Orthodontic care is one of the few dental procedures that has a heavy link to patient age. Most patients receive treatment as a teenager, but there are benefits for patients outside of that demographic.
To ensure clinicians can provide effective and safe care, however, it’s important to understand why orthodontic treatment is intrinsically linked to the adolescent experience. We can then begin to understand clinical factors that should be identified when assessing treatment suitability for other individuals.
Teen experience
Patients with malocclusions can benefit from orthodontic care, often providing improved aesthetics and function. For teenagers, this can improve their quality of life as a whole, as malocclusion influences self-esteem in individuals aged 11-14.[i] In fact, in a social media age where aesthetics are highly-prioritised, it’s no surprise that malocclusion is among the top three highest dental health priorities for patients.[ii]
Orthodontic intervention during adolescent years is indicated due to advantageous physiological factors. Favourable biologic characteristics have been noted in the literature as a key principle for success, alongside the skills of the orthodontist, the patient’s compliance with care, and the efficacy of an orthodontic appliance.ii The adolescent dentition is in a period of change and growth, experiencing the eruption of the teeth and the morphology of the jaw from childhood to adulthood. This makes it an opportune time to enact this sort of treatment, utilising the natural forces that are changing the dentition to support care.
Into adulthood, the dentition sees little change; the most significant may come with diminished bone density over time, though this typically begins at age 40 and continues through adult life.[iii] This includes a reduction in the height and thickness of alveolar bone during healthy ageing, after continued growth between the ages of 10-17 years old.[iv]
However, once an adult patient presents desiring orthodontic care – for functional or aesthetic benefits – there is no turning back the clock. If their bone density is favourable, treatment could be successful with the right support.
No such thing as too old
A 2023 report from the British Orthodontic Society noted that 76% of orthodontists saw an increase in adult patients seeking orthodontic care in the previous three years, with a majority (83%) aged 26 to 55.[v] This comes off the back of the coronavirus pandemic, with many feeling that the increase in online working and socialising through video calls was a contributing factor to the rise in demand.v
Adult patients seeking orthodontic support must have tempered expectations. They need to first understand if treatment is at all possible in their circumstances, and if so, what the process could look like. The chance of improvement to the malocclusion is more limited, and treatment is likely to take longer for adults.[vi] However the NHS notes that whilst these patients will likely need to seek private care, orthodontic treatment can start at any age.[vii]
Around 33% of adult patients are discouraged from having orthodontic treatment due to the length of treatment and the discomfort and inconvenience of care.[viii] Yet, a 2020 systemic review found that in many cases, there is not a clinically significant difference in the duration of comprehensive orthodontic treatment with fixed appliances between teenagers and adults.[ix] Be aware, however, that some in the literature have recorded extended treatment durations when addressing the alignment of palatally displaced canines in adults compared to adolescents.ix
The delay in tooth movement is thought to come with age, but this may be counterbalanced by adult patients improving compliance with orthodontic instructions.[x] This has a direct, and positive, effect on treatment duration.x
Keep it comfortable
For patients to engage with orthodontic care, and receive the aesthetic and functional benefits that come with it, they need to be willing to engage with an extensive treatment time (sometimes over a year) and adhere to strict instructions from the orthodontist. This is made more complicated if their orthodontic solutions, such as a fixed brace, cause discomfort.
When patients use the Ortho Relief Wax from Kemdent, they can undergo care with confidence and comfort. The wax protects gingival and buccal tissue from the metal edges of braces, which can cause irritation. After being softened in the patient’s hand, the wax can be placed over a brace or bracket, before later harmlessly flaking away or peeling off. Its available in small, sustainable tins that are 100% recyclable, and perfect to store in a bag or pocket.
Clinicians should expect more adult orthodontic patients going forward, and confidently assess them for treatment suitability. Where bone density is favourable, and the patient is receptive to the proposed treatment time, success could be found.
For more information about the leading solutions available from Kemdent, please visit www.kemdent.co.uk or call 01793 770 256
Author: Alistair Mayoh – Marketing Director, Kemdent
[i] Vanka, D. A., Alsindi, D. R. S., Alyaqoub, D. R. F., Alsaidi, D. E. A., Aljizani, D. F. A., Almaliki, R. A., … & Vanka, D. S. (2023). Dental Malocclusion Impact On Self-Esteem Levels Among Teenagers.(2023). Int. J. Life Sci. Pharma Res, 13(5), L311-L315.
[ii] Fazal, A., Khattak, O., Chaudhary, F. A., Hyder, M., Javaid, M. M., Iqbal, A., … & Sultan, S. E. (2023). Barriers and challenges faced by orthodontists in providing orthodontic care and implementing new innovative technologies in the field of orthodontics among children and adults: a qualitative study. Journal of Clinical Pediatric Dentistry, 47(4).
[iii] Demontiero, O., Vidal, C., & Duque, G. (2012). Aging and bone loss: new insights for the clinician. Therapeutic advances in musculoskeletal disease, 4(2), 61-76.
[iv] Zhang, Y., Yan, J., Zhang, Y., Liu, H., Han, B., & Li, W. (2024). Age-related alveolar bone maladaptation in adult orthodontics: finding new ways out. International Journal of Oral Science, 16(1), 52.
[v] British Orthodontic Society, (2023). New stats from The British Orthodontic Society reveal online working triggers a rise in adults seeking tooth straightening treatment. (Online) Available at: https://bos.org.uk/news/new-stats-from-the-british-orthodontic-society-reveal-online-working-triggers-a-rise-in-adults-seeking-tooth-straightening-treatment/ [Accessed July 2025]
[vi] NHS, (2022). Braces and orthodontics. (Online) Available at: https://www.nhs.uk/tests-and-treatments/braces-and-orthodontics/ [Accessed July 2025]
[vii] NHS, (2023). Overview, Orthodontics. (Online) Available at: https://www.nhs.uk/tests-and-treatments/orthodontics/ [Accessed July 2025]
[viii] Keser, E., & Naini, F. B. (2022). Accelerated orthodontic tooth movement: surgical techniques and the regional acceleratory phenomenon. Maxillofacial Plastic and Reconstructive Surgery, 44, 1-21.
[ix] Abbing, A., Koretsi, V., Eliades, T., & Papageorgiou, S. N. (2020). Duration of orthodontic treatment with fixed appliances in adolescents and adults: a systematic review with meta-analysis. Progress in orthodontics, 21, 1-11.
[x] Abbing, A., Koretsi, V., Eliades, T., & Papageorgiou, S. N. (2020). Duration of orthodontic treatment with fixed appliances in adolescents and adults: a systematic review with meta-analysis. Progress in orthodontics, 21, 1-11.
