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Orthodontics in adults


Often when we think of orthodontics, children and adolescents come to mind. However, one out of three orthodontic cases we treat at the Bracchetti Dental Clinic concerns adult patients.

It is becoming increasingly popular for adults to choose to straighten their teeth. The ability to choose between removable invisible aligners and fixed appliances with very little aesthetic impact is making orthodontic treatment more attractive for adults. While previously many adults chose orthodontic treatment only to solve an occlusal problem, today it is more common to choose it for aesthetic reasons with the aim of obtaining a more attractive smile. Invisible aligners are currently the preferred choice of adults for orthodontic treatment.

Enjoy an individualized treatment

The goal of more and more modern dental practices is oriented towards the maintenance and preservation of natural teeth, a philosophy that is perfectly suited to orthodontics for adults. In fact, one of the advantages of adult orthodontics is that the treatment can be customized to the needs of each patient in order to improve the position and appearance of the natural teeth, allowing to plan multidisciplinary treatments involving other branches of dentistry. This is much more conservative compared to the past. Options nowadays include fixed or removable equipment designed to deliver predictable and stable results in the most discreet way possible. Today these braces are practically invisible.

Why do adult patients choose orthodontic treatment? The main reasons why adults choose to undergo orthodontic treatments are:

  • Aesthetics - patients who wish to have teeth aligned
  • Reconstructive - patients who need aesthetic veneers on anterior teeth or dental implants and bridges may need to align and move their teeth before performing other dental procedures
  • Functional - functional problems such as headaches and joint pain where these are related to the presence of misaligned teeth or an incorrect bite.

When considering the opportunity to put an orthodontic appliance for adults, the main considerations to be made are:

  • Speed ​​- you may be looking for the quickest way to straighten your teeth with a particular date in mind like a wedding or graduation. Appointments that are short and closely spaced  are often a request by adult patients.
  • Discretion - you may be more interested in a method that is as discreet and less visible as possible and does not have a major impact on your social life.
  • Ease - you may travel or lead a demanding lifestyle and therefore want the simplest solution, that is, the one that requires scheduling the least possible number of dental appointments.

What are the most common dental problems that orthodontics can correct?

A very common concern is dental crowding, or when there is not enough space for all the teeth in the arches. Patients often want to realign their teeth to achieve a smoother, more attractive smile.

Another common problem is headache and joint pain. In these cases an evaluation is necessary to make sure that the origin of the pain is actually related to the teeth. It is important for us that patients do not have false expectations or do not waste money for unnecessary or orthodontic treatment that do not resolve their problems.

What are the considerations to make before undertaking orthodontic treatment for an adult?

A treatment aimed at aligning the teeth is suitable for most adults. In our study, we consider your oral health to be fundamental in treatment planning. Before embarking on an orthodontic treatment, your teeth should be judged to be substantially strong and healthy and should not show any signs of ongoing gum disease or tooth decay. If you have any dental health problems, these will need to be resolved before orthodontic treatment begins.

We also need to collect your medical history, including any medications you take, and if you have any medical problems that could affect orthodontic treatment. For example, diabetes is one of the diseases we should be aware of and, if present, it must be well controlled. People with diabetes are more likely to have dental health problems such as gum disease and tooth decay.

Smoking is a habit that can negatively affect the body's healing ability, and could also impact the bone remodeling that occurs during orthodontic movement. If you are pregnant, it is preferable to wait for the baby to be born; gum conditions must be particularly monitored: in fact, in this period, hormonal changes affect the way the gums react to oral bacteria and therefore can increase the risk of gingivitis, a transient gum disease that resolves itself after the baby is born .

If you have any health problems that may affect your treatment, it is vital that your orthodontist is aware of them. This does not mean that you are not suitable for orthodontics, but you may need to take extra precautions during treatment. For example, it may be necessary to have a more thorough oral hygiene regime, and this may require some appointments with the hygienist.

Having straighter teeth in adulthood: what are the health benefits?

Straighter teeth are usually easier to clean and therefore improve oral hygiene standards.

Aligned teeth tend to be healthier. This is because the occlusion load is correctly distributed. If pre-contacts exist and there is more pressure on one side of the mouth or the other. This can lead to problems over time including bone loss and recession of the gingiva. / p>

Finally, for example, crooked and teeth that stick out too far can sometimes prevent the lips from sealing properly, triggering oral breathing. Reducing dental protrusion can help restore proper respiratory function.

Can orthodontic appliances improve gum health?

Dental crowding can make oral cleaning more difficult and this can cause mouth health problems, such as inflammation of the gums due to plaque and tartar buildup. By straightening your teeth you create more favorable conditions for maintaining oral and gum health.

Which system should I choose for my teeth alignment treatment?

During the consultation, your dentist will explain the different solutions in terms of orthodontic appliances and will recommend the best treatment option based on your current smile, lifestyle, and budget.

Fixed braces mean less effort for the patient; the dentist will do most of the necessary work during the office appointments. Your job is mainly to keep your teeth clean and regularly show up for scheduled appointments.

Removable Invisalign aligners have the drawback of having to be removed every time you eat or drink but also have the advantage of being less visible to others. The maintenance of oral hygiene is facilitated and the likelihood that you will need an emergency appointment is greatly reduced.

In terms of cost and efficiency all the tooth straightening systems we offer are similar.

Frequently Asked Questions:

Can orthodontics correct the space between my front teeth?

For this problem you can use both a traditional fixed appliance and the removable transparent aligners. The orthodontic brackets should be placed on some teeth straddling the diastema (the space between the anterior teeth) in order to close the space. For the same problem it is possible to use the transparent removable aligners obtaining the same result.

Whichever system you choose, there is the possibility that the teeth have a tendency to regress into their old positions and the space can reopen. To avoid this inconvenience, a longer-lasting restraint is usually recommended. A fixed holding device (splinting) behind the incisors is often used for this purpose to keep the teeth in position for the long term.

Can orthodontics correct the position of only some of my upper teeth?

This can certainly happen with equipment with limited range. You will discuss your specific goals with your orthodontist who will create the right treatment plan for your smile.

Am I too old to undertake a dental alignment treatment?

Absolutely not! The biological system that activates when pressure is applied to a tooth to move it is exactly the same, regardless of your age, and is equally effective whether you are an adult or a teenager. The treatment goals may be different but the treatments will be just as effective.

Can orthodontics change the profile of my chin and jaw?

Yes, in some cases. By changing the position of the teeth it is possible to change the projection of the upper and lower teeth in the face. But for any major change you want to achieve, either surgery or extractions are required. In planning your treatment, your possible desire to change your profile and smile will be taken into consideration. The dentist will explain the dental and aesthetic changes to your smile involved in the proposed treatment and how these changes could affect the appearance of your face and profile .

What is the average cost of orthodontics for adults in Milan?

It is difficult to define an average cost because it depends on the duration of the treatment, the type of equipment used, the complexity of the case and the number of appointments needed. You can go from a simple treatment, for straightening front teeth with the use of equipment limited to the front teeth and lasting about six months, with a cost ranging from 2000 to 3000 euros, to a complex case with a duration 2 years which can cost up to 7000 euros.

Excellence in dentistry may seem expensive, but it is a worthwhile and forward-looking investment. The longer and more complex treatments obviously have higher costs. Fortunately, our practice offers deadlines for payment and the possibility of making loans, so that we can divide the cost of orthodontic appliances more economically.

Is adult orthodontics a lasting investment?

It is important to understand that the result of any orthodontic treatment must be maintained over time to ensure the most lasting effects possible. To keep the teeth aligned it is recommended to wear the retainers we provide for a period of two years after the end of the treatment, as per our instructions. During this time period, regular periodic appointments will still be fixed, to monitor the stability of the orthodontic results: after a few months the patient will be able to independently adjust to the use of the maintenance device, which he can choose to wear when necessary to keep the teeth aligned .

What should patients do to maintain oral hygiene during orthodontic treatment?

We give all patients an oral hygiene kit at the beginning of the treatment. This provides our patients with the appropriate tools to better manage their oral health during the treatment. In fact, at each appointment we also check dental hygiene and the presence of dental problems. If problems are highlighted, we suggest seeing the hygienist or general dentist during orthodontic treatment.

Is the orthodontic appliance painful?

There may be some discomfort just after the activation of the force system used for straightening the teeth. However, this is short-lived and disappears after a few days and tends to be the only problem encountered. The system of orthodontic aligners is certainly less painful than fixed equipment.

Is it easy to talk with fixed braces/ aligners?

Yes, of course, although it depends on each person. Only after the initial positioning of a fixed appliance it can take a few days to get used to. For this reason we place the fixed appliances on the first appointment and then, a week later, we apply the threads that activate the dental movement. With Invisalign language is certainly less influenced.

Do fixed braces/ aligners correct problems with the temporomandibular joint (TMJ) and bruxism?

Before we know if orthodontics can help solve a TMJ problem, we should diagnose the cause of the jaw pain. Pain in the temporomandibular joint could be caused by various factors, but in those cases where the problem is attributable to the way in which the teeth close, then appliances and aligners can help.

How long is orthodontic treatment for adults?

The time it takes to complete orthodontic treatment depends entirely on the orthodontic problems to be corrected. Usually, most adults will be able to achieve the goal of aligning their teeth in 9-15 months. Invisalign is a very popular treatment that makes use of removable transparent aligners, ideal for solving a large number of common orthodontic problems. Similarly, so-called aesthetic fixed appliances are an excellent solution.

If your posterior teeth are in occlusion and you only have limited problems with the front teeth that need to be aligned, you can complete orthodontic treatment in a few months. For example, fixed aesthetic orthodontic appliances (ceramic) can be indicated in these and other cases for those who pay particular attention to the aesthetic impact that the appliance could have during treatment. Invisalign produces an alignment system based on the use of removable transparent plastic aligners which, similarly, is perfect for adults and teenagers who are particularly attentive to aesthetics.

More complex issues will take longer to correct, even up to two years.  These treatments are aimed at ensuring that other teeth that are well aligned close properly also in the posterior sectors. Even when bite and tooth alignment issues are more complicated, both aesthetic fixed braces and removable invisible braces could be a great choice.

How do patients feel when they see their teeth aligned?

Patients are usually very satisfied with the results of their orthodontic treatment. Often they also eventually require a whitening treatment to bring out their new smile.

Are you ready to start your orthodontic treatment?

Most problems can be solved at any age. You are never too old to straighten your teeth! Orthodontics is a possible treatment for most patients. Anyone can have the opportunity to achieve a radiant smile and a healthy appearance. We also have deferred payment plans to make the treatment accessible to everyone.

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The clinical team lead by Guido and Veronica Bracchetti is committed to this work because they love to take on difficult challenges. They are passionate about doing their job well and prioritize precision and details. They are highly motivated and prepared to exceed expectations and achieve excellent results for patients. This often means they face clinical situations and problems which other dentists have not been able to resolve. The goal of the clinical team is to go beyond patients expectations and give them even better results than what they originally requested.


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