Until recently, I was quite happy with mine teeth. Was it perfect and snowy? Not quite—but I was pretty pleased with how they looked (especially considering I didn’t have braces as a teenager). Then, I got to thought: Wouldn’t it be great if my bottom teeth didn’t have people? And what if some of my upper teeth were a little more even? So I started thinking about getting adult braces — or, more generally, adult orthodontics.
Several sets of clear aligners later, I’m happy to report that my teeth have never looked better. In fact, when I look at older photos of myself, I’m shocked at the difference.
You might be in the same position I was last year around this time—wishing for straight teeth, but not sure what to expect. Or maybe you had perfect teeth after braces in your teenage years, but things have changed because you weren’t wearing your braces (oops!).
If any of these scenarios speak to you, keep reading: Below, Dale Anne Featheringham, DDSan orthodontist based in Columbus, Ohio, looks at the different types of orthodontic treatment available (plus their pros and cons!), what to expect from the procedure, and why she believes it’s such a solid form of self-care.
1. There are many reasons you might seek treatment.
There’s usually something that motivates adults to do it, Featheringham notes. “Covid, of course – with Zoom and cameras – was big [motivator].”
Some women whose families couldn’t afford (or didn’t prioritize) orthodontics seek treatment as soon as they can afford it, Featheringham says. Others watch their kids get braces (and pretty smiles) and then decide to do something nice for themselves.
Then there are those who seek contact for prior orthodontic treatment after they have stopped wearing their retainers. And if that sounds like you, no shame.
“I think the science around retainers wasn’t as good earlier,” explains Featheringham. “They’d say once your jaws get bigger when you’re 18 or 20 — they all had a number — it’s OK to stop wearing your retainer.” But over time, he says, teeth change.
2. Aesthetics are only part of the equation.
Another type of motivation, according to Featheringham, is discovering a health issue. For example, he says, your dentist might tell you that the way your teeth are grinding is causing you gum recession on your lower front teeth. And crowded teeth that are difficult to clean can lead to inflamed gums.
In other words, adult orthodontics isn’t *just* about making your teeth look prettier. Along with the cosmetic improvements, Featheringham explains, there’s an equally significant functional improvement taking place.
3. There are a few different types of treatment.
When you hear “orthodontics,” you might envision braces or clear plastic aligners—both of which are options your orthodontist may recommend. (Side note: Featheringham says sometimes people think orthodontists only do braces, but they also do aligners—in fact, they’re the experts!)
These days, braces come in ceramic versions that are less noticeable and therefore nicer for adults, according to Featheringham. Compared to aligners, he explains, they can more effectively treat certain types of bites, such as deep overbites. And some people just prefer this type of treatment, as it works on their teeth without them having to think about it.
Fun fact: There are also braces that go on the back 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. He also notes that they may have more limited use cases than standard braces (certain types of bites would probably require regular braces).
Ultimately, braces are used less often in adults, according to Featheringham, but it depends somewhat on the orthodontist and their comfort level with aligners.
“In our practice, I’d say nine out of 10 adults undergo alignment therapy,” says Featheringham. He adds that this option has the advantage in terms of comfort, appearance and hygiene (you can take out aligners to clean your teeth, whereas with braces you should expect to spend a little extra time cleaning around them). Additionally, structuring appointments can be much easier on busy schedules.
“With the aligners, we [often] stretch out the dates a bit more,” explains Featheringham. So you may end up in your orthodontist’s office every 10 or 12 weeks versus every six, seven or eight weeks.
Another advantage of this type of treatment is that you will be able to see the final result before you even begin the procedure.
“With aligners, we can take someone’s teeth, scan them, and show them what they’re going to 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 could take a picture of you and show this picture of what you’re going to look like after 18 months of working out.”
One downside to using aligners? You might get tired of taking them out for food and drink—and brushing your teeth every time you put them back in (especially if you’re out in public!).
4. If you had braces as a child, you can probably expect a different experience this time.
In fact, if you’re going to use aligners, your teeth-straightening experience will be completely different, according to Featheringham. The whole process is much simpler (fitting involves a scan and possibly placing small attachments on your teeth to anchor the aligners), he explains, and requires much less chair time.
Even if you get braces, you can probably expect some changes from your childhood experience. The braces themselves have improved (think: they’ve gotten smaller), says Featheringham, and the adhesives and lights used to attach the braces have also improved.
“The wires that move the teeth have been further improved,” he adds. In the “old days,” they used to literally tighten the wires, he explains—now, they put new ones in to move your teeth. And fitting your braces can be simpler than previous experiences as well. According to Featheringham, trays can be made based on a scan of your teeth that allow an entire 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 seen direct-to-consumer aligner ads 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. X-rays are the only way to see what is going on health-wise beneath the surface of the teeth. And there are some things you can only do in person, she adds, such as screening for oral cancer, examining tooth mobility, or evaluating overall gum health.
Additionally, Featheringham explains, orthodontics is a biological process that involves pushing teeth through gum and bone. “As we do this, all kinds of things can happen,” he says. For example, gums may recede and teeth become loose because of the way they click. You need an expert to identify problems – and, you should you notice a problem, you need to know exactly where to go. Featheringham adds that adult orthodontic treatment may require working with a dentist, oral surgeon or periodontist.
Long story short: It’s a red flag if a treatment plan doesn’t include you working directly with an orthodontist or dentist and receiving personal care. “I can’t think of any other transformative medical procedure that I would personally feel comfortable with without an in-person exam before starting,” notes Featheringham.
Consider treatments that require you to only wear your aligners at night, too. They really need 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,” he explains. In other words, this is the optimal way to get the fastest, most stable and healthy movement. But when you’re constantly taking your aligners in and out—pushing teeth forward instead of gently moving them to a new spot—you’re not following this principle. Plus, he says, each aligner moves your teeth so gradually that wearing them for 12 hours and taking them off for the same amount of time is like taking one step forward and one step back.
Bottom line: It’s important to do your homework before starting treatment, according to Featheringham. To help you, the American Association of Orthodontists has a list of questions to wonder while researching. And remember, if you’re hesitant to see a specialist because you’re worried about the cost, consider this: It may cost you more money in the long run to repair the damage from treatment gone wrong, according to Featheringham. Her advice? Do it once and do it right.
6. Treatment may involve some pain and/or strain—so keep your eyes on the prize.
One 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 break up the movement into bite-sized chunks rather than the bigger jumps you make with braces, he explains.
“I think it’s just having your mind set on that goal,” adds Featheringham. Be patient with yourself, she advises, expect it to be a bit of a bumpy ride at first and watch the changes happen to stay inspired. It’s like going to the gym, he notes – there will probably be tougher moments that you won’t enjoy, but it’s worth it in the end.
7. After all, adult orthodontics can be about more than just teeth.
“People are always so happy about change,” notes Featheringham. “And they always say ‘best money spent.’ Unlike a great pair of shoes that may go out of style next season, orthodontic treatment offers lifelong benefit and it’s self-care that leads to confidence, she explains. Sometimes, it even spills over into other ways of taking care of your body: “It’s the first domino that often falls with a lot of other self-care stuff.”
Erin Warwood is a San Francisco-based author, runner, and sparkling water enthusiast. He holds a BBA from the University of Notre Dame and an MS in journalism from Northwestern University. In her free time, you can find her watching Survivor, trying out new Peloton workouts, and reading Emily Giffin novels. Her ultimate goal: to become a morning person.
