Early Treatment
A first assessment from age seven, and interceptive treatment only where it will genuinely change the outcome.
Specialist orthodontics in Midland
Clear aligners, when they suit the case
Clear aligners move teeth with a series of custom trays you take out to eat. They suit a lot of people and they genuinely do not suit everyone. This page sets out how the movement actually works, what wear time really means, the parts nobody mentions before you start, and where fixed braces still do a better job.
- No referral needed
- Specialists since 1984
- Clear quote before you start
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The condition
They only work while they are in
This is the whole deal with aligners, and it is the reason two people on identical plans finish months apart. A tray applies pressure while it is on the teeth and applies nothing at all while it is in your pocket. There is no way for us to make up the difference at your next appointment.
22hours
a day
a day
- Trays in22h
- What the plan is built on
- Meals and cleaning2h
- Out for eating, then brush before they go back in
Two hours a day off plan
Sounds like nothing. Over a tray worn for a fortnight it is more than a day of lost movement, and the next tray does not fit properly onto teeth that have not finished arriving.
A tray that will not seat
The usual sign that wear time has slipped. It is fixable, but the fix is going back a tray or rescanning, not pushing harder.
The honest question to ask yourself
Not whether you like the idea of removable trays. Whether you will genuinely put them back in after a coffee at work, every time, for a year or more. If the answer is no, braces will get you a better result.
How it actually works
One tray, one small movement, thirty times over
There is no clever material and no trick. Each tray is manufactured very slightly straighter than your teeth are now, so wearing it applies gentle pressure in one direction. A typical course is twenty to forty of them, each moving a tooth about a quarter of a millimetre or turning it a couple of degrees. The result is the sum of those, which is why the sequence cannot be rushed.
Tray 10.25mm per trayTray 32
- Trays 1 to 3
Getting used to them
The first trays are usually the tightest and the most talked about. Speech adjusts within a few days, and taking them out gets easier once your fingers learn where to start.
- The middle stretch
Nothing much to report
A new tray every one to two weeks as instructed, a check-up every six to ten weeks, and very little drama. This is the phase where wear time either holds or quietly slips.
- The last trays
Detailing, and often a rescan
Teeth rarely track perfectly all the way to the end, so most plans finish with a fresh scan and a short series of refinement trays. That is normal, not a setback, and it is part of the plan rather than an extra.
Worth knowing first
Four things you will not read on a brochure
None of these are reasons to avoid aligners. They are simply the things people are told at the fitting appointment rather than at the consultation, and being surprised by them is what turns a good treatment into a disappointing one.
Attachments are usually part of it
Small tooth-coloured bumps bonded to some of your teeth, which give the tray something to push against for the harder movements. They are the same colour as enamel and are not obvious in conversation, but they are visible up close and they stay on for most of the treatment. Very few plans work without any.
Some cases need enamel reduced
Where teeth are crowded, a fraction of a millimetre is polished from between them to make the room the teeth need to straighten into. It is done with a fine strip, it does not hurt, and it is within the enamel. You will be told before it happens and it is not done routinely.
Refinements are normal
Teeth move biologically, not mechanically, so the last few rarely land exactly where the software drew them. Most people finish with a rescan and a short second series. Ask any provider whether refinements are included in the quoted fee, because that answer varies.
Your speech changes for a few days
A slight lisp on s sounds for the first two or three days with a new set, then it goes. Reading aloud speeds it up. Nobody at work notices it as much as you do.
The limits
Where fixed braces still win
We fit both and we are not paid more for either, which makes this easy to say out loud. Aligners have become capable of far more than they could ten years ago, and there are still bites where a tray is the wrong tool. Choosing the wrong one costs you a year.
Aligners are the better choice for
- Mild to moderate crowding and spacing
- Adults who need treatment to be discreet at work
- Anyone with a history of decay, because brushing stays easy
- Relapse after orthodontic treatment years ago
- People who will genuinely wear them twenty two hours a day
Braces are the better choice for
- Severely rotated teeth and deep crowding
- Bites that need correcting as well as straightening
- Cases where teeth are removed and gaps have to close
- Children and teenagers still growing
- Anyone who knows the trays would end up in a drawer
At the assessment we will tell you which category you are in. If both are reasonable we will quote both, and if aligners would give you a worse result we will say that rather than sell you the appliance you came in asking for.
One warning
What the cheaper option leaves out
Aligners bought online cost less because the parts that cost money have been removed. It is worth knowing exactly which parts those are before deciding the difference is only in the price.
Nobody examines you
Straightening teeth in a mouth with untreated decay, gum disease or an abscess makes all three worse. A photograph you take yourself cannot rule any of them out. An examination and x-rays can.
Nobody looks at the roots
X-rays show what is under the gum: root length, bone level, and teeth that have not come through yet. Moving teeth without that picture is the part that goes wrong quietly and is expensive to undo.
Nobody watches it happen
Teeth do not always track the way the plan drew them. Catching that at a six week review takes one adjustment. Finding out at the end of a mail-order series takes a new course of treatment.
There is nobody to ring
When a tray will not seat or a tooth starts aching, the difference between a specialist practice down the road and an email address is the whole point of paying for one.
FAQs
What people ask before they start aligners
What people want to know before committing to a year of trays. If yours is not here, ring the practice and ask it.
Simple cases run six to nine months and comprehensive cases twelve to twenty four, with a tray changed every one to two weeks as instructed. The single biggest variable is not your bite, it is whether the trays are actually in for twenty to twenty two hours a day.
Discreet rather than invisible. At conversation distance most people will not notice them. Up close the tray edge and any bonded attachments can be seen, and that is worth knowing before you decide rather than after.
Occasionally, yes, and the treatment survives it. Regularly, no. Every hour out is an hour of nothing happening, and the compounding effect of that is trays that stop fitting and a finish date that keeps moving.
Water only. Hot drinks can distort the plastic and anything coloured will stain it, so trays come out for coffee and go back in after a rinse or a brush. Brushing before they go back in matters, because a tray seals whatever is on your teeth against the enamel.
Rinse them whenever they are out and brush them gently with cool water. Not hot water, which warps them, and not toothpaste, which scratches the plastic and clouds it. Keep them in the case rather than a serviette, which is how most lost trays are lost.
Ring us the same day. Depending on how far into the tray you were, we will usually have you go back to the previous one or move forward to the next while a replacement is arranged. Keep your last tray for exactly this reason.
Yes, and this surprises people who assumed a removable appliance means removable results. Teeth drift for life. Retainers are what hold the result, and they are worn long term regardless of how the teeth were straightened.
No. Book an assessment directly and we will tell you honestly whether aligners will get you the result you are after, or whether braces would do it better in your case.
Find out whether aligners will work for your bite
A scan and an assessment will tell you what aligners can achieve in your case, what they cannot, and what it would take. You get a written quote before anything is ordered.
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Adult Treatment
Treatment at any age, planned around the dental work, gum health and working life you already have.
Jaw Surgery
The orthodontics either side of corrective jaw surgery, planned with your oral and maxillofacial surgeon.