Getting your braces on is exciting, but getting them off is the best day ever! Your orthodontist most likely gave you an estimated treatment time before your braces went on. If that day has come and gone, you are probably wondering why your braces are still on. There are three things that could cause your braces to stay on longer than expected: your orthodontist, you, or biology.

The orthodontist providing your care affects treatment time
Your orthodontist has advanced training to help him diagnose your problems and come up with a treatment plan that will best correct them. His experience should not only allow him to produce the best result, it should also help him select an approach that gets you there in a reasonable amount of time. Not all orthodontists are the same however. Some place more emphasis on speed than quality. Some are “hands-on” while others are not as intimately involved. It is a personality difference. Your treatment time will be directly affected by the treatment plan your orthodontist choses and how efficiently he executes it.

The 5 factors determined by your orthodontist
Some ways he can make your treatment take longer include 1) problems with the original diagnosis, 2) problems with the original treatment plan, 3) changes in the original treatment plan during the process, 4) too much time between appointments, or 5) insufficient attention to your progress. Some problems really do take 30 months to correct, but an experienced doctor should be able to warn you about those up front.

Patient compliance is critical to keeping treatment on track
You (the patient) are the second variable that affects your treatment time. Your orthodontist may have the perfect diagnosis and treatment plan, but he cannot succeed without your cooperation. Some things you might be doing to sabotage your own treatment time include 1) missing, changing, or spreading out your appointments, 2) arriving late to appointments so the technicians don’t have sufficient time to perform all planned procedures, 3) not getting other necessary procedures done in a timely manner (surgeries, extractions, restorative, etc.), 4) breaking or bending your wires or brackets between visits, or 5) not following instructions regarding rubber bands, aligners, and oral hygiene. Doing your part will not only help keep your treatment on schedule, it will give you the best final results too.

Mother nature may be working against you and your doctor
Even if your orthodontist is brilliant and you are the most compliant patient in history, there is still one other factor that neither of you can control. That factor is your biological response. Estimates of treatment time are based upon the complexity of the problem and the normal response of teeth to typical orthodontic forces. In some patients the teeth move faster than normal. In others they move slower. Some patients may have a condition called ankylosis where some teeth won’t move at all. In these cases it won’t matter what you or your orthodontist do, treatment time will be extended. The take home message is that even if you and your orthodontist are both vigilant in your roles, you’ll still need for your teeth to cooperate to get done on time.

If you are in treatment now and are concerned by your prolonged treatment time, consider these three factors: Are you really doing your part? Have you discussed your treatment progress with your orthodontist to see if anything has changed from his perspective? If you’re confident that both of you are doing your best, it may be that your body’s response to treatment is just slow. If you haven’t started yet, ask around and see if the orthodontist you are considering has a reputation for efficient treatment plans and finishing on time. Not all orthodontists are the same.

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 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 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 25,000 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.