Braces: Is Ugly Orthodontia Still the Best?

As orthodontic technology has evolved over the past few years, braces have become less and less visible—instead of the traditional metal wires glued on the front of patients' teeth, some now go behind the teeth, and others are clear plastic retainers that progressively straighten out patients' smiles. One might imagine that not-so-nice nicknames like "metal mouth" and "tetanus breath" could soon become things of the past.

Unfortunately, the most effective orthodontia are still the ones people think are the ugliest, University of Ohio researchers found. They showed 200 adults pictures of teeth with orthodontic appliances and asked them to rate the mouths for attractiveness. Respondents scored traditional metal braces—the most durable and efficient—the lowest, with ratings averaging between 25 and 40 on a 100-point scale. They thought ceramic braces, which are usually clear or tooth-colored, were better-looking, from about 55 to 70 on the scale, and clear tooth trays and teeth without braces (in this case, the ones with lingual, or behind-the-teeth braces) were by far the most attractive, with most rankings above 90. Ceramic braces tend to be more delicate than metal ones, and tooth trays are less flexible and forceful, researchers said.

This might not make a big difference to the 12-year-old who's excited about switching the elastic bands on her braces to red and green for Christmas—and many orthodontists tend to stick with traditional braces for youngsters anyway. Still, the researchers found that adults, who account for more than a quarter of people who get braces, are willing to pay hundreds more for the more expensive, more attractive orthodontia. But now they may have to consider that they are paying more for mouthware that might not work as fast or as well as the old-fashioned kind.