Adult Braces: What Grown-ups Need to Know

An orthodontic plan for a grown-up differs from one that meets the needs of a young adult. Learn more about adult orthodontic health from a Northern Michigan dentist, with this feature on adult braces by MyNorth editor Jeff Smith, originally published in the Medical Insider within the November 2015 issue of Traverse, Northern Michigan’s Magazine.


We all know young people who have shining, perfect smiles after realigning their teeth with orthodontics, and many adults are now inspired to fix teeth irregularities that they are tired of living with. But the teeth and bones of adults differ markedly from those of young people, and other issues need to be considered when mapping out an orthodontic plan for a grown-up. We asked Dr. David Swan of Traverse Dental Associates in Traverse City, a family dentist who often serves as a point person for patients undergoing orthodontics, to share things patients need to know when contemplating measures like braces.

It seems like we are seeing more adults with braces. What typically compels an adult to pursue orthodontics?

Well, yes, we do have a lot more adults wanting orthodontics. Sometimes it’s restorative, sometimes it’s cosmetic, sometimes the patient is suffering pain from TMJ (Temporomandibular joint syndrome) pain.

Briefly, why are orthodontics different for young people and adults?

Adolescent mouths are still growing—the bones are soft and malleable. So when you move teeth, the mouth adapts, and the teeth settle into their new positions nicely. But with adults, the bone is resistant to tooth movement, and the settling in is not as predictable. Also, the teeth are worn, and they won’t necessarily mesh when aligned. Sometimes, the teeth could even look worse because the wear becomes more apparent.

So how do dentists and orthodontists compensate for that, for what time has done to our teeth?

It’s a process called “occlusal equilibration,” and what that means essentially is detailing to get the bite to align more perfectly. It involves reshaping the teeth with procedures like selective grinding and polishing, replacing fillings or doing crowns, all so the teeth can mesh better. If the gums require plastic surgery, we might enlist the help of a periodontist.

How should adults approach this procedure?

It requires a team approach, bringing in various experts who have the specific skills needed. Typically your family dentist would quarterback the process. That person has the global understanding of your dental situation and the ability to coordinate the various specialists. Also the patient should make sure to get a very comprehensive evaluation. We make a model of the patient’s existing teeth and then a second model that shows what the finished product will be. This not only lays the groundwork for all the orthodontic and restorative work to come, but it also makes sure the full scope of the project is understood and all costs are accounted for.

Cases involving adult orthodontics can require a significant investment of the patient’s time and financial resources. Much of this care is far beyond the scope of what traditional dental insurance plans might cover, and we owe it to our patients to avoid any unpleasant surprises.


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