Invisalign vs braces: what the evidence says
How clear aligners such as Invisalign compare with braces on results, speed, cost, pain, gum health and daily life, in the words of the systematic reviews that compare them and of the orthodontists' own association. Every claim opens its source.
The newest review of the evidence (15 trials, 1,084 patients) concludes: “Both clear aligners and fixed appliances effectively achieve orthodontic treatment goals. Case complexity and patient compliance should guide appliance selection.” (Alhafi et al. 2025, Eur J Orthod) It found no significant difference in quality or duration for cases treated without taking teeth out, and better results with braces when teeth are taken out: “In extraction cases, fixed appliances provided superior treatment quality, attributed to enhanced control of tooth movements.” (Alhafi et al. 2025, Eur J Orthod) At US practices the two cost about the same: clear aligners average $5,108 and metal braces $6,343.
Which gives better results
What the systematic reviews comparing the two found, newest first, in their own words:
- Alhafi et al. 2025, Eur J Orthod · 15 trials, 1,084 patients
“No significant differences were found in treatment quality or duration between clear aligners and fixed appliances in non-extraction cases, although sensitivity analyses suggested shorter treatment duration with clear aligners.”
“In extraction cases, fixed appliances provided superior treatment quality, attributed to enhanced control of tooth movements.”
“Both clear aligners and fixed appliances effectively achieve orthodontic treatment goals. Case complexity and patient compliance should guide appliance selection.”
- Papageorgiou et al. 2020, Eur J Orthod · 11 studies, 887 patients
“Orthodontic treatment with aligners is associated with worse treatment outcome compared to fixed appliances in adult patients. Current evidence does not support the clinical use of aligners as a treatment modality that is equally effective to the gold standard of braces.”
- Ke et al. 2019, BMC Oral Health · 8 studies
“Both clear aligners and braces were effective in treating malocclusion. Clear aligners had advantage in segmented movement of teeth and shortened treatment duration, but were not as effective as braces in producing adequate occlusal contacts, controlling teeth torque, and retention.”
What the orthodontists say. The AAO, on aligners: “Typically, they can treat light to moderate alignment issues.” (AAO) And: “Clear aligners are not right for everyone. Your orthodontist will recommend the best treatment option based on your unique needs, which may include aligners, braces, or a combination of approaches. Aligners can also be paired with traditional orthodontic elastics, while some cases are treated more predictably with braces.” (AAO)
The most common conditions treated by aligners include: Gapped teeth, cramped or crowded teeth, overbite, underbite, open bite, crooked teeth and crossbite (AAO). Each opens the brands that say they treat it.
Which is faster
Braces, in the AAO's words: “most people have their braces for 12-24 months” (AAO) On aligners, it says “they don't work as quickly, can be easily lost since they're removable, and treat a much narrower set of orthodontic cases” (AAO). The reviews that measured treatment time differ:
- Alhafi et al. 2025, Eur J Orthod · 15 trials, 1,084 patients
“No significant differences were found in treatment quality or duration between clear aligners and fixed appliances in non-extraction cases, although sensitivity analyses suggested shorter treatment duration with clear aligners.”
- Alhamwi et al. 2024, Clin Oral Investig · crowding cases
“Based on currently available information, there was no significant difference in the treatment duration between the CA and FA groups in mild to moderate crowding cases.”
- Papageorgiou et al. 2020, Eur J Orthod · 11 studies, 887 patients
“No significant differences were seen for treatment duration.”
- Ke et al. 2019, BMC Oral Health · 8 studies
“Both clear aligners and braces were effective in treating malocclusion. Clear aligners had advantage in segmented movement of teeth and shortened treatment duration, but were not as effective as braces in producing adequate occlusal contacts, controlling teeth torque, and retention.”
Invisalign's maker says: “Many patients get the smile they want faster with Invisalign treatment rather than traditional braces – five months faster, in fact.” (Invisalign) Its page cites the studies behind that claim.
Which costs less
Invisalign: “In most cases, the cost of Invisalign treatment is comparable to the cost of braces.” (Invisalign) Typical fees at US practices for each kind of treatment, from CareCredit's cost survey, covering all 50 states and the District of Columbia, conducted by ASQ360° Market Research in 2023-2024:
Insurance, in the AAO's words: “Dental plans with orthodontic coverage usually cover both traditional braces and clear aligners equally!” (AAO) From Align's own survey (Align Technology's survey of 299 US orthodontists and 34 general dentists who had treated both braces and Invisalign cases): “53.5% of doctors reported that Invisalign costs the same or less than braces.” (Invisalign) What Invisalign costs by type of case, in every state and with insurance: Invisalign cost.
Which hurts less
The reviews that compared pain, newest first:
- Li et al. 2023, BMC Oral Health · systematic review and meta-analysis
“patients treated with clear aligners experienced lesser pain than those treated with fixed appliances on the third and fourth day after the initial treatment. The difference in pain intensity between the two treatment modalities was not noted at other time points.”
- Cardoso et al. 2020, Prog Orthod · 7 studies
“Based on a moderate level of certainty, orthodontic patients treated with Invisalign appear to feel lower levels of pain than those treated with fixed appliances during the first few days of treatment. Thereafter (up to 3 months), differences were not noted.”
On aligners, the AAO: “Mild discomfort is common for the first few days.” (AAO)
Teeth and gums during treatment
The reviews that compared plaque, white spots and gum health, newest first:
- Raghavan et al. 2023, BMC Oral Health · systematic review and meta-analysis
“A moderate-quality evidence reveals less plaque accumulation and less SCB in CA, which might be related to the reduced incidence and severity of WSLs associated with CA when compared with CF appliances.”
- Di Spirito et al. 2023, Healthcare (Basel) · 4 systematic reviews with meta-analysis
“Therefore, the impact of orthodontic treatment with clear aligners and fixed appliances on periodontal health status should be considered comparable.”
Living with each
Clear aligners
- How visible: “very difficult to see” (AAO).
- Wear: “Typically, each aligner is worn for 1 week at a time, at least 22 hours a day, and moves teeth a fraction of a millimeter at a time.” (AAO)
- Eating: “Aligners must be removed when you eat or drink and when brushing and flossing.” (AAO)
- Removable: Taken out daily to eat, to brush and for occasional social events, which also means they can be lost. (AAO)
Braces
- How visible: metal braces are “much more visible” (AAO); ceramic braces are “less noticeable braces than traditional metal braces” (AAO); lingual braces are “virtually invisible” (AAO).
- Removable: no. Attached to the teeth for the duration of treatment. (AAO)
- Eating, as Invisalign's maker puts it: “When you wear braces, there are many foods you should avoid. This includes popcorn, nuts, corn on the cob, candy, carrots, apples and more.” (Invisalign)
Invisalign's maker also claims “Invisalign patients require 30% fewer doctor visits, on average, than patients with fixed appliances like braces.” (Invisalign) and that “emergency visits with Invisalign clear aligners occur almost 80% less frequently than with braces.” (Invisalign) Both figures are its own data.
Retainers, and whether the result lasts
The AAO: “After your braces are removed, you will wear an orthodontic retainer.” (AAO) On stability afterwards:
- Alhafi et al. 2025, Eur J Orthod · 15 trials, 1,084 patients
“Limited evidence indicated similar post-treatment stability between the two interventions.”
- Regalado-Bazán et al. 2024, J Clin Exp Dent · 3 studies
“there are apparently no significant differences in frequency of relapse between the two types of treatment, suggesting similar stability results.”
Which brands include retainers, what replacements cost and how long to wear them: retainers after aligners.
How to choose
The AAO: “Which treatment is right for you typically depends on the complexity of the malocclusion (misaligned bite) that needs to be corrected.” (AAO) And: “An orthodontist is best qualified to determine whether braces or clear aligners are the best treatment option for you.” (AAO)
- Teeth to be taken out, or a complex bite: braces gave better results in the reviews (results).
- Mild to moderate crowding or spacing: both work, so it comes down to whether you will wear aligners 22 hours a day, how much you mind braces being seen, and the fee (cost).
- Gums or cavities a worry: aligners came out ahead on plaque and white spots, though gum health overall was judged comparable (teeth and gums).
- For a child: “The American Association of Orthodontists (AAO) recommends that children have their first orthodontic evaluation around age 7.” (AAO)
Where at-home aligners fit
Invisalign is in-office, doctor-directed: your dentist or orthodontist fits and adjusts treatment through regular visits. Remote, at-home brands work differently: impressions or a scan kit at home, a plan reviewed online, aligners mailed to your door. They suit mild crowding or spacing, when you are comfortable with no in-person exam. Every brand in price order: Invisalign alternatives. What can go wrong without in-person care, and each brand's FDA record: safety.
The reviews behind this page
Each opens the review itself. Every quote on this page is from its abstract, word for word.
- Alhafi et al. (2025). Quality and stability of orthodontic treatment outcomes with clear aligners versus fixed appliances: a systematic review and meta-analysis. Eur J Orthod. 15 trials, 1,084 patients.
- Alhamwi et al. (2024). Duration of orthodontic treatment with clear aligners versus fixed appliances in crowding cases: a systematic review. Clin Oral Investig. crowding cases.
- Regalado-Bazán et al. (2024). Comparison of relapse of orthodontic treatment following aligner versus conventional fixed appliance treatment. A systematic review. J Clin Exp Dent. 3 studies.
- Li et al. (2023). Comparison of pain intensity and impacts on oral health-related quality of life between orthodontic patients treated with clear aligners and fixed appliances: a systematic review and meta-analysis. BMC Oral Health. systematic review and meta-analysis.
- Raghavan et al. (2023). White spot lesions, plaque accumulation and salivary caries-associated bacteria in clear aligners compared to fixed orthodontic treatment. A systematic review and meta-analysis. BMC Oral Health. systematic review and meta-analysis.
- Di Spirito et al. (2023). Impact of Clear Aligners versus Fixed Appliances on Periodontal Status of Patients Undergoing Orthodontic Treatment: A Systematic Review of Systematic Reviews. Healthcare (Basel). 4 systematic reviews with meta-analysis.
- Papageorgiou et al. (2020). Treatment outcome with orthodontic aligners and fixed appliances: a systematic review with meta-analyses. Eur J Orthod. 11 studies, 887 patients.
- Cardoso et al. (2020). Pain level between clear aligners and fixed appliances: a systematic review. Prog Orthod. 7 studies.
- Ke et al. (2019). A comparison of treatment effectiveness between clear aligner and fixed appliance therapies. BMC Oral Health. 8 studies.
Common questions
Is Invisalign better than braces?
Neither wins outright. The newest review of the evidence (15 trials, 1,084 patients) concludes: “Both clear aligners and fixed appliances effectively achieve orthodontic treatment goals. Case complexity and patient compliance should guide appliance selection.” (Alhafi et al. 2025, Eur J Orthod) It also found: “In extraction cases, fixed appliances provided superior treatment quality, attributed to enhanced control of tooth movements.” (Alhafi et al. 2025, Eur J Orthod) An earlier review found: “Orthodontic treatment with aligners is associated with worse treatment outcome compared to fixed appliances in adult patients. Current evidence does not support the clinical use of aligners as a treatment modality that is equally effective to the gold standard of braces.” (Papageorgiou et al. 2020, Eur J Orthod) Every review: which gives better results.
Which is faster, Invisalign or braces?
It depends on the case, and the reviews differ. The AAO says “most people have their braces for 12-24 months” (AAO) and that aligners “they don't work as quickly, can be easily lost since they're removable, and treat a much narrower set of orthodontic cases” (AAO). “No significant differences were found in treatment quality or duration between clear aligners and fixed appliances in non-extraction cases, although sensitivity analyses suggested shorter treatment duration with clear aligners.” (Alhafi et al. 2025, Eur J Orthod) “Based on currently available information, there was no significant difference in the treatment duration between the CA and FA groups in mild to moderate crowding cases.” (Alhamwi et al. 2024, Clin Oral Investig) “No significant differences were seen for treatment duration.” (Papageorgiou et al. 2020, Eur J Orthod) “Both clear aligners and braces were effective in treating malocclusion. Clear aligners had advantage in segmented movement of teeth and shortened treatment duration, but were not as effective as braces in producing adequate occlusal contacts, controlling teeth torque, and retention.” (Ke et al. 2019, BMC Oral Health) Invisalign's maker says: “Many patients get the smile they want faster with Invisalign treatment rather than traditional braces – five months faster, in fact.” (Invisalign)
Is Invisalign cheaper than braces?
About the same. CareCredit's survey of US practices puts clear aligners at $5,108 on average, metal braces at $6,343, ceramic braces at $5,834 and lingual braces at $9,221. Invisalign says: “In most cases, the cost of Invisalign treatment is comparable to the cost of braces.” (Invisalign) The AAO: “Dental plans with orthodontic coverage usually cover both traditional braces and clear aligners equally!” (AAO) What Invisalign costs by type of case, in every state and with insurance: Invisalign cost.
Can Invisalign fix everything braces can?
No. The AAO says aligners “they don't work as quickly, can be easily lost since they're removable, and treat a much narrower set of orthodontic cases” (AAO), and: “Clear aligners are not right for everyone. Your orthodontist will recommend the best treatment option based on your unique needs, which may include aligners, braces, or a combination of approaches. Aligners can also be paired with traditional orthodontic elastics, while some cases are treated more predictably with braces.” (AAO)
Which hurts more, Invisalign or braces?
Braces, at first. “patients treated with clear aligners experienced lesser pain than those treated with fixed appliances on the third and fourth day after the initial treatment. The difference in pain intensity between the two treatment modalities was not noted at other time points.” (Li et al. 2023, BMC Oral Health) “Based on a moderate level of certainty, orthodontic patients treated with Invisalign appear to feel lower levels of pain than those treated with fixed appliances during the first few days of treatment. Thereafter (up to 3 months), differences were not noted.” (Cardoso et al. 2020, Prog Orthod) On aligners, the AAO says: “Mild discomfort is common for the first few days.” (AAO)
Can Invisalign fix an overbite?
The AAO lists overbite among the most common conditions aligners treat and says of aligners: “Typically, they can treat light to moderate alignment issues.” (AAO) Whether yours is one of them is for an orthodontist to judge: “An orthodontist is best qualified to determine whether braces or clear aligners are the best treatment option for you.” (AAO) Which brands say they treat it: clear aligners for an overbite.
Is Invisalign or braces better for adults?
The reviews mostly studied adults. One found: “Orthodontic treatment with aligners is associated with worse treatment outcome compared to fixed appliances in adult patients. Current evidence does not support the clinical use of aligners as a treatment modality that is equally effective to the gold standard of braces.” (Papageorgiou et al. 2020, Eur J Orthod) The newest concludes: “Both clear aligners and fixed appliances effectively achieve orthodontic treatment goals. Case complexity and patient compliance should guide appliance selection.” (Alhafi et al. 2025, Eur J Orthod)
Is Invisalign or braces better for kids?
Start with a check-up: “The American Association of Orthodontists (AAO) recommends that children have their first orthodontic evaluation around age 7.” (AAO) Which treatment follows depends on the bite: “Which treatment is right for you typically depends on the complexity of the malocclusion (misaligned bite) that needs to be corrected.” (AAO)
Do you need a retainer after Invisalign?
Yes, as after braces. The AAO: “After your braces are removed, you will wear an orthodontic retainer.” (AAO) On stability afterwards, the reviews found no clear difference between the two. Retainers and how long to wear them: retainers after aligners.
Sources checked 2026-10-08. This page summarizes published evidence; an orthodontist who examines you decides what suits your teeth.