Invisalign or Lingual Braces? Choosing Hidden Orthodontics in Tokyo

Many adults in Tokyo want straighter teeth without visible braces. At Ginza UC Dental, the two options I offer most often are Invisalign clear aligners and lingual braces with the Harmony system. Both are hard for other people to notice, but they work in different ways. Here is how to choose between them.

How each option works

Invisalign uses a series of clear, removable aligners. You change to a new set about every 1 to 2 weeks and wear them 20 to 22 hours a day.

Lingual braces are fixed brackets attached to the back of your teeth, with wires made to fit your teeth. They stay in place throughout treatment, and we adjust them at regular visits. Half lingual treatment uses lingual braces on the upper teeth and regular braces on the lower teeth.

Invisalign may suit you if

• You want to take your appliance out to eat, brush and floss

• You can commit to wearing aligners 20 to 22 hours a day

• Your case involves crowding, gaps or bite problems that aligners can treat

Lingual braces may suit you if

• You would rather not depend on remembering to wear aligners

• Your teeth need movements that are better controlled with fixed braces

• You want braces that cannot be seen from the front at all

Side by side

Comfort: With Invisalign, you feel pressure for a few days with each new set of aligners. With lingual braces, your tongue may feel sore and your speech may sound slightly different for the first few weeks.

Cleaning: Aligners come out, so brushing and flossing are as usual. Lingual braces take more care to clean around, so good home care and regular cleanings are important.

Treatment time: Invisalign usually takes 1 to 2.5 years for full treatment. Lingual braces usually take 1.5 to 3 years. Every case is different, and we give you an estimate at your diagnosis.

Cost (tax excluded): Invisalign ¥400,000 to ¥1,200,000 depending on the case. Full lingual braces ¥1,600,000, half lingual braces ¥1,400,000. Both also include a consultation (¥1,000), diagnosis (¥20,000) and adjustment visits (¥5,000 to ¥8,000). Orthodontic treatment is private (self-pay) and not covered by Japanese health insurance.

After treatment: retainers

Whichever you choose, retainers keep your new smile in place. I recommend wearing them at least 20 hours a day for about as long as your active treatment took, and then while you sleep for life. Patients with braces also have a fixed retainer bonded behind the front teeth.

Possible risks

Both options can cause temporary discomfort. Tooth decay and gum problems can develop if teeth are not kept clean. Root shortening, gum recession and jaw joint discomfort can occur, and teeth may shift back if retainers are not worn. Some cases need tooth extraction or miniscrews.

About Invisalign under Japanese regulations: Invisalign aligners are custom-made orthodontic devices manufactured overseas by Align Technology, Inc. As finished devices, they fall outside the scope of Japan's Pharmaceuticals and Medical Devices Act and are not approved as medical devices in Japan, so treatment may not be covered by Japan's Relief System for Sufferers from Adverse Drug Reactions.

Not sure which is right for you?

At an orthodontic consultation, I check your teeth, listen to your goals and lifestyle, and explain which options suit your case, in English or Japanese. You can book at hitomidentist.com/book-online.