What This Guide Covers and Who It Is For
This guide is for adults considering orthodontic treatment to straighten teeth, correct a bite problem, or both. It walks through your options, what makes adult treatment different from treatment for teens, and how to plan for the cost and time involved.
Orthodontics is the dental specialty focused on diagnosing, preventing, and treating misaligned teeth and jaws. An orthodontist completes two to three years of additional training beyond dental school. You can learn more about the specialty on the orthodontics page.
Whether you had braces as a teenager and your teeth shifted over time, or you never had orthodontic treatment at all, the information here applies to you. Adults of all ages seek orthodontic care for both cosmetic and functional reasons.
Adult Orthodontic Treatment: Core Facts
Adults can benefit from orthodontic treatment at any age, as long as their teeth and supporting structures are healthy. According to the American Association of Orthodontists, roughly 1 in 4 orthodontic patients is now over the age of 18. [1]
Why Adults Seek Orthodontic Treatment
Adults pursue orthodontic care for several reasons. Some want to correct crowding or spacing that has bothered them for years. Others have functional problems like an overbite, underbite, or crossbite that cause uneven wear on teeth, jaw pain, or difficulty chewing.
Teeth can shift throughout life. Even adults who wore braces as teenagers may notice crowding return over time, especially if retainers were not worn consistently. Tooth loss, gum disease, or normal aging can also change how teeth fit together.
Straightening teeth is not just cosmetic. Properly aligned teeth are easier to brush and floss, which can reduce the risk of cavities and gum disease over time. [2] A well-aligned bite also distributes chewing forces more evenly, which may help protect teeth and jaw joints from excessive wear.
What Makes Adult Orthodontics Different
Adult orthodontic treatment follows the same principles as treatment for younger patients, but several factors make it distinct. Understanding these differences helps set realistic expectations.
First, adult bone is denser and has finished growing. Because teeth move through a process called bone remodeling, where bone breaks down on one side of a tooth and rebuilds on the other, denser adult bone typically means slower tooth movement. This is why treatment times for adults are often slightly longer than for teens with similar problems.
Second, many adults have existing dental work. Crowns, bridges, veneers, or dental implants can affect treatment planning. Brackets may bond differently to porcelain or metal crowns than to natural tooth enamel. Dental implants are fused to bone and cannot be moved orthodontically, so the orthodontist must plan around them.
Third, adults are more likely than teenagers to have some degree of gum disease, also called periodontal disease. Moving teeth through bone that has been weakened by gum disease requires careful monitoring. In many cases, gum disease must be treated and stabilized before orthodontic treatment begins. [2]
Treatment Options for Adults
Several appliance types are available for adults. The right choice depends on the complexity of your case, your lifestyle, and your preferences for visibility and comfort.
- Traditional metal braces: Stainless steel brackets bonded to the front of each tooth and connected by a wire. Metal braces are effective for a wide range of orthodontic problems, including complex cases. Modern brackets are smaller and lower profile than those used decades ago.
- Ceramic (clear) braces: Function the same as metal braces but use tooth-colored or clear brackets that blend with your teeth. They are less noticeable but may be slightly more fragile and can stain if not maintained carefully.
- Lingual braces: Brackets placed on the back (tongue side) of your teeth, making them essentially invisible from the front. Lingual braces can treat many of the same issues as traditional braces, but they may affect speech initially and can be harder to clean. They also tend to cost more.
- Clear aligners: A series of removable, custom-made plastic trays that gradually shift teeth. Brands include Invisalign and others. Aligners are popular among adults for their near-invisibility. They work well for mild to moderate crowding, spacing, and some bite issues. Severe or complex cases may still require braces. [1]
Comparing Your Options
Each option has trade-offs. Metal braces are typically the least expensive and can handle the widest range of problems. Ceramic braces offer a more discreet look but at a slightly higher cost. Lingual braces are the most hidden but often the most expensive and may require a specialist with specific training. Clear aligners offer convenience and aesthetics but require patient discipline since they must be worn 20 to 22 hours per day to be effective.
Your orthodontist will recommend options based on your specific diagnosis. In some cases, only one or two options may be clinically appropriate. For instance, significant jaw discrepancies or severely rotated teeth may respond best to fixed braces rather than aligners.
Practical Details Before Starting Treatment
Preparation and timing matter. Knowing what to address before treatment starts helps avoid delays and complications.
Age Recommendations and Eligibility
There is no upper age limit for orthodontic treatment. Adults in their 30s, 50s, 70s, and beyond have successfully completed treatment. The key requirement is healthy teeth and gums, not a specific age. [1]
Certain medical conditions may affect treatment. Uncontrolled diabetes, medications that affect bone metabolism (such as bisphosphonates used for osteoporosis), and autoimmune conditions can influence how teeth move and how bone heals. Your orthodontist needs a full medical history to plan safely.
Address Dental Health Issues First
Before orthodontic treatment begins, your mouth should be in good overall health. Active cavities need to be treated. Gum disease should be managed and stabilized. Your general dentist or a periodontist (a specialist in gum health) may need to provide treatment before you start. [2]
If you have missing teeth, your orthodontist and general dentist or prosthodontist may coordinate a plan. Sometimes orthodontic treatment is used to close gaps left by missing teeth. Other times, the orthodontist moves teeth to create the ideal amount of space for a future implant or bridge.
Choosing Your Orthodontist
While general dentists can legally provide some orthodontic treatments, a board-certified orthodontist has completed a specialty residency focused entirely on tooth movement and jaw alignment. For adults, especially those with existing dental work or gum concerns, seeing a specialist is often advisable.
During your initial consultation, ask about the orthodontist's experience treating adult patients. Ask to see before-and-after examples of cases similar to yours. A thorough consultation should include diagnostic records such as X-rays, photographs, and dental impressions or digital scans.
What to Expect During Adult Orthodontic Treatment
Treatment follows a predictable sequence of steps, from consultation through retention. Here is what the process typically looks like.
Consultation and Treatment Planning
Your first visit involves a clinical exam, X-rays, and often digital scans or impressions of your teeth. The orthodontist evaluates your bite, tooth alignment, jaw position, and overall oral health.
Based on these records, the orthodontist develops a treatment plan. This plan outlines which appliance is recommended, estimated treatment time, and expected outcomes. You will review the plan together and discuss any alternatives. This is the right time to ask about risks, limitations, and what the orthodontist expects from you as a patient.
Active Treatment Phase
If you choose braces, the orthodontist bonds brackets to your teeth and places an initial wire. You will return for adjustments every four to eight weeks. Each adjustment uses a new or modified wire to continue guiding teeth into position.
If you choose clear aligners, you receive a series of aligner trays. Each tray is worn for one to two weeks before switching to the next one in the sequence. You typically visit the office every six to ten weeks so the orthodontist can monitor progress.
Adult orthodontic treatment typically takes 12 to 36 months. [1] The exact duration depends on the severity of the problem, the type of appliance, and how well the patient follows instructions. Mild crowding may be corrected in under a year. Complex bite corrections or significant tooth movement may take closer to two or three years. Results vary based on individual biology and compliance.
Some discomfort is normal, especially in the first few days after braces are placed or after switching to a new aligner tray. Over-the-counter pain relievers and soft foods typically manage this well. Most adults report that discomfort decreases significantly after the first week.
Retention: Keeping Your Results
After active treatment ends, retention begins. This is a critical phase. Without retainers, teeth tend to shift back toward their original positions. This tendency is called relapse, and it can happen at any age.
Most orthodontists prescribe a retainer to be worn full-time for several months, then at night indefinitely. Retainers may be removable (similar to a clear aligner tray or a wire-and-acrylic appliance) or fixed (a thin wire bonded behind the front teeth). Your orthodontist will recommend the type that best suits your case.
Cost of Adult Orthodontic Treatment
Adult orthodontic treatment typically costs between $3,000 and $8,000. Costs vary by location, provider, and case complexity.
Several factors influence where your treatment falls within that range. The type of appliance matters. Metal braces are generally at the lower end of the range, while lingual braces and clear aligners tend to cost more. The severity and complexity of your orthodontic problem also play a role. A simple spacing issue costs less to treat than a complex bite correction requiring two or more years of treatment.
Geographic location affects pricing significantly. Practices in major metropolitan areas typically charge more than those in smaller cities or rural areas. The experience and credentials of the orthodontist may also influence fees.
Many orthodontic offices offer payment plans that spread the cost over the duration of treatment, often with no interest or low interest. Ask about payment options during your consultation.
Insurance, FSAs, and HSAs
Many dental insurance plans now include orthodontic benefits for adults, though this was not always the case. Coverage often comes with a lifetime maximum, commonly between $1,000 and $2,000 for orthodontic treatment. This means the insurance company will pay up to that amount and no more, regardless of how many years you carry the plan.
Flexible spending accounts (FSAs) and health savings accounts (HSAs) allow you to use pre-tax dollars toward orthodontic treatment. This effectively reduces your out-of-pocket cost by your tax rate. Both FSAs and HSAs can typically be used to pay for braces, aligners, and related orthodontic expenses. [2]
Contact your insurance provider before starting treatment to understand your specific benefits. Your orthodontist's office can often help verify your coverage and submit claims.
When to See an Orthodontic Specialist
An orthodontist is the right provider when teeth are misaligned, your bite does not fit together properly, or both.
You should consider seeing an orthodontist if you experience any of the following:
- Crowded or overlapping teeth that are difficult to clean
- Gaps between teeth that bother you cosmetically or functionally
- An overbite, underbite, crossbite, or open bite (where upper and lower teeth do not meet properly when you close your mouth)
- Jaw pain, clicking, or difficulty chewing that may be related to bite alignment
- Teeth that have shifted noticeably since previous orthodontic treatment
- A general dentist or periodontist has recommended orthodontic treatment as part of a larger restorative plan
General Dentist vs. Orthodontist
General dentists can provide some orthodontic treatments, particularly clear aligners for mild cases. However, an orthodontist has specialized training in tooth movement, jaw growth, and bite correction. For adults with complex issues, existing dental restorations, or gum disease, an orthodontist offers a higher level of diagnostic and treatment expertise. [1]
If your general dentist has identified orthodontic concerns, asking for a referral to an orthodontist is a reasonable next step. Many orthodontists also offer free or low-cost initial consultations.
Find an Orthodontist Near You
If you are considering orthodontic treatment as an adult, the first step is a consultation with a qualified orthodontist. An in-person evaluation allows the specialist to assess your teeth, bite, and oral health, and to recommend options that fit your specific situation. Use our directory on the orthodontics page to search for orthodontists in your area and schedule a consultation.
Search Orthodontists in Your Area