Lingual braces, or inside braces are a type of orthodontic treatment appliance that are placed behind the teeth (by the tongue and palate), rather than in front, and therefore offer a great cosmetic alternative for those who want their teeth straightened, without the braces showing. They were the original “invisible braces”, and are still arguably the least noticeable orthodontic appliance available today.
Today, I’m going to share with you 5 facts that few people, even dentists, know about lingual braces!
1. Lingual braces were invented in the 70’s!
Developed in the 1970’s, lingual braces pre-dates Invisalign by 20 years! Its development was motivated by the increase in demand of a more aesthetic option from adults seeking orthodontic treatment. At the time, clear braces were still in its infancy and had a significant problem of staining. Dr. Kinya Fujita from Japan was the first guy to submit the concept of lingual braces in 1967, but it was Dr. Craven Kurz from Beverly Hill who first came up with a whole bracket system. The patent for Kurz Lingual Appliance was filed on November 15, 1976. With the help of Omrco, a company in California that makes orthodontic appliances, and Dr. Kurz’ lingual braces went on production in 1979 and it was the first commercialized lingual braces.
2. They were once so popular that they were featured in all major media
In just 2 years after Ormco and Dr. Kurz start production of the lingual braces, the new “invisible braces” was already featured in major magazines and broadcasted on both television and radio. It was called the “lingual fever”, and it spread even to the European and Asian markets. It reached the peak of its success in 1986 and Ormco had sold more than 18,000 cases by then! The development team was forced to provide an appliance for wide-scale use as quickly as possible. The beta-testing was never completed and the product was rushed into the market prematurely.
3. They were almost completely abandoned by the orthodontic community in North America.
Following the initial excitement and euphoria was a period of disappointment and frustration. Orthodontists were not happy with the lingual braces as they were not able to obtain the same level of finish they expect from regular braces. Furthermore, truly stain-free clear braces were introduced around the same time and they provided a viable alternative to metal braces. This was the last nail in the coffin for lingual braces. The original task force of Omrco that once had over 1000 orthodontists involved was reduced to just three members in 1988.
4. Lingual brackets and wires need to be customized for each patient
The outside surfaces of our teeth are smooth and generally have little variation between individuals. Therefore, orthodontists may use pre-made, stock appliances for the outside braces. The inside surface, however, has a lot of irregularities. It is so unique that customized brackets and wires are needed for each patient in order to obtain the best results.
This was a huge challenge in the early days of the lingual braces and required intensive laboratory service to set up the cases. The invention of digital CAD/CAM technology have greatly simplified the customization process. The brackets are designed and manufactured precisely to fit each tooth perfectly. The archwires are designed with the final (desired) position of the teeth in mind, and extremely precise bends are placed in the archwire by a wire bending robot. Because the brackets and wires need to be customized, lingual braces usually cost about twice as much as traditional braces.
5. Not all orthodontists are trained to provide lingual braces in North America
As mentioned above, lingual braces were almost completely abandoned by the orthodontic community in North America. While the research and development of lingual braces continued in Europe and Asia, it was not until early 2000’s before lingual braces were re-introduced in North America market again. Even today, only a selection of graduate school provides training for lingual braces, and many orthodontists graduated without having treated any patients using lingual braces.
Dr. Wang was an early adopter of the lingual braces technique and he had been providing lingual braces for more than 20 years! As such, he is not only an expert in lingual braces, he also teaches lingual braces at the graduate orthodontic program at UBC. Being a UBC alumnus, Dr. Lee was one of the students who treated patients using lingual braces under Dr. Wang’s supervision.
So here you go, these are 5 facts about lingual braces that you didn’t know before.
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