Orthodontics for adults

Adult orthodontics covers everyone from 18 to 80. It includes aligners, braces, and combined orthodontic and surgical treatment, and it differs from adolescent treatment in ways that matter for planning. This page is the overview; the Invisalign and braces pages go deeper on each appliance.

Why adults seek treatment

• Relapse after teenage treatment when retainers were lost or abandoned
• Crowding that has developed or worsened with age, especially the lower front teeth
• Preparation for restorative dentistry: moving teeth so a dentist can place crowns, bridges or implants in the right positions
• Gum health: aligned teeth are easier to clean, and reducing traumatic bite forces can help periodontal stability
• Bite problems causing wear, chipping or difficulty chewing
• Appearance, which is a valid reason and the most common one

Treatment options for adults

Clear aligners

The choice of most adults at this clinic. Removable, nearly invisible, visits every 8 to 10 weeks with remote monitoring between. Suitable for most crowding, spacing and mild to moderate bite problems. Details: Invisalign for adults.

Braces

Chosen by adults whose case involves large rotations, vertical movements, extractions or surgery, or who would rather not manage wear time. Ceramic brackets on the upper teeth reduce visibility. Details: braces.

Limited treatment

Aligning the front six to eight teeth only, in 4 to 9 months, when the bite is stable. Lower cost and shorter. Not appropriate when the crowding is a symptom of a bite problem that will keep pushing teeth out of line.

Orthodontics with jaw surgery

For adults whose jaws are significantly mismatched, moving teeth alone can only camouflage the problem. Orthognathic surgery, planned jointly with an oral and maxillofacial surgeon, repositions the jaws; orthodontics before and after aligns the teeth to the new jaw positions. Dr. Haerian Ardekani's clinical experience includes surgical orthodontic cases. It is a substantial undertaking with a hospital stay, and it is discussed candidly, including the option of accepting the current bite.

What is different about adult treatment

• No growth. Jaw discrepancies cannot be guided as they can in children; they are camouflaged, accepted, or corrected surgically.
• Gums and bone. Periodontal health is assessed first and any active disease treated by your dentist or a periodontist before tooth movement begins. Adults with reduced bone support can still be treated, with lighter forces and closer monitoring.
• Existing dental work. Crowns, veneers, bridges and implants are planned around. Implants do not move.
• Slower remodelling. Bone turnover is slower in adults, so movements take somewhat longer and the plan is more conservative.
• Jaw joints. TMD symptoms are more common in adults and are assessed before starting. See TMJ and jaw pain.
• Sleep and breathing. Adults with snoring or diagnosed sleep apnea are screened and planning avoids reducing tongue space. See sleep orthodontics.

Timelines and cost

Limited treatment: 4 to 9 months. Comprehensive aligner or braces treatment: 12 to 24 months. Surgical cases: 18 to 30 months including surgery. Comprehensive fees at Lower Mainland specialist offices commonly run roughly $5,000 to $9,000, with limited treatment less. Some employer plans cover adult orthodontics; many cover dependents only. Health spending accounts and the medical expense tax credit apply. Details on cost and insurance.

Retention for adults

Adult teeth drift for life, and adults who have already relapsed once know it. Expect a fixed wire behind the lower front teeth plus nightly clear retainers, indefinitely. See retainers.