Comparison of Clear Aligners and Fixed Orthodontic Appliances from the Patient's Perspective: A Questionnaire-Based Study

Purpose: This study aimed to evaluate and compare the treatment experiences of individuals receiving orthodontic care with either clear aligners or fixed appliances. Materials and Methods: This cross-sectional study included 90 individuals aged 12–20 years undergoing active orthodontic treatment (clear aligners: n=45; fixed appliances: n=45). A face-to-face questionnaire comprising Likert-type, and multiple-choice items was administered to assess pain, oral hygiene, and ease of appliance use. Non-parametric continuous variables were analyzed with the Mann–Whitney U test, whereas categorical variables were evaluated using Chi-square and linear-by-linear association tests. A p-value of <0.05 was considered statistically significant. Results: Pain during functional activities was significantly more pronounced in the fixed appliance group. Gingival bleeding and intraoral injuries were also more frequently reported in this group (p=0.004 and p=0.049, respectively). Conversely, speech impairment and halitosis were more commonly observed among clear aligner users (p=0.040 and p=0.007, respectively). Tooth brushing difficulty and the use of auxiliary oral hygiene tools were more prevalent in the fixed appliance group. The frequency of emergency-related additional appointments was significantly lower in the clear aligner group (p=0.023). No statistically significant differences were found between the groups regarding the impact on social life or willingness to recommend the treatment method (p>0.05). Conclusion: This study demonstrated that clear aligners and fixed appliances exert significantly different effects on patient experience across multiple domains. These findings underscore the importance of incorporating not only biomechanical considerations but also individual patient factors—such as lifestyle, communication needs, and oral hygiene routines—into orthodontic treatment planning.