Everything you've ever wanted to know about Adult Orthodontics
Young adults are now up to 10 times more likely to have braces in adulthood than a generation ago, as many more admit that they are unhappy with their smile. Braces have steadily grown in popularity amongst adults in recent years and one study has found one in nine Brits aged 25-34 are having braces in their adulthood (12%), significantly higher than their parents (1%).
The Oral Health Foundation poll also showed that one in four are unhappy with their smile and dental health (27%) while nearly two in three are more worried about how their teeth look now compared with five years ago (64%). Further findings show that just under half of adults suffer from a lack of confidence because of their smile (45%).
The survey also revealed that women are almost twice as likely to have braces in adulthood than men.
The demand for cosmetic dentistry in the UK is steadily increasing and three in four adults questioned say they would feel more confident from receiving a ‘smile makeover’ (76%).
Currently, more than two in three say they never smile in photographs as a result of their smile (70%) while one in ten point to it causing problems in their relationships (10%). Others believe the appearance of their smile affects their career prospects, determines how they speak or eat in public, and some even reported being bullied because of how their teeth look.
Further results discovered more than a third would not get adult braces or undergo adult orthodontic treatment because they would feel embarrassed (36%) while one in three over 35 year-olds believe it’s too late to straighten teeth once in adulthood.
However, Comparethetreatment.com’s founder, Tim Molony, says it’s never too late to straighten your teeth (both his wife and mother have had orthodontic treatment) and says modern techniques have made adult braces discreet and almost entirely invisible.
‘Tooth alignment can be improved at any age, so long as your gums and bone structure are healthy. Contemporary techniques, such as Invisalign treatment offer a way to achieve straighter teeth without any visible evidence of braces – and instead wear a series of ‘aligners’ that are removable and virtually invisible. This has led to a substantial increase in enquiries from adults seeking orthodontics and this has also been reflected in the growing numbers choosing to undergo this treatment.’
So, what is orthodontic treatment? Orthodontic treatment is the straightening or moving of teeth to improve their appearance as well as their function. In other words, when teeth are aligned, it enhances the way they slot together comfortably in a closed position – orthodontics, therefore, cosmetically reshapes a crooked or wonky smile as well as ensures our mouth feels comfortable when we speak or eat.
Straight teeth also help us to keep them clean and healthy because there are fewer awkward areas where toothbrushing may prove difficult or the brush simply cannot reach. Crooked teeth leave us vulnerable to tooth decay and gum disease, thanks to the crevices, gaps and hard-to-reach areas where food debris lingers.
Plaque and calculus (tartar) can build up in a very short time if good oral hygiene is not practised. If not removed, soft plaque can harden on the teeth and irritate the gum tissue and, if this is not treated, can lead to gum disease and unsightly stains as well as create smelly acids that dissolve minerals inside the tooth enamel, giving us bad breath.
The increasing popularity of adult orthodontics is thanks largely to a wider awareness of the importance of a straight, healthy smile. A newly straightened smile can boost confidence in social circles as well as at work and there is a general acceptance that a smile is the first thing we notice about each other when we first meet – especially important when on a first date or at a job interview!
Orthodontic treatment is carried out with the help a variety of dental appliances – or braces, as they are commonly known. There are many different orthodontic options available to adult patients. These include removable clear aligner or appliance systems and metal or ceramic fixed braces.
Key points
- Teeth straightening & adult orthodontics:
- Improves a smile
- Improves speech
- Improves ease of maintain oral hygiene
- Improves lip support and aesthetics
- Improves deep or traumatic bites
Is orthodontic treatment suitable for me?
You may have suffered with a crooked smile and wonky teeth since childhood and now feel it’s time to address the problem. Misaligned teeth can be hereditary or we might suffer with crooked teeth as a result of overcrowding. A small jaw may not allow enough room for all 32 of your adult teeth to come in, causing them to shift after eruption. Whilst crooked teeth are usually hereditary, other factors can also cause teeth to become crooked.
You may have had braces when you were younger and your teeth have drifted back into their pre-treatment position. Having given up on wearing your retainers years ago, your teeth have moved, or relapsed, into that misaligned smile that your braces worked so hard to straighten. Dentists commonly refer to those now seeking braces again in adult life as ‘re-treats’ – second-time around brace wearers all regretting that we were at an age when we thought we knew better. Without a retainer, teeth naturally fall out of alignment. Indeed, the latest advice from the British Orthodontic Society suggests lifelong retention in order to keep our newly straightened teeth in line. Remember, a smile is forever!
For those of us lucky enough to be born with straight, healthy smile, age can sometimes impact on this. Teeth can move, or drift, as we get older and lead to an overcrowded mouth.
Additionally, you may want orthodontic treatment for the following reasons:
- To fix a broken smile
- Confidence boost
- Job hunting
- Big occasion such as a wedding or a milestone birthday
- Health
- Difficultly eating
- Relationship
- Accident from sports injury.
So, for those of us who never had orthodontic treatment when we were younger, but have unsightly gaps, teeth that are overcrowded or even trouble eating and speaking – or we may have reached an age where we have the time, money and inclination to invest in a smile makeover – orthodontic treatment ticks those boxes.
Award-winning London orthodontist Dr Neil Counihan whose clinic, Metamorphosis Orthodontics, specialises in improving the aesthetics and health of our teeth, says:
‘I see lots of people at our clinic who are unhappy with their smile or have had orthodontic treatment already and the teeth moved back or relapsed because they failed to wear their retainer.
‘Whatever the reason, more and more people are seeking teeth-straightening solutions because they can afford it. They may be getting married, looking to further their career or are inspired to improve their appearance because of others having treatment. Certainly, braces are now more affordable, faster and more discreet – even invisible – which all adds to the treatment’s appeal.’
What age is best for orthodontic treatment?
Whilst the rule of thumb is the earlier the better – i.e. in childhood when we have lost all our baby teeth – adult orthodontic treatment is booming for all ages, from our early 20s to beyond retirement. A survey recently revealed that 54% of women felt so self-conscious about their teeth that are considering braces as well as teeth-whitening treatments.
And, for those of us who have reached an age where we are beyond feeling comfortable wearing traditional fixed braces – or ‘train tracks’ as they are commonly known – today’s more aesthetically acceptable options, such as clear brackets, removable aligners or near invisible braces placed behind the teeth (lingual braces), offer an acceptable solution.
Orthodontic treatment is now much more discreet and increasingly affordable – according to a recent survey by the British Orthodontics Society, 75% of its member dentists have seen an increase in adult treatment.
Who carries out orthodontics?
An orthodontist is a dentist with additional training who specialises in aligning and straightening teeth. However, more and more general dentists are comfortably offering orthodontic systems in high street dental practices – so the answer is, any dentist can carry out orthodontics so long as they are confident and competent enough to do so. Worth noting, however, is that only those registered on the General Dental Council’s orthodontic specialist list can call themselves a ‘specialist orthodontist’.
Comparethetreatment.com offers unbiased information about the extensive suite of orthodontic treatment options to help you on your treatment journey. From early research through to booking a consultation and beyond, you can also check out our real-life patient experiences as well as the dentists and practices that offer orthodontic treatment.
If you're ready then find an Orthodontist with Invisalign's Find a Provider feature.
What does orthodontic treatment involve?
At the initial consultation, you will have a full examination, which will mean a dentist looking at your teeth, taking X-rays or images with a digital intraoral camera and making models of your teeth. Your dentist will advise what treatment is possible – and worth noting here is that not all orthodontic treatment systems suit everyone; short-term orthodontic treatments are focused on achieving limited objectives – usually straightening the upper front teeth in the smile line – and you may need more comprehensive treatment to address more complex misalignment issues.
Your treating dentist will draw up a treatment plan so that you both know what to expect and when. You can then schedule in appointments and have some idea of how long treatment might take – although do be aware that sometimes treatment can take longer than planned.
The rapid development of digital technology also means that dentist can ensure controlled precision to improve the comfort and fit of your dental appliance as well as share the predicted results by simulating the desired change using 3D simulation software.
Thanks to these advances in 3D imaging, the entire process of orthodontic diagnosis and treatment is more comfortable, quicker and more accurate than ever before.
All braces work on the same physiological principle using gentle pressure to move your teeth and supporting soft tissue. So, once you have made a choice and had your braces fitted, you need to revisit your dentist or orthodontist regularly. Additionally, be sure to visit your dentist every six months during treatment as an orthodontist will not necessarily check for other problems.
What do I need to do to keep my teeth clean wearing braces?
Whatever type of braces you choose, you will need to be meticulous with your dental hygiene throughout the day and we need to protect the appliance as well as and clean it thoroughly.
Brushing teeth is as important as ever – but be sure to concentrate on the area between the braces and the gums, where food may lurk and lead to bacteria and plaque build-up. This can cause unsightly staining if not regularly removed – a bit of a letdown to find when you finally have your braces removed.
Plaque is invisible so just because you cannot see anything between the teeth and braces it doesn’t mean there isn’t anything there to clean away.
Your dental hygienist may recommend the small interspace brushes, such as those from TePe, or a Philips Sonicare electric toothbrush and a Philips Sonicare AirFloss Pro – both hugely effective at clean between the tooth and the wire, up against the brackets and so on.
Often, orthodontic patients need to re-learn how best to brush their teeth while undergoing teeth straightening treatment. Use a mirror to check you are not missing anywhere – and see a hygienist regularly who can help you achieve optimum oral health care while undergoing orthodontics.
Aim to avoid any food or drinks that contain sugar (natural or added). It’s easy to snack but regular grazing doesn’t give the teeth time to recover from the sugar and acid attacks so be mindful of the effects. And, of course, hard foods, such as crusty bread, should be eaten with great care or avoided, too. Any breakages may mean a delay in the treatment. And avid chewing gum – it makes a nasty mess of braces as you can imagine!
How is orthodontic treatment carried out?
There are many types of braces that move teeth incrementally into a more aesthetically pleasing and better functioning position by applying steady pressure that straightens crooked teeth.
What types of braces are there?
Discover Removable braces >
Simple treatment that address the front teeth that show when we smile may be carried out with a removable brace that is basically a plate that can be taken out to be cleaned. It has delicate wires and springs attached that gently move the teeth using gentle pressure.
Discover Fixed braces >
A fixed brace has brackets and bands that are bonded – or temporarily stuck – to the teeth. A flexible wire joins all the brackets and allows the teeth to be moved.
It is sometimes possible to change the way the jaws grow, using a functional brace. This works by using the power of your jaw muscles and can help with certain types of problem. Fixed braces are not always made of metal. Plastic and ceramic can be used, especially for adults.
Discover Invisible braces >
They are tough, clear plastic 'aligners' (moulds) that are used to straighten teeth. Several sets of specially moulded, slightly different aligners are made for each patient. Each set is worn for two weeks before being replaced with the next one. They are made from clear plastic, so they are nearly invisible. This means that no one need know you are straightening your teeth. The aligners should be worn for 22 to 23 hours a day for the best results. They can be easily removed for eating, drinking, brushing, and for cleaning in between your teeth. You need to have all your adult teeth before you can have this treatment.
How long does orthodontics take to work?
You may have seen places advertising short-term orthodontics in up to six months. Did you know that the average time it takes to straighten your teeth safely is actually 12-18 months? All cases are different and yes there are certain mild cases that can be completed in six to nine months. Generally, with this type of treatment, it is only the front six teeth that are treated with braces – or the ‘social six’, those teeth that show when we smile. If you are keen on short-term treatment, it is important that you ask the clinician what result is actually achievable within this time frame so your expectations are fully managed. Short-term orthodontics for most people will only produce a limited change to the teeth and the final result could be compromised. 6 months usually isn’t enough time to move a tooth and its roots into the right place. This usually means that the tooth may be more likely to move back into their original position once you have your adult braces removed. Lots of planning is involved to get the best result for you and the orthodontist usually has to consider your jaw, lips and facial profile when planning treatment, rushed treatment is not appropriate. Make sure you are comfortable and well informed when choosing to have braces in your adulthood.
Invisalign aligners are generally changed in two weekly intervals and are worn for an optimal period of 22 hours a day but because they are removable wearers can take them out for short periods, including when they want to eat or drink.
But also good to know is that thanks to advances in the Invisalign system, some Invisalign providers can offer one-week aligner wear instead of the previously recommended two-week changes, which means shorter treatment time – up to 50% faster. Discover the fastest invisible aligners and find a provider.
So if you are looking to make a change in the appearance of your teeth before a wedding or another milestone event, it may be possible to have straighter teeth in time for the big day. Your first step would be to consult an Invisalign provider closest to your home or work, who can advise you about the most suitable options, as well as treatment times.
What happens at the end of my adult orthodontic treatment?
Don't expect to be completely finished with the orthodontist – the recommendation now is that we should wear a retainer for life once the braces have been removed in order to keep the teeth in their new positions.
Your teeth and gums will be a bit sensitive at first. Don't immediately rush out and binge on crunchy and chewy previously forbidden foods – ease slowly into it. Hopefully, if you have done a good job at keeping your teeth clean, you will have healthy mouth but do consider scheduling a post-orthodontic treatment hygiene appointment, as there are still areas that you may have struggled to keep clean.
Will the teeth straightening treatment hurt?
Your mouth may be a little tender when you first get them fitted – but a course of painkillers should help until the pain disappears and this is usually within seven days. The need to preserve your newly straightened smile is as important as the creation of it; you and your dentist have invested much time, effort and money in your orthodontic treatment, in which case you should be keen to maintain the results for as long as possible.
Retention is an essential part of all orthodontic treatment and is necessary to effectively preserve your new beautiful smile.
Darsh Patel is one of our orthodontic experts. He says:
‘There is varying amounts of tooth discomfort associated with straightening teeth. Typically, traditional braces have thought to come with high pain levels. However, the newer technology braces have reduced the force levels considerably, making braces much more comfortable.
How long will each visit to an orthodontist take?
Brace adjustments at the orthodontist takes anywhere between 10 minutes to 30 minutes depending on the braces you are wearing. The answer also depends on your current dentition, how your orthodontist plans your treatment, and the type of orthodontic treatment you're getting –traditional or clear aligners and so on.
Although treatment time also varies between systems, you will need to make time every four to eight weeks for visits to your orthodontist if you wish your treatment to finish successfully on time. Throughout your orthodontic treatment, the orthodontist will adjust your brackets, answer questions and help check progress. These appointments typically take between 15-20 minutes to any up to an hour.
As time is precious in our busy lives, it is also good to know that there are fewer dental appointments needed for Invisalign treatment – you are given several sets of aligners at once, and you just need to pop into the practice check on your progress – and make any necessary adjustments – every few weeks.
How successful will it be?
If you have chosen the right dentist for you using our clinic finder [link to pages] you should be on track to achieving a new straight smile.
How much does it cost?
Costs vary and each system comes with a different price tag. You can browse our orthodontic treatment pages for estimates of each type of brace [link to pages].
Can adult orthodontics damage my teeth?
The actual process of teeth straightening cannot damage our teeth – but you will ruin a smile if you don't look after them properly during treatment, and it’s vital you wear any advised retainers after the orthodontic treatment is complete to protect your smile.
Specialist orthodontist Darsh Patel says:
‘Orthodontics can be damaging in many ways when not done properly or not looked after properly. The most common of these is demineralisation (marks) on teeth due to poor cleaning and a bad diet during brace treatment.’
So, whilst the braces themselves will not cause damage poor cleaning and too many sugary foods and drinks can cause permanent damage to your teeth. Hard food can dislodge brackets or bands and damage wires. Avoiding nuts, biting on nails and pencils, drinks with high sugar content and cutting hard fruit into small chunks is advised. But in our rush to straighten our teeth, let's not forget the importance of looking after the appliances during our treatment as well as the health of our teeth and gums.
Undergoing any orthodontic treatment – whatever the system – requires us to be hugely meticulous with our dental hygiene and we need to protect the appliance as well as our teeth – clean both thoroughly.
With Invisalign, most people report that after a few days they forget they are wearing their aligners and they have little impact on their lifestyles, allowing them to indulge in sports, play wind instruments, sing or speak in public – all of which can be difficult for fixed brace wearers.
Do I need to have teeth removed?
Dr Andy Toy is our Invisalign expert. He says:
‘It may be possible to correct your over-crowding without taking teeth out. However, you will need to make space straighten your teeth. You can make space by taking a tooth out, pushing the teeth out a little to the side or the front (making the ‘arch’ of teeth slightly bigger), or by making the teeth slightly narrower with a process called ‘slenderising’. One of the great things about Invisalign is the ClinCheck Treatment Planning software.
This provides a 3D image of your tooth movements from start to finish. The ClinCheck allows me to try different approaches to solving the problem of crowded teeth and compare them. For instance, sometimes it is quicker and more predictable to take a tooth out; other times it may be better to push the teeth out and apply slenderising. It also provides a very accurate measure of the amount of slenderising we need to do. I can then show the patient the different scenarios to help them make the best choice for themselves.’
Are teeth straightening treatments permanent?
In essence, no orthodontic treatment not a permanent fix. After your teeth-straightening treatment, the recommendation from orthodontists now is that you need to wear retainers for life in order to keep those teeth aligned. Retainers are fitted immediately after the braces are removed and can either be removable or fixed onto the teeth. Your orthodontist will explain which retainer is best for you. Sometimes you will be recommended to wear more than one type of retainer to reduce the chances of the teeth relapsing. Dr Hanel Nathwani is a UK Invisalign Diamond provider. He says: ‘The greatest myth with retention is that the patient is okay to wear retainers for only 6-12 months. More than 70% of my adult patients had braces as a teenager and either didn't retain for long enough or their retainer broke and they didn't replace or repair this in time.
‘Over time, teeth have a tendency to move towards the front of the mouth – medial drift – so this needs to be kept at bay with long-term retention. For this reason, I advise all patients that an understanding that retention isn't a short-term concept is more important than the process of straightening the teeth.’
What is clear is that it is necessary to allow the soft and hard tissues to reorganise for seven months post tooth movement, which requires full-time stabilisation for the duration.’
