The Indian Dental Association (IDA) Trivandrum branch recently addressed the media over growing concerns within the dental community. The trigger: Increasingly aggressive clear aligner promotions, some carrying the tagline, “The era of braces is over.
Yes, it sounds catchy. But the catch, as the IDA pointed out, was that orthodontic treatment is not an aligner versus braces war where you choose between two options, as you do in the case of different phone models. Every patient’s bite, bone levels and jaw growth are different. So clinical judgement should be based on their records, X-rays, and scans.
The concern put forward by IDA members was that when advertisements suggest fast, effortless results without explaining limitations, patients may walk in with fixed expectations, which could make evidence-based treatment plans less acceptable.
Officials also reminded practitioners that ethical violations in advertising will be taken seriously. They stated that the dentist who was advertising the above-mentioned tagline was suspended for 6 months. This has now sparked wider discussion in Kerala about where marketing ends and medical responsibility begins.
A 2023 review to evaluating the effectiveness of clear aligners in correcting complicated and severe misaligned teeth compared to metal braces, found that aligners, though effective in improving mild to moderate crowding, were found to be less predictable in complicated cases requiring complex tooth movements.
Another 2018 study that reviewed effectiveness of clear aligners, stated that even though aligners perform well in mild to moderate malocclusion; there are limitations in managing larger discrepancies.
Clear aligners are prescription devices which, if not prescribed correctly, have the potential to cause significant damage and harm. If forces are applied to teeth with underlying disease such as decay or gum disease, patients risk loosing teeth. It would be like trying to build a house without stable foundations – the house would eventually fall down!
Dr. Chloe Harrington Taylor ,Multi Award-Winning Dentist | Clinical & Educational Lead, Hereford, UK
They are two different tools designed for different clinical needs.
Skeletal discrepancies requiring surgical correction.
Complex open bites (when front teeth of opposing jaws don't touch) or deep bites (when upper front teeth overlap lower front teeth completely)
Large rotations or extraction cases that demand precise tooth movement. In such situations, fixed appliances or comprehensive orthodontic therapy often remain the standard of care.
Not Every Smile Is an Aligner Case
Compliance Is Everything
Aligners only work if worn 20–22 hours a day.
Biomechanics Matter More Than Branding
Complex rotations, vertical movements, and torque control are still more predictably managed with fixed appliances.
Specialist Evaluation Reduces Risk
While general dentists can provide aligners, an orthodontist’s advice is especially valuable in moderate to complex cases.
The IDA’s position in Kerala brings the focus back to ethics. Braces are not outdated. Aligners are not universal. They are complementary tools within modern orthodontics. The choice should depend on biological diagnosis, case complexity, and patient factors, not on marketing narratives.
At the end of the day, slogans will not correct misaligned teeth, science backed diagnosis and treatment plan will.
References
Jaber ST, Hajeer MY, Sultan K. "Treatment Effectiveness of Clear Aligners in Correcting Complicated and Severe Malocclusion Cases Compared to Fixed Orthodontic Appliances: A Systematic Review." Cureus. 2023;15(4):e38311. Published 2023 Apr 29. doi:10.7759/cureus.38311 https://doi.org/10.7759/cureus.38311.
Papadimitriou A, Mousoulea S, Gkantidis N, Kloukos D. "Clinical effectiveness of Invisalign® orthodontic treatment: A Systematic review." Prog Orthod. 2018;19(1):37. Published 2018 Sep 28. https://doi.org/10.1186/s40510-018-0235-z.
Ke, Y., Zhu, Y. & Zhu, M. "A comparison of treatment effectiveness between clear aligner and fixed appliance therapies. BMC Oral Health 19, 24 (2019). https://doi.org/10.1186/s12903-018-0695-z
