Orthodontic Treatment Expectations: A Step-by-Step Guide

Clinical Content Reviewed by Dr. Jay Khorsandi, DDS
Last Modified:

Table of Contents

  1. What is Orthodontic Treatment?
  2. Is Orthodontic Treatment Necessary?
  3. Best Age for Treatment
  4. Who Provides Care?
  5. Orthodontic Devices
  6. What to Expect During Treatment
  7. What To Consider Before Treatment
  8. Will It Hurt?
  9. Finding a Licensed Dentist or Orthodontist
  10. Starting Treatment

When considering orthodontic treatment for yourself or a loved one, the process can seem overwhelming.

Every mouth is different, and so is every bite and smile. Some orthodontic issues are mild or moderate and require a relatively straightforward treatment plan to correct.

Other problems may be more complex or complicated by other oral health issues. These may require a lengthier or more involved treatment plan or even surgery.

While orthodontic treatments vary greatly in scope, cost, and time, there are some general expectations you can have as you begin the process.

What is Orthodontic Treatment?

Orthodontics is a branch of dentistry that treats dental irregularities and bite issues. Orthodontic treatment diagnoses, corrects, and prevents bite and teeth movement and alignment issues with the help of orthodontic specialists.

With orthodontic treatment, teeth can be straightened or moved to help the bite and smile look better, feel more comfortable, and promote overall oral health.

Common problems like crooked teeth, an overbite or underbite, and crowding issues are addressed with orthodontics. Treatments like braces and aligners fall under the category of orthodontics.

Why Should I Have Orthodontic Treatment?

Many people seek orthodontic treatment for cosmetic problems. In fact, in the age of video conferencing and online meetings, teeth straightening services (like at-home aligners) are more popular than ever before.

While having a smile you’re proud of can boost confidence and set the stage for success, the benefits of correcting your bite with orthodontic services go far beyond the aesthetics.

Orthodontic issues, like overcrowding and crooked teeth, can make it hard to get in between the teeth while cleaning and flossing in problem areas. This can allow for the buildup of plaque in these areas, eventually causing tooth decay and gum problems.

Tooth decay and gum disease (periodontal disease) can lead to tooth loss as well as other serious health problems. The bacteria in plaque may travel to other parts of the body through the respiratory tract and bloodstream.1 This may cause or worsen inflammation in the body — a source of sickness and infection that can have a serious impact on health.

Bite problems can also cause discomfort and have a negative impact on a person’s quality of life. Chewing may be uncomfortable.

Incorrectly aligned teeth can cause shoulder and back pain or headaches and migraines. Jaw issues, like TMJ, can also occur and cause further problems like tooth grinding, which is another risk factor for tooth decay and wear and tear.

What Age is Best to Start Orthodontic Treatment?

Like most health and dental issues, when it comes to orthodontic treatment, early intervention is best. Catching an orthodontic issue early on allows a specialist to create a treatment plan before it gets worse or causes other problems.

For example, correcting a crowding issue earlier rather than later may help to slow or stop the movement of teeth if they’re still shifting in the wrong direction. Fixing the crowding problem will ensure that the areas in between those teeth can be reached in order to clean them properly before pockets of plaque and particles can build up and start to cause decay.

The American Association of Orthodontists (AAO) recommends that children receive their first orthodontic checkup at the first sign that there may be a problem but no later than 7 years old. At this age, enough permanent teeth have arrived in order to get a good idea of the child’s bite and any potential issues.

While receiving orthodontic treatment as a child is the best-case scenario, it doesn’t mean that adults shouldn’t pursue their ideal smile and bite. In fact, approximately one in three orthodontic patients is an adult.

Today, there are more orthodontic options available to adults looking to improve their smile and oral health with orthodontic treatment.

Who Provides Orthodontic Care?

General dentists and orthodontists, who are specialists that attend two additional years of school after completing dental school can both offer orthodontic care. Patients who receive in-office treatment will have regular visits with their doctors and staff.

Today’s other orthodontic options, such as at-home clear aligners, also allow a patient with mild-to-moderate orthodontic issues to complete a straightening treatment at home with the remote (or partially remote) supervision of a dentist or orthodontist.

Orthodontic Devices

Orthodontic devices apply pressure to the mouth and jaw in order to initiate or direct tooth movement, influence jaw development, and create new muscle patterns (retraining the muscles).

Fixed Orthodontic Devices

Fixed orthodontic devices are set in the mouth by an orthodontist and not removable. They stay in the mouth throughout the course of treatment. They include the following:


Easily the most well-known of orthodontic devices, braces use hardware to apply constant pressure throughout treatment and move teeth to their ideal positions. With traditional braces, small brackets are bonded to the teeth and connected with wires and bands that are tightened and adjusted on a regular basis throughout treatment.

Hardware used in braces includes the following:

  • Brackets: These are small pieces of hardware that are bonded to the tooth. A bracket is usually a square attached to the front of the tooth. Brackets may be made of stainless steel, plastic, or ceramic.

  • Bands: These are used as anchors for the appliance, placed around the tooth or teeth.

  • Arch wires: These are clear, metal, or tooth-colored. Arch wires attach through brackets and to bands. They’re tightened on a regular basis, usually monthly, to guide and move teeth to their desired position.

Space Maintainers

If a baby tooth is lost prematurely, a space maintainer may be used to keep the space clear and prevent decay. They can also prevent problems in bite and jaw development. Space maintainers are created by attaching a band to the tooth next to the empty space and extending a wire through the empty space.

Specialty Fixed Attachments

Though often considered an unappealing treatment option due to creating difficulties in everyday tasks like eating, in rare cases, specialty fixed orthodontic hardware may be used to correct or prevent oral issues like thumb sucking or tongue-related problems, such as tongue thrusting.

Removable Appliances

Removable appliances are used in treatment but can be removed as needed. They are not bonded or attached to the teeth.

Removable orthodontic appliances include the following:

Clear Aligners

Clear aligners, like braces, use continuous pressure in order to move teeth to their proper positions. Most daytime teeth aligners are prescribed to be worn for 22 hours a day.

Using an initial scan or impression of your teeth, aligner technology is used to design your unique ideal smile. With that ideal smile as the “end destination” in mind, a series of aligner trays is designed to gradually move your teeth. Each tray is worn for about two weeks, following the “route” of your treatment process until the desired smile is achieved.

Invisalign is the most popular in-office clear aligner treatment, with many orthodontists across the country providing full Invisalign treatment — from the initial consultation to checkups and completion.

Today, there are many at-home clear aligner options. These companies offer refundable mail-order impression kits to assess if you’re a candidate for their at-home aligner treatment. Aligner trays are then mailed to your home, and you never have to see an orthodontist in person with this convenient treatment.

Some hybrid aligner providers offer a combination of in-person and mail-order services. Patients may see an orthodontist for an initial in-office consultation in-office, but check-ins are then done remotely.

Other removable appliances include the following:

  • Headgear: This is used to control jaw development and the movement of back teeth.

  • Palatal expander: This is used to widen the upper jaw arch.

  • Splints: These retrain the jaw to close differently in order to treat TMJ.

  • Bumpers: These keep lips and cheeks away from the teeth to stop their muscles from placing unwanted pressure on the bite.

  • Removable space retainers: Like fixed space retainers, these are used to protect the vulnerable empty space created by a prematurely lost baby tooth.


If you’ve completed orthodontic treatment to straighten your teeth, you’ll have to wear a retainer after treatment to ensure your newly aligned teeth stay in their desired positions. Otherwise, your teeth can shift back because they are not stable in their new positions and may be trying to move.

The supporting structure of the teeth (ligaments and bones) needs time to strengthen and stabilize. Once that time has passed, they can properly hold teeth in their new locations.

Fixed Retainers

Like braces, fixed retainers are bonded to the teeth with brackets, though they are usually only made up of a thin wire that goes along the back of the lower or upper teeth.

Because they are attached to the teeth, they are excellent at keeping the new bite in place. However, they are harder to clean and maintain, and they don’t offer the convenience of removable retainers.

Removable Retainers

Removable retainers can keep your new smile in place, but they can be removed as needed. Depending on the straightening treatment you’ve completed and the provider you’ve chosen, your retainer may be made up of plastic, acrylic, and/or wires.

Removable retainers are easier to clean and provide more convenience, as they can be taken out to eat and for other important events. Because they are removable, patients may be tempted not to wear them as much as prescribed, and this can lead to teeth shifting back to undesirable positions.

What To Expect During Orthodontic Treatment Depending On Your Issue

The scope of your treatment and the type of treatments available to you will depend on your orthodontic issues and oral health.

Common orthodontic problems include the following:

  • Overbite: The upper front teeth are too forward, sticking out over the lower teeth.

  • Underbite: The lower front teeth appear too forward, or the upper teeth are too far back.

  • Crossbite: The front teeth do not come down in front of the lower teeth when the mouth is closed.

  • Open bite: There is space between the surfaces on the front and side teeth when the back teeth bite down.

  • Midline problems: The midline of the upper teeth is not aligned with the midline of the lower teeth.

  • Spacing problems: There are gaps between the teeth or issues caused by missing teeth.

  • Crowding problem: There are too many teeth in an area of the mouth.

Most people with mild-to-moderate cases of these common orthodontic issues will have their choice of today’s most popular teeth alignment treatments: clear aligners and braces.

People with severe cases of these orthodontic issues or who have other oral health problems, like gum disease or the need for surgery, will likely not be candidates for clear aligners. They will likely need specialized braces treatment with an orthodontist.

The Clear Aligner Treatment Process

For those seeking clear aligner treatment, the process will begin with either an in-office tooth scan or an at-home impression kit. This will determine whether you’re a candidate for aligners.

If you are a candidate, the timetable for completion of treatment with at-home aligners generally ranges from three to six months. During that time, you’ll wear an aligner tray for a week or two before switching to your next tray until treatment is complete.

After treatment, you’ll wear a retainer to make sure your teeth don’t move back to their original positions.

The Braces Treatment Process

After meeting with an orthodontist to diagnose your orthodontic problems and make an impression of your teeth, a treatment plan will be created. You’ll return to your orthodontist to have the braces attached. The appointment may be somewhat uncomfortable, and it will take about one to two hours.

Once attached, you’ll have in-office appointments to adjust the braces every month or so. These adjustments involve tightening wires to move the teeth.

The length of braces treatment varies greatly depending on your orthodontic issues, but the average treatment time for braces is around 24 months.2 After your treatment with braces is complete, you’ll wear a retainer to keep your teeth in their new positions.

What To Consider When Deciding On Orthodontic Treatment

If you have mild-to-moderate orthodontic issues, you’ll likely have the choice of completing treatment with braces or aligners. When deciding which path is best for your success, consider these factors:


Clear aligners are generally more affordable than braces. Research your costs and whether insurance will cover any part of treatment to gain an understanding of what you can expect to pay.

Some local orthodontists may offer discounts on braces at certain points in the year. Aligner companies may offer discounts, such as military discounts.

Treatment Time

Clear aligners are usually the quicker option, with results in as little as three to four months, but some braces treatment plans, especially for mild problems, can be fast as well. The aligner company should give you an idea of your treatment timeline, just like an orthodontist can.

Convenience vs. In-office Care

Clear aligners can be removed for cleaning, eating, and special events. Some aligner options also require few or no in-office visits. For many, this makes them a much more convenient option.

Others may not be comfortable with having the option of removing their aligners, knowing they might be tempted to not wear them as much as prescribed. For these individuals, completing braces treatment with regular in-office orthodontist appointments may be preferable.

Will Orthodontic Treatment Hurt?

Any new appliance in your mouth can feel strange or uncomfortable at first. Having braces attached to teeth can cause soreness for about a week, for example, and you’ll experience some pain and discomfort every time you have your braces tightened.

All orthodontic devices use pressure to move the teeth, and that pressure can cause pain and discomfort at times. People describe some degree of discomfort with aligner treatment, as the trays are moving teeth, but aligners are generally described as much more comfortable than braces.

For most people, the pain during teeth straightening treatment should be mild or moderate. Over-the-counter pain medications can alleviate pain during the most uncomfortable treatment periods.

How To Find A Good Licensed Dentist or Orthodontist

To find the best orthodontist for your needs, consider the following:

  • Location: It’s worth it to find someone in your area. Make in-office visits more convenient by finding a local orthodontist.

  • Online reviews: Sites like Yelp and Google reviews may give you some insight into others’ experiences with the office or specialist.

  • Recommendations from friends and family: Has anyone you know completed orthodontic treatment with a local orthodontist? Ask for their input.

  • Services offered: If you’re looking for clear aligners and not braces, make sure the orthodontist you choose offers clear aligners and has a lot of experience using them. Also, make sure they have experience working with your age group.

  • Other resources: The American Dental Association offers a Find-a-Dentist tool on their website. The American Association of Orthodontists also offers an online specialist search.

Starting Treatment

Whether you end up choosing clear, at-home aligners or traditional in-office orthodontic treatment like braces, you can get started today. Request an impression kit from an aligner treatment company like Byte to determine if you’re a candidate for at-home aligner treatment. If you’re not, we’ll refund the cost of the impression kit.

If you prefer braces or you learn that you don’t qualify for at-home aligner treatment, schedule a consultation with a local orthodontist today.

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.