BRACES

Pros

• A straight smile can build confidence.
• You’re never too old to have braces. The process of moving teeth can take longer in adults because they have denser bone tissue than children do, but healthy teeth can be moved at any age. In fact, one in four orthodontic patients is an adult (including many who had braces as kids but didn’t keep wearing their retainer). 
• Besides creating a better bite and making teeth fit better, braces can decrease the risk of future dental problems, such as tooth decay, gum disease, and difficulty chewing. 

Cons

• Braces can be an ordeal. The “hardware” and appliances that often have to be worn can create friction that causes minor irritation or injuries, and the pressure that’s put on teeth to move them can be painful, especially during the first night after they’re adjusted. Over-the-counter pain relievers (acetaminophen or ibuprofen) can help.
• Traditional metal braces can be difficult to keep clean, which can lead to tooth decay, white spots on your teeth, and swollen gums.
• Chewy foods and very hard or crunchy foods can damage your braces, so you’ll have to avoid them during your treatment. 
• Braces can be expensive, especially if your dental insurance won’t cover them.
• Depending on the type of braces you choose, you may need to see your dentist or orthodontist every 4–10 weeks while you’re being treated.
• To preserve the results of your treatment, you’ll need to regularly wear a retainer for the rest of your life.

• Average Cost:
• $3,686

• Range:
• $3,000 - $4,500

Headgear, retainers, plus other appliances may be an additional cost. You may be charged a monthly fee, or you’ll get a quote for the entire treatment. 

RealSelf Tip: Request a quote that includes all the charges you’ll accrue and won’t increase if you’re required to wear braces for a long stretch of time. 

Dental insurance will cover part of orthodontic treatment for children under age 18, but adults may not be covered. Additionally, many dental plans have an annual cap on services for the year, so you could exceed that limit and be liable for the balance. 

Medicaid may pay for braces as well, especially if they’re deemed medically necessary (see good candidates, above). Find out here if you qualify for Medicaid or CHIP. 

If you don’t have insurance or Medicaid coverage, look into financing plans, like CareCredit. Many dental professionals offer payment plans.

The average cost for other teeth-straightening methods are $4,975 for Invisalign, $8,050 for Incognito (invisible) braces, and $7,275 for other forms of lingual braces.

See our complete guide to braces costs

Dentists first see correctable bites and misalignment when patients are between the ages of 8 and 14, but you can get braces at any age. You just need healthy teeth that may be overcrowded, poorly spaced, or crooked. Some people have teeth that overlap in an underbite or overbite or an uneven crossbite. You may also have a jaw joint disorder (aka temporomandibular disorder, sometimes referred to as just “TMJ”), and braces can help pull the jaw into place. 

Some conditions—including cleft palate, problems opening the mouth or chewing, speech impediments, severe bite issues, and overjet (“buck” teeth)—can make braces medically necessary. Additionally, if you’re missing teeth due to hereditary conditions (hypodontia), braces can help straighten what teeth you have and close any gaps.

Getting braces with one or more crowns is no problem; your orthodontist will use a different adhesive to make sure the bracket will adhere. If you have gum disease, cracks in your teeth, or cavities, your dentist will help to resolve these conditions first. 

Let your provider know if you have any allergies. Some braces are stainless steel used in combination with titanium, which can trigger nickel sensitivities, but there are alternatives or substitute metals that can be used instead. Also, if you have a latex allergy, it’s important that your dentist not use latex gloves or any other devices with latex components during treatment. 

Those who have ankylosis, a rare condition where the tooth root has fused to the bone, won’t get good results from braces, simply because that tooth is immovable. The teeth surrounding it will begin to move, resulting in different alignment. Usually ankylosis occurs when you’ve had a tooth reimplanted but otherwise is unpredictable. You’ll need X-rays to confirm your candidacy.

Generally, braces are very safe to wear. While they’re on, taking the time to thoroughly floss and clean your teeth can help you to avoid plaque buildup and calcification around the brackets, tooth decay, and gum disease. Many people with braces rely on a Waterpik to clean the tiny spaces between teeth.

The pressure and tension of braces can cause root resorption (shorter roots)—which can mean less stable teeth. According to research, it is four times more likely to occur than if you didn’t have braces at all. Still, the risk is low, occurring in just 1–5% of teeth, total. 

There’s also the risk of a loss of correction if you don’t wear a retainer after braces removal. This means that your teeth can slowly start reverting back to their original places, and you might again have crowding, an overbite or overjet, or misaligned teeth. 

If you’re concerned about damaging your braces while you’re wearing them, follow the dietary instructions provided to you and take care of your teeth with your daily regimen. Visit your regular dentist for biannual cleanings.

RealSelf Tip: Because braces realign and straighten teeth to fit well in your jaw, some people find that the urge to grind their teeth (bruxism) is eliminated.

Traditional braces put continual pressure on your teeth, to slowly shift them into a straighter position. This is done by attaching metal brackets to the teeth in order to hold adjustment wires in place. The wires apply pressure to move your teeth, and they’re adjusted regularly (usually every four to eight weeks) during the course of your treatment.

If there’s overcrowding, orthodontists will sometimes request that some teeth be pulled in order to make room to adjust and straighten the remaining teeth. When extraction is determined to be beneficial, it’s common to remove between one and four teeth. 

You can expect it to take about two hours to have braces put on. This includes time spent cleaning and drying your teeth so the brackets can be secured with a special glue. If your dental work is up to date, you have good oral health and don’t need any further work (extractions or fillings), you can get braces installed on the day of your consultation. 

The required  length of time for wearing braces varies per person. The average treatment plan takes 18 to 22 months, but it’s not unusual to have braces for three years or more, if your bite is more complicated.

Braces are more comfortable and less noticeable than ever before; they’re smaller and have fewer brackets, and the wires are much less visible (while being more effective). You can choose between silver, gold, ceramic, or clear plastic brackets (the price varies). “If your braces are tooth-colored, they will be nearly invisible,” says Dr. Lance Timmerman, a dentist in Tukwila, Washington. 

You also can choose different colored brackets; ask your orthodontist for sample colors and determine which colors match most of your wardrobe or complement your skin tone.

Braces won’t change your face, but if you’ve had extractions, you may notice a loss of volume in your cheeks later in life. If you notice that your lips look bigger or plumper, that’s simply because the braces are pushing your lips out and isn’t a permanent change. “The lips might become a little more full, but not much,” says Dr. Timmerman. 

RealSelf Tip: In addition to being more expensive, ceramic braces are stronger than your own enamel, so they can damage the surface of the teeth. They also can create friction between the wire and the bracket, which can extend treatment time.

Oral hygiene is still, if not more, important when you have braces. Brushing and flossing can be a bit tricky with braces, so take your time and hit every tooth.

Before you brush, swish around some water to help loosen any food particles. Then brush the gum line at a 45-degree angle.

To brush the brackets, angle down on the top of the bracket and brush, then repeat on the bottom of the bracket while angling up. 

Dr. Steven Davidowitz of New York City recommends asking your dentist about special toothpastes and rinses that can help reduce cavities and white spots while you have your braces.

Flossing is easiest if you use an orthodontic floss threader (available near the toothbrushes in the drugstore). Pull the floss through the teeth by going above the wire and reaching the gumline, and vice versa for bottom teeth.

Dr. Timmerman recommends using a mouthwash or rinse after brushing and investing in a Waterpik. “Rinses and using a Waterpik can be very beneficial because flossing can’t reach every nook and cranny. You’ll be getting rid of extra food particles that you might miss otherwise.”

Depending on which type of braces you have, your options to whiten teeth may be either wide open or limited. Those with lingual braces or removable aligners have all the same options as those without braces, including in-office whitening procedures and at-home whitening regimens like toothpaste and strips.

If you have traditional braces, teeth whitening of any type isn’t recommended. Because your teeth are partially covered, the surface under the brackets won’t whiten—plus metal braces can oxidize and change color with whitening products.

There are braces-friendly foods, and your orthodontist will give you a thorough list, if requested.

While most of the recommended foods are softer, like eggs, oatmeal, mashed potatoes, and ice cream, you can also have lean proteins and most cooked or steamed vegetables.

Softer foods have the added benefit of being gentle on your already sore mouth. Chocolate is fine, and be sure to at least rinse your mouth 30 minutes after drinking coffee, to avoid staining. 

You can chew gum with traditional braces, but not if you have an expander (the device used to widen the upper palate). The American Dental Association has an approved list of sugar-free gum that includes Eclipse, Extra, Ice Breakers Ice Cubes, Orbit, and Trident sugar-free gums, among others. Sugar-free gum can actually help keep your teeth cleaner, by increasing saliva in the mouth. 

You’ll want to avoid nuts, popcorn, taffy, and hard or sticky candies. Skip the gummy candies, beef jerky, chips, and corn on the cob. 

Some favorite foods are iffy. For example, if you eat pizza with a tough crust, it can damage your braces. You may need to cut a burger into small pieces, and steak may be tough or too hard on your jaw. If peanut butter is chunky or very sticky, don’t attempt to eat it.

RealSelf Tip: While eating apples and carrots whole may be off-limits, they’re fine to have if sliced into wedges or julienned.

You can have braces while you’re pregnant, but your dental health is affected by hormonal changes. As a result, you’ll be more susceptible to gingivitis and “pregnancy tumors,” a misnomer for swellings on the gums in the second trimester that look like pink or red growths. They’re actually not cancerous and will go away after the baby is born, but they can be uncomfortable, especially with braces. Some women have them surgically excised, but dentists also use the Nd:YAG laser for quick removal without bleeding. 

If you crave foods that aren’t recommended (like nuts or candy), find a substitute snack that mimics the taste or has the same nutrients but won’t affect your brackets or wires.

You’ll notice soreness or pain during the first week as you adjust to the wires and brackets. Then, as they actively move your teeth, you’ll feel achy or sore.

Tightening can be uncomfortable as well, but after some time, you’ll find that the pain is more and more bearable. Over-the-counter painkillers can help alleviate discomfort. 

If the ends of wires or brackets scrape your cheeks or gums, your dentist or orthodontist will supply you with clear wax that be applied to pad the area. Press a pea-size ball of wax (softened by rolling between your fingers) against the area where your braces are irritating your mouth, covering any sharp edges. This is especially helpful if you’re prone to canker sores or ulcers from jabs or scrapes.

In order to tweak your bite or alignment, orthodontists use special rubber bands that hook onto the top brackets and connect to the bottom ones.

Some people start using these elastic bands after only a few adjustment appointments, whereas others start by the end of the first year.

This is a crucial part of adjusting your teeth, so be prepared to commit to wearing elastics 24 hours a day until instructed otherwise. 

• Wear the bands all day, every day, including when you eat and sleep. You can take them off only to brush, floss, and put on new elastics.
• Rubber bands aren’t painful, although you may feel tightness in the beginning.
• Because they lose effectiveness and strength, change your elastics anywhere from three to four times a day and at the very least every 12 hours. 
• Before you leave your dentist’s office, make sure to go over where you’ll be hooking the elastics. The locations are different for each person, and you may need to practice a few times.
• Don’t double up on elastics, even if you skip a day. Doubling up actually slows down tooth movement. 
• Wearing your rubber bands part-time can make your teeth resistant to straightening—and worse, your teeth will be sore from repeatedly going through the same adjustment period.

Power chains are a continuous chain of elastic rubber bands. Orthodontists typically add power chains to braces once your teeth are mostly aligned, to close gaps, rotate teeth, or make space for a tooth that doesn’t have enough room to straighten out.

These ower chains can speed up your treatment time or put more force on specific teeth, to bring them into alignment more quickly.

Your appointment to remove braces will take about an hour. Your orthodontist will use special pliers to break the bracket’s bond to each individual tooth.

This will leave an adhesive residue that your practitioner will then remove by polishing the teeth, much like when you have dental cleanings. 

Many people don’t have pain during this procedure, but they do say their teeth feel slimy and that their gums may become inflamed. After a week of brushing and flossing, these side effects will subside.

Don’t remove braces yourself or at home, because it’s possible you could damage or break your teeth. It could be very painful as well. 

After removal, your orthodontist will give you a retainer, to keep your teeth from shifting. Most patients need to wear removable retainers full-time for six months to a year, then downgrade to evenings only. Gradually, you’ll wear your retainer only a few times a week while you sleep. 

Another option is a permanent retainer (also called a bonded retainer or lingual bonded retainer), which is a metal wire that’s placed on the back of your teeth to keep them from moving. It is typically a thin, braided, stainless steel wire that’s bonded to the back of the six front teeth. They’re technically not truly permanent; you’ll need to replace it a few times over the course of your life, due to wear and tear. Some orthodontists suggest having a removable retainer, in addition to the permanent one, so all teeth are secure.

Today’s traditional braces are smaller and lighter and show far less metal than in the past, but for some people, they may still be too conspicuous. If that’s the case, there are other types of braces that you may like more.  

• Clear aligners, like Invisalign, require that patients wear a succession of progressively different clear aligner trays (usually 18–30) that move the teeth. Each aligner guides the teeth into a better position than the previous one. Though the trays are invisible, most people will also need to wear tiny tooth-colored attachments that can be noticeable (though less so than traditional braces). You remove the aligners to eat or drink, but otherwise, they’re worn all the time. 
• Lingual braces, including Incognito hidden braces and iBraces, are similar to traditional metal braces for straightening teeth, but the brackets and wires sit on the back of your teeth so they can’t be seen.

American Dental Association MouthHealthy, Braces (2020)

Gondivkar S., Gadbail A., and Chole R., Oral pregnancy tumor (2010)

Harvard Medical School and Harvard Health Publishing, Healthbeat: Are you too old for braces? (2020)

Kool Smiles, Can I Get Braces with Medicaid? (2018)Lyotard N., Hans M., Nelson S., Valiathan M.,Short-term postorthodontic changes in the absence of retention. (2010)

Papandreas, S., How to Care for Braces During [Pregnancy] (2019)

Salmassian R., Can I Really Chew Gum while in Braces? (2019)

Salem Pediatric Dental & Orthodontic Associates, How do I use that braces wax? (2019)

Topkara A., Karaman A., and Kau C., Apical root resorption caused by orthodontic forces: A brief review and a long-term observation (2012)

Tsibel, G. Elastics (Rubber Bands)