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Which braces are best for autistic kids?

Orthodontists for autism: A complete guide

Updated: August 31, 2023 · 8 Minute Read

Amy Gong

Reviewed by:

Amy Gong, Neurodiversity Advocate

Highlights

  • Braces are tools that help make teeth straight. There are different kinds like metal, ceramic, and clear aligners.
  • Regular braces require a lot of orthodontist visits, can feel uncomfortable, and are harder to clean.
  • Clear aligners are better for most autistic kids because they don't hurt as much, look great, and work well.

For some of us, braces are just an awkward rite of passage. But for autistic kids with sensory sensitivities, braces can be downright distressing. If your child’s orthodontist is recommending braces, you’ll want to weigh your options. While each type of braces has their own pros and cons, autistic kids will probably find clear aligners the most comfortable.

 

What are dental braces?

Braces are a device that straighten the teeth. They can come in metal, ceramic, or clear plastic materials. Traditional metal braces use brackets attached to the teeth, with a wire running through them. An orthodontist uses the wire to adjust tension on the teeth to move them into place. A patient typically has to wear braces for many months or even a few years to get the desired result. Read on to find out why!

 

When does a child need braces?

There are a few reasons your child may need braces. The most common reason people choose braces is to straighten and align teeth for a nicer looking smile. Straight teeth can be a good self-esteem booster, especially for teens. Your dentist may also refer your child to an orthodontist for braces if they have pesky cavities that can’t be reached because your child’s teeth are crowded. In that case, the child’s teeth need to be straightened out so the dentist can treat the hidden cavities. If your child has a malocclusion or jaw issue that interferes with their ability to chew or speak, braces or oral surgery may be necessary.

 

Does my child have to get braces?

Unless your child needs braces for health reasons, it’s okay to opt out. (This is a decision you and your child should make together along with the input of your dentist and orthodontist.)

 

The process of getting and maintaining braces can be very overwhelming for autistic kids. Your child would have to sit still for many appointments while their dental hardware is installed and adjusted. The daily maintenance, pain, and adjusting to changes within the mouth can be hard, too. Many kids with autism have difficulty with oral hygiene, and traditional braces make it even harder to clean teeth. For all these reasons, autistic people may find it easier to wait until they are adults to get braces.

What kind of braces are best for children with autism?

There are several types of braces out there, but what’s best for your child will depend on their preferences, comfort, and orthodontic concerns. Keep in mind, some kids may only require a retainer, while others may need “headgear” to help get the teeth and jaw into proper shape. Your orthodontist will explain your child’s options, but in the meantime, let’s take a look at the pros and cons of common braces.

 

Metal braces

 

These are what most people think of when they think of braces. Metal braces are made of several parts. Metal brackets are attached to the teeth and a metal wire is attached to each bracket through slots and with bands called ligatures. Your child can choose the color of the ligatures. The wire is used by the orthodontist to adjust the tension on teeth as needed. This tension helps the teeth move into place. Sometimes an orthodontist will attach “bands” to braces. These elastics can be vertical, horizontal, or both. The bands allow even more tension control and can help align the jaw and teeth.

 

Children with autism may struggle with the feeling of hardware in their mouths. Some autistic kids have even been known to rip traditional braces out of their mouths. The pain from the tension can range from dull to intense, but autistic kids often have more mouth sensitivity than their peers. Neurodivergent kids sometimes have dexterity, motor coordination challenges, or mouth sensitivities that make oral hygiene difficult. Metal braces make it even harder to keep teeth clean. Metal braces and similar types of mouth hardware require your child to change their diet and avoid gummy or crunchy foods that could mess up their teeth or braces.

 

The main benefit of traditional metal braces is that they can treat severe orthodontic problems that other braces can’t fix. Things like severe overbites, underbites, open bites, and other malocclusions.

 

Pros: Colorful | Can help with complex orthodontic issues

 

Cons: Uncomfortable | Difficult to clean | Painful | Requires a change in diet and routine | Many lengthy appointments

 

Beaming says: It will depend on your child’s individual preference, but metal braces are a nightmare for most autistic kids.

 

Ceramic braces

 

Sometimes called “clear braces”, ceramic braces are like metal braces. The difference is that ceramic braces are made with porcelain or plastic. The ceramic brackets and wires can be clear or colored to blend in with your teeth. Some kids like ceramic braces because they are less noticeable. This could be especially important to teens who want to avoid the look of metal braces.

 

The process of installing ceramic braces is pretty much the same as metal braces. All the same challenges that exist with traditional braces exist with ceramic braces. One major drawback to ceramic braces is that they can’t treat all the orthodontic issues that traditional braces can treat. They’re also more fragile and prone to breaking than metal braces. A positive of ceramic braces is that they may be less painful and more comfortable than metal braces.

 

Ceramic braces are usually best for adults whose teeth are finished growing.

 

Pros: Less noticeable than metal braces | Less painful than metal braces

 

Cons: Uncomfortable | Difficult to clean | Requires a change in diet and routine | Many lengthy appointments | Easier to damage than metal braces | Can’t treat complex dental issues

 

Beaming says: While ceramic braces are a good option, they’re still not the best option for most autistic kids.

 

Lingual braces

 

These braces are only applied to the back of the teeth, so you can’t see them from the front. These “hidden” braces can correct your child’s orthodontic problems, but it may take longer than traditional braces because of where they’re located. Being on the back of the teeth also makes lingual braces difficult to clean. Like traditional braces, lingual braces can be uncomfortable and take a while to get used to. One major benefit of lingual braces is watching your child’s smile change in real time. This also means no damage on the front of your child’s teeth when the braces are removed. Something to be mindful of is that installation of lingual braces can cause your child to have a temporary lisp.

 

Pros: Not visible from the front | See your child’s teeth change | No damage to the front of teeth

 

Cons: Takes longer to treat than other braces | Uncomfortable | Difficult to clean | Requires a change in diet and routine | Many lengthy appointments | Temporary lisp

 

Beaming says: Although lingual braces are cool, they’re not the right match for most autistic kids.

 

Self-ligating braces

 

Self-ligating braces are similar in style to traditional metal braces, but use specialized brackets that do not need elastics (ligatures). Instead, they have built-in clips that hold the wire in place. Self-ligating braces can provide faster treatment progress, and require fewer adjustments, because they are essentially self-tightening. Self-ligating braces tend to be less painful, easier to clean, and less noticeable, because they require fewer parts. The brackets can come in clear or ceramic tooth-colored, making them less noticeable.

 

Self-ligating braces affix to the teeth in a less obstructive way, leaving less damage when they’re removed. The downside is self-ligating braces can only treat minor orthodontic problems, which means they will not be a good fit for every child.

 

Pros: Less visible | Easier to clean | Less painful than traditional braces | Fewer adjustments/appointments | Gentler on teeth

 

Cons: Requires a change in diet and routine | Can’t solve complex dental problems

 

Beaming says: May be a good option for autistic kids who don’t want to fuss with removable aligners, but would be overwhelmed by metal braces.

 

Functional braces

 

Functional braces are a customized set of dental “appliances” that are made to fit your child’s unique orthodontic concerns. They’re removable and less obstructive than traditional braces. Your child would be able to eat and drink mostly normally, and wouldn’t have to wear the braces 24/7.

 

Functional braces are part of a subset of orthodontics called functional orthodontics. This is because they don’t just straighten teeth — they work to align your child’s jaw to achieve a perfect and balanced bite. Functional braces can also address face shape and jaw shape issues. AKA, a more “functional” mouth!

 

Like clear aligners, functional braces won’t work if your child doesn’t follow the treatment plan by wearing them when they’re supposed to. A qualified orthodontist will explain how many hours a day your child should wear their braces. As treatment progresses, the time may decrease. Treatment with functional braces can vary, lasting anywhere from 8 to 36 months (three years). Sometimes functional braces are used with traditional braces or other orthodontic treatments.

 

Pros: Less visible | Easier to clean | Less damaging than metal braces | Solves complex dental issues

 

Cons: Requires a change in routine | Not available everywhere

 

Beaming says: If your child has complex orthodontic problems, and can adopt a new routine, functional braces can be an attractive solution.

 

Clear aligners

 

While not technically considered “braces”, clear aligners (such as Invisalign) are a popular choice for orthodontic treatment for good reason. They’re made of a sturdy plastic, which gently and gradually move your child’s teeth all at the same time. Your child can remove the aligners to clean their teeth or eat as normal. Clear aligners don’t require your child to make any changes to their diet or lifestyle. They also don’t require any hardware installation, which means there’s no rubbing, cutting, or injury to the gums and mouth. Clear aligners usually work faster than traditional braces, and with less pain.

 

There are a couple things to consider, though. Clear aligners can only be effective if your child wears them properly. For example, Invisalign must be worn at least 20 hours per day. Your child will have to maintain good oral hygiene, and remember to put their aligners back on after eating or brushing. If your child would have difficulty keeping up this new routine, clear aligners may not be the way to go. It’s also important to know that clear aligners may not be able to treat more severe orthodontic concerns.

 

There are two common reasons clear aligners don’t get the intended results. First, because patients don’t go through a qualified orthodontist to get a custom treatment plan. Using online aligner services can be risky because you don’t know the quality of the aligner or the treatment plan. Second, because patients don’t wear their aligners the specified amount of time. If you choose to go with clear aligners for your kiddo’s smile, make sure you consult with a certified orthodontist to get the best results.

 

Pros: Invisible | Easy maintenance | Nearly pain-free | Fewer appointments | No damage | Works fast | No hardware | No diet change

 

Cons: Requires change in routine + proper maintenance | Can’t solve complex dental problems

 

Beaming says: Clear aligners are clearly the best option for most autistic kids.

 

Conclusion

Getting dental braces can improve your child’s confidence and smile. However, traditional braces can be really distressing for children with autism for many reasons. While traditional braces can correct more serious orthodontic issues, they’re also painful and difficult to clean. Clear aligners are the best choice for most autistic kids because they eliminate most of the problems that come with braces. It’s best to work with your child’s orthodontist to come up with the best treatment plan for your child. Need help getting ready for your child’s next visit? Check out our guide to preparing your child for a dental appointment.

Dive Deeper

Article References

  1. Benefits of Functional Braces. Oldham Orthodontics. https://www.oldhamorthodontics.co.uk/blogs/news/benefits-of-functional-braces
  2. Invisalign vs. Braces: Which Is Faster? Dental Health Society. February 14, 2022. https://dentalhealthsociety.com/invisalign/invisalign-vs-braces-which-is-faster/
  3. Jewell, T. Ceramic Braces: How Do They Compare? Healthline. May 17, 2019. https://www.healthline.com/health/ceramic-braces
  4. Pros And Cons Of Self Ligating Ceramic Braces. Profile Orthodontics. https://profileorthodontics.com.au/blog/pros-and-cons-of-self-ligating-ceramic-braces/
  5. Self-ligating braces: Pros and cons. Burlingame Smile Studio. https://www.burlingamesmilestudio.com/blog/self-ligating-braces-pros-and-cons/
  6. 10 pros and cons of lingual braces. Orthodontic Gallery. 2023. https://www.orthodonticgallery.com/pros-and-cons-of-lingual-braces/
  7. Braces. American Association of Orthodontists. https://aaoinfo.org/faqs/braces/