Orthodontics in adults, when is it necessary

At what age is it too old? Why would someone have to use orthodontics in adulthood? And what are the differences in treatment for these patients?

There is really no age limit for orthodontics. Due to advances in dentistry, especially the diagnosis and treatment of periodontal disease (gum disease), patients keep their natural teeth longer than ever. My grandparents had false teeth and my parents lost some piece. My generation still has most of its teeth, but it has many crowns. The improvement of the condition of dental care has meant that many more adults are going to keep their own natural teeth throughout their lives and that orthodontics for adults is more common.

In the 80s the majority of patients in dentist offices were children, but in recent decades the ages of patients have gradually increased. Half of my current patients are between 12 and 18 years old but we also have a growing number of patients from 50 onwards.

Adult patients seek dental treatment for several reasons. Most of the time it is due to teeth that wear out due to a bad bite, or that need to be moved so that other dental procedures can be performed (for example, making room for an implant). Other times patients come because there is something in their smile that bothers them and finally decide to address it.

It is not uncommon for this to happen at an advanced age since these patients have more time and some savings that they want to invest in themselves, at last.

Adult patients have the most of the same options as younger patients with some exceptions. The correction of posterior cross bites cannot be achieved with an expander alone. Although it can be corrected, the expansion may require the surgical reopening of the middle palatal suture.

Because expansion is not so easy in adults, the correction of moderate to severe crowding usually requires more extractions than with adolescents. And although bad biting can be corrected in adults, doing it with elastic bands is not as effective as it is with younger and growing patients. For this reason, adult patients require more extractions and mandibular surgeries than adolescents. But each patient is different and there are very simple cases to correct, too, as a simple treatment, painless and inconspicuous.

When I talk to adult patients who are thinking about whether to undergo orthodontic treatment, we discuss their reasons for treatment, their goals and expectations, and their options. Sometimes they want to address a specific problem. Other times they want to solve a problem they have had all their lives, once and for all.