If you are interested in orthodontic treatment for yourself or your child and wish to avoid traditional braces, the options have been made more extensive with the recent (2022) addition of the Brava appliance that is currently available from a limited number of orthodontists.
Pro Tip: No longer is treatment with aligners such as Invisalign the only discreet option for adults and teens. The Brava appliance presents significant advantages and is the first true alternative to the use of aligners, whether Invisalign or otherwise.
What is the Brava Orthodontic Appliance
The Brava tool is a lightweight, fixed appliance that sits against the soft tissue beneath and behind the teeth. It is completely invisible to onlookers with no attachments to the visible surface of any tooth. Each tooth is engaged by a curved arm that is shaped to deliver the exact, measured movements (tipping, rotation, retraction, expansion, etc.) prescribed by your orthodontist to be in the proper sequence with the correct results in both crown (visible tooth) and root movement.
The Brava appliance is the next generation in orthodontic tools, not only in aesthetics but also in tooth movement. The technological aspect of this tool resides in the associated software that converts the orthodontist’s comprehensive, detailed instructions into the exact arm shape that is required for each tooth.
As with Invisalign and braces, the orthodontist applies extensive, specialized knowledge to direct tooth movements from the beginning to the end of treatment when using the Brava invisible appliance.
Like Invisalign and braces, the Brava appliance is NOT a treatment, rather, it is a tool for orthodontists to use to quickly and correctly reposition teeth for a stable, healthy, and attractive smile and face.
The Brava Appliance versus Invisalign Aligners: Five Facts to Know
1. Unlike Invisalign, the Brava appliance is completely invisible to the onlooker.
The Brava appliance neither covers the teeth like an aligner nor does it require any attachments to the front of the teeth. Treatment with aligners, if properly prescribed, most often requires tooth-color attachments to the fronts of a limited number of teeth to enable the aligner to exert the required force in the required direction.
2. Unlike Invisalign aligners, the Brava appliance is fixed to the teeth with no parts to handle or remove when eating or for cleaning.
During treatment with aligners, the plastic aligner trays must stay seated on the teeth, i.e., fit very intimately, for the aligners to exert the necessary forces in the correct sequence. For this to occur, the aligners must remain on the teeth for at least 22 hours per day and be removed for short periods only. Removal must occur for eating, and the teeth and aligners must be cleaned before reinsertion to protect the teeth and gums from bacterial and tartar build-up on the teeth under the aligner and at the gum line.
The Brava appliance is not removed. It remains in place throughout treatment and is cleaned when brushing the teeth. Also, because the lightweight bar from which the curved arms extend sits below the teeth, the space between the teeth and beneath the gumline can be flossed in a normal manner with the appliance in place, unlike with braces.
3. A distinguishing feature of the Brava appliance compared to Invisalign aligners is that it is free of plastic.
The active appliance is composed of a thin, specialty metal, with metal attachments on the back of each tooth to which the curved arms are anchored. The only plastic used throughout treatment is the finishing aligner used by the orthodontist to make detailing adjustments at the treatment’s conclusion.
4. With each tooth engaged by an independent arm on a fixed appliance, the Brava tool exerts a very specific force for each tooth in a long, sweeping motion that creates fast movement.
This is in contrast to aligners, which move each tooth incrementally due to the manner in which the aligner must stretch over the teeth to effect change. The greater flexibility in tooth movement of the Brava tool means that the orthodontist’s treatment plan is executed more quickly. The result is a substantially reduced treatment time.
5. The only disadvantage: Unlike Invisalign aligners, the location of the Brava appliance creates temporary (two- to four-week) irritation to the tongue, which brushes against the curved arms and metal anchoring attachments on the back of the teeth.
Fortunately, this irritation fades and eventually resolves over a period of two to four weeks. The Brava appliance is well tolerated by patients. A comfort kit is supplied in my practice to aid patients during this adjustment period.
Conclusion
The Brava appliance is lightweight, flexible, and sits below and behind the teeth. Each tooth is moved by an independent arm, and the treatment proceeds without any outward sign.
Your smile is never compromised, and treatment is fast and effective.
The position of the appliance, with no wire to preclude flossing, also means full hygiene access without the removal of an aligner or wire.
There is no plastic and nothing to remove and replace.
See Brava in action: Your treatment plan executed using the Brava appliance results in efficient, invisible alignment, as illustrated in the video below.
As one of the pioneer Brava users, I would be happy to consult with you about this innovative treatment tool. If you would like to learn more or explore treatment, contact my Seattle office to schedule a complimentary examination.