Possible Responsibilities

and avoiding an unnecessary chain of events


Speech Impediment

Most removable braces consist of a body made of plastic (polymethyl methacrylate, or PMMA) and retaining clips and active elements made of steel wire. The plastic body is usually on the inside of the teeth, so that in the upper jaw a large part of the palate and in the lower jaw teeth and gums are often covered with plastic on the inside. The plastic base needs a certain thickness for stability reasons, so a large volume is taken up by the braces that is usually filled by the tongue.
For this reason, most removable braces cause a massive impairment of speech.
Especially with the so-called double braces of the activator or bionator type, often only sound speech is possible. The impairment is usually so severe that removable braces cannot be worn at school. Children, however, want their freedom in the afternoon and want to play or do sports without interference – here, too, the removable braces interfere and are therefore not worn.
Scientific studies have shown that for these reasons, removable braces are almost always worn only at night, the only time when the speech impairment is not a problem. However, wearing them at night hardly achieves any treatment effects, so that treatments with removable braces fail to a large percentage.

Fixed Braces, Lingual Technique, the Invisalign-System

Fixed braces, on the other hand, usually do not interfere with speech in any way because they are usually attached to the outside of the teeth and do not interfere with tongue function. Some fixed appliances, such as palatal braces or palatal expansion appliances, are placed on the palate side, but always leave the front palate free, which is most important for speech. Even with these appliances, there is normally no restriction of speech.
Only the fixed braces with brackets on the inside of the teeth (lingual technique) can lead to impediments in the formation of some sounds in sensitive people. After an adaptation period of a few weeks, however, most patients get over this. In our practice in Mannheim, considerably less than 10 % of the treatment time is spent with traditional removable braces. Aligner treatments, e.g. Invisalign, are of course something else. They have a promising future and are offered by us with full conviction.


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