When most people think of braces, they usually think of teenagers. The ideal age to get orthodontic treatment is usually after the 12-year-molars have erupted and the last of the baby teeth are gone. As you can tell from several of my other posts about two-phase treatment, I believe in providing an interceptive phase of treatment in 7 and 8-year-olds if they have complex crowding, crossbites, excessive overbites, or underbites. But what about at the other end of the spectrum. How old is too old? Why would someone get braces later in life? And what are the differences in treatment for older patients?
There really is no upper age limit for getting braces. As long as you have teeth and they are healthy, you may benefit from orthodontic treatment. Because of advances in dentistry, especially the diagnosis and treatment of periodontal disease (gum disease), patients are keeping their natural teeth longer than ever. My grandparents both had full dentures and my parents each lost several permanent teeth along the way. My generation still has most of their teeth but have many crowns due to decay earlier in life. None of my children are missing teeth or even have a crown. The improving condition of dental care, especially in the United States, means that a lot more adults will keep their teeth throughout their lives and that adult orthodontics will become more common.
When I started my practice in 1992, most of my patients were kids. While that is still generally true, the ages of my patients have gradually increased over the past two decades. Half of my current patients are between the ages of 12 and 18. 25% are younger than that and 25% are older. Although most adult patients are in their 20’s, 30’s, and 40’s, I have a growing number in their 50’s, 60’s, and 70’s!
Adult patients seek treatment for a variety of reasons. Most times they are referred by their general dentist because of teeth that are hard to keep clean, are wearing out because of a bad bite, or that need to be moved so that other dental procedures can be performed (making room for an implant for example). Other times patients come in on their own because there is something about their smile that bothers them and they finally decide to address it. It is not uncommon for this to happen upon retirement as these patients have more time and some savings they want to invest in themselves. My older patients are some of the most informed, appreciative, and compliant patients in the practice.
Adult patients have most of the same options as younger patients with a few exceptions. Correction of posterior crossbites cannot be accomplished with an expander alone. Although it can be corrected, expansion may require surgical re-opening of the midpalatal suture. Because expansion is not as easy in adults, correcting moderate to severe crowding usually requires more extractions than with adolescents. And although “overbites” can be corrected in adults, doing so with headgear, springs, or rubber bands is not as effective as it is with younger, growing patients. For this reason, adult patients require more bicuspid extractions and jaw surgeries than teenagers.
When I consult with adult patients who are considering orthodontic treatment, we discuss their reasons for seeking treatment, their goals and expectations, and their options. Sometimes they want to address a specific problem. Other times they want “the whole enchilada” as we say here in New Mexico. If you have always felt you could benefit from orthodontic treatment, maybe it is time to schedule an appointment for yourself!
NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist who is in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the Westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa in the United States. Dr. Jorgensen’s 25 years of specialty practice and nearly 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog is for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor can he select treatment plans for readers. Please understand that because he has over 40,000 readers each month, IT IS IMPOSSIBLE FOR HIM TO RESPOND TO EVERY QUESTION. Please read all of the comments associated with each article as most of the questions he receives each week have been asked and answered previously. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.