What Determines the Length of Orthodontic Treatment?


The length of your orthodontic treatment often depends on the condition of your teeth and your goals for orthodontic correction. The average length of treatment is between 18 and 24 months, but some patients may wear their braces for a longer or shorter time. You will only know how long you will wear braces once an orthodontist evaluates the position and alignment of your teeth.

Braces use a constant force to create tooth movement. The supporting ligament stretches on one side and compresses on the other teeth, allowing teeth to loosen. This stimulates bone deconstruction that enables teeth to move in an appropriate path. Once teeth are in the desired position, the bone rebuilds to support the new positions.

Because braces do so much behind the scenes, orthodontic treatment cannot be rushed. But, the medical and cosmetic benefits will last a lifetime, no matter how long your treatment takes. Here are a few factors that may impact the length of your orthodontic treatment.

Severity of Your Malocclusion  

Malocclusion is the term for the misalignment of the teeth that interferes with a patient’s ability to bite correctly. The type and severity of your malocclusion will impact your treatment times. Orthodontists assess the size and shape of the teeth, as well as their position with the jaw bones. When teeth are correctly aligned, the upper teeth rest slightly over and in front of the lower teeth, with corresponding molar points. 

The more your teeth need to move to correct your malocclusion, the longer you must wear braces. It is crucial not to over-accelerate tooth movement as this could permanently damage your teeth, tissues, and bones. Three basic categories of malocclusions exist and progress from easiest to most difficult to treat. 

A Class I malocclusion occurs when your teeth are positioned incorrectly, but the bite is unaffected. This could mean that the teeth are crowded (some teeth overlapping), or it could involve improper angling of some teeth toward the tongue. Class I malocclusions are the easiest to correct because they do not involve reshaping your mouth’s jaw bone or other supporting structures. 

Class II malocclusions typically involve a problem with the bite. While it is normal for the upper teeth to fit over the lower, an overbite is diagnosed when the bite space between the upper and lower teeth is more than 2 millimeters. Overjets are considered class II malocclusions, though they differ from overbites in that the upper front teeth protrude outward instead of overlapping the bottom. 

Class III malocclusions are the most severe, making them the most difficult to treat. Class III includes underbites and crossbites, which often require adjusting orthodontic appliances. In some cases, the patient will require surgical correction before braces. 

The Type of Braces You Choose 

The type of braces you choose for your orthodontic treatment also may affect the speed of treatment. Though there isn’t a huge difference between the options, some appliances are removable or more fragile, and those who are less disciplined will face longer treatment times.


Metal braces and lingual braces both use brackets that glue to each tooth and connect with a wire that exerts force to stimulate movement. Metal brackets attach to the front of the teeth, and lingual brackets attach behind and are completely invisible. Metal brackets are the least expensive option, while lingual brackets typically are the most costly treatment method. Lingual braces require four to six weeks to craft, so you will have a bit of waiting time before your treatment can start. 

Ceramic Braces 

Ceramic braces are applied similarly to brackets but rely on ceramic, porcelain, or plastic. Though ceramic braces require approximately the same time to straighten teeth as brackets, they are less durable, which could result in longer treatment times if you need to replace them often. While all orthodontic patients should adhere to guidelines for braces-friendly foods, those wearing ceramic braces must be especially careful. 


Invisalign uses customized clear plastic trays that your orthodontist will regularly reform to apply appropriate pressure to move your teeth. If you choose this option, you must wear your aligners exactly as directed (at least 22 hours per day). Even a tiny level of noncompliance can rewind the clock on your treatment. 

It also is important to stay on schedule with your replacement aligners. You might wear anywhere from 12 to 48 different aligners throughout the course of your treatment, which can require visits to the orthodontist as frequently as every two weeks. Each day you go past a replacement date is a day you are adding to your treatment time. 

Six Month Braces 

The six-month method offers the same results in less than half the time without ever visiting an orthodontist’s office. While this sounds great, it is only a good option for a small segment of orthodontic patients with mild malocclusions who want cosmetic correction only. Six-month braces only treat the visible top front teeth, so the treatment is faster because there are fewer teeth to move. 

Your Age 

Children and younger teens will experience shorter treatment times than older teens and adults with similar conditions. This is because the tissues and bone structures surrounding the teeth are still growing and, in their malleable state, will adapt more quickly to changes. 

While you’re never too old to correct the position of your teeth, orthodontic treatment involving skeletal issues will become more difficult to treat after adolescence and may require surgical correction before orthodontic treatment. Once the jawbones are fixed, orthodontics alone can no longer adjust or shape them. 

Your Dental Health And Hygiene 

Your orthodontist will provide instructions for caring for your teeth while in braces. This is an area where you have control over a substantial impact on your treatment time. It is vital to keep your teeth clean and healthy while you are in orthodontic treatment. Gum inflammation or cavities resulting from poor oral hygiene can force the orthodontist to slow her work as she addresses your dental problems. In addition, broken brackets or wires resulting from eating chewy or crunchy foods can slow the realignment process.

Medications You Take

If you regularly take non-steroidal anti-inflammatory drugs, such as ibuprofen (Motrin or Advil), aspirin (Bayer), or naproxen (Aleve), your teeth will take slightly longer to move. Corticosteroids and immunosuppressants can slow down tooth movement. Thyroid hormone and vitamin D increase movement. Do not begin or stop any medication without consulting your doctor. 

If you’re interested in receiving orthodontic treatment, contact us today to schedule a complimentary consult with one of our board-certified orthodontists.


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