Orthodontics is a specialized branch of dentistry that corrects teeth or jaw misalignment through using a variety of devices or appliances to place gentle, constant pressure on the teeth, gums, and jaws. Orthodontic specialists have extensive training in guiding the facial structure to its correct occlusion, or bite, so the teeth and jaws can function properly.
How should I choose an orthodontist?
Orthodontic treatment should only be performed by a trained, certified orthodontist. Orthodontists are professionals who specialize in dentofacial orthopedics and orthodontic treatment, which are focused on guiding facial development and jaw alignment. Orthodontists who are board-certified by the American Board of Orthodontics and/or are members of the American Association of Orthodontists (AAO) have both completed a dental program and advanced study in orthodontics from an accredited two- or three-year orthodontic residency program. They are also specifically trained in the proper approach to correcting misalignment or structural issues and are required to renew their certifications every 10 years.
You’ll be seeing your orthodontist often during your treatment, so be sure to choose one you are comfortable with and enjoy visiting. This will increase the likelihood that you adhere to your treatment plan for its duration. Friends and family can be a great source for referrals or recommendations, or you can browse reviews of orthodontists in your area for good practices to call.
Finally, orthodontic treatment can be expensive. To save costs, you will want to call several offices to compare average treatment prices and find out if they accept your dental insurance.
How do orthodontists plan a treatment?
Orthodontic treatment consists of repositioning the facial bones—including the jaws and teeth—and guiding them into proper alignment. Safe and effective treatment requires precise planning, application, and monitoring by a trained orthodontic specialist.
Orthodontic treatment is unique to each patient. The length of treatment will depend on factors like the severity of the problems needing correction and the patient age. The type of appliance used as well as patient participation and adherence to guidance will also affect treatment duration time.
However, most orthodontic treatment plans will follow the same process of a planning phase, active phase, and retention phase.
During the planning phase, the orthodontist evaluates your dental and medical health and takes several images of your mouth and jaws—digital, x-ray, or computer-generated, or a combination of all three—to determine the exact issues that need to be addressed and the best way forward for treatment. This is also when the orthodontist will decide on the best appliance for your situation as well as if you will need teeth extractions or additional corrections for spacing.
The majority of orthodontic treatment—anywhere between six and 30 months—takes place during the active phase. This phase includes the actual application of the orthodontic devices and the subsequent routine appointments during which the orthodontist will make necessary adjustments and evaluate your progress.
The retention phase begins once the teeth have been correctly aligned. Permanent devices like braces are removed and replaced with a custom retainer that will help support the teeth as they reform around the newly-realigned bone. These retainers must be worn for specified periods during the next few months or years to ensure the teeth do not shift back into their previous positions.
When is the right time to see an orthodontist?
Your bite function, jaw alignment, and smile all play important roles in your dental health and in basic functions like breathing, speaking, and chewing, but even slight misalignment can be an indication of more serious problems with your facial structure that can cause complications down the road. As such, any time you notice any irregularities in your or your child’s smile or alignment is a good time to see an orthodontist.
You may want to schedule a consultation with an orthodontist if you or your child are experiencing:
- Difficulty chewing or biting
- Crossbites, underbites, or overbites
- Mouth breathing
- Extra or missing teeth
- Teeth clenching or grinding
- Teeth that don’t meet normally or at all
- Inability to close lips comfortably
- Persistent jaw pain
- Crowded, overlapping, crooked, or protruding teeth
- Large gaps between teeth
Although the American Association of Orthodontists (AAO) recommends that children visit an orthodontic specialist by age 7, and while most orthodontic patients will begin treatment between ages 8 and 14, anyone of any age can seek and receive orthodontic treatment.
Can I get orthodontic treatment at any age?
Anyone can benefit from orthodontic treatment, no matter their age. The American Association of Orthodontists (AAO) recommends children visit the orthodontist by age 7 for at least an initial consultation and to identify early any potential development problems. Most pediatric patients, however, will not start treatment until they are between 8 and 14 years old, when the jaw and other facial bones are still forming and are more easily guided into proper alignment.
Although the majority of orthodontic patients are children or teens, adults now make up almost 25% of orthodontic patients in the U.S., and adults with severely misaligned bites, shifting teeth, or cosmetic imperfections can benefit greatly from braces and other orthodontic treatment. The fully adult jaw structure is denser and less malleable than a child’s or teen’s, so treatment may take slightly longer, but adult braces are very successful and produce a healthy smile you can enjoy for the rest of your life.
And, with virtually invisible options like lingual or clear braces and clear aligners, adults can now have that perfect smile without the embarrassment of bulky, old-fashioned metal appliances.
How effective is orthodontic treatment in adults?
No matter the age at which orthodontic patients experience improper alignment of the teeth and jaws, the desired outcome is generally the same—a straight, healthy smile with the proper occlusion, or bite. And, when safely performed and monitored by a certified orthodontist, orthodontic treatment can be just as effective in adults as in children, with the same range of dental and medical benefits.
Adult orthodontic treatment will be approached much the same way as a child or teen, with the same evaluations, the same overarching plan of an appropriate appliance with routine checkups and adjustments, and a follow-up retention period. Adult treatment will differ slightly in the time and strategy the orthodontist deems necessary to make the corrections; fully developed adult facial structures are denser and less malleable, making them more difficult to move and requiring slightly longer treatment times.
Can I stop an orthodontic treatment midway?
Most orthodontists will highly discourage pausing or discontinuing orthodontic treatment that is already in progress. Orthodontic treatment plans take time and gradual pressure to meet your unique needs safely and effectively, and stopping your individual plan early can cause your teeth to shift back to their original position. It may also result in permanent damage to your teeth, gums, or bone because new bone tissue has not yet formed to support the recently-shifted teeth, nor has your bone structure had the time to reshape.
However, an orthodontist may decide to end your treatment due to extenuating circumstances, such as poor dental hygiene during the treatment—which can compromise the strength and integrity of your teeth—or an inability to continue paying for treatment. Regardless of the reason, prematurely discontinuing your treatment will most likely incur an early termination fee from the orthodontist.
Orthodontic treatment can seem to take forever, but ending it early is never recommended. However, but there are good habits you can practice to help make sure your treatment doesn’t take longer than it should, such as:
- Following your orthodontist’s instructions and keeping all scheduled cleaning and adjustment appointments
- Avoiding foods that can break or damage your appliance
- Maintaining good oral health
Is orthodontic treatment harmful to my teeth?
When conducted by a professional orthodontist, orthodontic treatment itself is not harmful to your teeth. Patient behaviors during treatment, however, can cause harm or damage. Poor dental hygiene—like not brushing or flossing regularly—a diet heavy in sugary, chewy, or crunchy foods or beverages that can damage the orthodontic appliance, and avoiding dental cleanings or orthodontic treatment appointments and adjustments can cause long-term damage to your teeth. Your unique orthodontic treatment has been carefully designed to guide your jaw into its proper alignment; without proper care or timely and necessary adjustments, your mouth and teeth are at risk for developing cavities and will not function the way they should.
To further ensure your orthodontic treatment does not harm your teeth, be sure to choose an orthodontist who has been certified by the American Board of Orthodontics and/or is a member of the American Association of Orthodontists (AAO). Certified orthodontists have extensive experience in planning, administering, and monitoring orthodontic treatments, including the safe application and removal of devices as well as the physiological movements needed for proper alignment.
Is it necessary to remove teeth in orthodontic treatment?
Extractions are not always necessary to conduct orthodontic treatment. Extractions are more common before orthodontic treatment in children, who may have baby teeth that are late to fall out and need to be removed to allow adult teeth to erupt properly. Occasionally, teeth may also need to be pulled to correct overcrowding. Your orthodontist will do everything possible to correct your alignment without extracting teeth.
An extraction may be recommended in preparation for orthodontic treatment if teeth are:
- Extremely sensitive
- Sore or painful
- Severely decayed
- Growing in the wrong direction
- Too large to fit in the mouth
- Unable to be straightened without an extraction
- A threat to future shifting and misalignment
- Chipped, damaged, or cracked
In most cases when extractions are necessary, the teeth extracted prior to orthodontic treatment are usually your premolars, which are the fourth and/or fifth teeth from the front.
What should I know before getting braces?
With both a price and time commitment—$3,000 to $8,000 and 12 to 36 months for most patients—orthodontic treatment can seem daunting. However, both are well worth it for a healthy smile that lasts a lifetime. Straight, properly-aligned teeth are more than just pretty to look at; they are essential for the continued health and function of your mouth and jaws.
You can reduce some of the anxiety surrounding a commitment to braces or orthodontic treatment by being prepared for what to expect. Here are a few things to keep in mind:
- Orthodontic treatment is unique to each patient, so it is different for each patient. Your orthodontist will continually monitor progress throughout your treatment and make adjustments as necessary to make sure your treatment is completed safely and effectively.
- Adjusting to the sensation of braces will take a few weeks. You may find that closing your mouth feels strange, or notice some slight irritation as your gums and lips get used to the appliance.
- Brushing and flossing will require extra attention and effort. Keeping your teeth clean is always important, but it is especially so during orthodontic treatment. Food that is not properly cleaned from in between, under, or behind your appliance can lead to problems in the future such as cavities, decay, or damaged appliances. You will want to avoid foods that can get stuck in or break your appliances, like very chewy, sticky, or crunchy foods or foods you have to bite into.
- Very few patients experience severe pain that cannot be managed with over-the-counter pain medications, but most will experience some discomfort in the first few weeks of treatment (immediately after braces have been applied) and after routine adjustments.
- Orthodontic treatment like braces has become increasingly common for patients of all ages, so fewer people than you think will either notice or care if you have them.
- Orthodontic treatment that is administered by anyone other than an experienced, certified orthodontic specialist can potentially cause more harm than good, including lasting damage to your teeth and jaws. Be sure you choose an orthodontist who has the proper certifications, credentials, and experience.
How can braces affect your facial structure?
Orthodontic irregularities such as overcrowding, malocclusion (i.e., overbites or underbites), and misalignment, can affect the shape of your face, making your lips protrude unnaturally, preventing your lips from touching, or causing your chin and cheeks to look weak and sunken.
Improving the alignment of your teeth and jaws restores facial symmetry, better defines your facial features, and creates a more flattering, more natural-looking profile. Braces and other orthodontic treatments do this by applying constant, gentle pressure to bones in your facial structure.
How much your facial structure will change as a result of braces depends a lot on the severity of your orthodontic problems and your age. The facial bones in older patients are denser and harder to move, making for more subtle changes, while younger patients with more malleable jaws will experience more noticeable changes.
How much do braces cost?
The highly personalized nature of orthodontic treatment means the cost of braces can vary greatly as a result of several factors, such as the length and extent of treatment necessary, your age, your insurance plan, and the type of appliance used. For example, lingual braces—which are applied to the back of the teeth—can cost nearly twice as much as metal, ceramic, invisible, or self-ligating braces.
Typical orthodontic treatment costs range from $3,000 to $10,000, but many orthodontists offer some kind of installment plan so you do not have to pay for all of it upfront. You may also be able to finance orthodontic treatment using a Flexible Savings Account (FSA) or Health Savings Account (HAS) with your health insurance plan.
How long will it take for braces to straighten my teeth?
Orthodontic treatment, including braces, is individualized care that is unique to each patient. Factors such as your age, your specific condition, how well you care for your teeth, and how closely you follow your orthodontist’s instructions can all affect the length of your specific treatment plan.
Relying on constant, gradual, and strategically-placed pressure, orthodontic treatment plans take time—anywhere from six to 30 months—to implement safely. While many patients begin to see improvements in their teeth within the first month of treatment, seeing your plan through to the end is critical. Pausing or ending a treatment plan too soon can cause your teeth to shift back into their previous, misaligned position or cause even more problems than you had before you began treatment.
How do I care for and clean my braces?
The extra time and effort it takes to clean and care for your braces is worth it to make sure your teeth stay healthy during and after your treatment. More importantly, the length and effectiveness of your treatment can be impacted by how well you care for your braces and your teeth.
Braces and other orthodontic appliances can trap food and other debris that, if not removed, can lead to appliance damage, cavities, or plaque buildup.
To protect your braces—and your teeth—there are three simple actions you can take:
- Visit your dentist. You can still have routine dental cleanings and checkups even with braces. Dentists and dental hygienists are trained to work around orthodontic appliances to remove plaque and tartar buildup. They can also apply fluoride treatments and monitor your teeth for signs of cavities or decay.
- Brush often. To prevent food and plaque build-up in, under, and around the components of your braces, brush your teeth with fluoride toothpaste and rinse your mouth after every meal and every snack. Your orthodontist will also provide you with special tools to help you floss and brush in between brackets and wires, such as floss picks or threaders and interdental toothbrushes. While any soft bristle toothbrush will work, electric toothbrushes designed specifically for braces can help remove more particles from more places.
- Watch what you eat. Avoid very crunchy, chewy, sticky, or sugary foods that can break or pull at the appliance, get stuck in hard-to-reach places, or cause other damage to your teeth or the braces. Try to limit snacking or sugar beverages to reduce the opportunities for food to get stuck in the first place.