Episode 25: Invisalign vs. Traditional Braces

[Eon Engelbrecht E-Radio] (0:09 – 0:48)
Hello and welcome again to Save Your Money, Save Your Teeth, the go-to podcast where
curiosity meets dentistry straight from the experts. I’m Eon and I’m chatting to Dr Clifford
Yudelman from OptiSmile. We take a nice deep dive into the world of dental care from a
consumer’s perspective.
So, whether you’re looking to brighten that smile of yours or protect your wallet, we’ve got
you covered with practical advice and the latest insights. So stick around and join us as we
uncover the secrets to maintaining both your dental health and your finances. A big welcome
to you once again, Dr Clifford Yudelman.
[Dr Clifford Yudelman OptiSmile] (0:49 – 1:02)
Hi, thanks. Thanks for having me on. I hope you had a great week and I am very excited
about today’s episode. We did mention last week we were going to talk about Invisalign
versus traditional braces.
[Eon Engelbrecht E-Radio] (1:02 – 1:08)
So, doctor, what are the main differences between Invisalign and traditional braces?
[Dr Clifford Yudelman OptiSmile] (1:09 – 3:03)
So I’m very biased as at OptiSmile, we only do Invisalign clear aligners. We do occasionally
send patients to the orthodontic care practitioner for traditional braces. The obvious thing is visibility and
aesthetics. Invisalign aligners are clear, virtually invisible, and they’re very discreet.
Traditional braces are more noticeable, which is a concern for some patients. Comfort and
irritation: Invisalign aligners are smooth, and the genuine Invisalign are cut above the gum
line. Unlike some of the copy aligners which cover the gum line, the genuine Invisalign do
not irritate your gum at all. Traditional braces, with brackets and wires, can definitely cause
discomfort and often require adjustments.
Maintenance and cleaning: Invisalign aligners are removable, allowing for easier cleaning of
the aligners and the teeth. With braces, you can spend an hour cleaning your teeth and still
not get all the plaque off. I think a lot of people are familiar with that. And of course, we love
eating, and with Invisalign, there are no food restrictions. You take them out, you eat, you
rinse your mouth, and you give them a quick brush depending on the time of day. You only
really have to give them a good brush first thing in the morning and at night; after lunch, you
can just rinse your mouth.
Traditional braces: you’re always getting food stuck in them, and every time you eat
anything, it’s a whole big to-do to keep them clean. And yeah, so from that point of view,
there’s a very big difference. Invisalign is generally much, much quicker than braces, which
we can talk about a little bit later.
[Eon Engelbrecht E-Radio] (3:05 – 3:11)
And in terms of costs, doctor, how do the costs of Invisalign compare with traditional braces?
[Dr Clifford Yudelman OptiSmile] (3:12 – 6:34)
So as we were starting to talk about last week, the initial costs, Invisalign tends to have a
higher initial cost due to the advanced technology and the customisation involved. And of
course, I wouldn’t say the dentist or orthodontic care practitioner is the middleman, but it’s an imported
product in South Africa, which makes it more expensive in South Africa than maybe if you
were in New York. Traditional braces can be more affordable upfront and depending on the
orthodontic care practitioner, they might charge you quite a bit extra for adjustments and repairs.
When it comes to insurance coverage or medical aid, should I say, they cover both Invisalign
and traditional braces. Generally, if you’ve got orthodontic cover for braces, they should pay
the same towards your Invisalign, which can help, but you need to check with your medical
aid. The long-term value, so Invisalign is more predictable.
There’s fewer emergency visits and for a lot of people, it’s got a better long-term value. There
are ways to do Invisalign where we monitor virtually, we’ll talk about that, where you only
need to see the dentist, if not every month, in some cases, you can go every two or three
months, we use a special app to track, which uses AI. For most cases in South Africa, you can
get financing for traditional braces.
If you’re going to have braces on for 18 months or two years, the dentist might charge you
two grand or three grand, sorry, 3000 rand a month. Most places in South Africa that do
genuine Invisalign don’t offer payment plans. At OptiSmile, we do have a number of different
flexible payment plans.
It can still be quite expensive. You can pay anywhere from five to 8,000 rand a month over a
course of treatment, depending on how it’s broken up. There’s no way around it.
Invisalign is more expensive and the cheap alternate South African copycat ones on the
surface can appear less expensive, but I can assure people that it doesn’t do what Invisalign
does. There are a lot of hidden costs that one needs to ask about when it comes to having to
scan again at the end and get more and more and more liners. They actually charge quite a bit
for these additional liners.
We just saw a patient from Stellenbosch who had one of these other copycat aligner systems
and he’s been going for a long time. He could only change his aligners every two weeks with
Invisalign. It’s every week and he’s not finished yet.
We thought we would get a quote from that lab and get some more aligners for him. To get
13 more aligners, they wanted to charge us 26,000 rand, which is before we even add any of
our own fees on there. And what he needs, the actual manufacturer of Invisalign would
actually be a little bit less than that for more aligners because we’re a top Invisalign provider
in South Africa and we get special firms from Invisalign.
You always want to check out your options properly.
[Eon Engelbrecht E-Radio] (6:35 – 6:52)
Yeah, always do your research before you do this. I think that’s very, very important. Doctor,
we touched on it briefly in last week’s podcast, but perhaps you could elaborate a bit. What
are the aesthetic benefits of Invisalign?
[Dr Clifford Yudelman OptiSmile] (6:53 – 8:42)
It’s discreet. They’re clear, nearly invisible. You can straighten your teeth without drawing
attention.
It’s especially appealing to adults and older teens. You’d think that a 12, 13 or 14-year-old
wouldn’t worry about braces. Now that they know the kids watch TikTok and YouTube and
that, and they know that Invisalign is available, they’re not so keen.
It used to be that kids really wanted braces, but now we’re seeing it’s the opposite. It’s not
always that affordable if you’ve got two or three kids and they all need teeth straightening.
Those are the cases we tell parents, maybe you need to go and get traditional braces.
This is going to cost a small fortune for three of them. And often mum wants it and dad wants
it. So if people can afford it, we’re there for them.
But a lot of the time, it can be someone who had braces and their teeth have now gone
crooked again because they weren’t wearing their retainers, and they just need 14 aligners. It’s
not that expensive. They’re in their mid-20s or 30s and they just want them straight again.
It’s a confidence boost because during treatment, you don’t have railway tracks. You can
smile and speak freely with Invisalign in your mouth. When you smile in photos, you really
can’t see them.
And it’s really good in professional settings. People can wear them on Zoom meetings. You
can wear them in meetings, as long as you’re not eating.
The invisibility aligners reduce your self-consciousness when you’re in these meetings or
personal, when you’re going out with your friends. I know I love Invisalign so much, I sound
like a salesperson. And I think, in fact, I am.
[Eon Engelbrecht E-Radio] (8:44 – 9:04)
Okay. So it’s nice to know that you can’t really see it in photos because in the older days with
those train tracks, as some of the children called it at school, it was difficult. Everybody could
see that you had braces. But how does the comfort level of Invisalign compare with braces?
[Dr Clifford Yudelman OptiSmile] (9:05 – 10:22)
That’s a very good question. Thank you for asking. So basically, it’s a smooth surface.
Invisalign is smooth, smooth plastic. The braces, I think everyone’s familiar, can cause
discomfort with the metal brackets and wires. There’s fewer adjustments.
In fact, you just change your aligners generally weekly. And they push on the teeth a tiny,
tiny bit in the correct direction, 0.2 of a millimetre. When you go to the orthodontic care practitioner to adjust
traditional braces, there’s no, I’m not exaggerating, I’ve never had braces myself, but people
tell me that it can be extremely sore for a few days every time they get a new spring or elastic
or a new wire.
The ease of use: patients can remove Invisalign when eating and cleaning, which we’ve
spoken about, and the braces are stuck there. And there’s less discomfort. Basically, the
aligners shift the teeth very gradually, less overall discomfort compared to the abrupt
adjustments of the braces.
And they’ve done study after study to show that there’s less pain and soreness with Invisalign.
[Eon Engelbrecht E-Radio] (10:22 – 10:30)
So doctor, just to make sure, can Invisalign address
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all the same issues that traditional braces can?
[Dr Clifford Yudelman OptiSmile] (10:30 – 12:59)
So there’s a very large range of treatment that’s effective for treating things like crowding,
spacing, overbites, underbites, crossbites. There are some extremely complex cases, which
are few and far between, that may still require traditional braces to get the best results. There
are cases we’ve seen, just recently, I had a teenager where they’d left it a bit late and his
canine or eye teeth were stuck up in the palate.
He had to have surgery to expose these and the surgeon attaches a little gold chain onto those
and then they need to be attached to something fixed like braces and wires. There are ways to
do that with Invisalign using something called TADs, temporary anchorage devices, which I
won’t get into now. We’re exploring that as an added option at OptiSmile so that we can treat
even a broader range.
But for most things, Invisalign can do a lot more than what most dentists or orthodontic care practitioner
realise. Some of the limitations are just jaw alignment issues that, like we mentioned,
sometimes pre-surgical, if someone’s going to be having jaw surgery to correct quite a large
deformity, although now Invisalign is the more popular choice for pre-surgical orthodontics.
The best is to have a consultation with an orthodontic care practitioner or a very experienced dentist to decide
on the best option and not to try and make that decision yourself.
You have to be sure though, as far as I’ve seen, if it is a complex issue, the only orthodontic
system with clear aligners that has all of the patterns and the technology that could do
something like this would be Invisalign. The other copycat aligners don’t stand a chance.
They usually will work okay for what we call the social six, the six front teeth. They don’t
move back teeth around. I haven’t looked into them again lately, but as far as I’ve seen, they
don’t do very much compared to Invisalign. You might be better off with braces if you can’t
get genuine Invisalign.
[Eon Engelbrecht E-Radio] (12:59 – 13:06)
Okay. And in terms of maintenance, what is the maintenance like for Invisalign compared to
braces?
[Dr Clifford Yudelman OptiSmile] (13:07 – 14:38)
Well, Invisalign, it’s a breeze. You just basically brush them under cool water. You can soak
them in a special cleaning solution. It’s not always necessary. When you pop them out, you
don’t leave saliva. You just give them a quick rinse. You make sure you don’t have a lot of
food on your teeth. You pop them back in. We give you a thing called a chewy, a little sort of
like a mini pool noodle, a little piece of polystyrene that you chew on to push them in. And
it’s very, very convenient. You get a little hairy case. It’s quite easy.
Braces, I think we’ve spoken about even in the last podcast, it’s very time-consuming. Oral
hygiene is a lot more difficult with the braces. It’s obvious that the aligners are much more
convenient. And the follow-up visits: there’s no emergencies with Invisalign. Whereas braces,
there’s often emergency visits for broken brackets, springs that have popped off, wires that
have broken. There’s nothing like that with Invisalign. You can travel overseas. You take
your aligners with you. If you’re going to be away for three, four weeks, you just make sure
the dentist has given you your next three or four weeks of aligners. Whereas with braces, if
you’re not getting them constantly adjusted, they stop working really. And it’s a very stop-go
thing.
[Eon Engelbrecht E-Radio] (14:39 – 14:49)
Yeah. Invisalign is sounding like the much better option at this stage. But how do eating
habits differ between Invisalign and braces?
[Dr Clifford Yudelman OptiSmile] (14:50 – 15:19)
Yeah. You pop them out, you eat what you want, you have a rinse, or you brush, you pop
them back in. Really a no-brainer, so they say. Braces: you can’t eat sticky things, hard
things, things that get stuck. You can damage your brackets and wires. Yeah. I mean, ease of
eating: obviously, Invisalign is a winner. Oral hygiene: we just spoke about the dietary
flexibility. I think it speaks for itself.
[Eon Engelbrecht E-Radio] (15:19 – 15:25)
Okay. And what do your patients say about their experiences with Invisalign versus braces?
[Dr Clifford Yudelman OptiSmile] (15:25 – 16:34)
So that’s a great question because a lot of our patients that come for Invisalign had braces
when they were younger and then the retainer wire popped off or the orthodontic care practitioner removed
the braces too early and their teeth have shifted. So a lot of them have had braces before and
they swear they would never get it done again because of all the things we’ve mentioned. And
then they get Invisalign and they absolutely love it.
I know it sounds like I’m selling it, I am. Patients love it. Invisible, they feel more confident.
A lot of them that have had braces on themselves and their teeth are nice and straight and
they appreciate the two or three or four years that they had their braces and now they’ve got
teenagers and kids. They’re the ones that bring people and they say, there’s no way I’ll put
braces on my kid. Please tell me about Invisalign.
I’ve been saving up my whole life. Since little Johnny was born, I knew he was going to have
crooked teeth like me. So I’ve put away a small fortune and here I am, please do Invisalign
because I couldn’t let him suffer like I did.
[Eon Engelbrecht E-Radio] (16:35 – 16:42)
And now that you mentioned the kids, any age restrictions or recommendations for Invisalign
versus braces?
[Dr Clifford Yudelman OptiSmile] (16:42 – 19:10)
Well, it used to be that we couldn’t treat the younger kids, but now as long as the six-year-old
molars are in and the four front teeth, top and bottom, what’s called mixed dentition, we’ve
got Invisalign phase one or Invisalign for kids. And we actually like to treat them very early
like that at that stage to prevent the problems from getting worse. And a lot of time then
there’s a delay.
We do maybe three, four months or a little bit longer of early treatment. Then we keep them
in an Invisalign-type retainer that’s got space for the permanent teeth that guides the
permanent teeth into place. And then they might do a short course of Invisalign later on when
all the permanent teeth are in at 12 or 13 and then they’re done. They don’t ever have to have
braces. So that’s fantastic. We’ve only been able to do that treatment. It’s been available for a
long time overseas, but it wasn’t available in South Africa. It’s now been available since last
year in March. We are seeing more and more kids.
I’m friendly with an orthodontic care practitioner in Johannesburg. He told me last time I spoke to him, he’s
done about 50 kids like that just in the last year. He gets a lot of referrals from other dentists
and he does 99% Invisalign. He doesn’t do a lot of braces. The growing teeth, when the kids
are growing, it’s ideal. It works really quickly.
All kinds of teens, there’s no limitation on teens. And for adults, I think it’s obvious they
much prefer Invisalign for the aesthetic advantages. It’s a lot quicker. People worry about
compliance, that the kids are not going to wear the Invisalign. They can take it out as soon as
they get to school. But we don’t see that.
The kids, especially even the younger ones, they’re very good at wearing their Invisalign.
And Invisalign now, if you’re worried about compliance with a teenager, maybe a 14-year-old
boy, you can put these little blue dots into the compliance indicator. And if he’s not wearing
it, the colour won’t fade.
And they come in and they say they’ve been wearing it for a week and it’s still deep blue. And
it shows that they’re not telling the truth. So, you can run, but you can’t hide.
[Eon Engelbrecht E-Radio] (19:12 – 19:20)
And then, doctor, finally, what should patients consider when choosing between Invisalign
and traditional braces?
[Dr Clifford Yudelman OptiSmile] (19:21 – 21:45)
Obviously, budget and financing. Compare the cost of Invisalign to traditional braces,
including the consultation fees, the treatment costs, the follow-up visits. Look at all your
financing options.
We’re introducing a special payment plan, a new payment plan at OptiSmile where you can
pay on your credit card and they’ll deduct your monthly payments with no interest. So, that’s
very interesting. It’s called Flow.
There’s the complexity of the case. Sometimes, you may just decide that braces are better for
you. Although, like I said, there are very few cases that Invisalign can’t treat and it’s often
much quicker.
Lifestyle and convenience: you have to decide, is your lifestyle, your oral hygiene, what
you’re allowed to eat and not allowed to eat, is that more important to you than how much it’s
going to cost you if all other things are equal? And then, maybe you’ve got hours in the day to
clean your brackets and your elastics. Maybe you don’t mind spending a lot of time cleaning
the braces.
And the last one, which is most obvious, is aesthetic preferences. How important is it to you?
If you’re already embarrassed about having crooked teeth or you’re very shy and over the first
6, 8, 10 weeks, the teeth can already be straight and you’ve got clear aligners in, your
confidence just increases.
But if you put brackets and wires on, you’ll probably end up being even more embarrassed or
don’t want to smile in Zoom meetings because now, you not only have crooked teeth, but
now, they’ve got metal on them and you’re telling the world, I hate my smile, I’m
straightening it. So, I’m just throwing that out there. If the main concern is self-esteem and so
on, I think Invisalign clear aligners would be the winner, hands down.
I can’t see people feeling more confident with braces. Maybe when it’s over and everything
looks straight and neat and nice, for sure, but not during the – yeah. I mean, a lot of times, we
do 20 aligners, 20 weeks that we know an orthodontic care practitioner might spend a year or 18 months
doing the same thing.
[Eon Engelbrecht E-Radio] (21:46 – 21:58)
That’s incredible. I don’t know about you, but I’m totally sold on Invisalign right now. And
that wraps up today’s episode of Save Your Money, Save Your Teeth. Dr Yudelman, thank
you so much once again.
[Dr Clifford Yudelman OptiSmile] (21:58 – 22:48)
Thank you. I really love talking about Invisalign, as you can tell. If anyone is interested, they
can book a free video consultation with me. They can WhatsApp me via the website at
OptiSmile.co.za. I’m in Stellenbosch every Wednesday to do Invisalign at Dorp Street Dental.
We have an association with them. They’re specialists in that practice and I’m your Invisalign
guy in that Winelands region. And yeah, we get patients from all over the Western Cape.
Stellenbosch is a little bit more convenient rather than coming into Seapoint. And yeah, look,
until you actually find out if it’s for you or what one can do, you’ll just always be wondering.
So make that call when you’re ready.
[Eon Engelbrecht E-Radio] (22:49 – 23:20)
Exactly. Thank you so much again, Dr Yudelman. And also remember, while we strive to
provide valuable insights with this podcast, always consult with your own dental professional
for advice tailored to your personal health.
Don’t forget to subscribe to the podcast for more enlightening discussions. Join us again next
week as we continue to explore the fascinating intersection of dental health and financial
savvy. Until then, keep smiling and taking great care of your teeth.
[Speaker 3] (23:40 – 24:24)
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