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Aligners and Braces: Which Suits You?

Aligners and braces can both straighten teeth, but they work differently and suit different problems. This guide compares them fairly.

Key points

  • Fixed braces and clear aligners can both straighten teeth. Neither is better for everyone.
  • Aligners are most often used for mild to moderate problems without extractions, while fixed braces can treat a wider range, including complex cases.13
  • Aligners must be worn full-time, day and night, except at meals, so the plan depends on your habits.1
  • Pain is lower with Invisalign in the first days and no different after that, and plaque and bleeding scores were lower in 7 studies.56
  • Fixed braces usually stay on for 18 to 24 months, and retainers are needed after either treatment.17

If you want straighter teeth, the biggest choice is often between clear aligners and fixed braces. Each has strengths, and neither is better for everyone. The right one depends on what needs to move, how you live and what the evidence says about your kind of problem.

What they are

Fixed braces are brackets bonded to the teeth, joined by a wire. They are the most common type of appliance and can move teeth very precisely, but many brands and designs exist, and the British Orthodontic Society notes that manufacturers' claims of better results are often not backed by scientific evidence.2

Clear aligners are removable, custom-made plastic trays. You wear a series of them, and each moves the teeth a small distance before the next takes over. They need to be worn full-time, day and night, except at meal times.1 You can read about each on our pages for clear aligners and braces.

What each is used for

Aligners are most often used where the teeth can be lined up without taking any out, for example in mild to moderate irregularity, mild spacing, or crowding that can be treated with a little widening of the arch or by slimming the sides of teeth.1 The British Orthodontic Society describes them as ideally suited to adults whose lifestyle or work makes visible fixed braces difficult.1

Fixed braces can deal with a wider range, including severe crowding, treatments that need teeth to be taken out, complex tooth movements and problems that come from the size or position of the jaws.1

What the research says

A review of 22 studies of Invisalign found it a viable alternative to conventional treatment for mild to moderate problems in people who have stopped growing and who do not need extractions, and that it can level, tip and turn most teeth predictably.3 The same review found limited effectiveness for widening the arch by moving teeth bodily, closing extraction spaces and correcting larger front-to-back or vertical problems.3

A review of 11 studies of aligners in general, with 887 patients, found moderate-quality evidence of a worse occlusal result than with fixed braces, and concluded that the evidence does not support aligners as equally effective.4 Evidence in this area is still developing, so treat any strong claim with caution.

Comparing them

Fixed braces Clear aligners
Worn Fixed, 24 hours a day Removable, but worn day and night except at meals1
Suited to A wide range, including complex cases Mild to moderate problems without extractions3
Appearance Visible, with ceramic and lingual options Nearly invisible
Eating Avoid hard and sticky food Take them out to eat
Cleaning Around brackets, with interdental brushes Brush teeth and clean the trays
Pain Often sore for a few days after adjustments Lower in the first days, then no different5
Gum health Plaque collects around brackets Plaque and bleeding scores were lower in 7 studies6
Visits Every six to eight weeks8 Reviews to your orthodontist's schedule

Pain and comfort

A review found that pain with Invisalign was lower than with fixed braces in the first days, and no different after that, up to three months.5 Soreness after a new tray or an adjustment is common with either type.

Cleaning and gum health

In a meta-analysis of 7 studies with 368 patients, plaque and bleeding scores were lower with Invisalign than with fixed braces, and gum index and probing depth did not differ.6 That suggests aligners are easier to keep clean, but you still need to brush and clean the trays carefully.

How long it takes

Fixed braces usually stay on for 18 to 24 months, and in a review of 22 studies the average was 19.9 months.7 One review found no difference in treatment duration between aligners and braces, and another found shorter treatment and less chair time with aligners in mild to moderate cases.4 Your own timeline depends on your teeth.

Discipline matters

Aligners only work when worn, so a plan depends on your daily habits.1 If you struggle to wear trays most of the day and night, fixed braces may suit you better. If you cannot avoid hard food or brush around brackets, aligners may be easier.

Retainers for both

After any aligner or braces treatment, retainers are required so that the teeth keep their corrected positions.1

How to decide

  1. Ask your orthodontist what your teeth need.
  2. Ask whether aligners can achieve it, or whether braces or additional techniques are needed.1
  3. Think honestly about wearing time, eating habits and cleaning.
  4. Consider appearance, speech and comfort.
  5. Ask what happens if the plan needs to change.

A proper orthodontic assessment, diagnosis and treatment plan is essential to successful aligner treatment, so aligners should not be started without an examination.1 Our guides on Invisalign or ceramic braces and what kind of braces are right for me may help.

Who tends to do well with aligners

Aligners tend to suit adults and older teenagers who have finished growing and whose problems are mild to moderate.3 The people who do well are those who can wear the trays for most of the day and night, who are happy to take them out for every meal and who clean their teeth after eating before putting them back. They also suit people who find it hard to clean around brackets or who work in roles where a very discreet appliance matters.

A proper assessment still comes first. The British Orthodontic Society stresses that a diagnosis and treatment plan are essential before aligner treatment starts.1

Who tends to do better with fixed braces

Fixed braces tend to suit people whose teeth need larger or more complex movements, including severe crowding, rotated teeth, teeth that need to be brought into position from a distance and problems related to the position of the jaws.1 They also suit people who would find it difficult to wear removable trays consistently, because the appliance works whether or not they remember it. Younger patients, whose jaws are still growing, are usually treated with fixed appliances or other appliances chosen by the orthodontist.

What can change your plan along the way

Treatment plans are not always followed exactly. Teeth do not always move as the first plan predicted, so aligner patients may need a refinement, which means a further set of trays. Some aligner plans use small tooth-coloured attachments or elastics to help certain movements. Some patients start with one appliance and move to another if the first is not achieving what was planned.

For this reason, ask what the plan is if treatment needs to change, who will see you and how any extra visits or trays are handled. Our article on Invisalign attachments explains one common part of aligner treatment.

Myths and facts

Myth: aligners are only cosmetic. They move teeth in the same way as braces, with gentle, continuous force, and need the same careful planning.

Myth: braces are outdated. Fixed braces remain the most common type of appliance and can move teeth very precisely.2

Myth: aligners are easier and need no effort. They work only when worn, so they depend on your habits.1

Fact: some people need both. Some problems need additional techniques, such as fixed appliances, alongside aligners.1

Practical questions for your consultation

  1. Which of my problems can aligners treat, and which need something else?
  2. What happens if I do not wear the aligners enough?
  3. How often will I be seen?
  4. What will happen if a refinement is needed?
  5. What will I wear afterwards?

Take the answers away and compare them with a second opinion if you want one.

Frequently asked questions

Are aligners as effective as braces?

For mild to moderate problems without extractions, a review found Invisalign a viable alternative, but a wider review found worse occlusal results with aligners than with fixed braces.34

Can I take aligners out?

Yes, but they need to be worn day and night except at meals.1

Are braces always visible?

Metal braces are. Ceramic braces are tooth-coloured, and lingual braces sit behind the teeth.

Do I need a retainer with aligners?

Yes. After any aligner treatment, retainers are required.1

Can I switch from braces to aligners halfway?

Sometimes, if the plan allows it. Ask your orthodontist.

Which is better for teenagers?

It depends on the problem and on reliable wear. Fixed braces do not depend on the patient remembering to wear them.

Do aligners hurt?

Many people feel tightness for a few days with each new tray. A review found pain with Invisalign was lower than with fixed braces in the first days and no different after that.5

Can children have aligners?

Children and younger teenagers are usually assessed for fixed or growth-related appliances first, because their jaws and teeth are still developing. An orthodontist can advise what is suitable.

About the author

Portrait of Dr Anupam Sinha

Dr Anupam Sinha, BDS, MDS – Orthodontics. BDS (2002), KLE Vishwanath Katti Institute of Dental Sciences, Belgaum. MDS in Orthodontics (2006), SDM College of Dental Sciences, Dharwad. His thesis work won a national research award in 2005, and he holds a certification in aesthetic dentistry. He sees patients at Orion Dental Clinic in Greater Kailash 1, South Delhi. Read the full profile of Dr Anupam Sinha.

Sources

  1. British Orthodontic Society. Clear aligners (patient information leaflet). https://www.bos.org.uk/Public-Patients/Patient-Information-Leaflets/Clear-Aligners
  2. British Orthodontic Society. Conventional fixed braces (patient information). https://bos.org.uk/conventional/
  3. Papadimitriou A, Mousoulea S, Gkantidis N, Kloukos D. Clinical effectiveness of Invisalign orthodontic treatment: a systematic review. Progress in Orthodontics, 2018;19(1):37. https://pubmed.ncbi.nlm.nih.gov/30264270/
  4. Papageorgiou SN, Koletsi D, Iliadi A, Peltomaki T, Eliades T. Treatment outcome with orthodontic aligners and fixed appliances: a systematic review with meta-analyses. European Journal of Orthodontics, 2020;42(3):331-343. https://pubmed.ncbi.nlm.nih.gov/31758191/
  5. Cardoso PC, Espinosa DG, Mecenas P, Flores-Mir C, Normando D. Pain level between clear aligners and fixed appliances: a systematic review. Progress in Orthodontics, 2020;21(1):3. https://pubmed.ncbi.nlm.nih.gov/31956934/
  6. Lu H, Tang H, Zhou T, Kang N. Assessment of the periodontal health status in patients undergoing orthodontic treatment with fixed appliances and Invisalign system: a meta-analysis. Medicine (Baltimore), 2018;97(13):e0248. https://pubmed.ncbi.nlm.nih.gov/29595680/
  7. Tsichlaki A, Chin SY, Pandis N, Fleming PS. How long does treatment with fixed orthodontic appliances last? A systematic review. American Journal of Orthodontics and Dentofacial Orthopedics, 2016;149(3):308-318. https://pubmed.ncbi.nlm.nih.gov/26926017/
  8. NHS website. Braces and orthodontics (patient information). Page review date 29 June 2026. https://www.nhs.uk/conditions/orthodontics/

Medically reviewed by Dr Anupam Sinha, BDS, MDS – Orthodontics, on . General information for patients from Orion Dental Clinic, last updated 23 October 2026. It is not advice for one person, so ask a dentist what suits you. To report an error, contact us.