Braces for Adults: Are They Right for You?

Wearing braces is a rite of passage for many kids. But increasingly, adults are also getting braces to straighten their teeth, fix their bites and improve their smiles. Orthodontic options that make braces inconspicuous are a big part of this rising popularity. If you're considering getting braces, here's what you should know.

First, you're not alone. A 2014 survey from the American Association of Orthodontists found that adults made up a record high of nearly 1.5 million orthodontics patients in the U.S. and Canada.

About three-fourths of adult patients at Storie and Sturgill Orthodontics, based in Johnson City, Tennessee, are there for cosmetic reasons, says orthodontist Dr. Jeremiah Sturgill. "Several years ago it was very, very rare," he says. "But now the technology we have, and the clear brackets that have also come a long way, are helping adults feel more comfortable about getting braces as well."

Even for patients who get braces to look better, it's often a matter of "form follows function," says Sturgill, an assistant professor at Virginia Commonwealth University. "A beautiful smile is not only great aesthetics, but it's also easier to clean your teeth if they're well-aligned. You don't have those nooks and crannies."

Sometimes, functional reasons send adults to the orthodontist, Sturgill says. Teeth may be missing, or patients might need space opened or bone built for an implant. In some complex cases, he says, braces are a means to build a foundation for prosthetic work.

Stephanie Kern, 47, of Wise County, Virginia, is an attorney who represents children. Her doctor advised her to see an orthodontist for problems with her back teeth, which were crooked, painful and affecting her jaw.

"Sometimes I would even talk funny because it would be so sore underneath my tongue, and I would bite myself in my sleep," Kern says. A tendency to grind her teeth led to two cracked molars that had to be removed, she says, leaving gaps in her mouth when she smiled.

Kern, now among Sturgill's patients, has been wearing metal braces since January. "Wax is my best friend now," says Kern, who feels discomfort from braces rubbing against her mouth. However, she jokes, her daughter, who also wears braces, calls her a "wimp" for using wax.

In public, her braces draw little attention. "I noticed a couple babies staring because they like things that sparkle." she says. Most people don't mention her braces unless they've had them, too.

Kern sees braces for adults in a positive light. "Often, time passes and things deteriorate as opposed to improve," she says. "So it's nice to know you've got something to look forward to as an improvement over time."

Brace Options

Braces apply gentle but steady pressure to ease crowding and move teeth. Braces have three main components: brackets placed on each tooth; a band or bonding to affix the bracket to the tooth; and an arch wire which goes from one bracket to the next. Common options for braces include the following:

Metal braces. Stainless steel braces remain the best choice for some more-complex cases, says Dr. Greg Jorgensen, an orthodontist in private practice in Rio Rancho, New Mexico. "The metal braces are still a little more precise because they can be smaller," he explains. "They can fit into smaller areas where teeth are more crooked."

Clear or tooth-colored braces. These are also known as ceramic braces. "While they're still visible, they're less intimidating," Jorgensen says. "They don't grab your attention." One drawback of ceramic braces is that they can stain.

Invisalign or clear aligners. These appliances, which patients can remove to eat, brush and floss, align the teeth without wires or brackets. Patients wear them 20 to 22 hours a day, Sturgill says. While many people are attracted because they're so unnoticeable, clear aligners can be high-maintenance for patients who prefer to snack and drink coffee throughout the day.

Lingual braces. These are placed on the inner, tongue-side of the teeth. Lingual braces are an option for patients who shy away from wearing visible metal braces but whose cases are complex enough to need more than Invisalign, Jorgensen says.

Gold braces. Still made of steel but coated with shiny gold, these are an option for people ready to full-out embrace their braces. Gold braces are far more popular with teens than adults, Sturgill says.

Not Your Childhood Braces

Treatment with braces can be more challenging for adults. "Kids have really thick, healthy gums," Sturgill says. With age, patients are more likely to have problems like receding gums or bone loss. Orthodontists work closely with patients' general dentists before they start with braces, he says, to make sure gums are healthy and periodontal disease is under control.

If you had braces as a kid, you surely remember the mold-making process. It's different now. Digital X-ray technology is much more advanced, Jorgensen says, cutting down on radiation and eliminating the need for dental impressions made with "goop" in your mouth.

In general, time spent wearing braces is shorter than in years past. The average time for all cases in his practice is 17 months, Jorgensen says. Simpler cases, like fixing small spaces in the upper teeth, may take as little as six months. Complexity drives the length of treatment. "We want to fix everything," he says. "If a patient has an impacted tooth in the lower jaw, it might be a three-year case."

After braces come off, teeth can continue to move and crowd even several years later, Sturgill says. "Because of that, we now recommend retainers for life," he says. Retainers are worn at night. That could be every night for the first two years, he says, then eventually one or two nights a week.

Who Should Treat You?

For consumers who are considering braces, the "No. 1" question to ask their provider is, "'Are you an orthodontic specialist? Have you had specialty training in diagnosing and treating my case as an adult?'" Jorgensen says. "Because right now, the line between a specialist and a dentist who does braces has been blurred by advertising."

Orthodontists have up to 36 months of extra training, Jorgensen notes, and more experience treating misalignments and recognizing complex cases.

Covering Costs

On average, braces fall in the $5,000 to $6,500 price range, Sturgill says. If your budget is tight, talk to the office treatment coordinator about working out an in-house payment plan. Practices also may offer parent-child discounts, he says.

Also, check your insurance. You may be pleasantly surprised to find that orthodontic treatment is partially covered.