Lingual Braces Vs. Invisalign® – which one is right for me?

Lingual Braces vs. Invisalign® — Which Is Right for You?

When adults consider orthodontics to straighten their teeth and/or correct their bite, two of the most popular choices for treatment are lingual braces and clear aligners (eg. Invisalign®).  Lingual braces and Invisalign® treatment have been gaining popularity because of their aesthetic advantages.

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When most people think of braces or orthodontics, they think of the traditional metal braces that are placed on the front of the teeth. Some adults are self-conscious about braces, and lingual braces or clear aligners (eg. Invisalign®) are appealing options for orthodontic treatment.  Read more about Esthetic and Customized Orthodontic Treatment.

Damon Invisalign Lingual

Instead of front-facing metal brackets and wires, teeth are moved into the correct position with:

  • Lingual braces – braces that are placed on the back of the teeth
  • Clear aligners (eg. Invisalign®) – a series of clear, removable aligners that gradually straighten your teeth.  Read more about clear aligner therapy at How can I straighten my teeth at home? and What is Invisalign?

What are Lingual Braces?

Lingual braces work in a similar fashion to the traditional front-facing metal braces, except that the brackets and wires are placed on the inside of teeth, making them virtually invisible.

How do I know if Lingual Braces are right for me?

There are some challenges associated with wearing them that aren’t found in traditional braces:

  • Can be more difficult to clean
  • Can have an overall treatment time that is longer than with traditional braces
  • Typically, more expensive
  • Not ideal for all cases
    • Severe crowding
    • Complicated bite problems
    • Small or unusually shaped teeth
  • Can be more uncomfortable at first due to the proximity of the lingual braces to the tongue
    • Feeling of sharpness or abrasion on the tongue
    • Difficulty swallowing without using a tongue thrust
    • Speech (eg. lisping) issues
  • Appointments can take longer than with traditional braces


If you understand the challenges and are willing to make the effort required for wearing lingual braces, discuss the option with your orthodontist to determine whether it’s right for you.

Are there different types of lingual braces?

Each orthodontist chooses their own lingual system according to his or her preference, level of training, cost, and patient factors . There are a variety of brands available, and they differ slightly as to design, but they all basically function the same way. Some popular lingual braces brands are:

  • Incognito by 3M
  • Harmony by American Orthodontics 
  • SureSmile by OraMetrix
  • Alias by Ormco
  • In-Ovation L by Dentsply GAC


How much do lingual braces cost?

Because the braces are custom-made, require special armamentarium, and require a certain level of education and technical skill to use effectively, they usually cost more than traditional braces or clear aligners.  

How do I find an orthodontist who offers lingual braces?

Not all orthodontists offer lingual braces due to the technical skill, equipment, education, and training required to effectively treat patients with these specialized braces.  Call the orthodontic offices in your area to find out if they offer lingual braces. If they do, you can schedule a consultation to find out if lingual braces are the right option for your treatment needs.

At Mashouf Orthodontics, we are proud to offer lingual braces as a means of straightening one’s teeth and correcting the bite.  Please call us at: (408) 266-8820, visit our website at:, e-mail us at:, or request an appointment online to learn more and set up a free consultation.  





To Extract or Not To Extract?


The age old question is,”To extract or not to extract?” (image above is a patient who we did not perform extractions on with Damon Clear braces)

One objection that some patients have to getting orthodontic treatment is that they just don’t want to have “healthy teeth” removed. Is it wrong to remove teeth when there is seemingly nothing wrong with them? Are there alternatives to removing healthy teeth?

There are several reasons why orthodontists prescribe the removal of permanent teeth in some treatment plans. The most common are:

  • crowding
  • overbite
  • protrusive teeth
  • asymmetries

We’ve had patients who are insistent that teeth not be removed and others who are insistent that we remove teeth (see upcoming blog on patient perspective).

The question is:

“Why remove perfectly healthy teeth?” or “Why remove perfectly healthy enamel?”

Factors taken into consideration when deciding to remove healthy teeth or enamel include, but are not limited to:

  • The health of the supporting structures of the teeth (the bone and gums)
  • The ability to close one’s lips more naturally
  • The position of the upper teeth in relation to the lower teeth (eg. removing teeth on top to correct an overbite, thus, preventing the need for surgery)
  • The volume of one’s airway/breathing space
  • Esthetics
  • Patient perspective (some patients feel that their teeth are “too forward”)

If we can provide treatment without removing teeth, that is our preference.

Like all dentists, orthodontists are concerned with preserving healthy teeth/enamel. We identify all of the problems that exist, evaluate every option available, and then formulate a plan that provides the maximum benefit for each individual patient.

The best way to make sure you’re receiving the best treatment plan for you is to find an experienced orthodontic specialist who will carefully evaluate your individual case and then put your trust in him/her. In the end, your customized treatment plan will give you a result that is much healthier than before your treatment began.

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*some information courtesy of:


Esthetic and Customized Orthodontic Treatment in San Jose

As the number of adults seeking orthodontic treatment continues to grow, the demand for esthetic and comfortable ways of straightening teeth increases. At Mashouf Orthodontics, we are committed to finding the right solution for your needs.

Damon Invisalign Lingual

The 3 main cosmetic methods of aligning teeth and correcting the bite are:

We can help you find the treatment that is right for you – some of the options include:

  • Clear aligners for the initial stages of treatment, followed by clear braces for fine-tuning
  • Clear braces on top and bottom teeth
  • Clear braces on top and metal braces on the bottom
  • Lingual Braces on top and bottom teeth
  • Lingual Braces on top and metal braces on the bottom

Request a complimentary consultation appointment to find out what treatment best suits your needs.

How can I straighten my teeth at home?

We have been asked a lot, lately, about services, such as SmileDirectClub® and Invisalign®.  There seems to be an increasing demand for convenient, esthetic, and efficient ways of straightening one’s teeth.

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Do I have to see a dentist or an orthodontist?

The answer is, yes.  At some point in your treatment you will have to see a dental professional.   This is for good cause:

  1. You are investing a lot in your smile
  2. Your smile (your teeth) is a part of your body and overall health
  3. Your teeth need to be evaluated periodically to monitor how your treatment is progressing
  4. There are steps dentists or orthodontists can take to to ensure your treatment is successful, and your smile is beautiful and healthy

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What is SmileDirectClub®?

According to their website, SmileDirectClub® “is for anyone who wants a smile they’ll absolutely love. We straighten and brighten most smiles gently, remotely, and in an average of 6 months for quick, clear confidence.”

They summarize the process in 3 steps:

  1. Obtain a 3D image of your teeth by booking a 3D scan at one of their SmileShops or get an at-home impression kit sent to you

    What is a SmileShop®?  A location where a 3D scan is taken of your current smile.  3D scans eliminate the need for traditional molds and are a fast, accurate way of capturing a 3D image of your teeth.  Our intra-oral Scanner is a complete digital imaging system that takes impressions of our patients mouths with extreme accuracy. The high quality images that the system provides will help us to diagnose issues more accurately and create a personalized treatment plan for you

  2. After your 3D smile is reviewed by a dental professional, your treatment plan (on average, 6 months) is created, and your invisible aligners (and whitening materials) are sent directly to you
  3. At the completion of treatment, you can order retainers to help maintain your results


What is the difference between Invisalign® and SmileDirectClub®?

The truth is, they’re essentially the same form of orthodontic treatment: instead of metal brackets and wires, they use a series of clear, removable aligners to straighten the teeth, close gaps, and improve your bite. These aligners are almost invisible when worn and can be taken out to eat, drink, brush, and floss, providing a number of conveniences and benefits.

Invisalign® and SmileDirectClub® are both name-brand products.  Our office uses clear aligners to provide a similar orthodontic treatment method without the branding.  Read more at What is Invisalign?


How do I choose between Invisalign®, SmileDirectClub®, or other clear aligners?

Treatment with our clear aligners is often cheaper, faster, and even more convenient than treatment with Invisalign® itself! Here are a few of the benefits of our clear aligners as compared to Invisalign®:

  • Customized Treatment: With Invisalign, we send your treatment plan to the Invisalign company, which then manufactures your aligners. Clear aligners allow us more control in the treatment process, allowing us to use our own manufacturer and control your treatment more directly.
  • Speed: Because of this increased control, we can often perform your treatment more quickly.
  • Quick Turnaround: We use a local lab for manufacturing clear aligners, which means you’ll get your aligners and start your treatment faster. Turnaround time for clear aligners is roughly 2 to 3 weeks, as opposed to 4 or 5 weeks with Invisalign.
  • Fewer Aligners: Because we control the process directly, we can often treat patients with fewer aligners using clear aligner treatment.
  • Cost: Clear aligners don’t have the same branding as Invisalign, so you’re paying less for a virtually identical form of treatment!

Invisalign Insurance

Schedule a Consultation with Your San Jose, CA Orthodontist

While both are excellent options for orthodontic treatment, clear aligners offer a number of advantages over both braces and Invisalign – and because it’s such a discreet form of treatment, it’s hugely popular with our adult orthodontic treatment patients. If you’re interested in learning more about how our clear aligners can revolutionize your own smile, we’d be thrilled to help. Call us today at (408) 266-8820 to learn more about clear aligners and orthodontic treatment in general, and if you’d like to get started on the path towards a brand new smile, just request an appointment online at our San Jose office. We can’t wait to hear from you!

*some information courtesy of

Do wisdom teeth cause your teeth to become crowded?

What we often hear from our adult patients is, “I had braces as a kid, and my teeth were straight.  My wisdom teeth came in, and, now, they are crooked.”  The belief that wisdom teeth cause the front teeth to become crowded by “pushing” them forward is a common one.

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Many patients are encouraged by their dental professionals to have their wisdom teeth (third molars) extracted to prevent future crowding.

Is there any validity to this theory?

In short, current research does not support the belief that wisdom teeth, alone, cause crowding of the teeth in front of them, or “push” on them enough to cause movement, nor that they contribute to the relapse after orthodontic treatment. The majority of peer reviewed research shows that even if people have their wisdom teeth removed, teeth (especially the lower front teeth) continue to crowd as we age. This is the case whether a person has had braces or not. Research has shown that teeth tend to drift forward throughout life, even in the absence of posterior teeth or molars.


The age that people stop wearing their retainers, many times, coincides with when the wisdom teeth first start to erupt.  Many adults report that they wore their retainers for only a year or so after they had their braces removed, but once the wisdom teeth became impacted (stuck below the gums), their teeth started to crowd. We have learned that without retention, teeth that were previously crowded will start to revert back towards their previous position.  Often wisdom tooth issues that arise at this age are correlated with the crowding that occurs during these years after retention is stopped. A long term use of your retainers is the only way to guarantee you will keep your teeth straight.  

If the wisdom teeth are not major contributors to increased dental crowding as we age, where does it come from?

Factors that may affect lower incisor crowding include dental (crown size, dental arch length loss, poor periodontal status and primary teeth loss), skeletal (growth of the jaws and malocclusion), and general (age and gender).



The take home message, and current standard of care, is that chances of future crowding, alone, does not warrant wisdom teeth be extracted.

There are a number of other reasons that may indicate the need for extracting these teeth, including the inability to properly clean these teeth, tooth decay, pericoronitis (inflammation of the gingiva around partially erupted third molars), and impacted positions that may cause damage to the surrounding jaw structures. Each person is an individual, and the decision to extract the third molars should be discussed with your dentist, orthodontist, or oral surgeon.

How do I fix the crowding without getting braces again?

Braces are still the most popular orthodontic treatment we offer – but they’re far from the only option. Invisalign (clear aligners) is an exciting alternative to braces that transforms your smile using clear, removable plastic aligners to straighten teeth instead of metal wires and brackets.  Clear aligners are discreet, convenient, and effective for orthodontic patients.  Read What’s the Difference Between Invisalign & Clear Aligners?  and read more about Invisalign at our website.




Is There a Benefit to Early Treatment?

Timing is everything – even when it comes to your child’s orthodontic treatment. “Early” treatment, also called “interceptive” treatment, means treatment that is performed while some baby teeth are still present.

The American Association of Orthodontists (AAO) recommends that your child’s first check-up with an orthodontist be performed when an orthodontic problem is first recognized, but no later than age 7. Why age 7? By then, your child has enough permanent teeth for an orthodontist to evaluate the developing teeth and the jaws, which in turn can provide a wealth of information. Orthodontists are trained to spot subtle problems even in young children.

There are generally three outcomes of an initial check-up:

1. No treatment is expected to be necessary.

2. Treatment may be needed in the future, so the child will be followed periodically while the face and jaws continue to grow.

3. There is a problem that lends itself to early treatment.

While there are many orthodontic problems that orthodontists agree are best treated after all permanent teeth have come in, early treatment can be in a patient’s best interests if their problem is one that could become more serious over time if left untreated. The goal of early treatment is to intercept the developing problem, eliminate the cause, guide the growth of facial and jaw bones, and provide adequate space for incoming permanent teeth. A patient may require a second course of treatment after all permanent teeth have come in to move those teeth into their best positions.

The kinds of problems orthodontists may recommend treating while a child still has some baby teeth include:

• Underbites – when the lower front teeth are ahead of the upper front teeth

• Crossbites – when the jaw shifts to one side

• Very crowded teeth

• Excessively spaced teeth

• Extra or missing teeth

• Teeth that meet abnormally, or don’t meet at all

• Thumb-, finger-, or pacifier- sucking that is affecting the teeth or jaw growth

Some of these orthodontic problems are inherited, while others may result from accidents, dental disease, or abnormal swallowing.

Early orthodontic treatment can take many forms. The orthodontist could prescribe a fixed or removable “appliance” – a device used to move teeth, change the position of the jaw, or hold teeth in place in order to bring about desirable changes. Sometimes, no appliances are necessary.

Regardless of how treatment goals are reached, the bottom line is that some orthodontic problems may be easier to correct if they are found and treated early. Waiting until all the permanent teeth have come in, or until facial growth is nearly complete, may make correction of some problems more difficult.

To give your child the best opportunity for a healthy, beautiful smile, visit our San Jose office. No referral needed! We provide an initial consultation at no cost and with no obligation. We can alert you to potential problems and recommend treatment when it is most appropriate for your child.

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How Much do Braces Cost?

So how much do braces cost? First, it’s necessary to identify the type of braces for you or your child and the duration of the treatment. This will help you understand your options in providing the very best care for your investment.

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The Right Age

When should my child get braces?  The American Association of Orthodontics (AAO) recommends that children receive their first orthodontic screening by the age of seven years.

If your orthodontist identifies an incorrect bite or potential for crowding during the screening exam, he or she can sometimes take what is called “interceptive” action to prevent the problem from playing out or getting worse. This can include fitting a palatal expander or other appliance to ensure that the permanent teeth erupt in the right position. The exam might also highlight the need to control habits such as thumb-sucking, which can cause damage to a child’s mouth over time.

Types of Braces

The braces your orthodontist recommends will depend on you or your child’s particular problem. Types of braces include:

  • Traditional metal braces – Have color ties holding the wires to the brackets.
  • Damon® braces – They do not have color ties, as the brackets themselves hold the wires in place (the braces are self-ligating).
  • Invisalign® (or other clear or removable aligners) – Fit over the the teeth in a way that resembles a mouth guard.
  • Lingual braces – Instead of the brackets and wires being placed on the front of your teeth, they are placed behind the teeth.

In addition to appliances like an expander, your orthodontist might also recommend the use of an appliance to use in conjunction with braces to correct problems affecting you or your child’s natural bite.

Variations in Treatment Costs

Determining how much braces cost for kids depends on the type of braces you choose and the estimated length of time you or your child will need to wear them. According to the Consumer Guide for Dentistry, the cost of wearing braces ranges between $3,000 and $7,000 – with respect to the type of braces recommended – for the following reasons:

  1. With traditional braces the cost is driven by what the orthodontist will charge for the orthodontic treatment for your case, which includes multiple visits during the time it takes to straighten the teeth and correct the bite over a monthly or yearly period.
  2. Damon® Braces are typically more expensive, initially, due to the higher cost of materials used during your treatment.
  3. With Invisalign® (clear aligners), you will receive a number of aligners to use in a specific order, changing every week or couple of weeks. The cost is usually determined by the number of aligners needed to achieve the right result.
  4. Lingual Braces are a completely invisible braces solution. Instead of the brackets and wires being placed on the front of your teeth, they are placed behind the teeth. Due to the fact that you can’t see the braces at all, lingual braces are another orthodontic treatment type that is very popular among adults.

Ways to Pay

We never want costs to stand in the way of quality treatment, which is why we are dedicated to providing our patients with care that is both effective and affordable. Your treatment plan will include a breakdown of all applicable fees, and we will inform you of all costs before treatment is administered.

If you have insurance, it may cover a portion of the cost (if your insurance plan has orthodontic benefits).  The treatment is usually eligible for flexible savings account (FSA) reimbursement, too.

In addition, we are pleased to offer in-house financing options with little or no down payment and low monthly payments that make your treatment more affordable. If you can pay in advance for some or all of the treatment, this typically qualifies you for a discount. This flexible payment option allows you to pay for your treatment over a period of time so you can focus on what matters most – keeping your smile healthy!

You can read more at our website. If you have any questions about financing or payment, ask us! We will thoroughly explain your choices and work hard to accommodate you.

*some information courtesy of: