Healthy teeth can be moved at almost any age. Many orthodontic problems can be corrected as easily and as well for adults as children. Orthodontic forces move the teeth in the same way for both a 75-year-old adult and a 12-year-old child. Complicating factors, such as lack of jaw growth, may create special treatment planning needs for the adult.

One in five orthodontic patients is an adult. The AAO estimates that nearly 1,000,000 adults in the United States and Canada are receiving treatment from an orthodontist. To learn about correction of a specific problem, please consult your family dentist or an orthodontist.

Adults are not growing and may have experienced some breakdown or loss of their teeth and bone that supports the teeth. Orthodontic treatment may then be only a part of the patient's overall treatment plan. Close coordination may be required between the orthodontist, oral surgeon, periodontist, endodontist and family dentist to assure that a complicated adult orthodontic problem is managed well and complements all other areas of the patient's treatment needs. Below are the most common characteristics that can cause adult treatment to differ from treatment for children.

No jaw growth: Jaw problems can usually be managed well in a growing child with an orthopedic, growth-modifying appliance. However, the same problem for an adult may require jaw surgery. For example, if an adult's lower jaw is too short to match properly with the upper jaw, a severe bite problem may result. The limited amount that the teeth can be moved with braces alone may not correct this bite problem. Bringing the lower teeth forward into a proper bite relationship could require jaw surgery, which would lengthen the lower jaw and bring the lower teeth forward into the proper bite. Other jaw-width or jaw-length discrepancies between the upper and lower jaws might also require surgery for bite correction if tooth movement alone cannot correct the bite.

Gum or bone loss (periodontal breakdown): Adults are more likely to have experienced damage or loss of the gum and bone supporting their teeth (periodontal disease). Special treatment by the patient's dentist or a periodontist may be necessary before, during and/or after orthodontic treatment. Bone loss can also limit the amount and direction of tooth movement that is advisable.

Worn, damaged or missing teeth: Worn, damaged or missing teeth can make orthodontic treatment more difficult, but more important for the patient to have. Teeth may gradually wear and move into positions where they can be restored only after precise orthodontic movement. Damaged or broken teeth may not look good or function well even after orthodontic treatment unless they are carefully restored by the patient's dentist. Missing teeth that are not replaced often cause progressive tipping and drifting of other teeth, which worsens the bite, increases the potential for periodontal problems and makes any treatment more difficult.

Jaw muscle and jaw joint discomfort is commonly associated with bruxing, that is, habitual grinding or clenching of the teeth, particularly at night. Bruxism is a muscle habit pattern that can cause severe wearing of the teeth, and overloading and trauma to the jaw joint structures. Chronically or acutely sore and painful jaw muscles may accompany this bruxing habit. An orthodontist can help diagnose this problem. Your family dentist or orthodontist may also place a bite splint or nightguard appliance that can protect the teeth and help jaw muscles relax, substantially reducing the original pain symptoms. Sometimes structural damage can require joint surgery and/or restoration of damaged teeth.

Your dentist is probably recommending orthodontics so that he or she might treat you in the best manner possible to bring you to optimal dental health. Many complicated tooth restorations, such as crowns, bridges and implants, can be best accomplished when the remaining teeth are properly aligned and the bite is correct.

When permanent teeth are lost, it is common for the remaining teeth to drift, tip or shift. This movement can create a poor bite and uneven spacing that cannot be restored properly unless the missing teeth are replaced. Tipped teeth usually need to be straightened so they can stand up to normal biting pressures in the future.

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