What is most important is finding an ortho you trust and who comes highly recommended. If he/she recommends and or uses SL brackets - that should not be a concern as long as you trust their opinion and skill.
Keep in mind many, many orthos use SL's -- why would they would continue to use them if they caused such agony on a consistent basis for their patients or if they did not like the results achieved? Clearly the success of their ortho practice is going to be of utmost importance here.
As explained to me - all adjustments will cause pressure. Whether it is the 'cranking' or 'twisting' feeling of having new ligatures swapped out, or the opening or closing sensation of doors on SLs.
I contemplated braces for TWO years and over that time period I met with ten different orthos - that's right ten. (I moved to another area midway and then changed a job so there were a few reasons for so many consults.) Five of those orthos used traditional brackets and five of those orthos used self ligating. Interestingly enough, only one of the orthos who uses traditional brackets was board certified, and three of the orthos who use self ligating are board certified.
In addition prices were all over the place and the use of self ligating made NO difference in many instances - nor did the use of ceramic. In other words self ligating brackets or damon wires did NOT increase the price with the majority of orthos. The most expensive ortho had 35 years experience, board certified and used self ligating - and he wanted to charge me $8,000 for my braces. He also did not take my insurance therefore he could charge what he wanted for braces. Other orthos in my plan were under a fixed rate to charge based on insurance guidelines. Their prices were more down around $5,000-$5500. And I had orthos who charged $6,000 for traditional brackets as well.
I think what I found most interesting was that an eleventh orthodontist insisted he would NOT use traditional braces on me but rather insisted on invisalign to correct my open bite and crossbite - the cost would be $7,000 and he said at the end of treatment I'd need braces to 'perfect' the job!! AND the additional braces would cost more, but he could not say for sure how much more but atleast another $1,000. I've had other orthos SHUTTER at this ortho's recommendation of Invisalign for me - infact they could not even believe he called himself an ortho. I know I know - teeth can me moved with ANY technique. Guess the key word there is CAN be moved, but that does not mean that there are not far superior techniques to use that will give a better chance of overall success vs. another technique. And when I'm paying for this with time and money - I'm going to go with the odds being in my favor.
Lastly - - - since getting my self ligating braces, not only have I experienced minimal discomfort in the closing and opening of doors (no tears to the eyes) -- but I've met a large number of other adult patients with SL's who are further along in treatment, had thicker wires added and they have had no issues whatsover.
I can only assume this comes down to the individual patient's case, perhaps their overall sensitivity as well as the person doing the work on their mouth, time between adjustments, etc. But not the technique of opening and closing doors to secure an arch wire vs. the popping in of an arch wire and keeping it secured by placing a ligature on every tooth.
Best of luck with your choice!!
