What This Guide Covers and Who It Is For
This guide explains what adults can realistically expect before, during, and after orthodontic treatment with braces. It covers common bite and alignment problems, treatment timelines, cost factors, and long-term retention.
Adults now make up a growing share of orthodontic patients. According to the American Association of Orthodontists, one in four orthodontic patients in the United States is over the age of 18. [5] You may be considering braces for the first time, or you may have had braces as a teenager and experienced relapse (teeth shifting back).
Adult orthodontics is not the same as teen orthodontics. Your teeth still move through bone using the same biological process, but several factors change with age. Bone remodels more slowly. Gum tissue may have years of wear. You may have crowns, implants, or missing teeth. This guide addresses each of these factors so you can set accurate expectations.
Whether you are exploring metal braces, ceramic braces, or clear aligners, the core principles in this guide apply. For more detail on how orthodontic specialists differ from general dentists, visit the orthodontics page.
What Adult Braces Can and Cannot Fix
Braces can correct most alignment and bite problems in adults, though some severe skeletal issues may also require surgery.
Common Conditions Braces Treat in Adults
Crowding is the most frequent reason adults seek braces. Crowded teeth overlap or twist because the jaw does not have enough space. Braces create space by moving teeth into better positions along the arch. In some cases, the orthodontist may recommend removing one or two teeth to make room.
Spacing problems are the opposite of crowding. Gaps between teeth can result from missing teeth, small teeth, or habits like tongue thrusting. Braces close these gaps by gradually pulling teeth together.
Bite issues include overbite (upper teeth overlap too far over lower teeth), underbite (lower teeth sit in front of upper teeth), crossbite (some upper teeth sit inside lower teeth), and open bite (front teeth do not touch when you close your mouth). Each of these can cause uneven wear, jaw pain, or difficulty chewing. Braces reposition the teeth and, in many cases, improve how the upper and lower jaws fit together.
- Crowding: overlapping or twisted teeth due to limited space
- Spacing: gaps between teeth from missing teeth or size discrepancies
- Overbite: excessive vertical overlap of upper over lower front teeth
- Underbite: lower front teeth positioned ahead of upper front teeth
- Crossbite: one or more upper teeth biting inside the lower teeth
- Open bite: front teeth that do not meet when the jaw is closed
How Adult Treatment Differs from Teen Treatment
The main biological difference is bone density. In teenagers, bones are still growing and remodel quickly. Adult bone is denser, which means teeth move more slowly. This typically adds several months to overall treatment time compared to a teenager with the same condition.
Adults are also more likely to have periodontal disease (gum disease). Even mild gum inflammation can complicate tooth movement. An orthodontist may refer you to a periodontist before treatment begins to make sure your gums and the bone supporting your teeth are healthy enough for braces. The American Dental Association recommends maintaining good oral hygiene and addressing gum disease before starting orthodontic treatment. [6]
Existing dental work adds another layer. Crowns, bridges, and large fillings change how brackets bond to teeth. If you have a dental implant, that tooth cannot be moved because implants fuse directly to bone. Your orthodontist will design a plan that works around these restorations.
Realistic Before and After Results
Most adults see significant improvement in tooth alignment and bite function. Mild crowding or spacing cases often produce dramatic visual changes. Moderate to severe cases typically show clear improvement, but the final result depends on factors like jaw structure, gum health, and patient compliance with wearing rubber bands or other appliances.
Results vary from person to person. An adult with healthy bone and gums who wears all prescribed appliances can typically expect results comparable to a teenager. An adult with bone loss from gum disease may achieve functional improvement but with some compromises in ideal alignment. Your orthodontist will outline what is achievable during your initial consultation.
Practical Details Before You Start
Preparation for adult braces involves dental health checks, understanding your options, and planning for time commitments.
Age Recommendations and Timing
There is no upper age limit for braces. Adults in their 30s, 50s, and even 70s can benefit from orthodontic treatment if their teeth and gums are healthy. The key factor is not your age but the condition of your bone and soft tissue.
The best time to start is after any active dental problems are resolved. Cavities should be filled. Gum disease should be treated and stable. If you need a tooth extracted or a crown replaced, your orthodontist and general dentist will decide whether to do that before or during treatment.
Types of Braces Available for Adults
Metal braces remain the most common and typically the most cost-effective option. Modern brackets are smaller than those used decades ago. Ceramic braces use tooth-colored or clear brackets that are less visible but function the same way. Lingual braces attach to the back of the teeth and are nearly invisible from the front, though they can be harder to clean and may affect speech initially.
Clear aligners, such as Invisalign, are a popular alternative for adults who prefer a removable appliance. Aligners work well for mild to moderate crowding and spacing. Complex bite corrections may still require traditional brackets and wires. Your orthodontist will recommend the type that fits your specific condition.
How to Prepare for Treatment
Schedule a dental cleaning and checkup before your orthodontic consultation. Your orthodontist needs to see healthy teeth and gums before placing braces. Bring a list of any medications you take, since some drugs (like bisphosphonates for osteoporosis) can affect how bone remodels during tooth movement.
Plan for some dietary changes. Hard, sticky, and crunchy foods can damage brackets. If you choose clear aligners, you will remove them to eat but need to wear them 20 to 22 hours per day for the treatment to stay on schedule.
What Happens During Adult Orthodontic Treatment
Treatment follows a predictable sequence: records and planning, appliance placement, regular adjustments, and finally retention.
Initial Consultation and Records
Your first visit typically includes X-rays, photos, and either physical impressions or a digital scan of your teeth. The orthodontist examines your bite, checks for gum disease, and reviews your dental history. These records allow the orthodontist to create a treatment plan with a projected timeline.
During this visit, the orthodontist will explain which problems can be corrected, how long treatment is expected to take, and what type of appliance is best for your case. Ask about the expected number of visits and any coordination needed with your general dentist or a periodontist.
Braces Placement and Ongoing Adjustments
Bracket placement takes about one to two hours. The orthodontist bonds each bracket to the tooth surface and threads a wire through the brackets. You will feel pressure and mild soreness for the first few days. Over-the-counter pain relievers like ibuprofen typically manage this discomfort.
Adjustment appointments happen every four to eight weeks. At each visit, the orthodontist may change the wire, add elastic bands, or adjust the force on specific teeth. Each adjustment may cause a day or two of soreness. Total treatment time for moderate adult cases is typically 18 to 30 months. Mild cases involving only minor crowding or spacing may finish in 6 to 12 months. Complex cases with significant bite correction can take longer. [5]
Caring for Your Teeth During Treatment
Oral hygiene becomes more demanding with braces. Food and plaque collect around brackets easily. Brush after every meal using a soft-bristled toothbrush. Use floss threaders or a water flosser to clean between teeth and under the wire. The American Dental Association recommends fluoride toothpaste and regular dental checkups during orthodontic treatment. [6]
Continue seeing your general dentist for cleanings every six months, or more often if recommended. If you develop signs of gum disease during treatment, your orthodontist may pause adjustments until the gums heal.
Retention: Keeping Your Results Long Term
After braces are removed, teeth tend to shift back toward their original positions. This is called relapse. For most adults, retention is a lifelong commitment. Your orthodontist will typically place a bonded retainer (a thin wire glued behind the front teeth) and may also give you a removable retainer to wear at night.
Wearing your retainer as instructed is the single most important factor in keeping your results. Skipping retainer wear, even for a few weeks, can allow noticeable shifting. Many orthodontists recommend indefinite nightly retainer use for adult patients.
Cost of Adult Braces
Adult braces typically cost between $3,000 and $7,000, though costs vary by location, provider, and case complexity.
Metal braces tend to fall on the lower end of that range. Ceramic braces usually cost slightly more due to material costs. Lingual braces and clear aligners are often the most expensive options, sometimes reaching $8,000 or more for complex cases.
Many orthodontic offices offer payment plans that spread the cost over the length of treatment. Some dental insurance plans cover a portion of adult orthodontics, though coverage limits are common. A typical insurance benefit for orthodontics ranges from $1,000 to $2,000 over a lifetime. Check with your insurance provider before starting treatment to understand your coverage.
Additional costs may include preliminary dental work such as cleanings, fillings, extractions, or gum treatment. Retainers at the end of treatment may or may not be included in the quoted fee. Ask your orthodontist for a detailed breakdown before you begin.
When to See an Orthodontist Instead of a General Dentist
You should see an orthodontist whenever your case involves bite correction, complex tooth movement, or coordination with other dental specialists.
General dentists can identify alignment problems and may offer limited clear aligner treatment for mild crowding. However, orthodontists complete two to three years of additional residency training focused specifically on tooth movement, jaw growth, and bite mechanics. [5] This training prepares them to manage complications that can arise in adult cases, such as root resorption (shortening of tooth roots from movement), bone loss, and treatment around existing restorations.
If you have any of the following, an orthodontist is the appropriate provider: a bite problem such as an overbite, underbite, crossbite, or open bite; moderate to severe crowding; missing teeth that affect the treatment plan; a history of gum disease; or previous orthodontic treatment that relapsed. Visit the orthodontics page to learn more about what orthodontists do and how their training differs from general dentistry.
- Bite problems (overbite, underbite, crossbite, open bite)
- Moderate to severe crowding or spacing
- Missing teeth that require space management
- History of gum disease or bone loss
- Previous orthodontic relapse
- Need for coordination with periodontists, oral surgeons, or prosthodontists
Find an Orthodontist Near You
If you are considering braces as an adult, a consultation with an orthodontist is the best first step. An orthodontist can evaluate your teeth, bite, gum health, and any existing dental work, then give you a realistic picture of what treatment can achieve. Use the search tool on the orthodontics page to find a qualified orthodontist in your area and schedule a consultation.
Search Orthodontists in Your Area