have changed in recent years. There are many misconceptions
about types of braces and how to find a dentist to treat
you. This article explains all the basic things that you
should know before you commit to several years of
1. There is no age limit for dental braces
When most people think of orthodontic braces, they think of
teenagers. But an increasing amount of adults are getting
braces, too. As long as your teeth and gums are healthy, you
could benefit from getting your teeth straightened. One of
the most important things to consider is the state of your
gums and jaw bones. If you have unhealthy gums, a lot of gum
recession, or bone loss, braces may not be recommended
because the pressure they put on your gums could cause
Why do people get braces in adulthood? Usually, their
families could not afford braces when they were children.
Now that they are adults, they want to improve their smile
and their dental health. Some adults had braces as children
or teenagers, but didn't wear their retainers, causing their
teeth to become crooked again. And still others have more
complicated cases, which may involve jaw surgery and braces.
Many people wonder how much
dental braces will cost. The average cost of a two-year
orthodontic treatment with metal braces is between $3,000 to
$6,000, depending on where you live. Ceramic or special
brackets may cost more. Invisalign treatment costs about the
same, or more. Payment is usually made through an initial
down payment, and then monthly payments.
2. Your "bite" is as important as the straightness
and aesthetics of your teeth
Many people think that braces only make teeth straight. In
fact, they accomplish a lot more than that. An orthodontist
evaluates a lot of things when you go in for a consultation.
Are your teeth straight? Do they meet properly? Does your
tongue stick out of your front teeth? Does your jaw hurt or
click? Do you have a lot of crowding or large gaps? Have you
lost all your baby teeth? Are your teeth and gums healthy?
Do you have problems breathing or speaking?
One of the most important things that orthodontists evaluate
is your "bite." This is the way that your top and bottom
teeth meet when you open and close your mouth. Orthodontists
are just as concerned with how your mouth functions as they
are with making your teeth look great. After all, what good
are straight teeth if you can't chew or speak properly, or
if you get TMJ headaches?
3. An Orthodontist has a lot more training than a
You may love your family dentist, and he or she may have
told you that they can "do your braces" for a lot less money
than an orthodontist. While this is very nice, it's also a
big gamble. On the ArchWired.com message board, we have read
about many people who got braces done by a regular dentist
who didn't really understand how complicated their case was.
These people wound up needing to go to an orthodontist for
more years of braces to un-do the faulty work of the
Orthodontists are specially trained in tooth movement and
jaw function; dentists are not. Yes, some dentists have
taken a few course hours to learn how to do Invisalign or
other types of treatment, but that is not the main thing
that they do. Would you get heart surgery from a doctor who
only operated on hearts once or twice a year? Of course not!
Orthodontists first go to dental school and become dentists.
Then they attend an Orthodontic program for several more
years to learn specifically about tooth movement, jaw
function, and facial aesthetics. After that, they take a
special exam to become Board Certified.
Which brings me to another point: when you choose an
orthodontist, make sure that he or she is Board Certified.
That way, you are assured that they are totally trained, and
that their work is expected to live up to certain standards.
Does this mean that a
regular general dentist should never do braces? No. Some
general dentists have successfully treated many patients for
simple tooth movement. It's all a matter of experience. Ask
your dentist how many orthodontic cases he has done in the
past year. Ask how complicated your case is. Remember,
braces will not only straighten your teeth, they can change
the function of your bite and the mechanics of your jaw. If
your treatment is complicated and is not done properly, you
may wind up needing to go to an orthodontist to finish the
job, which will cost you more money in the long run.
4. Consultations are usually free. Get as many as you
Many people get a referral to an orthodontist from their
dentist, or from a friend. Most orthodontists do not charge
for a consultation -- consultations are usually free! If you
do not like one orthodontist, or want to get several
opinions, it's OK to do so. Don't worry, you won't offend
anyone! In fact, it's usually a good idea to get at least
two or three opinions before going ahead with braces. This
is especially true if an orthodontist has recommended that
you get teeth extracted, or if your case is complicated.
There are many ways to move teeth, and different
orthodontists use different approaches. There is usually no
"one right way." You need to evaluate what the different
orthodontists tell you and decide what you are comfortable
with and what you can afford.
During a consultation, an orthodontist will get to know you
and take a good look at your teeth and your mouth. An
experienced orthodontist will be able to tell you, with a
fair amount of accuracy, what needs to be done: what types
of braces you could wear, whether you need extractions, how
long your treatment might be, and (ballpark) how much it
Once you have picked an orthodontist, you will need to get a
mold of your mouth done, and panoramic x-rays (and sometimes
also photos of your face). Using these tools, the
orthodontist will be able to develop a treatment plan for
you. Until he does that, he will only be taking an "educated
guess" at what needs to be done to fix your smile. Once he
has worked up a treatment plan, he will know exactly what
needs to be done. At that point, you will come back to his
office, and he will explain all the details, including the
5. Bracket types are not as important as you think
Not everyone is a candidate for Invisalign or similar
"invisible braces treatments." Most adults go into an
orthodontist hoping that they can get Invisalign, but only a
percentage of them are actually good candidates for the
plastic aligners. The reason is: some types of treatment
just don't work as well with Invisalign as they would with
traditional braces. And when I say "traditional braces" I
don't mean all metal. There are many tooth-colored brackets
on the market that are less conspicuous and work just as
well as metal brackets. You need to trust your orthodontist
if he tells you that he would not be able to treat you with
Invisalign or other types of brackets you may have heard of.
If you had your heart set on Invisalign or some other
system, then ask why it won't work. It's OK to ask why, and
it's better for you to fully understand the orthodontist's
approach before your treatment begins.
With that said, you should also understand that these days,
the companies that make orthodontic brackets and appliances
spend a lot of money on advertising and marketing. Any good
orthodontist will tell you the truth: it's not the brackets
that make the difference, it's the technique and experience
of the orthodontist who is treating you. Sure, some of the
newer brackets have advantages because they are smaller,
less noticeable, or don't require elastic "o-ring"
ligatures. But that doesn't make them any better than other
types of brackets.
Another thing to consider is this: orthodontists need
special training to use some types of brackets. For example,
an orthodontist must be trained by the company that makes
Damon brackets before he can use them on his patients. Same
for lingual ("behind the teeth") braces. If your
orthodontist doesn't have the extra training in these
specific products, he cannot offer them to you.
So don't get hung up on one type of bracket or one type of
treatment. Trust the experience of your orthodontist. If you
don't like his approach, you can always get another opinion
from a different orthodontist, or find one that offers the
type of brackets you had in mind.
6. Cost and treatment times vary
Braces aren't cheap. If your braces are covered, even
partially, by a dental plan consider yourself lucky. The
average cost of orthodontic treatment is between $3,000 and
$6,000, depending on where you live and what needs to be
done. Invisalign usually costs as much as traditional
braces, and sometimes it costs more. Usually treatment costs
more in major cities than it does in rural areas. You will
not be expected to pay it all at once. Usually you pay
separately for molds and panoramic x-rays. Then when
treatment begins, you pay a down payment of about $1,000.
The balance is usually put on a payment plan, where you pay
several hundred dollars per month.
Some dental offices offer a discount for paying upfront in
advance for all your treatment. While this may be tempting,
it is not recommended. You never know what will happen
during the course of your treatment. What if the office goes
out of business? (It has happened to a few unlucky
patients). Saving money is great, but protecting yourself
financially is even better. While most orthodontists are
ethical and run a financially sound practice, there are rare
occasions where that is not the case. Being on a payment
plan is always the best way to go.
How long will you be in braces? That depends on your
individual case. The average treatment is two years (24
months). There are methods for moving teeth faster, but
before you choose those, get all the information you can
about what the treatment will entail. There is one six month
method, for example, that incorporates fairly painful jaw
surgery to accomplish its goals. Know what you're getting
into beforehand. Two years in braces may seem like a long
time, but it will go by faster than you realize, and is
often safer and more reliable than the newer quick methods.
7. Read your contract!
Before you begin orthodontic treatment, your orthodontist
will draw up a treatment plan and have you sign a contract.
Read the contract! It tells you a lot of important details,
such as terms of payment, what happens if you miss payments,
and whether retainers are included in your treatment cost.
If something goes amiss during your treatment, your contract
is a binding legal document.
Don't think, however, that your orthodontist is going to
cast you aside if you miss a few payments. If you suddenly
begin to have financial difficulty, talk to your
orthodontist or his office manager about working out new
terms with you. As long as you try to make payments in
earnest, most orthodontists will continue to treat you.
8. Stay put, if possible
In a perfect world, you pick an orthodontist and stick with
him for several years until your treatment is finished.
After all, you have signed a contract stating that you agree
to pay $x for x-number-of-years. But sometimes life throws
us a curve and we need to uproot ourselves and move. There
are a few things you need to know about moving once you
begin orthodontic treatment.
First of all, you may be entitled to get a partial refund
for your treatment if it is not totally paid off. That
depends on...you guessed it...your contract.
Secondly, once you are in new city, you will need to start
over with a new orthodontist. There is usually no "treatment
in progress" discount for new patients. In fact, it can be
more complicated for a new orthodontist to finish your
treatment, because (as stated earlier), different
orthodontists have different approaches. To make sure that
your new orthodontist picks up where your old one left off,
ask your old orthodontist to give you your records (or give
him the address to forward the records). It might possibly
cost you less to complete your treatment with a new
orthodontist, but don't count on it. You may need to start
over financially, so be prepared for it to cost you several
thousand dollars more.
9. You will need to take good care of your teeth
Why bother to spend thousands of dollars and years of your
time on your teeth, and then ignore your oral hygiene? When
you have braces, you will need to brush your teeth several
times per day, ideally after every meal. This may sound like
a big pain, but you'll get used to it. In fact, you will
want to brush your teeth often, because food gets stuck
between your brackets, which can be really disgusting and
cause bad breath and tooth decay. At the very least, you
should swish your mouth with water after eating.
You can get an orthodontic toothbrush or use a regular soft
toothbrush. The important thing is to clean your braces
thoroughly, making sure that there is no food debris on any
of the brackets. You should also floss at least once per
day. It isn't always easy, but there are many "floss
threader" products on the market that help. Your
orthodontist can show you how to brush and floss properly.
Speaking of brushing, remember that you should not use a
whitening toothpaste when you have braces. It could cause
you to have "two tone" teeth after the brackets are removed!
Another thing to remember is that although a device like a
Waterpik is great for gum stimulation and dislodging food,
it is not a substitute for flossing. Even if you use an oral
irrigator like a Waterpik, you still need to floss daily.
Because you will be brushing so often, it helps to keep a
dental kit with you. DentaKit.com has one that includes
everything you need, including a spill-proof folding cup.
You can see it
10. Yes, it will hurt for
Yes, it hurts to wear braces
at first. It doesn't hurt to get them put on your teeth; the
pain and pressure come a day or two later. Not only will
your teeth feel sore, but the brackets will rub the insides
of your gums and lips and cause mouth sores. This is not
pleasant, but fortunately this stage only lasts a couple of
weeks. Soon scar tissue forms inside your mouth and
everything hurts less. To soothe the mouth sores, rinse your
mouth with warm salt water several times per day, or use a
mouth rinse like Rincinol PRN. Take Tylenol or Motrin for
the pain -- narcotic painkillers are not necessary. Use a
lot of dental wax or get a lip protector for braces. The
initial stage of braces is not fun, but it passes soon
enough. You will need to eat soft foods and chew very slowly
and carefully. Believe it or not, in a few months the braces
won't bother you very much at all.
11. Beware of allergies
Some people are allergic to
nickel, which is found in some brackets and wires. Some
people are allergic to latex, which is found in o-ring
ligatures, elastics, and exam gloves. And recently, it seems
that some people are allergic to something in the plastic of
aligner trays and plastic retainers.
If you know that you have an
allergy or sensitivity to any substance, tell your
orthodontist or dentist. There are always alternative
products they can use which won't cause problems for you.
Even if you've never before had an allergic reaction to a
substance, you can suddenly develop an allergy at any time.
If you feel that your braces or retainers are causing an
overabundance of mouth sores, or if you develop upper
respiratory symptoms, hives, or swelling, tell your
orthodontist. If you feel that your throat is swelling up or
you are having an obvious allergic reaction, go to your
nearest Emergency Room. If you feel that you can't breathe,
call 911. Do not take these sort of reactions lightly. A
severe allergic reaction can kill you in a matter of
12. You will need to wear retainers afterward
After your braces come off, your orthodontist will make a
mold of your mouth and produce a set of retainers. The type
of retainer you need depends on your case. Sometimes,
orthodontists recommend a bonded permanent retainer to
ensure that your teeth do not move at all.
Aside from a permanent bonded retainer, there are two other
types that most people get.
A Hawley Retainer is
made of acrylic and metal. The acrylic goes behind your
teeth and up against your upper palate; the metal is in
front of your teeth. This is the most reliable type of
retainer. Your orthodontist can "tweak" the metal to help
finish any small refinements that still need to be done to
An Essix Retainer is
clear plastic and looks like an Invisalign aligner tray.
Many people want this type of retainer, but it has its
disadvantages. Many orthodontists feel that because it
covers the biting surface of your teeth, they do not
"settle" properly after treatment. For this reason,
sometimes orthodontists give a patient both types of
retainers: an Essix Retainer to wear during the day when
they are people-facing, and a Hawley Retainer to wear at
night when they are home sleeping.
No matter what type of retainer your get, the most important
thing is to wear it exactly as the orthodontist tells you.
Most people need to wear their retainers 24/7 for at least 6
months, then switch to wearing it only at night when
How long will you need to wear your retainer? Forever.
That's right, forever. Your retainer ensures that your teeth
will not move back into their old crooked positions. If you
have been out of braces for several years, you can switch to
wearing it only few nights per week. But if you stop wearing
it totally, you will be asking for trouble.
Keep your retainer in a
retainer case. Don't wrap it in a tissue. This is the most
common way that retainers get thrown out. A new retainer
costs around $250, so pay attention and take good care of
Remember that it is important to keep your retainers clean.
Like your teeth, your retainers can get a buildup of
bacteria and white plaque. You must clean your retainers
every single night with a bacteria-killing product like
Retainer Brite, SonicBrite, or DentaSoak. These products are
not sold in local stores, but you can get them on the web at
sites like DentaKit.com.
You can brush your retainers with a toothbrush and
toothpaste, but this will not adequately kill the bacteria.
A good retainer cleaning product will ensure that your
retainers stay clean and fresh smelling.