You can get braces as an adult, and it is a common and highly effective path to a healthier smile. Advancements in orthodontic technology have made treatment more comfortable and discreet for older patients. Today, roughly one in four people wearing braces in the United States is an adult, seeking treatment for both aesthetic improvement and functional oral health benefits. Modern options allow for a customized approach that fits an adult’s lifestyle and professional demands.
Unique Dental Health Considerations for Adult Orthodontics
Adult orthodontic treatment is different from adolescent treatment because an adult’s facial and jaw bones have stopped growing. Since the jaw cannot be guided into a new position, severe skeletal discrepancies, such as a major overbite or underbite, may require orthognathic surgery in conjunction with braces to achieve proper alignment. The absence of growth means that tooth movement relies solely on bone remodeling, which often results in a slower pace of movement than in younger patients.
A prerequisite for adult treatment is the management of periodontal health. Active periodontal disease, like periodontitis, must be completely treated and stabilized before any tooth movement can begin. Adults are more likely to have some degree of bone loss, which means the orthodontist must apply lighter forces to move the teeth safely. Close coordination with a periodontist is frequently needed to monitor gum and bone health throughout the orthodontic process.
Pre-existing dental work, such as crowns, bridges, and large fillings, complicates treatment planning. These restorations may need to be adjusted, replaced, or worked around since brackets cannot be bonded directly to certain materials. Spaces from missing teeth or teeth that have drifted may require specialized mechanics to prepare the area for future restorative work, like a dental implant. The treatment plan is often part of a comprehensive strategy that involves multiple dental specialists to ensure the long-term stability of the entire oral system.
Treatment Options and Aesthetics
Adult patients prioritize aesthetics and lifestyle integration, leading to several discreet hardware options beyond traditional metal braces. Traditional metal braces remain effective for managing complex movements and are often the most economical choice. They consist of stainless steel brackets and wires, offering control and durability for all types of bite corrections. For a less noticeable option, ceramic braces use tooth-colored or clear brackets that blend in with the teeth.
While ceramic brackets are less conspicuous, they can be slightly more fragile than metal and are not always recommended for the most complex cases. Lingual braces offer high invisibility, as the custom-made brackets and wires are placed on the backside of the teeth. This option is generally more expensive and may require a period of adjustment for speech and tongue comfort. Clear aligner systems, such as Invisalign, consist of a series of custom-made, removable plastic trays worn for 20 to 22 hours per day.
Aligners are removed for eating, brushing, and flossing, which simplifies oral hygiene. They are most effective for mild to moderate alignment issues. Patient compliance in wearing the trays consistently is necessary for the success of this treatment type.
The Adult Orthodontic Timeline and Retention
The active phase of adult orthodontic treatment typically ranges from 18 to 36 months, which can be longer than the average for adolescents due to the non-growing jaw structure and the slower biological response of mature bone tissue. The total duration is influenced by the complexity of the malocclusion and consistent patient compliance. Failing to follow instructions, especially with removable aligners, can prolong the entire timeline.
Once the teeth are moved into their corrected positions, the retention phase begins, which is often considered a lifetime commitment. Adult teeth are susceptible to relapse, a natural tendency to shift back toward their original positions, because the bone and gum fibers surrounding the teeth need time to fully stabilize. The retention phase may include both fixed and removable appliances to counteract this tendency.
Fixed retainers are thin wires bonded permanently to the back surface of the front teeth, providing stabilization. Removable retainers, often a clear plastic shell or an acrylic and wire design, are worn full-time immediately after braces are removed and then transitioned to nighttime wear indefinitely. Fixed retainers do not last forever and require careful cleaning and monitoring for breakage to ensure results are maintained.
Cost and Insurance Coverage
The cost for comprehensive adult orthodontic treatment generally falls in the range of $3,000 to $7,000, depending on the appliance chosen and the complexity of the case. Treatment using aesthetic options, such as lingual braces or clear aligners, is typically at the higher end of this cost spectrum. Unlike pediatric orthodontics, adult orthodontic coverage is less common unless the treatment is medically necessary to correct a severe functional problem.
When coverage is available for adults, insurance plans impose a lifetime maximum benefit toward treatment costs. This maximum is usually separate from the annual dental maximum and may only cover a percentage, such as 50 percent, of the total cost. Most adults rely on self-pay options, including in-house, interest-free payment plans offered by the orthodontic office to spread the expense over the treatment period.
Adults can leverage tax-advantaged accounts to cover their out-of-pocket expenses. Both Flexible Spending Accounts (FSAs) and Health Savings Accounts (HSAs) consider orthodontic care as an eligible medical expense. Using pre-tax dollars from an FSA or HSA can reduce the total cost of treatment. HSA funds roll over year to year, while FSA funds must typically be used within the plan year, requiring careful planning.