Adult Braces Are a Growing Trend. Find Out Why—and Why Now

Getting braces isn’t just something for kids anymore. Turns out more grown-ups getting their teeth straightened is a growing trend, locally and nationally. We find out why.
Adult braces
photos: thinkstock


Hawai‘i bookkeeper Brandy Shumate wanted to straighten her teeth after a deteriorating bridge messed up her dental alignment. Although she had braces when she was 13, Shumate felt awkward about wearing them now, in her early 40s.


“I was apprehensive about braces and I even mentioned something to my orthodontist and the nurses but they assured me that they’ve had lots of patients who were adults, many way older than I was,” says Shumate. After consulting with her orthodontist, Wendell Hoshino of Hawai‘i Family Dental, and setting up a payment plan, Shumate was hooked.


More adults than ever are getting braces, according to the American Association of Orthodontists. While the majority of orthodontic patients are still ages 9 to 14, the number of adult patients seen by orthodontists increased by 40 percent between 1989 and 2012. About 1 million adults sought treatment from orthodontists in the U.S. and Canada in 2012. By 2014, that figure jumped to 1.4 million.


“It’s a common misconception that orthodontic care is just for adolescents,” said AAO President Morris N. Poole in a 2016 interview with the Journal of the American Orthodontic Society. “We have data showing that adults report improvements in their professional and personal lives after completing orthodontic treatment.”


Orthodontics, which corrects and prevents improperly positioned teeth and jaws, isn’t just about a better smile. A more precise alignment of teeth can help prevent dental issues later in life that stem from crowding pressure, tooth decay, abnormal wear of enamel and surfaces, and jaw joint pain. But why the rise in adult braces—and why now?


“I think probably a lot of it started with Invisalign and other options for braces that became available for adults,” says Malia Kamisugi of Hi Smile Orthodontics in Honolulu and Kailua. “People are much more attuned to the mouth-body connection now than they were in the past—knowing that if you have straighter teeth and a better bite, your chance of keeping all your teeth throughout your life is higher.”


For some adults, braces may not have been affordable when they were younger. Others may have had braces but didn’t continue to use retainers and their teeth shifted back. One study by the peer-reviewed American Journal of Orthodontics and Dentofacial Orthopedics in 2011 found that 68 percent of adults with braces got them to improve their smiles and 35 percent got them “to improve the appearance of my face.” According to the study, about half of the adult patients surveyed sought treatment themselves.


Having braces as an adult can be problematic, though. It’s usually harder to rearrange misaligned teeth in the mouth as a patient gets older and might take more time and patience compared to growing kids whose bones are still growing. Women who are pregnant may find their gums swell, which can cause the brackets to cut their gums. Adults with temporomandibular joint, or TMJ, disorders, who experience pain and dysfunction with the muscles and joints of the jaw, may find relief in a better aligned jaw, but the presence of braces during the orthodontic process can be uncomfortable.


But there are upsides: Adults tend to take better care of braces than their younger counterparts. While kids may not be as vigilant about wearing their retainers or avoiding certain foods, adults generally have a better dental hygiene regimen. Part of this may stem from realizing just how expensive—and valuable—braces are: Because they’re often considered cosmetic and an elective treatment, most health insurance plans won’t cover orthodontic treatment for people over 18.


Local orthodontists estimate the cost of adult braces at between $5,500 and $8,000, depending on the patient. This is just for the orthodontics; it doesn’t include any dental work that might be needed before or after, to prepare mouths for braces, or follow-up after they’re removed. Ceramic braces and Invisalign can cost more. “Patients may elect to set up a payment plan or financing. Most insurance plans aren’t covering it but there are a few that are,” says Kimi S. Caswell, who has been operating her orthodontics practice on O‘ahu since 1995. “Generally, if braces are something that a patient wants, we can make it work for them.”


For some, price isn’t an issue if they can undergo subtle orthodontic treatment, without the perceived stigma of wearing braces. Companies such as Invisalign or SureSmile offer alternatives to traditional metal wire braces, such as clear teeth molds that rotate out every few weeks (to slowly align teeth) or 3-D imaging and custom archwires to create an individualized set of braces that can minimize treatment time.


“There are different techniques now which can make teeth move into alignment quicker,” Caswell says. “There’s AcceleDent and vibration technologies which stimulate blood flow to facilitate movement; LED lights that activate cells; and microperforation, where we drill little holes in the bone to create space for teeth to move.”


For Kamisugi, who has worked with patients ages 3 to 92, getting braces as an adult is about finding a system and an orthodontist who works for you. “We spend a lot of time with new patients just educating them on what the options are, benefits and risks, how long it’ll take,” says Kamisugi. “Orthodontics is a long relationship, so you really want to make sure you feel comfortable with your doctor, the staff and the practice itself. [It’s about] what feels right for you.”  


Types of Braces

Traditional Metal Wired

Traditional braces

Made from high-grade stainless steel or titanium, these are your most commonly seen braces, with brackets and wires tied by elastic bands. This type usually offers the shortest treatment time, fewer adjustments and less pain.


Progressive, Removable Aligners

Progressive aligners

A series of between 18 and 30 medical grade clear plastic teeth molds—approved by the FDA—that are worn by patients daily except to eat, drink, brush and floss. Every two weeks, a new set is swapped in, forcing teeth to align to the new mold. The most common system is Invisalign.


Lingual Braces

Lingual braces

Similar to traditional braces, except the brackets are placed against the inner sides of the teeth instead of the front to be less noticeable. However, some drawbacks include difficulty cleaning behind the teeth, often longer treatment time and higher costs.


Clear Ceramic or Plastic

Clear braces

Similar to traditional braces, except the brackets are made with clear or natural teeth color, offering a less conspicuous appearance than regular metal.


Customized Treatment Systems

High-technology, such as 3-D imaging, treatment planning software and custom-bent wires, can be combined and specifically tailored to patients for more efficient orthodontic results and faster treatment times. These can be expensive.