Up until recently, I was pretty happy with my teeth. Were they picture perfect and snowy white? Not quite—but I was pleased enough with their appearance (especially considering I didn’t have braces as a teen). Then, I got to thinking: Wouldn’t it be great if my lower teeth weren’t crowded? And what if some of my top teeth were a little more even? So, I began to consider getting adult braces—or, more generally, adult orthodontia.
Many sets of clear aligners later, I am happy to report that my teeth have never looked better. In fact, when I see older pics of myself, I’m shocked at the difference.
Maybe you’re in the same position I was last year at about this time—wishing for straight teeth, but not quite sure what to expect. Or perhaps you had perfect teeth post-braces in your teenage years, but things have shifted because you didn’t wear your retainers (oops!).
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If either of those scenarios speak to you, keep reading: Below, Dale Anne Featheringham, DDS, an orthodontist based in Columbus, Ohio, weighs in on the different types of orthodontic treatment available (plus their pros and cons!), what to expect from the process, and why she thinks it’s such a solid form of self-care.
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1. There are plenty of reasons you might seek out treatment.
There’s usually something that prompts adults to do it, Featheringham notes. “COVID, of course–with Zoom and cameras—that was a big [motivator].”
Some women whose families couldn’t afford (or didn’t prioritize) orthodontics seek treatment once they have the means to do it, Featheringham says. Others watch their children get braces (and beautiful smiles) and then decide to do something nice for themselves.
Then there are those seeking touch-ups for prior orthodontic treatment after they stopped wearing their retainers. And if that sounds like you, no shame.
“I think the science around retainers wasn’t as good earlier on,” Featheringham explains. “They would say once your jaws are done growing when you’re 18 or 20—everyone had a number—it’s OK to stop wearing your retainer.” But over time, she says, the teeth do change.
2. Aesthetics are just one part of the equation.
Another kind of motivator, according to Featheringham, is finding out about a health issue. For instance, she says, your dentist might tell you that the way your teeth hit is causing gum recession on your bottom front teeth. And crowded teeth that are difficult to clean can lead to inflamed gums.
In other words, adult orthodontia is not *just* about making your teeth look prettier. Along with cosmetic improvements, Featheringham explains, there’s equally important functional improvement that occurs.
3. There are a few different types of treatment.
When you hear “orthodontics,” you might envision braces or clear plastic aligners—and both are options your orthodontist might recommend. (Side note: Featheringham says sometimes people think orthodontists only do braces, but they do aligners, too—in fact, they’re the experts!)
These days, braces come in ceramic versions that are less noticeable and therefore nice for adults, per Featheringham. Compared to aligners, she explains, they can more efficiently treat certain kinds of bites, like deep overbites. And some people just prefer this type of treatment, since it’s there working on their teeth without them having to think about it.
Fun fact: There are also braces that go on the backs of your teeth. The obvious advantage, Featheringham says, is that they’re less noticeable—but sometimes people complain about the discomfort of having them so close to the tongue, she adds. She also notes that they might have more limited use cases than typical braces (certain kinds of bites would probably call for regular braces).
Ultimately, braces are used more rarely in adults, according to Featheringham, but it depends to some extent on the orthodontist and their comfort level with aligners.
“In our practice, I would say nine out of 10 adults go into aligner treatment,” Featheringham says. She adds that this option has the advantage in terms of comfort, appearance, and hygiene (you can take aligners out to clean your teeth, whereas with braces you should expect to spend some extra time cleaning around them). Plus, the appointment structure can be much easier on busy schedules.
“With the aligners, we [often] stretch the appointments out a little bit more,” Featheringham explains. So, you might end up in your orthodontist’s office every 10 or 12 weeks versus every six, seven, or eight weeks.
Another benefit to this kind of treatment is that you’ll be able to see the end result before you even start the process.
“With the aligners, we can take someone’s teeth, do the scan, and show them what it will look like,” Featheringham says. “And I think that gives you a goal. It’s like if the first time you went to the gym, they were able to take a picture of you and show this picture of what you were going to look like after working out for 18 months.”
A downside to going with aligners? You might get tired of taking them out to eat and drink—and brushing your teeth whenever you put them back in (especially if you’re out in public!).
4. If you had braces as a kid, you can probably expect a different experience this time around.
In fact, if you’re going with aligners, your teeth-straightening experience will be totally different, according to Featheringham. The whole process is much simpler (placement involves a scan and potentially having small attachments put on your teeth to anchor the aligners), she explains, and it requires much less chair time.
Even if you’re getting braces, you can likely anticipate some changes from your childhood experience. The braces themselves have improved (think: gotten smaller), Featheringham says, and the adhesives and lights used to attach the braces have gotten better, too.
“The wires that move the teeth have improved on top of that,” she adds. In the “old days,” they used to literally tighten the wires, she explains—now, they put new ones in to get your teeth moving. And the placement of your braces might be simpler than past experiences as well. According to Featheringham, trays can be made based on a scan of your teeth that allow a whole arch of braces to go on at once.
5. If a treatment seems too good to be true, it probably is.
By now, you’ve probably noticed ads for direct-to-consumer aligners that make the whole teeth-straightening process seem super simple. But here’s the deal: Featheringham can’t see how you’d develop a customized treatment plan without an in-person exam. An x-ray is the only way to see what’s happening health-wise under the surface of the teeth. And there are some things you can only do in person, she adds, like checking for oral cancer, examining the mobility of the teeth, or evaluating the overall health of the gums.
Plus, Featheringham explains, orthodontics is a biological process that involves pushing teeth through gum and bone. “As we do that, all kinds of things can happen,” she says. For instance, gums can recede and teeth can loosen due to the way they’re hitting. You need an expert to detect problems—and, should you notice an issue, you need to know exactly where to go. Featheringham adds that adult orthodontic treatment can require collaboration with a dentist, oral surgeon, or periodontist.
Long story, short: It’s a red flag if a treatment plan doesn’t involve you working directly with an orthodontist or dentist and receiving in-person care. “I can’t think of any other transformative medical process that I would personally be comfortable going through without an in-person exam prior to starting,” Featheringham notes.
Take note of treatments that only require you to wear your aligners at night, too. They really have to be on your teeth most of the day (think: 22 hours) to get the job done as seamlessly as possible, according to Featheringham.
“Teeth move best with light, continuous forces,” she explains. In other words, that’s the optimal way to get the most rapid, stable, and healthy movement. But when you’re constantly taking your aligners in and out—shoving the teeth forward instead of gently walking them to a new spot—you’re not following that principle. Plus, she says, each aligner is moving your teeth so incrementally that wearing them for 12 hours and removing them for equally as long is kind of like taking one step forward and one step back.
Bottom line: It’s important to do your homework before embarking on treatment, according to Featheringham. To help you out, the American Association of Orthodontists has a list of questions to ask yourself while researching. And remember, if you’re shying away from seeing an expert because you’re worried about the expense, consider this: It might cost you more money in the long run to repair the damage from treatment gone wrong, per Featheringham. Her advice? Do it once and do it right.
6. Treatment can involve some pain and/or pressure—so keep your eyes on the prize.
An advantage of aligners is that they can be more comfortable (causing more of a pressure sensation than pain), according to Featheringham. That’s because they divide the movement into bite-size chunks rather than the bigger jumps you get with braces, she explains.
“I think it’s just about keeping your mind on that goal,” Featheringham adds. Be patient with yourself, she advises, expect it to be a little bit of a bumpy ride at first, and watch for the changes happening to stay inspired. It’s kind of like going to the gym, she notes—there are probably going to be tougher moments you don’t enjoy, but it’s totally worth it in the end.
7. Ultimately, adult orthodontics can be about more than just teeth.
“People are always so happy about the change,” Featheringham notes. “And they always say, ‘best money spent.’” Unlike a great pair of shoes that might go out of style next season, orthodontic treatment offers a lifelong benefit, and it’s self-care that leads to self-confidence, she explains. Sometimes, it even spills over into other ways of looking after your body: “It’s the first domino to fall oftentimes with a lot of other self-care things.”
Erin Warwood is a San Francisco-based writer, runner, and sparkling water enthusiast. She holds a B.B.A. from the University of Notre Dame and an M.S. in journalism from Northwestern University. In her free time, you can find her watching Survivor, trying new Peloton workouts, and reading Emily Giffin novels. Her ultimate goal: become a morning person.