Adults and braces

Adults are embracing orthodontia like never before.

A survey by the American Association of Orthodontists (AAO) showed that the rate of people over 18 with braces grew 14 percent from 2010 to 2012. That brought the number of adults with braces in the United States and Canada to over a million.

“We’re more concerned about our appearance and we’re more concerned about keeping our teeth,” says DeWayne McCamish, DDS, MS, AAO president.

Adults getting braces today will find far more options than they remember — or had themselves — in their youth, notes Mina Abdolahi, DDS, MS, an associate in the northern Virginia practice of Saba Orthodontics. The choices can be daunting.

“For adults, aesthetics is the main consideration,” says Abdolahi. Cost and “lifestyle” are the other key considerations, she says. Each option offers advantages and disadvantages.

They include:

Conventional braces

Decades ago, braces consisted of a metal band around every or almost every tooth. Today, conventional braces hold wires with just a single bracket cemented on the front of the tooth. A few bands in the back anchor the wires.

A second option for conventional braces switches out metal for clear or tooth-colored ceramic. Abdolahi says her practice even experimented with white-colored wires, but that the pigment wore off quickly.

Treatment time is usually the shortest with conventional braces. But these devices are the most noticeable, even if you have the ceramic option.

“I’ve had patients who had braces as a teenager, and they said they would never again be a ‘metal mouth,’” Abdolahi says.


Aligners are clear trays that are switched out every two weeks to accommodate the movement of teeth. They remain in the mouth for 20 to 22 hours per day, removed just long enough for meals and cleaning your teeth. The most common brand of aligners is Invisalign.

Aligners are less conspicuous, but they’re still not completely invisible. They don’t affect how you brush and floss your teeth (unlike other types of braces).

However, aligners require the discipline to keep them in every possible moment and to switch out the trays on schedule. Shirking this responsibility sometimes means that treatment with aligners takes longer than with conventional options.

Self-ligating braces

In self-ligating braces, the wire passes through a small metal clip on the bracket. The system eliminates the need for elastic bands to help move the teeth.

Lingual braces

Lingual braces are similar to conventional braces, except the brackets are cemented to the back side of tooth.

Lingual braces are virtually invisible and work just as quickly as conventional braces. However, they are custom-made and typically cost more than other options.

Regardless of the type of appliance, your orthodontist may want you to wear a retainer after treatment is complete. You might wear it part or all of the day.

Recently, products have been created that can help speed up your braces treatment.


AcceleDent uses a tray inserted into the mouth for 20 minutes a day over braces or aligners. The tray vibrates, sending “micropulses” to the teeth. The manufacturer says the process cuts treatment time up to 50 percent. Abdolahi says her clients see about a 30 percent reduction.


In a Propel treatment, a doctor inserts a thin probe through the gum just into the bone in two or three places around a tooth. The mouth is numbed with a topical or local anesthetic.

Propel takes advantage of the fact that braces or aligners move teeth through bone, a living tissue. The irritation caused by the probe is meant to trigger your body’s healing response that allows the teeth to move more quickly.

The treatment can be done for people with conventional braces or aligners. It can be done more than once, with a gap between treatments of about six to eight weeks. Patients using Propel see their time in orthodontia cut by half, Abdolahi says.

The cost of orthodontia depends on the initial condition, other health conditions you may have, and the type of device used. Delta Dental, a dental insurance provider, reports on its website that a typical course of orthodontic treatment costs $5,000 to $6,000. Invisalign estimates that a typical course of treatment with its clear aligners would cost $3,000 to $8,000. Dental insurance often will cover the cost of part of your orthodontia treatments, but it’s important to check coverage limits.

A typical course of orthodontic care takes about 18 to 22 months, McCamish says, depending on severity of the problem and the type of appliance chosen. Though the length of treatment with aligners depends on wearing the device faithfully, McCamish notes that adults usually are very motivated to do so.

It’s possible to use more than one device during a course of treatment, McCamish says. For example, a person might want to start with an aligner for several months before switching over to conventional braces.

Your orthodontist will take a complete medical history before starting orthodontia care. Because teeth move through living bone during orthodontic care, it’s important for an orthodontist to know if you have low bone density or are taking drugs for the condition. The issue predominantly concerns women, as they are more likely than men to seek orthodontic care as adults and more likely to be affected by low bone density.

The popularity of braces among adults is growing and showing no signs of slowing down. Technology offers choices for a variety of lifestyles and strategies for completing treatment quickly and effectively.