When you think of braces, you probably think of those awkward adolescent years, but getting braces as an adult can have some great cosmetic and health benefits. Now that Zoom has become a verb and online meetings are the new normal, people have become more conscious of straight and healthy-looking teeth.
“During the pandemic, one of the reasons adults have sought treatment is because of the ‘Zoom effect,'” according to Dr. Ken Dillehay, president of the American Association of Orthodontists. “Looking at ourselves through the lens of a camera during meetings created an urgency among adult patients to begin orthodontic treatment.”
Why Get Braces?
Adults can have the same kinds of orthodontic problems that children and teens have, such as crowding or too much space between teeth, as well as overbites and underbites. A common misconception is that you may be too old for orthodontic treatment or your situation is too difficult to consider treatment, but that’s not the case, says Dr. Richard Williams, professor of orthodontics at the University of Tennessee Health Science Center in Memphis, Tennessee. “The deciding factor on whether a patient is a good candidate for treatment is the health of their teeth and gums and not their age.”
Over time, misaligned jaws or teeth can cause both health problems and pain as it leads to abnormal wearing of the teeth’s surfaces.
“If an adult patient leaves misaligned teeth untreated, it could lead to other dental problems such as tooth decay, gum disease and difficulty chewing” and TMJ problems, Dillehay explains. “Orthodontic treatment creates a better bite, making teeth fit better and decreasing the risk of future dental problems.”
According to a recent survey conducted by the AAO, adult patients seeking a healthier smile now outweigh adolescent patients in treatment. People who had braces or aligners when they were younger may be surprised that treatment as an adult may take longer. Since adults have stopped growing, their bones are more stable, which makes the process slower. In the end, however, it’s the patient’s biology, regardless of age, that will drive the speed of tooth movement.
[Read: How to Find a Good Dentist.]
Types of Braces
Braces use small fixtures called brackets that are attached to the teeth with a thin metal wire called an archwire to exert gentle, but consistent pressure over time to slowly straighten and reposition teeth. All braces require periodic visits to the orthodontist for adjustment. Braces come in four main types — each with their pros and cons:
These are standard metal braces that connect to the front of the teeth by wire.
— Pros: They are no longer as cumbersome as they once were. Present-day brackets are smaller and more unobtrusive. Metal braces are the least expensive option.
— Cons: They are the most noticeable.
These use tooth-colored or clear brackets, rather than metal.
— Pros: The brackets are less noticeable than metal braces. To be even more inconspicuous, tooth-colored wires can be used.
— Cons: As the brackets are tooth-colored or clear, patients need to be diligent with their oral care as the brackets can stain easily.
These are the same as metal braces, but they go on the inside (backside of tongue side) of the teeth.
— Pros: Because they’re on the inside of the teeth, they’re invisible from the outside.
— Cons: They’re more expensive and harder to place. Regular adjustments will take longer. They’re more of a challenge to clean effectively due to their placement.
These braces use a system built into the bracket to hold the archwire rather than using elastic bands or metal ties like metal, ceramic and lingual braces.
— Pros: A 2019 study found the alignment of the upper teeth was substantially faster in the initial four months of treatment, making this a good option for those who are looking for a shorter duration of treatment. Another benefit is that they are easier to clean than other braces.
— Cons: Using this more modern technology typically makes them more expensive. The brackets are also more prone to breakage.
Invisible Aligner Options
Aligners are a popular choice for adults as they are made of a clear plastic-like material and use a discreet bonding material that help the aligner properly grip the teeth. Invisalign was the first aligner available, and while there are many other brands out there today, many still use the words Invisalign and aligner synonymously.
Another plus for many adults is that aligners are worn about 22 hours a day so they can be briefly taken out, making eating and oral hygiene easier. Teeth are gradually moved into their proper position by wearing a set of aligners that the orthodontist changes out every two to three weeks for the duration of treatment. Unfortunately, not all orthodontic problems — like extremely misaligned teeth — can be treated with aligners.
What to Expect
During an initial consultation, the orthodontist will listen to your concerns and work with you to determine what options are best both for your lifestyle and for your particular orthodontic issues. It’s important to be clear when talking to the doctor about your general health history, all medications you are taking and any habits like smoking or nighttime teeth grinding that may affect treatment.
The orthodontist will perform an oral exam and take an X-ray looking to determine the health of your teeth and gums both above and below the surface before recommending a course of treatment. Someone from the orthodontist’s practice will discuss your payment options, fees charged and insurance coverage.
After a retractor, which is a device that keeps the mouth open so the orthodontist may work unimpeded, is placed, a mild solution will be put on the tooth surface, which is then quickly rinsed off. It prepares the tooth surface for the adhesive that will be applied before adding the bracket. The orthodontic wire will be threaded through the brackets once they are placed. Depending on the type of braces, the wire can either be held by a clip built into the bracket or by a series of small rubber bands called ligatures.
When getting aligners, orthodontists follow a similar approach to putting on braces. A retractor will be put into place and a mild solution will be put on the tooth surface and then quickly rinsed off. A special adhesive will be placed on certain teeth determined by the orthodontist so the aligner will stay in place. At this point your first set of aligners will be placed. Remember you are trying to move the teeth so, similar to braces, this will not be comfortable at first.
Paying for that Smile
Fees for orthodontic treatment vary as there are a few factors to consider, including:
— Doctor’s costs.
— What type of orthodontics are recommended.
— Severity of the problem.
— How long the treatment lasts.
— What insurance will cover.
All health insurance plans differ in how much, if any, they will cover for adult orthodontic treatment so check with your health insurer before starting treatment to avoid any costly surprises. When calculating the out-of-pocket costs of braces or aligners, keep in mind you may use tax-free money you have deposited throughout the year in a flexible savings account, or FSA, or health savings account, or HSA.
Many factors like your biology, diligent oral care and following the plan your orthodontist gave you contribute to the length of treatment and overall success attained. The more time and energy you devote to taking care of your investment, the better results you will obtain.
Once the braces or aligners are removed, retainers are prescribed to keep your teeth in place. Wearing them diligently is the key to maintaining the success of orthodontic treatment. According to Dillehay, “the responsibility for keeping teeth where you and your orthodontist moved them rests ultimately with you.”
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Update 03/17/22: This story was previously published at an earlier date and has been updated with new information.