Adults make up a substantial share of the patients we treat, and healthy teeth can be moved at any age. The biology is the same at forty-five as it is at fifteen. What changes is everything around the teeth.
Adults arrive with dental history: crowns, implants, fillings, gum recession, worn edges, missing teeth, and sometimes a course of orthodontics from decades ago that did not hold. Treatment has to account for all of it, which is why Dr. Rosenbloom plans every adult case around your full dental history.
Why Adults Come In
The reasons are usually practical rather than cosmetic.
Crowding that has slowly worsened. Lower front teeth in particular tend to crowd further with age, whether or not there were braces earlier.
A bite that has become uncomfortable. Uneven contact means some teeth take more load than they should, which shows up as wear, sensitivity, cracked fillings, or jaw discomfort.
Teeth that drifted after treatment years ago. Retainers get set aside, and teeth move for the rest of your life. This is one of the most common reasons adults come back.
Preparation for other dental work. Sometimes a tooth needs to be moved into position before a crown, bridge, or implant can be placed properly, often in coordination with your dentist.
Appearance, straightforwardly. That is a perfectly good reason and nobody here will treat it as a lesser one.
What Is Different About Treating Adults
Three things, and they are worth understanding before you start.
The jaw is no longer growing. Problems involving jaw size or position cannot be guided the way they can in a child. Teeth can still be moved, but a significant skeletal discrepancy may need either compensation or, in some cases, surgery. See surgical orthodontics.
Existing dental work has to be worked around. Crowns and implants behave differently from natural teeth. Brackets bond less predictably to porcelain, and an implant does not move at all, because it is fused to the bone rather than suspended in a ligament. That does not prevent treatment; it shapes the plan.
Gum and bone health set the limits. Teeth move through bone, so the bone has to be healthy enough to support it. Where there is active gum disease it must be treated and stable before orthodontics begins. Where there has been bone loss, treatment is often still possible but the forces used are lighter and the plan more conservative.
None of these is a reason to skip treatment. All of them are reasons to have it planned by someone who does this exclusively.
Braces or Aligners for Adults
Both work. Most adults ask about Invisalign® first, and for mild to moderate crowding or spacing it is often an excellent fit, particularly where visible brackets would be unwelcome at work.
Braces still have the edge for complex bite correction, substantial rotation, and cases needing precise vertical control. Ceramic brackets are a middle option, far less visible than metal while keeping the control. More on types of braces.
Adult treatment is frequently shorter than people expect, because the goal is often narrower. A limited course aimed at one specific problem can be a completely appropriate plan, and it is worth asking whether that fits your case.
Book a Free Exam
The consultation is free, takes about 45 minutes, and requires no referral.
Call or text (845) 471-1186, or request an appointment online. We are at 1145 Route 55, Suite 1 in LaGrangeville, half a mile west of the Taconic State Parkway.
Frequently Asked Questions
Does Medicaid cover braces for adults in New York?
Generally no. New York Medicaid covers orthodontic treatment for patients under 21, and only where the case meets the state’s medical-necessity standard for severe malocclusion. Adult orthodontics is not usually covered. Our financial policies page explains how coverage works more broadly.
Does adult treatment take longer than it does for teenagers?
Slightly, in many cases. Bone remodels a little more slowly in adults, so the same movement can take somewhat longer. The difference is smaller than most people assume, and it is often offset by adults being more consistent with wear and appointments.
Will my crowns, implants, or fillings be a problem?
They are a planning consideration rather than an obstacle. Brackets bond differently to porcelain and require a different preparation. Implants cannot be moved at all, so the plan works around them. Tell us what dental work you have at the consultation and it will be factored in from the start.
Can I have orthodontic treatment if I have gum disease or bone loss?
Often yes, but not while gum disease is active. It needs to be treated and stable first, usually with your dentist or a periodontist. Where bone support is reduced, we use lighter forces and set more conservative goals. We would rather tell you that honestly than start treatment your gums cannot support.
I had braces as a teenager and my teeth have moved again. What now?
This is one of the most common reasons adults come to see us, and it is usually straightforward. Relapse after retainers stop being worn is normal rather than a sign anything went wrong. A second course is frequently shorter than the first, and it ends with a retention plan designed to be sustainable.