Orthodontics is the dental practice of correcting the alignment of teeth and jaws to improve both function and appearance. Many people assume this type of treatment is strictly limited to childhood or the teenage years, believing their window of opportunity has closed. This assumption is a common misconception, leading many adults to postpone treatment. Age is almost never a barrier to successful tooth movement.
Dispelling the Myth of Age Limits
It is almost never too late to start orthodontic treatment because the biological mechanism that moves teeth is active throughout life. Tooth movement relies on a natural process called bone remodeling, which occurs in the jawbone surrounding the tooth root. Applying a gentle, consistent force to a tooth initiates a cascade of cellular activity.
On the side of the tooth where pressure is applied, specialized cells called osteoclasts break down the existing alveolar bone to create space. Conversely, osteoblasts are activated to rebuild new bone on the opposite side where tension is created. This synchronized process of resorption and apposition allows the tooth to safely migrate through the bone. Since this bone remodeling process is continuous, a 60-year-old’s teeth can move using the same biological principles as a 16-year-old’s.
Unique Biological and Health Considerations for Adults
While the teeth can move at any age, the foundation they move within is biologically different in an adult compared to a growing child, necessitating a careful approach. The most significant consideration is the health of the periodontium, which includes the gums and supporting bone. Any active gum disease or significant bone loss must be completely treated and stable before orthodontic forces are applied.
Adult bone tissue is fully mature and often denser than adolescent bone, which means the cellular remodeling process tends to occur more slowly. This density often translates to longer overall treatment times, sometimes extending the duration compared to a similar case in a teenager. In cases of severe jaw misalignment, where a teenager would benefit from growth modification, an adult may require orthognathic surgery combined with orthodontics to achieve a major structural correction.
Existing Dental Work
Many adult patients also present with existing dental work that complicates treatment mechanics and planning. Teeth with crowns can still be moved because their roots are intact, though the brackets require a special type of adhesive for secure bonding. Fixed restorations like dental bridges pose a greater challenge, as the teeth supporting them are physically linked and cannot move independently, sometimes requiring the bridge to be removed. Dental implants cannot be moved at all because they are fused directly to the jawbone.
Relapse Management
A final common factor in adult treatment is the management of previous orthodontic relapse. Studies suggest that over half of patients experience some degree of relapse within ten years of finishing treatment if retainers are not used consistently. Retention planning is a major focus for adults, with most requiring long-term or lifelong retainer wear to maintain the achieved alignment.
Modern Aesthetic Treatment Options
A primary concern for most adults considering treatment is the aesthetic impact of visible appliances, but modern orthodontics offers several discreet options.
Clear Aligners
Clear aligners, such as those made popular by systems like Invisalign, are a highly popular choice due to their near-invisibility and removability. These clear plastic trays are custom-made to fit tightly over the teeth and are replaced sequentially to guide the teeth into position. Clear aligners are convenient for eating and hygiene but require a high degree of patient compliance, as they must be worn for approximately 20 to 22 hours per day.
Fixed Appliances
For cases requiring more complex movements, ceramic braces function similarly to traditional metal braces but use tooth-colored or clear brackets and wires. These appliances offer the same mechanical control as metal braces but blend in more effectively with the natural tooth color. The most discreet fixed option is lingual braces, where the brackets and wires are placed on the inner, tongue-side of the teeth, making them completely hidden from view when smiling. This option is highly specialized and requires a trained orthodontist.