The estimated time that your braces will be on is not just an average quoted by your orthodontist to every patient, nor is it a number that is determined by the kind of braces or specific treatment technique used. How long you’ll have your braces depends on the problems that exist in your mouth at the beginning of treatment and the goals that you and your orthodontist have for how you want them to look at the end. Here are some of the important things that will affect the length of your treatment.
Let’s start at the end of treatment first. If you choose to go to an orthodontist (a specialist who does orthodontics and nothing else), chances are that he will propose a treatment plan that provides you with the best bite and smile possible before removing braces. Although this may seem obvious, there is a popular trend among non-specialists (general dentists who do some braces along with everything else) what they basically only do is line up the front teeth and not even remotely finish the job. They call this “short-term orthodontics,” and market it to the public as an alternative to treatment by real orthodontists. Their promise of “faster treatment for less money” is eye-catching but definitely misleading since they begin treatment without any intention of finishing (correcting the bite). There is no disclosure in their ads saying, "hey we're going to just do part of the treatment and then remove the braces."
For the purpose of this blog post, let’s assume that we’re all talking about treatment provided by a real orthodontist that is going to finish your treatment correctly. The easiest, and therefore shortest, orthodontic cases are those where all the permanent teeth are out and the bite is normal. Also the crowding and alignment problems do not require removing any permanent teeth. Technically speaking, these cases can be completed in less than a year and a half by an orthodontic specialist. If you have more crowding (that requires perhaps the use of a palatal expander for example), a posterior crossbite, mild to moderate bite issues, but don’t need to have any permanent teeth removed, your treatment will probably take between 18 and 24 months. These are routine cases for a specialist and represent the majority of the patients I see in my office.
Some surgery cases that start off with straight teeth but a bad bite can also be finished within 18 months. When you have moderate to severe crowding or any condition that requires the removal of permanent teeth, you should plan on at least 24 months of treatment. The reason this takes so much longer is that every tooth in your mouth must be shifted to close the extraction spaces or to compensate for your jaw size. Most orthodontists consider these moderately severe orthodontic problems.
There are additional variables that complicate treatment and can make treatment time longer and more difficult to estimate. These include impacted or missing teeth and severe jaw-size discrepancies that may require jaw surgery. Depending upon how each individual patient's anatomy responds to the treatment, these are severe cases and may require 30 months or more to finish. Most adult extraction cases fall into this category.
Everyone is different, but these estimates give you a general idea of what you can expect going in to your treatment.
Don’t be fooled by promises of faster treatment by an orthodontist who uses “special brackets” or markets an “advanced technique.” When these claims have been put to the test in controlled studies, they have been shown to be mostly hype. We all play by the same biological rules and no bracket manufacturer has an inside track with Mother Nature to get the job done any quicker. Even the newest technologies claiming to shorten treatment time (tooth vibrators, bone perforators, pulsating light energy, etc..) have been shown to reduce it by only a very small percentage at huge additional cost.
I'm sure you've heard the saying, "if something sounds too good to be true, it probably is." If there really was a faster way to move teeth, wouldn’t orthodontists, who are the experts in moving teeth, know about it and use it? There are no shortcuts to excellent orthodontic results. If you follow your orthodontist’s instructions to the "T", take care of your braces, and don’t miss any of your appointments, your braces will be off before you know it… and the job will be done right!