Too old for braces?

The full answer

A tooth moves because the bone around it keeps renewing itself. When a tooth is pushed gently in one direction, bone dissolves on one side and rebuilds on the other. That happens at 15 and it happens at 50. So age itself does not rule braces out, as long as the bone and gum around the teeth are healthy.

What actually matters is not your age but the state of your mouth: healthy gums, enough bone around the roots, and no active decay. If those are in place, braces are possible. If one of them is not, it is treated first, and the examination then says whether braces have become an option.

And all of that is decided at the examination. Not by your age, not from a photo you send, not by an article, not even this one.

What is different about braces as an adult

• Growth has finished. In a child or a teenager the jaw is still growing, and the doctor can guide that growth. In an adult the jaw has stopped, so braces move the teeth within the bone that is there. If the problem is the size of the jaw itself rather than the teeth, the answer is either moving the teeth in a way that softens the difference, or braces coordinated with a jaw surgeon in the larger cases, to whom the doctor refers you if your case needs it. Either way, you hear it plainly at the first examination.
• Your mouth has a history. Fillings, crowns, a root-treated tooth, a missing tooth, an implant. Each one changes how a tooth is moved and what is bonded to it, and only an implant does not move at all, and each goes into the plan from the start.
• Gums matter more. Gum inflammation is more common with age, and braces on inflamed gums make it worse. So for many adults the first step is not the wire; it is a cleaning and gum treatment.
• It may take a little longer. Adult bone renews itself more slowly than a teenager's, so the same movement can take more time. How much more? That comes out of the examination as an expectation for your case, not as a figure from an article.
• And discipline is in your hands. Appointments on time, elastics worn, trays in for most of the hours of the day: that is what keeps the plan on schedule, and most adults manage it well.

If you are pregnant and thinking about braces, pregnancy is not a barrier either, but timing matters: Braces during pregnancy: what waits and what doesn't.

Fixed, clear or removable?

Many adults ask for “removable braces” because they do not want visible metal at work. So let us sort out the types in plain words, because “removable” gets used for two very different things.

Fixed braces

Small brackets bonded to the teeth with a wire running through them, and they stay in your mouth for the whole course. This is the option that can do every kind of movement, from a simple tilt to moving a whole tooth with its root, which is why it remains the foundation for moderate and difficult cases. Brackets exist in metal and in a shade close to the tooth, and you learn at the examination which kind is available.

Clear aligners

Clear trays that fit over the teeth and are swapped in stages, and you take them out to eat and brush. This is what most adults mean when they say “removable”. They suit many adult cases, not all of them: heavy crowding, or teeth that need to rotate a long way, usually need fixed braces, or start with them. And their secret is discipline: if the trays are not in for most of the hours of the day, they do not work. Clear aligners have a page of their own that goes into more detail: Clear aligners.

And the removable plate

A plastic plate with wires and springs that you take in and out. It manages simple movements only, tilting a tooth or a little widening, which is why it is mostly used in children while the jaw is growing. In an adult its main role comes after braces, not instead of them: as a retainer that holds the result. So if you are an adult and want something that comes out, the honest answer is usually clear aligners, not the plate. And the examination settles whether your case can be treated with them at all.

Front teeth only: does it work, and how long does it take?

This is one of the questions adults ask most. The answer: sometimes it works, but not always, because your front teeth are not on their own in your mouth.

If your bite is sound and the problem is confined to a slight tilt or a small gap at the front, there is such a thing as limited braces: they work on the front teeth only, and the course is usually shorter than full braces. But if the front teeth lean because the jaw is crowded further back, or because the bite itself is off, moving the front teeth alone either drifts back or opens up a problem in the bite. That is what the examination picks up before we start.

The neighbouring question, “braces on the upper jaw only?”, follows the same logic and has its own article: Braces on one jaw only?.

What decides how long it takes

There is no fixed number for front-teeth braces or for any other kind, and any number you see online belongs to a case that is not yours. What decides it:

• How far the tooth has to move. A small gap is not a protruding tooth that has to come a long way back.
• Crowding or gaps. Crowding sometimes needs space made, which means light filing between the teeth (a very thin layer of enamel) or an extraction, and that adds a stage.
• Your discipline. Appointments on time, elastics worn, trays in for most of the day. Every delayed visit stretches the road.
• Breakages. A bracket that comes off or a wire that snaps means the teeth stop moving until it is fixed.
• Gums and bone. Slower bone, or gums that need treating first, change the arithmetic.

After the examination you hear an expectation for your own case, and you know from day one that the retainer afterwards is part of the plan, not an add-on at the end.

Do braces slim the face?

No. Braces on their own move teeth within the jawbone. They do not change the bones of the face and they do not melt the fat in your cheeks. The main exception is a case whose plan is braces coordinated with a jaw surgeon, and that is discussed on its own at the examination. If what someone wants is a slimmer face, braces are not the tool, and you hear that plainly at the examination rather than starting a treatment on a hope that is not right.

So why do people say “my braces slimmed my face”? Three reasons, and none of them is slimming:

• Eating is harder in the first weeks. After fitting or an adjustment, people eat less and softer, and some lose a little weight, so the face looks thinner. That is you, not the braces, and it goes back when you eat normally again.
• The lips change with the teeth. When protruding front teeth come back, the lip that rested on them comes back with them, so the profile changes and the face looks different in photos. That is a change in the shape of the mouth, not the size of the face.
• Extractions change the profile a little. In cases that need an extraction to make space, the lips can settle further back. The doctor weighs that before deciding on an extraction, and tells you.

And the same answer to the opposite question: braces do not widen the face or make it bigger. What changes is your smile and the shape of your lips, and that is talked through with you beforehand, not discovered afterwards.

What to do now

1. 1

   Book an examination, not a decisionThe examination looks at the gums, the bone and the bite, with an x-ray if it is needed. You leave knowing whether braces suit you, which type, and what to expect in your case. No pressure to decide in the same visit.

2. 2

   Health before hardwareTartar, gum inflammation or decay are dealt with first. Braces go onto a healthy mouth, because decay and gum inflammation carry on around the brackets and under the wires if they are not treated beforehand.

3. 3

   Say exactly what you wantFront teeth only? The bite? One particular gap? And what would bother you at work or in daily life about how braces look? That steers the choice of type, and the doctor tells you whether what you want can be done or needs more.

4. 4

   Say if you have had braces beforeIf you had them as a teenager and your teeth drifted back, say so from the start. Drifting back is common once people stop wearing the retainer, and a second course is usually shorter than the first. If you started treatment in another country and then moved to Amman, bring whatever records you have; after an examination the doctor tells you whether the plan carries on as it is or needs to change.

5. 5

   Ask about the retainer from day oneTeeth keep wanting to drift back after any braces, and the retainer is what holds the result. You learn its type, fixed behind the teeth or a removable clear tray, how many hours a day you wear it, how long it stays with you, and why for many people the night-time retainer stays for a long time, all before you begin.

6. 6

   Plan your visits nowBraces are a course of regular visits, not a single session. If you travel a lot, are only in Amman for part of the year, or your work makes appointments hard, say so first, because it goes into the choice of type.

When to call

Most of what happens with braces can be sorted out at the next visit. But some things do not wait for the appointment:

• A wire sticking out and cutting your cheek or tongue that you could not cover with wax.
• A bracket that has come off the tooth, or a wire that has snapped.
• Pain that gets worse after a few days instead of easing, or pain in one particular tooth.
• Swelling in the gum or cheek, or heavy gum bleeding that does not stop with gentle brushing.
• A clear tray lost or broken, so your teeth are not left without one for days.
• A fever with any of the above.

Call during opening hours and we give you the earliest open slot, and tell you what to do until you get here. If a large swelling reaches your eye, or swallowing or breathing becomes difficult, that does not wait for an orthodontic appointment: it is a hospital emergency, and you tell us afterwards. If you have a fever with swelling and the clinic is closed, do not wait for opening hours: go to the nearest hospital emergency department, and tell us afterwards. And if one tooth has been hurting and getting worse at night since before any braces, that is a different matter with its own page: Toothache: what to do right now.

Questions people ask