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Straightening teeth


Expert reviewer Dr Steve Preddy, Dentist
Next review due October 2020

Straightening your teeth can make them both look and work better. Treatment involves wearing a fixed or removable brace to help correct problems such as crooked or crowded teeth. This branch of dentistry is called orthodontics, and you can have it at any age.

Dr Steve Preddy, one of Bupa UK’s senior dentists says: “Orthodontic treatment gives you straighter teeth that are easier to clean, and less likely to be lost. It can improve your ability to eat more comfortably, and lower your risk of having jaw and joint problems caused by an incorrect bite. And, with so many different types of braces available, you can get the right treatment for you.”

About straightening teeth

Teeth straightening is a treatment used to correct malocclusion. Malocclusion means your teeth aren’t properly arranged so they don’t sit together properly. If you have malocclusion, you might have:

  • overcrowded teeth or too much space between your teeth
  • an improper bite (your upper and lower teeth don’t meet properly when you close your jaw)
  • an overbite (your upper teeth cover your lower teeth when you close your mouth)

Orthodontic treatment can also help if you have gaps and spaces between your teeth.

Orthodontic treatment can improve the positioning of your teeth and, in turn, their look and how well they work. Since crowded teeth are more difficult to keep clean, orthodontic treatment might reduce the risk of tooth decay and gum disease

What orthodontic treatment involves

Treatment to straighten your teeth involves wearing a fixed or removable brace. A brace works by slowly moving your teeth to the right position using gentle pressure. You’ll usually have to wear your brace all the time, anything from a few months to two-and-a-half years. Every four to 10 weeks, your dentist or orthodontist (a dentist who specialises in straightening teeth) will check your brace and may make some adjustments.

People of all ages can benefit from teeth straightening. Most people have it done when their milk (baby) teeth have all come out – usually by the time they’re 13. But more and more adults are seeking treatment. For more information about having treatment later, see our FAQ: Can adults have their teeth straightened? below.

It’s important to talk through your treatment with your orthodontist. It might be different from what we’ve described here, as it’ll be designed to meet your specific needs. 

Preparing for teeth straightening

Before you start treatment to straighten your teeth, your orthodontist will need to do a full assessment. This will involve them looking at your teeth and possibly taking X-rays and maybe photographs, to find out what the best options are for you. You may need to have some teeth taken out if they find there isn't enough room in your mouth, for example.

This examination will also check that you have a healthy mouth – teeth straightening isn't a good idea if you have decayed teeth or inflamed gums. Excellent oral hygiene is really important too. It lowers the risk of developing complications during treatment. 

Alternatives to teeth straightening

There are alternatives to having orthodontic treatment, which include the following.

  • Veneers (or caps). A veneer is a thin layer of porcelain or composite material that’s bonded to the front of a tooth. Veneers work relatively quickly and can be used to fill gaps between your teeth. You can find out more about veneers on our page: Restoring teeth
  • Dental contouring. This is the reshaping of natural teeth to make them look straighter, or to repair them if they’re cracked or chipped.

Sometimes you can have these treatments as well as orthodontic treatment to straighten your teeth. 

Types of braces

Braces are used to treat malocclusion (when your teeth are crooked, crowded or you have an overbite). Your orthodontist will talk you through treatment options and which type of brace is most suitable for you.

You’ll need to wear most braces all the time. You can remove some for eating and cleaning, whereas others are fixed to the front or back of your teeth.

Removable braces

Removable braces consist of a plastic plate that has wire clips and springs attached to it to move specific teeth. They can only move teeth by tipping or tilting them so they’re often used when you just have mild teeth crowding.

If you have a removable brace, you’ll need to wear it all the time, including at night and when you eat. It can feel awkward to eat with a brace at first, but it should get easier with practice.

You’ll need to take your brace out to clean it. Brush it gently under running water with a regular toothbrush and toothpaste – your orthodontist will show you how to do this properly. It’s best to clean your brace at least twice a day, when you brush your teeth. Clean your brace over a sink full of water so if you drop it, it’s less likely to get damaged.

Aligners

Aligners are computer-generated moulds (like mouthguards) made of clear plastic that you can remove. They’re used to move your teeth into place if your condition is mild, and you don’t need to have any teeth removed for treatment. They’re only suitable for people with all their adult teeth.

You’ll usually need to wear a set of two aligners (one for your upper teeth, and one for your lower teeth) for two weeks. Then you’ll replace them with a new set. This will continue until your teeth have moved to the correct position. Your dentist or orthodontist will take a bite impression of your teeth to produce all the sets you need using computer technology.

Aligners are difficult to notice because they’re almost completely transparent. While you need to wear them all the time, you can remove them when you eat and drink. But it may take longer to correct your teeth than with braces. For more information, see our FAQ: Can I have braces that aren't noticeable? below.

Fixed braces

Fixed braces are attached to the surface of your teeth, so only your orthodontist can remove them. They can move your teeth in a very precise manner, and are the most common type of brace in children.

A fixed brace consists of small brackets that your dentist will cement to your teeth and join together with a wire. It’s usually made of metal, but there are ceramic versions that are less noticeable. You might need to have separators between your teeth. And you may need small elastic bands, to keep the wires in place and move your teeth into the right position. Brackets and elastics are available in different colours.

Headgear

You might need to wear a headgear in the evening or at night. This is a frame on a headband that attaches to your brace. You wear it to either move your back teeth backwards to make more space, or stop them moving forward while your front teeth are being straightened. It can take a while to get used to wearing a headgear, but it’s an essential part of orthodontic treatment for some people. It can help prevent your upper jaw from sticking out when you have the brace removed, for example.

Mini-implants

A mini-implant (also called a temporary anchorage device) can be used to help straighten teeth too. This is a really small titanium alloy screw that acts as an anchor point in your jaw. They’re often put between the roots of your teeth, but you can have them put in the roof of your mouth too. Your dentist will put it into your jawbone under local anaesthetic, and attach it to your brace.

Retainers

Straight after your orthodontic treatment, there’s a chance that your teeth may move back towards their original position. This is called relapse. Retainers are a type of brace that help stop this from happening, by keeping your teeth in the correct position. How long you will need to wear them for, will depend on your specific needs – ask your orthodontist.

Retainers can be removable or fixed, and both have pros and cons. You can take removable retainers out at home and they’re easy to keep clean. But it is also easy to forget to wear them. Fixed retainers may break and need more attention to keep clean. But they usually provide stronger teeth support, and it’s impossible to misplace or forget them. Your orthodontist will help you choose the retainer that’s best for you.

Having a brace fitted

It doesn’t hurt to have a brace fitted. If you’re having a fixed brace, your orthodontist will put it in place by attaching brackets and metal wires to your teeth. For a removable one, they’ll show you how to put it in and take it out correctly.

You’ll need to visit your orthodontist regularly, usually every four to 10 weeks. They’ll check your brace and see if the treatment is working, and will adjust the pressure on your teeth, as necessary. You’ll also need to continue visiting your dentist for regular check-ups.

How long your treatment will last will depend on things like how severe your malocclusion (teeth positioning) is and the type of brace you have. It usually takes anything between a few months to two-and-a-half years to get results.

What to expect after having a brace fitted

After your brace has been fitted, you might feel some discomfort and pain in and around your teeth and gums. This is completely normal so don’t worry. It happens because your teeth slowly start to move. It might help to take over-the-counter painkillers, such as paracetamol or ibuprofen. The soreness usually wears off within a few days.

You may also feel some discomfort from your brace rubbing your lips, tongue or the inside of your cheeks. Your orthodontist can give you a soft wax to put on your brace to help ease this.

Your brace might affect your speech at first and make it difficult to pronounce certain words. This usually happens more with removable braces, but should improve over time. 

Taking care of your brace

Good oral hygiene is always important, but especially so while wearing a brace. Braces can trap food, which can lead to plaque build-up and increase your risk of tooth decay and problems with your gums. So, it’s really important to keep your teeth and brace clean. Brush them for at least three minutes, at least twice a day (and always after meals) with fluoride toothpaste. For more information on how to look after your teeth see our separate topic: Caring for your teeth.

You need to take extra care when brushing to prevent any damage to your brace – your orthodontist or hygienist can show you how to do this. If your brace breaks, see your orthodontist as soon as possible. When you’re not wearing your brace, your teeth may start to return to their original position (relapse), so your treatment can take longer.

When you first have a brace fitted, you might find it easier to eat soft foods while you get used to it. There are some foods you shouldn’t eat, as they could damage or break your brace. These include:

  • chewing gum and other sticky, chewy foods such as toffees
  • crunchy foods such as nuts

When you play sports, it’s a good idea to wear a mouthguard. Your orthodontist can give you some advice about getting one that fits your brace. If you have a removable brace, take it out before you put your mouthguard in.

If you play a musical instrument such as the flute or trumpet, you might need to take out your removable brace. If you wear a fixed brace, you may find it difficult to play these instruments at first, but you should soon get used to it. 

Side-effects of teeth straightening

You’ll probably have some soreness and pain after having a brace fitted, when your teeth slowly start to move. It might help to take over-the-counter painkillers such as paracetamol or ibuprofen. It normally gets better within a few days.

Complications of teeth straightening

If you have poor oral hygiene and diet (that includes lots of sugary foods) during your treatment, it may lead to tooth decay and gum problems. Your orthodontist will usually refuse to start treatment if they’re concerned about your oral hygiene and diet. Orthodontic braces themselves don't cause these problems. But, because they can trap food, plaque can easily build up on and between your teeth, which increases your risk.

Another potential complication of orthodontic treatment is damage to the roots of the teeth. There’s a chance this might happen from the force applied to your teeth during treatment. Your orthodontist will take steps to reduce this risk.

Frequently asked questions

  • Yes, adults can have orthodontic treatment to straighten their teeth.

    More information

    Adults can have orthodontic treatment to correct the same dental problems that children have, such as crowding, an overbite or gaps between the teeth. Treatment is likely to involve wearing a brace for a few months to two-and-a-half years, depending on what needs to be done. Your dentist will go through your options with you.

  • Depending on the type of brace you need, it might be possible to have one that isn’t very visible. Your orthodontist will let you know if this is an option for you.

    More information

    If you have a fixed brace, you might be able to have one made of a material that isn’t so obvious. Ceramic brackets can be transparent or tooth coloured. While these are less noticeable than metal ones, they’re generally more expensive. They’re also more likely to break or get discoloured overtime.

    You may be able to have what are called lingual braces. These attach to the back of your teeth so you can’t see them. But they can make your tongue sore and affect your speech at first. They’re also more expensive than conventional fixed braces.

    If your dental problem is mild and you have most of your natural teeth, another option you may want to consider is aligners, also called ‘invisible braces’. These are removable, see-through, plastic moulds – one for your upper teeth and one for your lower teeth. You replace each set of two aligners every two weeks with a new set. You’ll need to wear them all the time – day and night – but you can take them out when you eat, drink and brush your teeth.

  • The price of orthodontic treatment can vary. It will depend on how severe your condition is, and the type of brace, the techniques involved. Your orthodontist will give you a written estimate of how much they expect your treatment to cost.

    Orthodontic treatment is available on the NHS for children who have severe problems with their teeth such as crowding or other forms of malocclusion. Adults usually have to pay for private orthodontic treatment. Aesthetic treatment, that is, treatment for appearance alone, is usually only available privately, regardless of age.

    If you decide to have private treatment, your orthodontist will assess your teeth and give you an idea of the costs of various options.


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Related information

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  • Reviewed by Rachael Mayfield-Blake, Freelance Health Editor, October 2017
    Expert reviewer Dr Steve Preddy, Dentist
    Next review due October 2020



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