‘It has exploded’: Why so many adults are getting braces

Wearing braces is usually considered a teenage experience. Visit any high school, or watch any Hollywood teen movie, and chances are there will be several people sporting metal. So, when adults like 23-year-old Bella Amoroso get braces, it can throw some people off.

“As a mature-aged student at uni, people often assume I’m fresh out of high school, which has both pros and cons,” Amoroso, who got ceramic braces when she was 22, says.

Bella Amoroso decided to get braces when she was 22. She’s far from the only adult to do so.Credit: Dominic Lorrimer

“Initially, I avoided going into detail when people asked about my braces,” she says. “But as my treatment progressed and the gaps started closing, I’ve felt more comfortable sharing. I usually just show people an old photo of my teeth, and they completely understand my decision.”

Amoroso is one of a growing number of Australian adults getting braces. Dr Shane Fryer, a specialist orthodontist and a fellow of the Royal Australasian College of Dental Surgeons, says adult braces constitute about 25 per cent of orthodontic practice now, up from about 5 per cent two decades ago.

“It has exploded,” Fryer says. “To put it into perspective, just yesterday I had a 68-year-old retired school teacher and a 58-year-old paramedic visit for treatment.”

So, why are more adults choosing orthodontic treatment, and what are the risks?

What’s behind the surge?

Dr Robbie Schwartz, a practising orthodontist and spokesman for the Australian Society of Orthodontists, attributes the rise to social media.

“When I started my practice, which was at the end of ’91, no one took photos of themselves every day. With social media now, people are seeing themselves from different angles all the time,” he says.

They’re also seeing celebrities and influencers post pictures of themselves – along with their perfectly straight teeth. After Dream Kardashian, daughter of reality star Rob Kardashian, got metal braces last year, Schwartz had several adults visit his practice asking for similar treatment.

Are braces riskier for adults?

Physiologically, braces present no greater risk for adults compared to children, Fryer says. However, braces cannot be inserted until the person is “orally fit”.

“In adults, there tends to be more restorations [fillings] in the mouth,” Fryer says. “They need to make sure they’ve got good gum condition. A general dental practitioner can assess that.”

Adults considering braces will need to see a dentist for any loose fillings, tartar build-up, gum disease and general oral hygiene before visiting an orthodontist.

Adults must have their gums, fillings and oral hygiene checked by a dentist before pursuing orthodontic treatment.Credit: Getty Images

Teeth can feel slightly mobile or “loose” during orthodontic treatment, says head of discipline of orthodontics at the University of Sydney Ali Darendeliler. But the risk of losing teeth is extremely rare, unless there are underlying dental issues, such as gum disease, significant bone loss, decaying teeth, or trauma to the teeth.

“A small percentage of individuals – around 2 to 4 per cent – may experience root resorption, which is a shortening of the tooth roots,” he says. “But this process typically halts once treatment is stopped, and the body may initiate a repair response on the root surface.”

How much do they cost?

Schwartz says the cost of braces has dropped slightly, which is another reason why more adults are seeking treatment. They are still costly, though.

“I personally don’t charge more for an adult than for a child,” he says. “It usually comes down to the length and complexity of the treatment.”

Prices vary from state to state, he says. The average cost for full treatment is just over $8000. If someone were to get a single-arch treatment (braces only on the upper or lower jaw), it would cost on average $4500 to $5000.

Is it covered by health insurance?

Certain health insurance plans will include orthodontic coverage, but the degree of coverage differs between plans. Some providers pay a set annual amount, while others offer a fixed contribution regardless of the duration of treatment.

Schwartz says some can be claimed just once in a lifetime, meaning adults who had braces as a child couldn’t claim it again if their teeth move over time.

What are the alternatives?

While metal braces are becoming more common among adults, Darendeliler says many still pursue more “aesthetic” options. This includes aligners, clear ceramic braces and lingual (tongue-side) braces.

For those who want more subtle orthodontic treatment, aligners are a viable option.Credit: Craig Sillitoe

The most popular of these options are aligners, he says, which were popularised in Australia by Invisalign in 2001. Aligners are more subtle than braces since they fit over the teeth but they usually aren’t as precise as braces, which orthodontists generally recommend for more complex cases.

Lingual braces, which can aggravate the tongue over time, are generally about 50 per cent more expensive than other treatments.

Are adult braces worthwhile?

Schwartz, Darendeliler and Fryer agree that braces are always worthwhile if inserted for functional reasons. Any aesthetic improvement should be considered a bonus.

“Braces aren’t only for the aesthetics of a dental smile,” Fryer says.

“One client of mine has worn away about 40 per cent of his lower front teeth, so he’s in for a functional reason. But he’ll get an aesthetic bonus from the treatment. The function, and getting a good bite, is the driver of treatment.”

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