The goal of orthodontics is to correct misaligned teeth and improper bites, improving both function and long-term oral health. Although traditionally associated with adolescence, a significant and growing number of patients seeking treatment are adults. The misconception that age limits the possibility of achieving a healthy smile is inaccurate. Modern orthodontic science confirms that the biological mechanisms allowing tooth movement remain active throughout a person’s life, making treatment possible at any age.
Orthodontics Is Not Limited By Age
The biological process that allows teeth to move is a lifelong function, meaning it is not too late to begin orthodontic treatment as an adult. This movement occurs due to the body’s ability to remodel the alveolar bone surrounding the teeth. Pressure from an appliance creates areas of tension and compression on the periodontal ligament (PDL), the soft tissue connecting the tooth root to the jawbone. On the side experiencing tension, new bone is deposited, while on the side experiencing compression, old bone is resorbed by specialized cells. This continuous cycle allows the tooth to travel through the jawbone to its corrected position, though the biological speed of the process may differ from that of adolescents.
Unique Physiological Considerations for Adult Patients
Bone Density and Treatment Speed
Orthodontic treatment for adults requires specialized planning due to distinct biological differences compared to growing children. The alveolar bone is typically denser, more mature, and less pliable in adults. This denser structure translates to a slower rate of tooth movement, often requiring a longer treatment time than for a younger patient. Orthodontists must use lighter, more controlled forces to prevent damage, as the surrounding tissue may be less responsive.
Pre-existing Dental Conditions
Periodontal health is a major consideration, as many adults have pre-existing gum recession or bone loss that must be stable before treatment begins. Active gum disease must be fully managed and controlled, often requiring collaborative care with a periodontist. Adults frequently have previous dental work, such as crowns, bridges, or root canals, which require careful consideration during treatment planning, as these restorations may react differently to mechanical forces.
Treatment Options Beyond Metal Braces
Clear Aligners
Modern orthodontics offers a range of discreet options that appeal to adults concerned about the visibility of traditional metal appliances. The clear aligner system uses a series of custom-made, transparent plastic trays. Aligners are nearly invisible and can be removed for eating and oral hygiene, making them a convenient choice for many adult lifestyles. However, success relies on patient compliance, as they must be worn for 20 to 22 hours per day to be effective.
Fixed Appliance Options
Ceramic braces offer a less visible fixed option, using tooth-colored or translucent brackets that blend with the natural enamel. While they function similarly to metal braces, ceramic materials are more brittle and can be prone to staining if oral hygiene is not meticulous. For patients seeking invisibility, lingual braces are an option, with the brackets bonded to the back of the teeth, hidden from view, though they may cause temporary speech issues or tongue irritation.
Maintaining Results The Importance of Retention
Once the active phase of treatment is complete, the retention phase begins, which is a lifelong commitment for most adult patients. Retention is necessary because the periodontal fibers surrounding the moved teeth have a natural memory, causing them to pull back toward their original positions, a phenomenon known as relapse. Retainers stabilize the corrected alignment until the surrounding bone and soft tissues have fully reorganized to support the new tooth position. Retention devices typically come in two main forms: fixed and removable. The use of a retainer is the only way to ensure the long-term stability of the achieved results.
Types of Retainers
Fixed retainers consist of a thin wire custom-bonded to the tongue side of the front teeth, providing continuous stability. Removable retainers are usually clear plastic trays or Hawley appliances, which the patient must wear as prescribed, often nightly.