As orthodontic options expand, many patients today are presented with two primary ways to straighten their teeth: Clear aligners and traditional braces. Clear aligners have become heavily marketed, especially to adults looking for a discreet option. However, it’s important to understand that clear aligners are an alternative to braces—not an equal substitute.

Both systems move teeth, but they do so in fundamentally different ways, with different strengths, limitations, and expectations for results.

Equally important is the expertise, training, and philosophy of the provider. The rise of corporate dentistry has created environments where the focus is often on quickly starting treatment rather than planning the most predictable, stable final result. Orthodontists—specialists who straighten teeth all day, every day—approach treatment with an entirely different level of depth, flexibility, and long-term focus.

How Clear Aligners Move Teeth

Clear aligners straighten teeth by using a sequence of plastic trays, each programmed to create small incremental movements.

Key characteristics include:

• Incremental movement: Each clear aligner represents a planned “step” of tooth movement.
• Compliance is everything: Clear aligners only work when worn 20–22 hours per day. If they’re not worn as instructed, they simply don’t work.
• Pre-programmed movement: All aligners are typically ordered at once.
• Tracking challenges: Teeth don’t always follow the plan perfectly—especially small teeth such as lateral incisors or teeth with rounded contours.

These tracking challenges are common with:

• Small or short anterior teeth
• Extrusions (bringing front teeth down—often the most esthetically important movement)
• Rotations of certain tooth shapes

When teeth don’t track: New scans and a new series of clear aligners are required.

Clear aligners grip teeth using attachments and tooth contour. If the tooth doesn’t stay fully engaged in the aligner, movements like extrusion or rotation become unpredictable. Aligner companies are laboratories—not treatment planners. Clear aligner companies fabricate whatever tooth movements the provider submits. They are similar to a dental lab: they make what is prescribed, but they do not diagnose or decide what is best for the patient.

Posterior open bites & Clear Aligners

Because clear aligners cover the biting surfaces, the back teeth may intrude, sometimes resulting in a bite that no longer meets properly. Braces rarely produce this issue because teeth maintain natural contact throughout treatment.

How Braces Move Teeth

Braces use brackets and wires to apply continuous, gentle pressure to teeth. Unlike clear aligners, braces do not rely on patient compliance to be effective.

Key advantages include:

• 24/7 activation: Braces are always working, regardless of patient habits.
• More efficient for complex movements, such as significant rotations, intrusions/extrusions, major crowding, and movements requiring controlled three-dimensional force
• The bite can be evaluated throughout treatment: The teeth touch during braces treatment, which helps prevent issues like posterior open bites.

Orthodontist vs. Dentist vs. Corporate Dentistry

Clear aligners are now offered across many dental settings, but the training and treatment philosophy behind them differ greatly.

General Dentists

Many general dentists:

• Use one clear aligner system (often corporate-branded)
• Do not offer braces or alternative modalities
• Depend heavily on pre-programmed aligner software
• Have limited training in orthodontic biomechanics
• Are influenced by production goals, especially in corporate dental settings

In corporate dentistry, the priority is often:

Start a clear aligner treatment—without proper evaluation from an orthodontic specialist. This is especially important when considering your child’s teeth, as children are still growing and require careful, specialized evaluation of bite, airway, and developing jaw structures. This business model may not emphasize:

• Long-term stability
• Bite correction
• Growth considerations
• Predictability of movement
• The ability to switch modalities when clear aligners fail

When the only tool available is clear aligners, nearly every case becomes a clear aligner case—even when braces or a hybrid approach would produce a better result.

Orthodontists

Orthodontists are specialists in tooth movement. They receive 2–3 years of additional full-time specialty training dedicated exclusively to orthodontics.

Orthodontists:

• Use multiple clear aligner companies
• Provide braces, clear aligners, or hybrid treatment
• Understand biomechanics at an advanced level
• Monitor growth and development in children
• Can switch from clear aligners to braces mid-treatment if necessary
• Are focused on achieving the best final outcome, not simply starting a case quickly

Most importantly, orthodontists don’t rely on a single modality. They have the full toolbox—and can shift treatment to achieve the precise result each patient deserves.

Straight Teeth Are Not Always Healthy Teeth

Straightening teeth is only part of the picture. True orthodontic success considers:

• Proper bite relationship
• Gum and bone health
• Tooth wear
• Stability
• Growth patterns
• Airway development in children
• Long-term function

A corporate or aligner-only approach often focuses on the cosmetic result—what the teeth look like—not how they fit together or how they will function over time.

Are Clear Aligners Right for Everyone?

Clear aligners are a great option for many patients—but not all.

Marketing by clear aligner companies and direct-to-consumer brands has led many patients to believe aligners are universally appropriate. In reality, some movements are simply more predictable, efficient, and stable with braces or a hybrid approach.

That is why evaluation by an orthodontist is so valuable: the treatment plan is customized based on biology and biomechanics, not marketing trends.

The Bottom Line

• Clear aligners are an excellent alternative—but not an identical substitute—for braces.
• Clear aligners depend heavily on patient compliance, and some tooth movements are inherently unpredictable.
• Braces can achieve certain movements more efficiently and with more control.
• Corporate dentistry tends to emphasize starting treatment quickly, not necessarily ensuring the best final bite or long-term stability.

Orthodontists specialize in designing predictable, stable, esthetic outcomes and can switch modalities at any point to get the best result. A smile is an investment. Choosing a specialist who has every tool available—not just one—helps ensure the outcome is healthy, stable, and exactly what you envisioned.