Fixed braces in Cologne – brackets for children & teens

There is no such thing as the “best” braces – which type suits you depends on the findings and the treatment goal. The common options:

• Metal brackets: sturdy, proven and effective, but visible.
• Ceramic brackets: tooth-colored and less noticeable, but more fragile.
• Self-ligating brackets: manage without rubber bands, often with fewer appointments.

Which option makes sense for you is something we discuss in the consultation. In a twelve-month clinical comparison study, ceramic brackets came loose more often, at 15.9 percent, than metal brackets, at 9.1 percent – but they are less noticeable.

Here you will find an overview of all types of braces: fixed braces, removable appliances and clear aligners.

In the first few days after the braces are placed or adjusted, the teeth are often sensitive to pressure – this is normal and comes from the pressure that moves the teeth. There may also be rubbing against the cheeks and lips. The discomfort usually subsides within a few days, once the lining of the mouth has gotten used to it. It can be eased with soft food and, if needed, a pain reliever such as ibuprofen or acetaminophen. If severe pain lasts longer, you should have the braces checked. For most people, the feeling of pressure eases noticeably after about 3 to 5 days.

That depends on the findings. Fixed braces – brackets plus archwires, bonded firmly to the teeth – are suitable for more pronounced misalignment and are worn continuously. A removable appliance corrects milder misalignment or holds the result after treatment as a retainer ; it can be taken out. Often the two are combined. What fits depends on the severity of the misalignment, on age and on individual factors. In direct comparison studies, the difference in the result achieved at the overjet – the horizontal distance between the upper and lower front teeth – was less than one millimeter between fixed and removable appliances. What matters is therefore which misalignment is present, not which type of device.

Fixed braces correct misaligned teeth and jaw anomalies. The benefits:

• Alignment: corrects overbite, underbite, crossbite and open bite as well as crowding.
• Esthetics: an even smile strengthens self-confidence.
• Dental health: lowers the risk of gum disease, cavities and wear.
• Function: improves chewing and speech, and takes strain off the temporomandibular joint.
• Durability: with good follow-up care, the results last long-term.

Treatment takes time, good oral hygiene and regular check-ups. In children with markedly protruding upper front teeth, the risk of an injury to the front teeth is two to three times higher. In Germany, it is assumed that about 40 percent of ten-year-olds have a need for orthodontic treatment, and around 456,700 treatments are newly planned each year.

Without coverage by health insurance, the costs usually range between 3.000 € and 8.000 €, depending on the findings and the type of braces. How high they turn out to be depends on the type of braces, the length of treatment and the effort involved.

Statutory health insurance covers braces for children and adolescents up to the age of 18 if there is a medical need – for example a pronounced misalignment of the teeth or jaws, or a functional impairment (graded using the KIGlevels, the German grades of orthodontic treatment need). What is paid for is conventional fixed braces; esthetic alternatives such as ceramic brackets cost extra. The conditions differ from one insurer to the next – we will check with you whether a medical need exists and what the options are.

For children and adolescents with a recognized treatment need (KIG grade 3–5), statutory insurers such as AOK generally cover the full cost of fixed braces. Below KIG 3, treatment is usually paid for privately (approx. 3.000–8.000 €).

Yes, braces can often be paid for monthly through an installment plan with the practice. An installment plan may, however, involve interest or fees – check the terms beforehand. As a rough guide: without insurance coverage, costs usually range between 3.000 € and 8.000 €, depending on the findings and the type of braces.

The least expensive option is usually conventional fixed metal braces – proven and comparatively inexpensive. Invisible alternatives such as Invisalign or ceramic brackets cost more. The exact cost depends on the region, the practice and the findings. From KIG 3 upward, statutory insurers generally cover fixed metal braces in full as the standard treatment; below that, treatment usually costs approx. 3.000–8.000 €.

After treatment, teeth tend to shift again – how much depends on your predisposition, the treatment and the follow-up care. This is why retainers (fixed or removable) stabilize the result. They are usually worn for at least six months to a year at first, and often permanently. It is important to follow the retention recommendations consistently.2

In most cases, braces are possible at any age. In some situations, however, they are not advisable or only make sense after preliminary treatment:

• severe jaw abnormalities that require surgical correction
• too little bone or too little space for the teeth
• advanced gum disease or other serious dental problems
• severe allergy to the materials the braces are made of

These points do not automatically rule out treatment. Before we begin, we examine thoroughly whether braces make sense, and we name alternatives if needed. Treatment can only be covered by statutory health insurance if it begins before the patient’s 18th birthday – the only exceptions are severe jaw anomalies that also require oral surgery. If oral hygiene remains inadequate over the long term despite instruction, the treatment goal has to be redefined or the treatment ended – with fixed braces, about one third of patients develop new white decalcification spots.

How quickly something changes depends on the initial findings, the type of braces and the severity of the misalignment. The teeth already move slightly at the start, but a visible result takes time. Depending on the case, treatment lasts from a few months to several years, during which the teeth are under continuous gentle pressure. We check the progress regularly and inform you about the expected time frame. Depending on the case, treatment with fixed braces usually takes about 1.5–2.5 years.

The duration depends above all on the findings and cannot be shortened at will. Consistently keeping the check-up appointments and maintaining good oral hygiene do, however, help keep the treatment within the planned time frame without delays. In one study, every missed appointment extended treatment by about a month on average, as did every phase in which elastics were worn carelessly – regular appointments and consistent wear are therefore the most effective lever. For vibration devices that promise shorter treatment, a benefit for the overall treatment time has not been demonstrated so far.