Orthodontics for Adults

In the early 1900s, the dental wisdom of the time considered that teeth could not be successfully repositioned or straightened after the age of 16 years. Orthodontics for adults was deemed to be impossible.

This assumption meant that there were only a few short years to make adjustments to the arrangement of teeth: during the precious early teenage years. If you didn’t get your teeth straightened as a child or teenager, the door was permanently closed.

Fortunately, our understanding of tooth movement has vastly improved, and we have access to better materials and technologies. It is now entirely possible for adults of ANY AGE to have their teeth straightened.

One in five orthodontic patients in Australia is an adult*. Adults are discovering that it’s not only possible to get their teeth straightened but that it can be done without traditional metal braces.

The Benefits Of Having Orthodontic Treatment As An Adult

Many adults choose to have orthodontic treatment because they are dissatisfied with the appearance of their smile. But aesthetics is just one of several reasons that an adult might decide to go ahead with the treatment.

Overcrowded teeth can make it challenging to keep the teeth and gums clean and healthy. Better-aligned teeth are much easier to clean and can reduce an adult’s experience of gum disease and tooth decay.

Some orthodontic conditions can cause or exacerbate jaw joint problems. Orthodontics may be part of the treatment to relieve the associated pain or inconvenience associated with these conditions.

The treatment of Obstructive Sleep Apnoea, a debilitating condition affecting many adults, may involve orthodontic repositioning of teeth and jaws.

Orthodontic treatment may be required to prepare the teeth for other types of dental treatment. For example, it might be necessary to move a tooth or teeth into better alignment to allow room for a crown, bridge or implant.

Why Would Someone Wait Until Adulthood For Orthodontic Treatment?

There are several reasons why an adult might consider having orthodontic treatment.

• They didn’t get treatment done as a child or teenager
• Orthodontic treatment was received. However, earlier styles of orthodontic care weren’t able to achieve the desired outcome
• They received treatment, but their teeth have shifted back (“Orthodontic Relapse”)
• They didn’t want to wear braces or orthodontic appliances as a teenager. Now, many years later, they are interested and motivated to receive treatment.

Why Would An Adult Need Orthodontic Treatment?

Genetics

The genes that you have inherited from your parents can cause

• Crookedness and crowding of teeth
• Misalignments of the jaws.

If these dental problems weren’t treated during childhood, it’s encouraging to know that adult teeth still respond well to modern orthodontic treatments.

The (Mis)Adventures Of Youth

Misalignments of teeth can still occur even if your genetic makeup favoured straight teeth. The presence of certain childhood oral habits, or traumatic incidents, can affect the alignment of otherwise straight teeth.

Habits that can affect the alignment of teeth and the growth of jaws include things like thumb sucking and mouth-breathing. While these should ideally be treated early (or entirely prevented when possible), adults of any age can be successfully treated for malocclusions caused by oral habits.

Early loss of baby teeth or loss of one or more adult teeth later in life can create crowding problems and allow misalignments to develop.

Changes in tooth alignment can also occur during adulthood.  Gum disease, tooth loss, and abnormal tooth wear can all create discrepancies in tooth alignment.

Orthodontic Relapse

Historically, following a year or two of wearing braces, a young patient was instructed to wear an appliance called a “retainer”. The retainer was worn at night for 1-2 years after orthodontic treatment, to train the teeth to remain in their new position.

Unfortunately, many patients experienced an orthodontic relapse, years or decades after they stopped wearing their retainer. This term describes how teeth tend to drift back (relapse) into their pre-orthodontic positions

We now know that retention after orthodontic treatment should ideally remain in place for a lifetime. 

Fortunately, adults who have experienced orthodontic relapse can be treated again (and this time be fitted with long-term retention).

What Conditions Can Be Treated By Orthodontics In Adulthood?

• Any form of crowding
• Teeth that are protruding (“bucky teeth”)
• Misalignment of the jaws. This includes conditions such as underbites, overbites, and crossbites. 
• Closure of spaces such as those created by the loss of one or more teeth, or of naturally-occurring spacing
• Teeth can also be moved into an ideal alignment in preparation for cosmetic or restorative dental procedures
• Snoring and sleep apnoea
• Some jaw joint dysfunctions, headaches and neck pain may improve with orthodontic treatment
• Improved breathing patterns for better health

Orthodontics for Adults: What Are The Options?

Adults are often reluctant to receive orthodontic treatment. This reluctance is usually due to the expectations that they will have to wear highly-visible, traditional metal braces for an extended period.

Fortunately, there are now several different types of treatment available to adults, and a number of these have been developed to be more aesthetically pleasing during the treatment phase.

Braces For Adults

Braces are also called “fixed appliances” because they are attached to the tooth enamel using a strong bonding agent. They are therefore worn 24/7 for the duration of the treatment.

There are several different types of braces available for adults – ceramic, lingual and traditional.

• Traditional Braces – because of improvements in technology, the old “train tracks” have been superseded by smaller, less noticeable, and more comfortable metal braces. The new materials also mean that treatment times are often shorter than they were previously. Traditional braces may be more suitable for the treatment of more complex misalignments of the teeth and jaws.
• Ceramic Braces – while the wire used to move the teeth is still metallic, the brackets that hold the wire onto the teeth are tooth-coloured and therefore far less noticeable. They sit on the outside surface of your teeth, in the same way as traditional metal braces do.
• Lingual Braces – these metal brackets and wires adhere to the inside surface of your teeth, so they aren’t visible from the front. 

Clear Aligners

Clear aligners are a series of custom-made, clear, removable, plastic aligners, that are changed every 2 to 3 weeks, over 18 to 24 months. Teeth can, therefore, move into alignment without fixed brackets and wires.

This treatment is popular because the aligners are much less noticeable than metal braces. Because they are removable, it’s much easier to clean teeth and gums than if wearing braces.

However, it’s essential to know that treatment with aligners will only be successful if patients are entirely compliant, which means wearing them for the majority of the day.

Aligners aren’t suitable for correcting every malocclusion.

Having Orthodontic Treatment As An Adult

Our adult patients have lots of questions about their treatment before it begins. Here are some of the most frequently asked questions we hear about orthodontics for adults. Please note that the answers may or may not apply to your unique circumstances.

How Long Do Adults Have To Wear Braces?

Every orthodontic case is different. People are individuals, and there is no one-size-fits-all approach to orthodontic treatment. You should anticipate that you will be wearing your orthodontic appliance for at least 18 months.

Can My Orthodontic Treatment Be Finished In Time For My Special Occasion?

We understand that sometimes the reason that an adult will undertake treatment is to prepare for a special occasion. We can never accelerate a longer treatment plan so that it fits into a shorter time frame. However, we can work with you to ensure that your appearance on your special day/s is as close to ideal as possible. This may require a “Hybrid Approach” to your orthodontic care.

Do Adult Teeth Move As Easily As Children’s Teeth?

Teeth move through the bone through a process of bone remodelling, which involves a similar process as happens when a broken bone knits together.

Regardless of whether the orthodontic patient is an adult or a child, the science behind the treatment is identical. What may be different is the adult body’s response to the forces that are needed to move the teeth through the bone.

Some adults heal more slowly than their younger counterparts. The slower healing adult’s treatment may take a little longer than the equivalent procedure in a teenager, but this isn’t universally true.

It’s also important to be aware that the timing of some orthodontic treatments takes advantage of the fact that children grow during treatment. Timing treatment to coincide with natural growth spurts makes some jaw discrepancies much easier to treat in children compared with adults. While the adult’s treatment might still be successful, the procedure:

• May be more difficult
• Might require specialist intervention or surgery
• Will almost certainly take longer
• May not be able to achieve quite the same outcome as could have been obtained for a child.

What’s The Biggest Difference When Treating Adults?

One big difference is that the teeth of an adult have experienced a lot more that life has had to offer. As a result:

• Teeth may have more fillings or other restorations, such as crowns
• Teeth may have experienced some wear and tear
• The gum support may not be as plentiful or sturdy as it once was.

Once an adult’s teeth have been moved into place by orthodontics, they may need further treatment.

• They may have previously experienced tooth wear, which gives the tooth a noticeably odd shape. The shape may need correction, possibly using composite resin bonding or a crown 
• Fillings that were previously masked by crowding might be visible once the teeth are straight. If the filling is noticeable, the patient may request its replacement.

Is There Anything That Might Prevent An Adult From Receiving Orthodontic Treatment?

There are very few situations that will prevent an adult from being considered medically or dentally fit to receive orthodontic treatment.

For adult orthodontics to be successful:

• Teeth and gums need to be in excellent health. Gum disease or tooth decay require treatment before orthodontic treatment commences. 
• Their general health should be good. 
• The patient needs to be completely compliant with the dentist’s instructions during treatment. This includes:
  • wearing their aligners as instructed
  • following dietary advice
  • keeping their teeth and gums meticulously clean.
• The presence of impacted adult teeth, including wisdom teeth, will need to be considered. If impacted teeth are likely to interfere with the success or progress of treatment, the impacted teeth will require surgical removal.

Are You Interested In Orthodontics For Adults?

If you are an adult considering orthodontic treatment, the first step is to call us to arrange a consultation appointment.

*Reference: Survey by the Australian Society of Orthodontics, December 2015