Braces for adults
introduction
Most people associate orthodontic treatment with the very young, whose jaw- and tooth development is not yet complete.
For a long time, the general knowledge prevailed that correcting misaligned teeth in adulthood was very difficult or even impossible.
But there is a mistake here, because orthodontic therapy can be carried out for a lifetime, regardless of age. A braces for adults is no longer uncommon today. It is also not uncommon for people who are already in the youth a braces have to have their teeth straightened again at an older age. This may be necessary because the teeth be in motion for a lifetime and can move again even after a successful correction.
Braces for adults are not only useful for cosmetic reasons, because in principle it can be said that crooked teeth are the result of carious defects and / or Gum disease / inflammation of the gums favor. In addition, the teeth wear out much faster in the event of misalignment due to abrasion processes.
In adulthood, the same orthodontic appliances are usually possible with braces for adults as in young years, but it is important for older people to choose a treatment method that is as inconspicuous as possible.
Due to the fact that the jaw growth is usually completed during adolescence and the teeth of an adult are relatively tight in the jawbone, fixed appliances are usually used.
Find out more on our main page: The fixed braces
Fixed braces are dental devices that are used to correct jaw and tooth misalignments, but cannot be removed from the oral cavity by the patient himself. It remains in the mouth for the entire duration of the treatment and must be adjusted by the orthodontist at regular intervals.
In addition to the well-known fixed braces with visible brackets, there is the option of using almost inconspicuous ceramic brackets for braces for adults.
Learn more about: Brackets of a brace
Fixed braces offer the advantage that they remain permanently in the oral cavity and thus the wearing time can usually be shortened and also very extensive tooth movements can be brought about.
The so-called lingual technique (Lingua of Tongue) offers the possibility to carry out an inconspicuous tooth and jaw correction.
In this treatment variant, the brackets are not glued to the front surface of the tooth, as is usual, but attached to the side of the tooth facing the tongue. The braces are therefore absolutely invisible from the outside.
Since the inner surfaces of the teeth, in contrast to the outer side of the teeth, are not shaped in the same way in every person, the brackets must be shaped individually and in a complex manner for each individual tooth. In addition, it is a lot more complicated for the treating orthodontist to thread the wires through the brackets and then attach them.
Read more on the topic: Braces behind the teeth
For this reason, orthodontic treatment is via Lingual technique a lot more expensive than a normal correction.
When starting treatment with fixed braces for adults, patients usually experience mild or even moderate symptoms for several days to weeks Toothache.
Biting down can be particularly unpleasant, so it is advisable to avoid overly solid food for a while.
In addition, instead of the usual loose braces, so-called Clear aligners be used.
These are transparent plastic splints that are fairly inconspicuous and can therefore be worn all day without restrictions.
During orthodontic therapy with Clear Aligners, the tooth and Jaw misalignment corrected in several steps by successively placing different rails with ascending Pressure intensity be worn.
Orthodontic treatment after the age of eighteen is usually not covered by statutory health insurance. The exception in this context are tooth corrections, for which additional surgical measures are necessary.
Indications for braces
One of the most common causes is your desire to straighten your teeth. Especially in adult orthodontics. In children and adolescents, however, the indication is usually a misalignment of the teeth and the jaw, which is not acceptable from a medical point of view. The health insurance companies only cover the costs from a certain degree of severity. Indications are, for example, an open bite with a distance of 2-4 mm or a deep bite with a distance of more than 3 mm between the upper and lower jaw cutting edge. Basically, a bilateral crossbite and crowding, or a resulting lack of space of more than 3 mm, is considered a reason for orthodontic treatment. More serious misalignments, such as a tooth that has not been applied or that has remained behind, an upper jaw that is more than 6mm in front of the lower jaw, a lower jaw that is in front of the upper jaw, or a disease-related malalignment, must be treated.
Read more on the topic: Jaw misalignment
Who needs loose braces, who needs fixed braces?
That depends on the severity or extent of the misaligned teeth. Only an orthodontist can answer this question after examining the patient carefully. Often loose and then fixed braces are used. The loose brace helps, for example, when the jaws have to be adjusted to each other. As long as children and adolescents are growing, the shape and function of the jaw can be changed using an activator. Loose braces are also used if only one tooth needs to be moved slightly and can be pushed to the desired position with little pressure. However, if several teeth are to be moved parallel through the bone, this is only possible with a fixed brace that can exert sufficient pressure. In adults, loose braces do not give good results.
Read more on the topic: The loose braces
A multi bracket appliance or therapy with alligners, i.e. plastic splint therapy, is therefore recommended. External braces like headgear are not always necessary. This appliance is the only one that succeeds in creating more space in the upper posterior region. Otherwise teeth would have to be extracted. This means that the therapy would also be possible without external braces, but the result would be different, if not worse.
You might also be interested in: Brackets of a brace
Advantages and disadvantages of loose / fixed braces in adults
With loose braces, the braces and teeth can be cleaned thoroughly after each meal. The clasp can also be removed for eating. On the one hand, the pain when chewing is less, and on the other hand, no food gets caught in the braces. In contrast to fixed braces, this reduces the risk of tooth decay or inflammation of the gums. The removable braces are much more aesthetic compared to the fixed ones. Fixed brackets hide a large part of the white tooth structure. The removable clasp shows only a thin metal wire when smiling. The disadvantage of the removable ones is the long treatment time. It depends a lot on how often and how consistently you wear it, but even if it is worn as often as possible, it takes longer to achieve the same result as with a fixed brace. It is important to wear the brace regularly, otherwise the orthodontics may be canceled. In such cases, if the therapy fails due to a lack of cooperation on the part of the patient, the health insurance company can demand part of the money back. Another disadvantage of loose braces is that you have problems speaking and pronunciation at first, as some of the braces have a large plastic body. In difficult cases, loose braces are not enough to achieve the desired result. With a firm, however, serious misalignments can be corrected.
Read more on the topic: The loose braces
With the fixed braces, upper and lower jaws can be corrected at the same time, regardless of your age. Orthodontic treatment works even in adulthood. There are tooth-colored ceramic brackets or lingual brackets that are attached to the inside of the tooth, especially for older patients or those who would like to wear inconspicuous braces. However, the disadvantages of fixed braces are that they require very good care. After every meal, the teeth must be cleaned thoroughly with a special toothbrush. If necessary, you should also use interdental brushes. There are also regular check-ups with the orthodontist to check the position of the brackets and ligaments. Because if the clasp breaks spontaneously, it is not so easy to repair.
Read more on the topic: The fixed braces
Pain when wearing the braces
In order to move the teeth in the jawbone, the braces have to exert a certain amount of force on the teeth. Nowadays there are braces that can get by with relatively little force thanks to the wire materials. Nevertheless, the forces are 0.2 to 0.3 Newtons. This is equivalent to about 20-30 grams applying pressure on all teeth. The pain is strongest at the beginning of the treatment or after each re-tensioning of the wires. The following helps against the pain: In the first few days, it is advisable to eat soft foods. This includes, for example, a soup, porridge or applesauce. Many also use baby food. Cold drinks and foods that numb the oral mucous membrane help against the inflammation. But they shouldn't be so cold that they hurt your tooth.
Hard and acidic foods should be avoided. On the one hand, the acid also irritates the sensitive gums, on the other hand, chewing nuts or the like hurts even more. In the worst case, painkillers such as ibuprofen or paracetamol can also help against severe acute pain. However, you should not take the medication for more than three consecutive days. In the longer term, use a softer toothbrush and toothpaste for sensitive gums to prevent further pain. Also, orthodontic wax helps stick to the brackets to prevent injury to the oral mucosa.
Read more on the topic: Pain from braces
Duration of treatment with fixed braces
Theoretically, treatment with fixed braces lasts for life. A distinction is made between the treatment phase and the retention phase. In the last phase, the teeth are held in place, either with a retainer behind the teeth, or with loose braces for the night. The duration of the treatment phase varies from patient to patient. In some cases, early orthodontic treatment begins in the primary dentition. An operation may also have to take place, which further extends the duration. The time in which the fixed brace is worn is on average 2-4 years. Of course there are cases in which you only need one year, in more difficult cases the brace has to be worn for 5 years.
Duration of treatment with loose braces
The duration depends heavily on the patient's cooperation. The more often it is worn, the faster the desired result will be achieved. However, the length of time that loose braces are worn also depends on erupting teeth. Mostly loose braces are used on children with mixed dentition who are also still growing. You wait with the fixed braces until all teeth have erupted. There must also have been some growth during this time. The loose brace can only do its job with the help of the growing bone. This can happen at different speeds for each child.
Fixed braces cost
In some cases, the costs are partially or even fully covered by the health insurance company, in others, nothing is reimbursed. The costs vary on the one hand due to the type of treatment, i.e. depending on which form of therapy is chosen with which type of braces. In addition, the costs rise or fall, depending on the severity of the jaw and tooth misalignment. For adults aged 18 and over, treatment must be paid for privately. The costs can vary between 5,000 and 15,000. Larger interventions that are medically justified and that require additional surgery are usually reimbursed by the health insurance company.
You might also be interested in: Cost of braces
Cost of loose braces
Since there is usually a medically indicated justification for a loose brace, the conventional braces are paid for by the health insurance. Loose braces such as an Invisalign splint (invisible braces) are not included. You have to ask the health insurance company whether and how much will ultimately be covered.
Tax deductibility of braces
There are some cases where patients have been able to remove at least part of their brace. However, there is no guarantee that the tax office will accept every invoice. It depends on how high the cost of the invoice is within a year and whether you can get over the tax-free limit. In addition, the job certainly plays a role. In some professions, a friendly smile and well-groomed appearance are more important than in others. Medically necessary treatments and illness costs are considered by the tax office as an "extraordinary burden". Since orthodontic treatment is mostly a cosmetic or aesthetic problem, and not a health problem, it also becomes difficult to submit the invoice on such a pretext. Orthodontics bills are the same as bills for cosmetics, hairdressers or opticians. In such specific cases, it is advisable to consult a tax advisor.
