Which Orthodontic Treatment Is Right for You?
For adults choosing how to straighten their teeth: why case complexity comes first, five deciding questions, a decision matrix, and what to weigh when discretion, speed or cost matters most. The core point, drawn from British Orthodontic Society and NHS guidance: complexity limits which appliances can achieve the result, and retainers follow every route.
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Clinically reviewed by Dr Ibraheem Ijaz, dentist · GDC 301711
Medical disclaimer: This page is for general information only. It does not replace an examination or treatment by a dentist.
Dr Ibraheem Ijaz, a General Dental Practitioner and principal dentist at Deepcar Dental Care, checked this page. His degrees are a BDS and a BSc (Hons), and his postgraduate qualifications an MSc (Leeds), a PG Cert in Restorative and Aesthetic Dentistry and, in implant dentistry, a PG Dip.
Why should the choice start with how complex the problem is?
Complexity comes first because it decides which appliances can achieve the result at all; preferences such as appearance then choose between the options that can.
The British Orthodontic Society (BOS) explains that braces fixed to the teeth can treat and improve a wider range of problems than removable treatments.
Some problems need more than a brace. BOS's guide for adults says a small group of adults also need jaw surgery, because braces alone will not achieve the improvement needed, and it calls an open bite (front teeth that do not meet) surprisingly complex to treat.
Each problem, from crowding to an open bite, has its own page; browse this section to see yours, and our orthodontic treatment page covers the wider picture, including general risks.
What five questions decide which treatment suits you?
Five questions, taken in order, narrow the options.
- How complex is the problem? This sets which appliances are possible, and BOS says a full clinical examination by a trained clinician is needed to decide whether treatment is in your interests.
- Are your teeth and gums healthy? BOS sets no age limit on moving teeth; what matters is that teeth and gums are healthy. If age is your worry, our page answering am I too old for braces? covers it.
- Can you keep up the routine? Compliance matters: a 2017 review of 24 studies of removable appliances and add-ons such as headgear, not specific to aligners, found they are worn less than prescribed and that patients routinely overestimate their wear. BOS advises against starting if you cannot keep appointments, usually every four to ten weeks.
- What matters most to you? Once complexity allows a choice, discretion, speed and cost each have their own section on this page.
- Are you ready for retainers? BOS's advice is not to start brace treatment unless you are willing to wear retainers to keep the result.
What does the decision matrix show?
The decision matrix pairs common situations with what guidance says to weigh, complexity first; it ranks no appliance above another.
| Your situation | What guidance says to weigh | Source |
|---|---|---|
| Mild to moderate crowding or spacing | Aligners are described for mild to moderate problems; fixed braces can treat a wider range | BOS |
| Severe crowding, extractions or complex tooth movements | Aligner treatment may need added techniques, such as fixed braces | BOS |
| A problem from jaw size or position | Aligners may need added techniques; for some adults, braces alone cannot achieve the improvement and jaw surgery is needed too | BOS |
| Doubt about keeping up wear or cleaning | Removable appliances were worn less than prescribed in a review not specific to aligners; fixed braces need careful daily cleaning | 2017 review; NHS |
| Not willing to wear retainers long term | BOS advises against starting brace treatment | BOS |
Where both could work, the head-to-head comparison of braces or clear aligners has its own page.
Which options suit you if discretion matters most?
If discretion matters most, BOS names three less visible options, ceramic braces, lingual braces and clear aligners, each with advantages and disadvantages. Complexity still decides which of them can treat your problem.
Ceramic brackets are tooth-coloured and less conspicuous than metal, and BOS says adults often favour them. Its listed drawbacks are that they can discolour from food over time, break more readily than metal, may make treatment longer because the wire slides less freely, may wear teeth in the opposite jaw if they touch when biting, and carry a slightly higher risk of tooth-surface damage on removal.
BOS's fixed-braces guidance adds that they can be as effective as metal braces at moving teeth and, though slightly harder to remove, are unlikely to damage healthy teeth in most cases. If a bracket breaks, or you notice wear on the teeth it touches, tell the team treating you.
Lingual braces sit on the tongue side of the teeth, where BOS calls them virtually invisible and says research suggests white marks from enamel damage are likely to be less frequent and less severe than with standard braces. They can make the tongue sore, make speaking difficult at first and be harder to clean; tell the team treating you if soreness or speech changes persist.
Clear aligners are removable plastic trays that BOS calls effectively invisible. In selected cases BOS finds them very effective, but says their scope is limited: in more severe cases, notably extraction cases, they lack the control needed for consistently good results and often lead to disappointment, and suit prominent upper front teeth poorly.
Each type of brace is described in the options in this section. Our clear aligner therapy page explains how aligners straighten teeth.
To ask about orthodontic treatment, book online or call 0114 288 2121.
What should you know if speed matters most?
If speed matters most, the fastest way to straighten teeth depends on the problem, since BOS says no brace is, in general, predictably quicker.
BOS says getting the teeth to bite together better often takes 1 to 2 years and may take longer for difficult problems; simple straightening, particularly of the front six teeth only, can sometimes be done in as little as 6 months, but usually changes less and may not last, as the teeth can soon drift back.
BOS calls treatment that typically involves only the front six teeth limited or short-term orthodontics. It can suit an adult's cosmetic concerns if offered alongside every other suitable option after a full diagnosis, BOS says, but not everyone is suitable, particularly people with complex problems, and an existing bite may get worse. If your bite feels different or uncomfortable after treatment, or your teeth start to move back, show a dentist.
Add-ons offered to speed treatment have weak evidence. A 2023 Cochrane review of trials in children and adults, rating all its evidence low to very low certainty, suggests light vibration and low-level laser or LED light give no added benefit in shortening overall treatment; laser or LED light may give a limited benefit in some treatment phases, a finding it says needs caution because its clinical significance is questionable.
BOS warns of serious risks in at-home “DIY” straightening advertised online with fast results: unsupervised treatment may give a poor result that needs further treatment or, at worst, cause damage to dental health that cannot be undone. The General Dental Council said in 2021 that, at present, there is no effective substitute for a physical, clinical examination.
What should you weigh if cost matters most?
If cost matters most, ask for the total cost of treatment before you start; our page about treatment costs covers orthodontic costs.
BOS suggests asking that question, and whether the total includes any breakages and retainers.
Why does retention apply whichever treatment you choose?
Retention applies to every route because teeth tend to move back to their old positions, which BOS calls relapse.
NHS guidance says a retainer is needed once braces come off, and BOS's aligner guidance says the same for aligners, so every route, braces or aligners, ends with retainers. BOS links relapse with very quick treatment and with retainers not given appropriately, notes that the bone and gums can take at least a year to settle, and advises long-term retention because the risk remains.
Removable retainers depend on you remembering to wear them, BOS notes, and fixed ones, usually glued behind the teeth, need a high standard of cleaning. If a fixed retainer breaks, contact the team treating you at once, because the tooth may drift; if you notice teeth moving after treatment, show a dentist. Retainer types and care are explained under retention after treatment.
Which orthodontic treatments does Deepcar Dental Care offer?
At Deepcar Dental Care, orthodontic treatment is for adults only. The options our dentists provide include clear aligners and fixed braces in metal, ceramic and lingual forms.
Our dentists treat problems including mild to moderate crowding and spacing; bite correction is also offered, and complex and extraction cases are assessed case by case.
As general guidance, a patient whose problem cannot be met by braces or aligners at the practice, such as one rooted in jaw position that may need surgery, is referred on to a hospital orthodontic department or an orthodontic practice; your consultation confirms whether this applies.
Frequently asked questions
Is orthodontic treatment for adults available on the NHS?
Occasionally. NHS guidance says adults usually have to pay privately for braces, and the NHS Business Services Authority says NHS orthodontic care is not usually available for adults but may be approved on a case-by-case basis if it is needed for health reasons, with eligibility assessed using the Index of Orthodontic Treatment Need.
Will you need teeth taken out for orthodontic treatment?
Sometimes. BOS says that in some patients, adults as well as young people, extractions are needed to align crowded teeth or correct the bite, as an overcrowded mouth may have no room to place every tooth ideally. Extractions should never be undertaken lightly, it says, and in some cases can improve the chances of a stable long-term result.
Can orthodontic treatment change the shape of your face or your jaw joints?
BOS knows of no evidence for either. It advises caution if a treatment is said to cure or cause jaw joint problems, sees no scientific evidence that orthodontics or facial exercises can reshape the face, and urges patients to be wary of exaggerated claims and to seek alternative advice when in doubt.
Can crowns or veneers be used instead of orthodontic treatment?
Sometimes, with trade-offs that need a full assessment of risks and benefits, BOS says. Crowns or veneers mask crooked teeth quickly, but preparing teeth is, to a greater or lesser extent, destructive and irreversible, restorations need replacing over the years, they disguise only limited irregularity, and their edges may affect the gums over time.
Is having no orthodontic treatment a reasonable choice?
It can be. BOS says the option of doing nothing should never be overlooked, and its guide for adults goes further: no treatment is better than poor treatment. One question it suggests asking is what would happen without treatment, so the answer can be weighed against each option's risks.
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You will find the practice at 334 Manchester Road, Deepcar, Sheffield, S36 2RH. It is about 15 minutes' drive from Sheffield city centre, and parking is free directly outside. Our page on braces in Sheffield covers getting here for appointments.
334 Manchester Road
Deepcar, Sheffield S36 2RH
0114 288 2121
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