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 employed. How long you’ll have your braces on is dependent upon 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.

Length of treatment depends upon treatment goals
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 the braces come off. Although this may seem obvious, there is a popular trend among non-specialists (general dentists who do some braces along with everything else) to merely line up the front teeth and purposefully not 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 deliberately misleading since they begin treatment without any intention of finishing (correcting the bite for example). There is no disclosure in their ads that they’re going to just do part of the treatment and then remove the braces. For the purpose of this article, let’s assume that we’re all talking about treatment provided by a real orthodontist that is going to finish your treatment correctly.

Simple treatments usually require a year or less
The easiest, and therefore shortest, orthodontic cases are those in which all of the permanent teeth are erupted, the bite is normal (jaw size not an issue), and the crowding and alignment problems do not require the removal of permanent teeth. Generally speaking, these cases can be completed in less than a year by an orthodontic specialist.

Most common orthodontic problems require about 18 months
If you have more crowding (that requires 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 12 and 18 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.

Bigger overbites or severe crowding may take up to 2 years
When you have moderate to severe crowding, a bite problem that is more than half a tooth off, or any condition that requires the removal of permanent teeth, you should plan on 18 to 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 the problems with your jaw-size discrepancy. Most orthodontists consider these moderately severe orthodontic problems.

Difficult problems take longer, usually over 24 months
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 require supplemental anchorage or jaw surgery. Depending upon how each individual patient’s biology 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.

All dentists and orthodontists must play by the same biological rules
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.

My dad always taught me that 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 and use it? There are no shortcuts to excellent orthodontic results. If you follow your orthodontist’s instructions to the letter, 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!

NOTE: The author, Dr. Greg Jorgensen, is a board-certified orthodontist who is in the private practice of orthodontics in Rio Rancho, New Mexico (a suburb on the Westside of Albuquerque). He was trained at BYU, Washington University in St. Louis, and the University of Iowa in the United States. Dr. Jorgensen’s 25 years of specialty practice and nearly 10,000 finished cases qualify him an expert in two-phase treatment, extraction and non-extraction therapy, functional orthodontics, clear aligners (Invisalign), and multiple bracket systems (including conventional braces, Damon and other self-ligating brackets, Suresmile, and lingual braces). This blog is for informational purposes only and is designed to help consumers understand currently accepted orthodontic concepts. It is not a venue for debating alternative treatment theories. Dr. Jorgensen is licensed to diagnose and treat patients only in the state of New Mexico. He cannot diagnose cases described in comments nor can he select treatment plans for readers. Because he has over 35,000 readers each month, it is impossible for him respond to all questions. Please read all of the comments associated with each article as most of the questions he receives each week have been asked and answered previously. The opinions expressed here are protected by copyright laws and can only be used with written permission from the author.