What This Guide Covers
This guide explains how orthodontic treatment works for adults and what makes it different from childhood treatment. It is written for anyone over 18 considering braces or aligners.
Orthodontics is the dental specialty focused on diagnosing and correcting malocclusion, which is the clinical term for misaligned teeth or an improper bite. According to the American Association of Orthodontists, about one in four orthodontic patients in the United States is an adult. [1] That number has grown steadily over the past two decades.
Adults seek orthodontic care for many reasons. Some want to correct crowding or spacing that bothers them. Others have functional problems such as difficulty chewing, jaw pain, or uneven tooth wear caused by a misaligned bite. In some cases, a general dentist refers an adult patient to an orthodontist before placing crowns, implants, or veneers because the teeth need to be repositioned first.
You can learn more about the specialty and what orthodontists treat by visiting the orthodontics page.
Adult Orthodontic Treatment Options
Several types of braces and aligners can straighten adult teeth, and each option has distinct pros and cons.
Traditional Metal Braces
Metal braces remain the most widely used orthodontic appliance. They consist of small stainless steel brackets bonded to each tooth and connected by an archwire that applies gentle, continuous pressure to move teeth into position.
Modern metal brackets are smaller and more comfortable than older designs. They are effective for nearly every type of malocclusion, including severe crowding, large gaps, and complex bite problems such as underbite or open bite. [1]
The main drawback for adults is visibility. Metal braces are the most noticeable option. Some adults find this acceptable, especially given that metal braces are often the least expensive choice and may achieve results slightly faster for complex cases.
Ceramic (Clear) Braces
Ceramic braces work the same way as metal braces but use tooth-colored or translucent brackets. This makes them less visible, which many adults prefer.
The brackets are slightly larger than metal brackets and can stain if exposed to certain foods and drinks over time. They also tend to cost more than metal braces. Ceramic braces are a reasonable middle ground for adults who want the reliability of traditional braces with a less obvious appearance.
Lingual Braces
Lingual braces are placed on the tongue side (back surface) of the teeth, making them virtually invisible from the front. They are custom-made for each patient.
Because of their placement, lingual braces can be harder to clean and may initially affect speech. They also tend to be the most expensive bracket option. Not all orthodontists offer lingual braces because they require specialized training and techniques.
Clear Aligners
Clear aligners are removable, transparent plastic trays that fit snugly over the teeth. The patient wears a series of trays, switching to a new set every one to two weeks. Each tray moves the teeth slightly closer to the final position.
Aligners are popular with adults because they are nearly invisible and can be removed for eating, brushing, and flossing. According to the American Dental Association, clear aligners are effective for mild to moderate crowding, spacing, and certain bite issues. [2] More severe malocclusions may still require braces.
Success with aligners depends heavily on patient compliance. Most systems require 20 to 22 hours of wear per day. Wearing them less than recommended can slow treatment or compromise results.
How to Compare Your Options
No single appliance is best for every adult. The right choice depends on the type and severity of the bite problem, lifestyle preferences, budget, and the orthodontist's clinical recommendation.
Metal and ceramic braces handle the widest range of cases. Clear aligners offer convenience and aesthetics but may not be suitable for complex tooth movements. Lingual braces provide invisibility with the mechanical advantages of brackets, but at a higher cost. An orthodontist can explain which options are realistic for a specific case after a thorough examination.
What Adults Should Know Before Starting Treatment
Adult orthodontic treatment is safe at any age, but a few biological and practical factors set it apart from treatment in teenagers.
How Adult Teeth Respond Differently
Adult bone is denser than the bone of a growing adolescent. This means teeth typically move more slowly in adults, and treatment times may be somewhat longer. [1] Results vary by individual, but many adult cases take 12 to 36 months.
Adults are also more likely to have existing dental conditions. Periodontal disease (gum disease), bone loss, missing teeth, crowns, and root canals can all affect treatment planning. An orthodontist will evaluate these factors before recommending a plan. In some cases, gum disease must be treated and stabilized before orthodontic work begins.
Getting Your Mouth Ready
A healthy mouth is essential before starting orthodontics. This usually means having a recent dental cleaning and exam, treating any active cavities, and ensuring gum health is stable. [2]
If you have not seen a general dentist recently, schedule that visit first. Your general dentist and orthodontist may need to coordinate care, especially if you have crowns, bridges, or implants. Teeth with implants cannot be moved orthodontically because implants are fused directly to the bone.
Retainers After Treatment
Retention is a critical part of adult orthodontics. After braces or aligners are removed, teeth have a natural tendency to shift back toward their original positions. This is called relapse.
Most orthodontists prescribe a retainer to be worn full-time for several months and then nightly for an extended period, often indefinitely. Retainers can be removable trays or fixed wires bonded behind the front teeth. Skipping retainer wear is one of the most common reasons adults lose their orthodontic results over time.
What to Expect During Adult Orthodontic Treatment
Treatment follows a predictable sequence: consultation, records, appliance placement, adjustment visits, and retention.
Initial Consultation
The first visit typically lasts 30 to 60 minutes. The orthodontist examines your teeth, jaw, and bite. They may take X-rays, photographs, and digital or physical impressions of your teeth during this visit or at a separate records appointment.
Based on these records, the orthodontist develops a diagnosis and treatment plan. They will explain what type of malocclusion you have, which appliance options are appropriate, the estimated treatment time, and the cost. This is the right time to ask questions about each option.
Active Treatment Phase
If you choose braces, the bonding appointment usually takes one to two hours. Brackets are attached to the teeth with a dental adhesive, and the archwire is placed. You may feel pressure and mild soreness for a few days after placement and after each adjustment visit.
Adjustment visits occur every four to eight weeks. The orthodontist checks progress, changes wires, and may add or adjust elastics (rubber bands) that help correct bite alignment. Each visit typically lasts 15 to 30 minutes.
If you choose clear aligners, you receive your first sets of trays and instructions on wear time. Attachments, which are small tooth-colored bumps of composite material, may be bonded to certain teeth to help the aligners grip and move teeth more effectively. Aligner check-in visits are usually scheduled every six to ten weeks.
Finishing and Retention
When the orthodontist is satisfied with tooth positions and bite alignment, the braces are removed or the final aligner tray is completed. Bracket removal usually takes about an hour and involves carefully debonding the brackets and polishing any remaining adhesive from the teeth.
Retainer impressions or scans are taken the same day or shortly after. The retainer is then delivered, and the orthodontist provides specific instructions on how many hours per day to wear it. Follow-up visits to monitor retention are usually scheduled at intervals over the following year.
Cost of Adult Orthodontic Treatment
Adult orthodontic treatment typically costs between $3,000 and $10,000. Costs vary by location, provider, and case complexity.
Metal braces generally fall in the $3,000 to $7,000 range. Ceramic braces may add $500 to $2,000 to that cost. Clear aligner treatment often ranges from $3,500 to $8,000, depending on the brand and the number of refinement stages needed. Lingual braces tend to be the most expensive, with fees that can range from $6,000 to $13,000.
Many orthodontic offices offer in-house payment plans that spread the cost over the length of treatment, sometimes interest-free. Health savings accounts (HSAs) and flexible spending accounts (FSAs) can also be used to pay for orthodontic care with pre-tax dollars.
Some dental insurance plans include orthodontic benefits for adults, though many have a lifetime maximum, commonly $1,000 to $2,500, that may cover only a portion of the fee. Check with your insurance carrier before treatment begins to understand what is covered and whether pre-authorization is required.
When to See an Orthodontist Instead of a General Dentist
An orthodontist is the right provider when you have a bite problem, significant crowding, or tooth alignment issues that affect function or oral health.
General dentists can identify alignment problems and may offer limited aligner treatment for mild cases. However, an orthodontist completes two to three years of specialty residency training beyond dental school, focused entirely on tooth movement and jaw alignment. [1] For moderate to severe malocclusion, crossbites, open bites, deep bites, or cases involving jaw discrepancies, an orthodontist has the advanced training to manage these complexities safely.
You should also see an orthodontist if your general dentist recommends tooth movement before restorative work such as crowns, bridges, or implants. An orthodontist can reposition teeth to create the space and alignment a restorative dentist needs.
Consider scheduling a consultation with an orthodontist if you experience any of the following:
- Crowded, overlapping, or widely spaced teeth that make cleaning difficult
- An upper and lower jaw that do not meet properly when you bite down
- Jaw pain, clicking, or difficulty chewing related to bite alignment
- Teeth that have shifted noticeably after previous orthodontic treatment
- A referral from your general dentist or another specialist for pre-treatment alignment
Find an Orthodontist for Adult Treatment
If you are considering braces or aligners as an adult, the next step is a consultation with a qualified orthodontist. During that visit, you will learn which treatment options fit your specific bite problem, how long treatment may take, and what the total cost looks like. You can search for an orthodontist in your area by visiting the orthodontics page and browsing providers by location. Most orthodontists offer free or low-cost initial consultations, making it easy to get informed before committing.
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