Am I Too Old for Braces or Invisalign?
One of the questions I hear from adult patients is, “Am I too old for braces or Invisalign?”
My answer is simple: absolutely not.
I believe we are never too old to work toward a healthier smile and a healthier bite. I have treated adults in their 40s, 50s, 60s, and 70s. My oldest orthodontic patient was a 78-year-old gentleman.
Adult orthodontics is not always about having perfectly straight front teeth. As we get older, the way our teeth fit together can become increasingly important. Teeth may shift, wear down, become crowded, develop spaces, or lose some of their periodontal support. Missing teeth and years of dental work can also change the bite.
For me, the question isn’t simply, “Can I make these teeth straight?”
The better question is:
My Oldest Orthodontic Patient Was 78 Years Old
He Didn’t Come to Me Just for Straighter Teeth
One of my favorite examples of adult orthodontic treatment is a gentleman I treated when he was 78 years old.
He had poor posterior contact. In other words, his back teeth were not contacting and functioning together as well as we wanted.
What did he want?
He told me he wanted a stronger bite so he could bite and chew a steak better.
I loved his goal because it illustrates something that is sometimes forgotten about orthodontics. Teeth aren’t only there to look good in photographs. They have a job to do.
We treated him with braces. He specifically preferred something fixed because he didn’t want to deal with removing and replacing aligners throughout the day.
His age didn’t automatically disqualify him from orthodontic treatment. What mattered was his dental health, periodontal support, treatment goals, and whether I believed we could safely improve his bite.
Adult Orthodontics Is About More Than Straight Teeth
Of course adults want a beautiful smile. I understand that completely.
But when I evaluate an adult, I am also looking at the bite.
I evaluate things such as:
- Deep bite
- Open bite
- Overjet
- Crossbite
- Crowding
- Spacing
- Missing teeth
- Worn teeth
- Posterior contacts
- Jaw relationships
- Gum recession
- Periodontal bone support
- Tongue posture and function
- Existing crowns, bridges and implants
- Jaw discomfort and function
A smile can look straight from the front while still having significant functional problems.
That is why my goal is not simply to line up six front teeth. I want to understand the entire orthodontic problem and determine what treatment makes sense for that individual patient.
Deep Bites Can Be Especially Important in Adults
I see adult patients with significant deep bites. Some have lived with the problem for decades.
A severe deep bite can be associated with excessive tooth contact, tooth wear, soft-tissue trauma and an unfavorable bite relationship. Some patients also grind or clench their teeth.
Over many years, heavy forces from grinding and clenching can contribute to wear and may be particularly concerning in patients who already have compromised periodontal support.
In selected patients, orthodontic treatment can help us improve the bite relationship, open a deep bite and distribute contacts more favorably. Some of my adult deep-bite patients have also reported improvements in comfort and less jaw discomfort as their bite improved.
Can Orthodontic Treatment Help Breathing?
This is an area where I think we have to be thoughtful and very careful about making promises.
The teeth, jaws, tongue and surrounding structures are related anatomically, but breathing and sleep disorders are complex medical issues. Orthodontic treatment should not be presented as a universal treatment or cure for obstructive sleep apnea.
However, I do pay attention to what my patients experience during treatment.
A 55-Year-Old Invisalign Patient Who Noticed a Difference
I treated a 55-year-old patient with Invisalign and elastics. He had a Class II bite, a retrusive lower jaw and a deep bite. He also had a history of sleep apnea.
As part of his orthodontic treatment, we used elastics to help improve his bite relationship.
He loved the feeling when his bite was positioned farther forward with the elastics because he told me that he felt he could breathe and sleep better in that position.
That was his individual experience, and I think that distinction is very important.
It does not mean that Invisalign or orthodontic elastics cure sleep apnea, and patients with sleep-disordered breathing should be appropriately evaluated and managed by their medical providers.
But experiences like this are one reason I believe an orthodontic evaluation should look beyond whether the front teeth are straight. The relationship of the teeth and jaws, tongue function, bite and the patient’s individual symptoms can all be relevant to treatment planning.
Is Orthodontic Treatment Different at 50 Than at 15?
Yes.
The biology matters.
A healthy teenager can often be more biologically forgiving than an adult who has experienced decades of dental treatment, gum recession or periodontal bone loss.
That doesn’t mean the adult cannot receive orthodontic treatment. It means I have to respect the patient’s biology.
For an adult patient, I pay particularly close attention to:
- Bone levels around the teeth
- Periodontal health
- Gum recession
- Root condition
- Existing restorations
- Missing teeth
- Implants and bridges
- The amount and direction of tooth movement required
In some patients with significant bone loss, aggressive tooth movement or an extensive extraction treatment plan may create more risk than benefit.
I still want the best orthodontic result possible. But I will not pursue a textbook result at the expense of the patient’s periodontal health.
Respect the Biology
One of the most important lessons in adult orthodontics is to respect human physiology.
If achieving a certain result would require extensive movement through compromised bone, I have to ask whether that movement is truly in the patient’s best interest.
Sometimes the best orthodontic treatment is the treatment that accomplishes the patient’s most important functional and esthetic goals while preserving the teeth and their supporting structures.
Sometimes We Need to Stabilize the Gums and Bone First
If I see significant periodontal disease or bone loss, I don’t simply put braces or Invisalign on the patient and hope for the best.
I frequently collaborate with the patient’s general dentist and periodontist.
If necessary, we stabilize the periodontal condition first. I may ask the periodontist to evaluate whether the patient is ready for orthodontic treatment and whether there are areas that require special attention.
Sometimes we have to wait.
That’s okay.
The objective isn’t to start treatment as quickly as possible. The objective is to start treatment when it is appropriate and to have the different doctors working toward the same goal.
Orthodontics Can Also Help Prepare for Implants, Crowns or Bridges
Adult orthodontics often involves teamwork with restorative dentists, periodontists and other dental specialists.
For example, a tooth next to a missing tooth may have tilted into the empty space over many years. Simply placing an implant or bridge may not provide the restorative dentist with the ideal space or tooth position.
In selected cases, I can use orthodontics to upright teeth and create appropriate restorative space.
I may also use temporary anchorage devices, commonly called TADs, when they provide the mechanics we need to move a tooth more predictably without relying entirely on the other teeth for anchorage.
This can allow the restorative dentist to work with a much better foundation when planning an implant, bridge or other restoration.
Braces or Invisalign for Adults: Which Is Better?
I don’t believe there is one answer for every adult.
I usually start by asking the patient what they want.
Some adults tell me:
“I don’t want to take aligners in and out. Just put braces on me.”
That’s perfectly reasonable.
Other adults tell me:
“There is no way I’m wearing braces at my age.”
That’s okay too. Invisalign or another clear-aligner approach may be an excellent option depending on their orthodontic problem.
You can read more about my personal experience with braces and Invisalign.
Sometimes I Use Both Braces and Invisalign
Orthodontics is about mechanics.
Braces are a tool. Invisalign is a tool. Elastics are tools. TADs are tools.
The important part is understanding what each tool can and cannot do efficiently for a particular patient.
In some of my more complex cases, I may use both braces and clear aligners during different stages of treatment. I may also incorporate elastics, TADs or other orthodontic mechanics when necessary.
I don’t think the objective should be to force every patient into one treatment system.
If you’re deciding between the two, you can also learn more about our braces treatment and Invisalign treatment.
Adults Can Be Some of My Best Orthodontic Patients
People sometimes assume teenagers are automatically easier orthodontic patients.
Not necessarily.
Some of my adult patients are fantastic patients because they made the decision themselves. They care about their smile, they are investing their own time and money into treatment, and they want a great result.
Orthodontics is teamwork.
I sometimes tell my patients, “You helped create this result.”
Maybe they wore their rubber bands exactly as instructed. Maybe they wore their aligners consistently. Maybe they worked on keeping their tongue in a better position. Maybe they maintained excellent hygiene.
I can design the treatment and provide the mechanics, but the patient’s cooperation can make an enormous difference.
What If I Had Braces Before and My Teeth Shifted?
This is extremely common.
I see adults who are coming back for orthodontic treatment for the second time.
Sometimes they stopped wearing their retainers. Sometimes tongue posture or oral habits contributed to changes. Sometimes the original treatment did not fully address the underlying problem. And sometimes teeth simply changed over many years.
I’m not here to judge why the teeth moved.
My job is to evaluate where you are today and determine whether orthodontic treatment can help.
And once we finish treatment, retention becomes extremely important. You can learn more about orthodontic retainers and maintaining your result.
Sometimes Closing Spaces Can Improve More Than Appearance
Spaces between teeth aren’t always purely cosmetic.
Certain spaces can trap food repeatedly. Food impaction can become frustrating and may make it more difficult to keep an area clean.
When appropriate, orthodontically improving tooth position or closing certain spaces may help create contacts that are easier for the patient to maintain.
Again, this is why adult orthodontic treatment has to be individualized. The reason for moving a tooth should make sense for that particular patient.
I Understand Adult Orthodontic Treatment Personally
I Had Both Invisalign and Braces as an Adult
This subject is personal for me because I went through adult orthodontic treatment myself.
When I was growing up, my parents couldn’t afford to get me braces. They took me to a university clinic because my front teeth overlapped.
At the time, we were told that my teeth were okay and that I didn’t necessarily have to do anything.
But as I got older, the overlapping of my front teeth bothered me.
In my 30s, I finally decided to do something about it.
I initially had Invisalign treatment through a friend who was a general dentist. He was learning Invisalign at the time and provided my treatment at no charge.
I appreciated what he did for me, but the rotations and final result were not completed to my satisfaction. Some of that may have been related to the mechanics and limitations of clear aligners at the time, and some may have been related to treatment experience.
Later, during my orthodontic residency, I had braces.
So when an adult sits in my chair and talks about orthodontic treatment, I understand it from both sides.
I know what braces feel like.
I know aligners can be inconvenient.
I know what it is like to lose an aligner.
I know what elastics feel like.
I know there can be soreness and discomfort.
And I also know what it feels like to finally address something about your smile that has bothered you for years.
That experience has made me more compassionate with my patients because I’ve actually gone through it myself.
Are Braces Weird at 40, 50 or 60?
Not at all.
Braces aren’t just for children and teenagers.
Adults today are working longer, living longer and taking better care of themselves. It is completely acceptable for someone in their 40s, 50s, 60s or beyond to decide that they want to improve their teeth and bite.
In fact, I sometimes joke with adult patients that braces can make you look younger.
They can even become a conversation starter.
And for people who simply don’t want visible braces, clear aligners such as Invisalign may provide another option.
What If Orthodontic Treatment Isn’t a Good Idea for Me?
Then I will tell you.
There are situations where the risks of moving teeth may outweigh the benefits.
If I believe orthodontic treatment is not going to help you—or that extensive treatment could potentially compromise your teeth, gums or bone—I would rather be honest about that.
Sometimes the best decision is to protect what you already have.
My Philosophy
My job is not to convince every person who walks into my office to get braces or Invisalign.
My job is to evaluate your teeth, your bite, your gums, your bone, your goals and your overall dental situation and give you my honest opinion.
If I believe orthodontics can meaningfully help you, I will explain how.
If I don’t believe it will help—or I believe the risks outweigh the benefits—I will tell you that too.
So, Are You Too Old for Orthodontic Treatment?
For most healthy adults, age by itself is not the reason to say no.
What matters more is the health of your teeth, gums and supporting bone, the condition of your bite, and what you are trying to accomplish.
You may be 45, 55, 65 or 75.
If you are going to be using your teeth for many more years, taking care of them today still matters.
Your teeth are important for eating. They are important for smiling. Your bite affects how your teeth function together. Your jaw relationship and oral structures can also be relevant when we evaluate overall function.
So I don’t think someone should postpone an orthodontic evaluation simply because of the number on their birthday.
An evaluation doesn’t mean you have to start treatment. Sometimes I recommend braces. Sometimes Invisalign. Sometimes a combination of orthodontic approaches. Sometimes I coordinate treatment with your dentist or periodontist.
And sometimes I tell a patient that I would leave things alone.
The important thing is to understand your options.
Frequently Asked Questions About Adult Orthodontics
Am I too old for braces at 50?
No. Age 50 by itself does not make someone too old for braces. I evaluate periodontal health, bone support, existing dental work, the bite and the amount of tooth movement required before recommending treatment.
Can I get Invisalign in my 50s or 60s?
Potentially, yes. Many adults can be treated with Invisalign or other clear aligners. Whether aligners are appropriate depends more on your specific orthodontic problem, oral health and ability to wear the aligners consistently than on your age alone.
Can a 70-year-old get braces?
In selected patients, yes. My oldest orthodontic patient was 78 years old and chose fixed braces. Chronological age is only one consideration. The health of the teeth, gums and supporting bone is much more important when determining whether orthodontic treatment is appropriate.
Is Invisalign better than braces for older adults?
Not necessarily. Both can be excellent tools. Some adults prefer Invisalign because it is less noticeable. Others prefer braces because they don’t want to remove and replace aligners. The complexity of the required tooth movements also influences which treatment I recommend.
Does orthodontic treatment take longer when you’re older?
It can, but age alone doesn’t determine treatment time. Bone health, periodontal condition, the complexity of the bite, the amount of movement required and patient cooperation can all influence how treatment progresses. In adults with compromised periodontal support, gentler mechanics and careful monitoring may be especially important.
Can I get braces if I have bone loss?
Possibly, but this requires careful evaluation. When a patient has significant periodontal bone loss, I often coordinate with the patient’s periodontist and general dentist. The periodontal condition may need to be stabilized before orthodontic treatment begins, and the treatment mechanics may need to be modified.
Can orthodontics help if I need an implant?
Yes, in selected situations. Orthodontics can sometimes upright tilted teeth, redistribute space or create appropriate room for a future implant or restoration. I frequently coordinate these cases with the patient’s restorative dentist, periodontist or oral surgeon.
Can braces or Invisalign help with sleep apnea?
Braces and Invisalign should not be considered stand-alone treatments or cures for obstructive sleep apnea. Sleep apnea requires appropriate medical evaluation. However, orthodontists evaluate the relationship of the teeth and jaws, and certain orthodontic changes may affect how individual patients perceive their breathing. Any treatment involving sleep-disordered breathing should be coordinated appropriately with the patient’s medical providers.
Why did my teeth move after braces?
Teeth can shift for many reasons, including not wearing retainers, oral habits, tongue posture, changes in the bite, periodontal changes and natural changes that occur over time. If your teeth have shifted, an orthodontic evaluation can determine whether retreatment would be beneficial.
What is the most important thing to know about adult orthodontics?
The goal should not simply be to make the front teeth look straight. Adult orthodontic treatment should consider the bite, periodontal support, existing dental work, function and the patient’s individual goals. Treatment should be designed around the patient—not around the appliance.
Wondering If You’re Too Old for Braces or Invisalign?
If you have been thinking about improving your smile or bite but keep telling yourself that you are too old, I would be happy to evaluate you and give you my honest opinion.
Dr. Pejman Nasibi
My Orange County Orthodontist
1081 N Tustin Ave #114
Anaheim Hills, CA 92807
Important: This article is for general educational purposes and does not replace an individual dental, orthodontic, periodontal, or medical evaluation. Orthodontic treatment recommendations vary based on each patient’s dental and medical history, periodontal health, bone support, bite and treatment goals. Orthodontic treatment is not a substitute for medical evaluation or treatment of obstructive sleep apnea or other sleep-related breathing disorders.