire has a special coating that makes it tooth-colored, but the downside to its coating is that the friction is higher, and it can add months to treatment time in complicated cases.

Tooth-colored archwires get chipped easily, and the paint rubs off in places from using cutlery and dental instruments, so keep that in mind as well. I’d much rather use normal archwires on my patients, and sacrifice beauty for efficiency.

Ceramic braces durability

The most annoying thing about ceramic braces – coming from an orthodontist – is their fragility. Both ceramic and sapphire brackets get chipped so easily! Their hooks are the ones that break most of the time, which makes it hard for patients to wear their rubber bands.

Sometimes, one of the 4 bracket wings breaks, and then it’s difficult for the elastic tie to stay on. Ligatures and power chains are also harder to place because of all the rounded surfaces. All in all, it’s a bit harder to work with ceramic braces as a doctor.

For the patient, this translates into longer chair time at certain appointments, and perhaps even longer treatments overall, although that’s not a rule.

Ceramic braces usually have a great bond with the tooth enamel, so they don’t become loose as easily, but they do chip, in which case you might need a new bracket.

Ceramic braces and tooth wear

Ceramic braces are a wonderful option for the top arch since most of us show our top teeth when we smile and talk. But many orthodontists don’t recommend them for the lower arch.

The porcelain that makes up ceramic braces is a very hard material – harder than enamel. And since lower ceramic braces can be bulky, your top teeth will most likely touch them throughout treatment. This can cause tooth wear on the back of your top incisors, or even your incisor edges over time.

This is why you’ll often see combinations of top ceramic braces and bottom metal braces, depending on the patient’s occlusion.

Are ceramic braces more comfortable?

You may have heard that ceramic braces are more comfortable. They do have rounded edges and a smoother profile, so your cheeks may feel more comfortable than wearing metal braces.

However, you must keep in mind that ceramic braces have much bulkier profiles to keep them from breaking too easily. This could change the position of your lips and make them more protruded than if you would be wearing metal braces.

Because they’re so bulky, ceramic braces can be more difficult to clean, leading to food accumulation, staining, and even gums growing over braces. Self-ligating braces can sometimes be even bigger than traditional ceramic braces because there are more components that need to fit into a small bracket.

When it’s time to debond them, some ceramic braces don’t come off as easily. Others are extremely brittle and crack, making the debonding session more difficult and uncomfortable. This is an issue that many ceramic braces manufacturers are beginning to solve, but it used to be a problem in the past.

So, tooth-colored braces, while beautiful, may not always be the most comfortable and hygienic option.

Does orthodontic treatment take longer with ceramic braces?

When teeth start aligning during orthodontic treatment, it’s vital the archwire can slide freely and not become wedged or experience friction. Studies showed that ceramic and sapphire brackets cause significantly higher friction in contact with the archwire than metal braces do.

Friction, most of the time, is something that slows tooth movement, so we don’t want too much of it. Ceramic braces in combination with a white, coated archwire will cause even more friction – which for really crowded teeth means longer treatment time.

There is an exception to this: ceramic braces that have metal slots. This way, you can still benefit from the aesthetics of ceramic braces and have a treatment time similar to metal braces.

Who should wear ceramic braces?

Ceramic braces are not for everyone. They’re mainly aimed at adults, especially if working in professions where appearance is important.

Kids shouldn’t get ceramic braces, because they’re difficult to clean and could easily cause gingivitis. Adolescents are not great candidates either, considering teenage boys are notorious for breaking brackets.

Case selection is also very important when deciding on the type of braces. For example, a difficult extraction case would require a longer treatment time, and the forces applied would be greater. Any chipped or broken bracket could potentially delay treatment.

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