Orthodontic treatment is often associated with adolescence, but a 35-year-old can definitively get braces. Age alone does not prevent the successful repositioning of teeth. Many adults seek treatment to address alignment issues that were never corrected in youth or to correct shifting that has occurred over time. The biological mechanisms that allow for tooth movement remain active throughout life, making treatment a viable option.
Adult Orthodontics: The Biological Process
The fundamental process that allows teeth to move is bone remodeling, a continuous biological cycle. When a gentle, sustained force is applied by an orthodontic appliance, it creates areas of pressure and tension on the surrounding tissues. The periodontal ligament (PDL), which anchors the tooth to the jawbone, senses this change.
On the side experiencing pressure, specialized cells called osteoclasts dissolve the adjacent alveolar bone. Simultaneously, on the side experiencing tension, osteoblasts build new bone to fill the space created. This coordinated removal and deposition allows the tooth to gradually shift through the jawbone.
In adults, this process is identical to that of a teenager, but the bone is denser and fully mature. This increased density makes movement slightly more resistant and slower compared to a younger patient. Since adults lack growth modification, treatment focuses purely on dental alignment within the existing skeletal structure, ensuring the biological response is predictable and effective.
Modern Treatment Options for Adults
Adult patients often prioritize discretion, and modern orthodontics offers several aesthetic alternatives to traditional metal braces.
- Traditional braces use stainless steel brackets and wires, which are effective for complex movements and are often the most economical choice. They provide constant, fixed force.
- Ceramic braces function like metal braces but utilize clear or tooth-colored brackets for a less noticeable appearance. The ceramic material can be more brittle, and elastics may stain.
- Lingual braces are placed on the tongue-side surface of the teeth, making them completely invisible from the front.
- Clear aligner systems use custom-fabricated, transparent plastic trays changed sequentially every one to two weeks. They are removable, simplifying oral hygiene and eliminating dietary restrictions.
Clear aligners are effective for mild to moderate cases, though fixed appliances are preferred for more severe or complex bite corrections.
Practical Considerations and Treatment Duration
The overall timeline for adult orthodontic treatment ranges from 18 to 36 months, which is longer than the average for adolescents. This extended duration is due to the increased density of adult bone structure, which necessitates gentler forces over a longer period. Pre-existing dental conditions must also be stabilized before starting tooth movement.
Adults often have accumulated dental work like crowns, bridges, or fillings that must be factored into the treatment plan. Maintaining excellent periodontal health is a prerequisite; active gum disease or bone loss must be managed before orthodontic forces are applied. A risk of treatment is root resorption, which is minimized through light, controlled forces and regular monitoring.
The orthodontist and general dentist must collaborate closely to manage restorations and monitor gum health. This coordinated care ensures teeth are moved safely, and necessary restorative work is planned for completion after alignment. Compliance with wearing removable appliances for the prescribed 20 to 22 hours per day also impacts the treatment timeline.
Securing Long-Term Results
Once the active phase is complete, a dedicated retention phase is mandatory for adults. Teeth have a natural tendency to shift back toward their original positions, known as relapse. Retention devices must be used to stabilize the new alignment permanently.
Retention involves either fixed retainers, removable retainers, or a combination of both. Fixed retainers are thin wires bonded to the tongue-side surfaces of the front teeth, offering continuous stability. Removable options include Hawley retainers or clear plastic retainers molded to fit the arch.
Retainer wear is considered lifelong to secure the stability of the result. The orthodontist will prescribe a specific schedule, often full-time wear initially, followed by nighttime wear indefinitely. This final phase is important for ensuring the long-term success of the treatment.