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Although they may seem like an adolescent rite of passage, braces are increasingly used for adults. In fact, one in four orthodontic patients is an adult, according to the American Association of Orthodontists.
“Teeth can be moved and straightened at any age,” says Celeste Block, a doctor of dental surgery and specialist in orthodontics and dentofacial orthopedics at Old Metairie Orthodontics in Metairie, Louisiana. “Adult patients want excellent and quick results with the least amount of discomfort, and some may be surprised to see how the technology has changed since they were kids.”
While some adult braces are used to achieve a better smile, their function isn’t solely cosmetic, she adds. Braces can have significant benefits when it comes to addressing dental conditions, like an uneven bite that may cause jaw problems, or gaps between teeth that can affect gum health, allowing adults to keep their teeth in good shape for decades to come.
Dental braces are devices designed to align teeth into a better position, which can improve both the function and aesthetic of the teeth.
Your adult teeth don’t stay in a fixed position after they’ve grown in, according to Block. Due to constant pressure from chewing and your tongue pushing against them, your teeth shift and move slightly. This movement can create misalignment. This can cause inflammation and creates tiny pockets in the gums where bacteria can lodge, increasing the likelihood and severity of gum disease.
Adults also sometimes want braces for aesthetic reasons if they’re unhappy with their smile, says Robert Berry, a doctor of dental surgery and founder of Mountain Aire Dentistry in Broomfield, Colorado. They can address teeth that are gapped, crowded or crooked.
There are a surprising number of braces options.
Traditional braces involve putting metal brackets (typically made of stainless steel) onto the teeth, which are attached to wire (often made of metal alloys). The wires are then held together by tiny rubber bands. The wires are designed to provide constant, gentle force to move your teeth into the desired position. Although this style has been used for decades, they’ve improved with the use of smaller, less noticeable brackets.
Similar to metal braces, ceramic braces have thin wires connecting the brackets. However, the brackets are made from clear ceramic or are colored to match the teeth. This makes them less prominent than metal braces. Additionally, these types of braces tend to be more comfortable than traditional braces, although they are often slightly more expensive.
Lingual braces are the same as traditional braces, but the wires and brackets sit on the inner part of the teeth, making them the least visible of the bracket-and-wire types. However, they’re more challenging to keep clean and can be uncomfortable at first since they may initially cause tongue sores.
Clear, plastic aligners are similar to mouth guards used by athletes. They’re custom-made and come as one single piece rather than in individual components like traditional braces. Although they’re similar to retainers (more on those below), aligners are designed to move teeth in small increments, similar to traditional braces. Retainers, meanwhile, keep teeth in place. Also, retainers are usually worn for short periods of time while aligners are meant to be worn most of the day and night (although you can take them out to eat, drink, and brush and floss your teeth).
Are invisible aligners the right option for your smile makeover? Alignerco makes at-home teeth straightening easy and affordable.
While traditional metal and ceramic braces use rubber bands to connect brackets to the wire, self-ligating braces have brackets that clip right onto the wire. The brackets are smaller and can be clear, making them less noticeable. Also, without the bands, food is less likely to get trapped, so brushing and flossing is easier.
Power chains are connected rows of elastics, usually used with traditional metal or ceramic brackets. These braces create more pressure and force in moving the teeth and are typically used to close gaps between teeth.
Braces work by slowly moving teeth into alignment to create a better foundation for them, says Isabel Sustegui-Mursuli, a doctor of dental surgery in Chicago who often advises patients on adult braces. Proper alignment not only improves gum health, but also creates a better environment for the teeth themselves. Your teeth are composed of four types of dental tissue, and when they’re in a more ideal position, they are more resistant to the forces of biting and chewing, and are easier to keep clean.
Using slight pressure—the kind that gradually took them out of alignment in the first place—braces gently guide teeth into a better formation, says Sustegui-Mursuli. This process is completed over time, so teeth can move gradually and adjust. If done too quickly, she adds, it could cause loosening and put your teeth at risk.
Patients undergo a dental exam to determine if they are a good candidate for orthodontic treatment, says Block. An orthodontist looks at the health of the gums, as well as the overall oral health of the teeth and mouth.
“Some of the reasons why braces might be recommended include teeth crowding or the opposite, which is too much space between teeth,” she adds. “We can also fix overbites and underbites.”
Reasons for getting braces, according to orthodontic practices, can include:
Dentists and orthodontists will likely not recommend adult braces if you have significant gum disease, tooth decay or multiple cavities, experts say. That would be particularly true if you need major dental procedures like implants. Braces wouldn’t be out of the question, but these issues would need to be corrected before you get them.
Comprehensive orthodontic treatment can range from a year and a half to two years to complete, according to Block. In more complex cases, like a severe overbite, it can take longer—sometimes up to three years—depending on the patient.
The term “invisible braces” is a common, umbrella term used to describe teeth straightening solutions with a minimal appearance. This term can be used to describe clear aligners (like Invisalign), clear braces (which use clear or tooth-colored brackets) and lingual braces.
Both aligners and braces are designed to correct teeth and jaw alignment, says Berry, but the differences are substantial. Traditional braces consist of metal brackets and wires that are attached to the front of the teeth and tightened at different times throughout the length of treatment, he notes. Clear, plastic aligners work to straighten your teeth by introducing slight alignment adjustments over time that gradually move the teeth into place.
“During treatment, you will get new aligners on a set schedule,” he says. “Each new aligner will slightly adjust your smile a little more than the last one did. These are invisible and removable, which allow patients to take them out to eat and clean them and their teeth as normal.”
Aligners typically cost about the same as braces. Depending on your dental alignment needs and number of visits, they can cost $3,000 to $8,000.
Several different types of braces exist within the world of orthodontics—including power chains. With regular braces, the elastics fit over each bracket individually. However, power chains consist of connected strings of elastics, connecting the brackets to one another, forming a continuous band across your teeth.
Power chain braces provide more force than traditional braces, and therefore, may shorten treatment time. They can also be used to correct a number of dental issues, including misalignments and crooked teeth.
There are a number of strategies you can try to speed up the treatment time for braces. As mentioned above, adding power chains to your orthodontia may help move things along. Orthodontic practices also recommend taking the following steps to help your braces work faster:
The cost of braces depends on the starting condition of a patient’s oral health, according to Berry.
The average cost of braces is:
These ranges include dentist and orthodontic visits, but if you require oral health treatments before getting braces, your costs may be higher. Power chains, which are added to other types of braces, will add some cost, but it’s minimal, says Berry, since those are specialized elastics.
Although dental insurance may cover some of the costs of braces, Berry says some dental plans don’t pay for orthodontic care if you’re over 18 years old.
“It’s important to check with your insurance provider about what your coverage entails before choosing what braces option is best for you,” he says. “Most dental plans will cover both traditional and retainer options, but be sure to know what’s covered as you’re going forward.”
If your insurance doesn’t cover orthodontics, talk to your orthodontist about payment options. Some offer payment plans. Additionally, funds from flexible spending accounts and health savings accounts can be used to pay for orthodontic treatments.
How much your braces will cost with insurance will vary greatly based on your provider and your plan. Delta Dental recommends asking your orthodontist to submit a pre-treatment estimate, which can help you get a better idea of your expenses.
Some types of aligners can be a more affordable alternative to braces because they don’t require a dentist or orthodontist to fit them. With aligners that can be fitted at home, you receive an impression kit delivered to your home, or arrange an in-person scan, and then the manufacturer creates several custom aligners designed to progress the alignment of your teeth over time. Aligner companies that use this care model include:
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If you choose to go with one of these options, it’s still a good idea to have an initial appointment with your dentist to make sure there are no serious issues that could cause the braces to loosen your teeth, suggests Chicago-based dentist Sustegui-Mursuli. For example, gum disease might weaken the tissue too much for adult braces and should be addressed first.
“Also, it’s helpful to have checkups to make sure everything is progressing the way it should be and that there are no habits you have that could be interfering with the process,” she says. For example, frequently chewing on a pen could push on ligaments in the mouth and affect the performance of your braces.
In addition to utilizing any dental insurance coverage you may have—and any Medicaid or Medicare benefits you may be eligible for—ask your orthodontist about any payment plans they may offer. You might also be able to use health savings account (HSA) funds or flexible savings account (FSA) funds to pay for braces.
Braces usually cause soreness for a few days after they’re put on. Typically, it goes away in about a week, says Sustegui-Mursuli. Depending on the type of braces you get, you may have some soreness on your tongue, too, but that should also resolve itself over time. Many people also have some soreness after every adjustment, but this discomfort should diminish within a few days as well. You can use over-the-counter pain medication if needed, says Sustegui-Mursuli.
Begin by threading the floss above the wire at each tooth, making sure not to pull on the wire. Floss gently between the teeth and pull the floss out afterward. You can also use dental tape or floss threaders, which many people with braces find easier to manipulate in the small space, Sustegui-Mursuli says. Another helpful tool is an interdental pick, which looks like a tiny tree and lets you clean between teeth more thoroughly.
Brushing with braces is similar to brushing without them. Using a soft bristle toothbrush or electric toothbrush is recommended. If you have an aligner, take it out to brush and floss.
You can eat a wide range of foods with braces, including breads, pancakes, pasta, cooked meats, tuna, steamed vegetables, cooked beans and soft cheeses.
Try to avoid foods that have smaller bits or chewy textures that can get stuck in brackets, such as nuts, caramels, licorice or gum. Harder foods like raw fruits and vegetables are safe when cut into smaller, bite-sized pieces.
Adult’s guide to orthodontics. American Association of Orthodontics. Accessed 04/09/2021.
Braces. American Dental Association. Accessed 03/17/2021.
Braces and Orthodontics. American Dental Association. Accessed 03/17/2021.
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Elizabeth Millard is a freelance journalist specializing in health and wellness. She has extensive experience covering topics like aging, sleep, fitness and emotional health. Her work has appeared in Prevention, Runner’s World, Everyday Health, HuffPost, among other publications.