Lingual Orthodontics: Features of Appliances on the Inside of the Teeth, Adjusting to Them and Brushing Care

Lingual orthodontics is fixed orthodontics in which brackets are attached to the tongue-side surface of the teeth rather than the outer surface to move the teeth. The Korean Association of Orthodontists (KAO, 대한치과교정학회) introduces the lingual bracket as an appliance attached to the back of the teeth so it cannot be seen from the front, and explains that, like other fixed appliances, its structure is complex so oral hygiene care is very important. In Korea the cost is non-covered, and the duration varies with the degree of malocclusion.

Published 2026-11-08 · Updated 2026-11-08 · DentalStatics editorial team

Key facts

Appliance position	Attached to the back of the teeth (tongue side), so not seen from the front (source: Korean Association of Orthodontists)
Appliance type	Fixed bracket appliance (source: Korean Association of Orthodontists)
Typical orthodontic duration	Usually 1-3 years (individual differences), adjusted about every 4 weeks (source: Seoul National University Hospital medical information)
Adapting to the appliance	Discomfort from the appliance is mostly adapted to within a few weeks (source: Korean Association of Orthodontists)
Health insurance	Dental orthodontics is not covered (source: National Health Insurance Service (NHIS, 국민건강보험공단))

What kind of orthodontics is lingual orthodontics?

The principle is the same as ordinary bracket orthodontics. Brackets are bonded to the teeth and force is transmitted with a wire to move them; the difference is that the brackets are attached to the tongue side rather than the outside. So the appliance is almost invisible when you smile or talk.

The inner surface of the teeth varies greatly from person to person, so the bracket positions are often decided in advance from dental models or scan data and then bonded. Seoul National University Hospital's medical information also states that, among fixed appliances, the method of attaching them on the tongue side is possible.

It is also used for partial orthodontics that aligns only the front teeth and for re-treatment of limited range. The Korean Association of Orthodontists explains that re-treatment of a limited range is possible with a lingual or clear appliance.

Who considers lingual orthodontics?

It is considered by people who find a visible appliance a burden because of their job or lifestyle, but are not confident about keeping the wearing time on their own as with clear aligners. A difference from clear aligners is that it is fixed, so there is no taking it out.

However, it does not have the same effect for every malocclusion, and application may be difficult depending on how deeply the upper and lower teeth overlap or the size of the inner surface of the teeth. Whether lingual orthodontics is possible is judged by the dentist from diagnostic records.

The Korean Association of Orthodontists stresses that an accurate diagnosis and plan decide the result more than the choice of appliance. Rather than choosing it for the advantage of being invisible alone, first check whether it suits your own malocclusion.

What discomfort is there during the adjustment period for lingual orthodontics?

Because the brackets are where the tongue moves, in the first few weeks the tip of the tongue may be rubbed by the appliance, or some speech may feel leaky. The Korean Association of Orthodontists explains that discomfort from orthodontic appliances is mostly adapted to within a few weeks.

After the appliance is adjusted, there is a pressing pain in the teeth that usually lasts 2-4 days and then disappears. During this time eat soft food, and if the tongue or cheek is sore, cover the contact area with the wax received from the clinic.

If you have a schedule that requires a lot of talking, discuss it in advance when deciding the date the appliance is attached. If a wound on the tongue does not heal for a long time or a wire end keeps poking, get it adjusted at the clinic.

How do I brush during lingual orthodontics?

The appliance on the inside of the teeth is hard to see even in a mirror, so missed spots easily arise. Stand the toothbrush upright and clean the tongue-side surface of each tooth one by one, then tidy around the brackets and wire with an orthodontic toothbrush and interdental brushes.

The Korean Association of Orthodontists recommends using auxiliary tools together, such as an orthodontic toothbrush, interdental brushes, a water flosser and a floss holder. The back of the front teeth and the inside of the rearmost molars are among the places hardest to clean, so check them once more at the end.

Stand the toothbrush upright and brush the tongue side of the front teeth up and down
Tidy between the brackets and wire with interdental brushes
Clean between teeth with floss using a floss holder
Have missed spots pointed out at check-ups

How are the cost and duration of lingual orthodontics decided?

Dental orthodontics is non-covered by health insurance, so the clinic sets the cost, which varies with the way the appliance is made, the extent of treatment, whether mini-screws are used and the duration. Get the quote split into diagnosis fee, appliance fee, adjustment fee and retainer fee and compare it with other appliances.

The duration depends more on the degree of malocclusion, whether teeth are extracted and the speed at which the teeth move than on the position of the appliance. Seoul National University Hospital's medical information says orthodontic duration differs by individual and usually takes 1-3 years. The duration can lengthen if the appliance comes off or appointments are often postponed.

Scaling received before orthodontics is also not covered by health insurance if it is for orthodontics. If cavity and gum treatment is needed before the appliance is attached, include its cost and schedule in the overall plan.

Common myths and facts

Myth: Lingual orthodontics is less effective than outside orthodontics.

The Korean Association of Orthodontists explains that the appliance does not decide the result; diagnosis, planning and the treatment process matter more. Whether it can be applied is judged by the malocclusion.

Myth: Lingual orthodontics is possible for anyone.

It may be difficult depending on the depth of the bite or the shape of the inner surface of the teeth, so it is decided after diagnosis.

Frequently asked questions

Does speech keep leaking with lingual orthodontics?

At first the tongue touches the appliance and some speech may be awkward, but discomfort from orthodontic appliances is mostly adapted to within a few weeks. If it continues for long, have the position of the appliance or the wire ends checked at the clinic.

Can I do lingual on the upper teeth and outside on the lower teeth?

Because how visible each tooth is and the bite differ, upper and lower are sometimes planned in different ways. Whether it is possible and the cost difference are confirmed at the diagnostic consultation. The lower teeth are less visible when smiling, so there are cases in which upper and lower choices differ.

Are there foods I must not eat during lingual orthodontics?

Hard or sticky foods can knock off brackets, so avoid them. A lingual appliance is hard to notice even when it comes off, so if the feeling at the tip of your tongue changes, contact the clinic. Cut hard fruit or meat into small pieces and chew with the molars.

Does lingual orthodontics need more frequent adjustment visits?

The visit interval is set by the treatment stage and plan rather than the position of the appliance. Adjustments are often at about 4-week intervals, and the exact schedule is explained by the clinic. If appliances come off and extra visits are frequent, the total number of visits also increases.

Is a retainer needed after lingual orthodontics too?

Yes. Whatever appliance was used, moved teeth tend to return until they settle, so wear a fixed or removable retainer as instructed. A fixed retainer is also bonded to the inside of the teeth, so keep cleaning the inside as you did when you had a lingual appliance.

References

Korean version →