What Are Lingual Braces, and Who Are They For?

Lingual braces use the same idea as any fixed brace: a bracket on each tooth and an archwire that guides the teeth through a planned sequence. The difference is the surface. The brackets are bonded to the back of the teeth, facing the tongue, so from the front the smile shows nothing.

The back surfaces of teeth vary in shape far more than the front, so lingual brackets are usually made to fit each tooth, which is part of why they cost more. The wire is also shaped differently, and the distance between brackets is shorter, which makes the mechanics more demanding. The result can be as good as with front-mounted braces when the case suits and the orthodontist is experienced. The teeth do not move faster or slower because the brackets are behind them, and treatment usually takes a similar length of time.

The tongue is in constant contact with the brackets, so it is common for it to be sore or to develop small ulcers in the first weeks. Many people lisp on s and sh sounds at first. This usually settles over a few weeks as the tongue adapts, and reading aloud helps.

Eating feels odd at the beginning, because the tongue has to move food around the brackets, and soreness of the teeth after fitting and adjustments is similar to any other braces. Soft food for the first week or two makes it easier. Orthodontic wax over a rough bracket can give the tongue some relief. If the tongue stays raw after a few weeks, tell your orthodontist, because a bracket can sometimes be smoothed or adjusted.

You cannot see the back of your teeth easily, so plaque is harder to find and remove. Use a small mirror, take your time, and use the methods in how to brush with braces, including interdental brushes. Plaque left around any bracket can cause white marks and gum inflammation, and with lingual braces you are less likely to notice it.

Appointments tend to be longer, because the orthodontist works from the back of the mouth, often in a mirror, and bonding the brackets accurately takes more time. A broken bracket can also be harder to reach. Expect more chair time than with regular braces, and keep your visits regular, because a wire left too long between changes slows the case.

They are well suited to mild to moderate crowding, spacing and many rotations in teenagers and adults who want the treatment hidden. They can also correct some bite problems, with elastics where needed.

They are less suitable where the teeth are very short, where a deep bite makes the lower teeth bite onto the brackets, where a large movement is needed, or where the tongue is strongly involved in the problem. Sometimes a case is better treated with conventional braces on the upper arch and hidden ones elsewhere, or not hidden at all. Teeth with very small crowns can also be a problem, because the bracket needs enough surface to hold. Only an examination and records can say which applies to you.

Both are hidden. Aligners come out for eating and brushing, have no brackets to rub the tongue, and are easier to keep clean, but they work only if worn 20 to 22 hours a day. Lingual braces cannot be left in a drawer, which suits people who would struggle with that, and they can manage some movements that aligners do less predictably.

The trade-offs are discussed in clear aligners vs braces, and the clear aligners page explains how aligner treatment works. Lingual braces generally cost more than regular braces, since they are custom-made and take more chair time. The braces cost page shows the Lucknow ranges for the other types.

Few clinics offer lingual braces, and results depend on the operator more than with front-mounted braces. Ask how many lingual cases they have completed, who will be treating you, and what happens if a bracket breaks or the tongue stays sore. Call the clinic to ask whether lingual braces are available and whether your case would suit them. The overall process is on the braces and orthodontics page, and types of braces compares the rest.