Straightening Teeth: Braces, Aligners and Retainers

Written by Dr. Nick Jadidi, DDS — Last updated June 13, 2026 · 10-minute read

This article is general information for our patients, not a diagnosis. If something in your mouth hurts, changes, or worries you, have it examined.

Orthodontics collects more second-hand belief than almost anything I see: braces are only for teenagers, aligners work like magic, once they come off the job is done. Most of it isn’t true — and the gap matters when you’re deciding whether to spend a year or two moving teeth, yours or your child’s. Here’s how I read it chairside.

One thing first, because it shapes everything below: whether teeth need treatment, and which approach fits, isn’t something I’d settle from a single crooked tooth or a photo. A feature that points one way alone can point elsewhere once the rest is in. The answer comes from reading it all together, at once — your history, an exam, how your bite meets and slides, and an X-ray showing the roots and any teeth still under the gum. That whole picture, read together, is what settles it, and that happens in the chair.

What orthodontic treatment actually fixes

Orthodontics straightens crowded or gapped teeth and corrects bites that don’t meet properly, by moving teeth and guiding growing jaws. A bite that doesn’t line up is a malocclusion — literally “bad bite.” The common ones:

• Crowding: too little room, so teeth twist or overlap — the most frequent complaint.
• Spacing: gaps, sometimes from small or missing teeth.
• Overjet: upper front teeth sitting well ahead of the lowers (teeth that “stick out”).
• Deep overbite: the vertical kind — upper front teeth overlapping too far down, sometimes biting the gum behind them.
• Crossbite: upper teeth biting inside the lowers, sometimes forcing the jaw to slide sideways to close.
• Open bite: front teeth that don’t meet even with the back teeth together.

A perfect bite is rare — nearly everyone is off “ideal” somewhere. The question isn’t “are my teeth perfectly straight?” but “is this difference causing a problem worth fixing?”

Is it just cosmetic?

Mostly it improves appearance and confidence — but a few bite problems carry real, measurable risk, and those are the ones worth knowing:

• Prominent front teeth. Upper front teeth sticking out more than about 3 mm tend to be roughly twice as likely to break in a fall or a sports knock — the further out, the higher the risk. If one is ever chipped or knocked, dental trauma first aid is worth knowing in advance.
• Crossbites that shift the jaw. When a crossbite forces a child’s lower jaw to slide sideways to close, the jaw can grow off to one side over the years and the teeth wear unevenly — one of the few problems where early correction clearly pays off.
• Deep bites that damage gum. Lower front teeth biting into the gum behind the uppers cause ongoing damage — that earns treatment on health grounds alone.
• Stuck (impacted) teeth. A tooth that can’t come through — most often an adult canine, the pointed tooth at the corner of the smile — can quietly dissolve its neighbours’ roots or, rarely, form a cyst. Finding it early protects the teeth around it.

The honest part: for ordinary crooked teeth without those features, the evidence that straightening prevents cavities or gum disease is weak. Straight teeth are easier to clean, but a motivated person keeps crowded teeth healthy, and a careless one loses straight ones. What research does support is confidence — people self-conscious about their teeth often feel better afterward, and for many that alone justifies it.

When should my child first be checked?

Around age seven — not because most seven-year-olds need braces, but because a few growing problems are far easier to fix if caught then. It’s the standard recommendation of the Canadian and American orthodontic associations, and it’s what I’m watching for during regular children’s check-ups and cleanings.

By seven, the first adult molars and front teeth are in — enough to see where the bite is heading. An early look catches specific problems while they’re still small (interceptive orthodontics):

• A crossbite with a jaw shift, often fixed with a simple expander that widens the upper jaw over a few months, before it can steer how the jaw grows.
• Thumb or finger habits pushing the front teeth apart — best stopped before the adult teeth settle.
• Very prominent front teeth in a child taking knocks or being teased — bringing them back early is about the risk of breaking them, not haste.
• Adult canines coming in off-course. From about age nine I feel for the canine bulge in the gum at each check-up; if one drifts off path, removing the baby canine at the right moment lets the adult tooth self-correct in about 3 of 4 cases where there’s room, usually within a year — a one-visit fix instead of possible surgery.

For everything else, earlier isn’t better. Most treatment is timed for ages eleven to fourteen, when most adult teeth are in and a growth spurt can be put to work; starting a routine case at eight instead of twelve gives a longer result, not a better one. Most age-seven checks end with “everything’s developing fine, see you in six months” — a good outcome. If you’re earlier on, here’s what to expect at your child’s first dental visit.

Am I too old for braces or aligners?

No — healthy teeth move at almost any age, and adult treatment is routine. The real question is your gums, not your birthday. Two differences from teenage treatment. Adults have finished growing, so we can move teeth but can’t guide jaw growth; when a bite problem comes mostly from the jawbones, the options are to disguise it by moving teeth, accept it and straighten what we can, or — in severe cases — refer you to discuss jaw surgery alongside braces. And gums must be healthy before anything moves: shifting teeth through inflamed gums speeds bone loss, so active gum disease has to be treated and stable first. That’s why professional cleanings and scaling come before orthodontics, not after.

Braces or clear aligners?

Neither wins for everyone: braces handle complex movements without relying on willpower, while aligners are discreet but only work while they’re in. The trade-off with aligners is wear time — about 20 to 22 hours a day, and every coffee break they spend on a napkin is time teeth drift back. They reward disciplined wearers and frustrate the 14-hours-a-day crowd.

Most full treatments run about 18 to 24 months, longer for complex bites. For mild-to-moderate crowding or spacing, both can deliver a good result and lifestyle can fairly decide it; for severe rotations, large bite corrections or precise root positioning, fixed braces stay the more dependable tool. Anyone who says one option is simply better across the board is selling it.

What are the risks?

The main ones — white marks that can become permanent, slight root shortening, soreness, and teeth drifting back — shouldn’t scare you off appropriate treatment, but you should hear them before you start.

• Permanent white marks (decalcification). Plaque around brackets dissolves mineral out of the enamel, leaving chalky marks that can be permanent — effectively the first stage of a cavity. Roughly half of fixed-braces patients develop at least one (published rates run about 25% to 75%, depending on brushing, fluoride and diet), sometimes within the first month. This is the risk you control: meticulous brushing, fluoride toothpaste, a daily fluoride rinse, and easing off sugary drinks (constant sipping is the killer). If hygiene falls apart mid-treatment, the responsible move is to pause or remove the braces — straight teeth with permanent scars is a bad trade.
• Root shortening (root resorption). Roots shorten slightly as teeth move — about a millimetre over two years on average, invisible and harmless. In a small minority, roughly 1 to 5%, it’s more noticeable; previously injured teeth and very long treatments carry more risk. We watch with X-rays where there’s concern, and it stops when treatment stops.
• Soreness. Teeth ache for a few days after an adjustment or a new tray; over-the-counter painkillers can take the edge off and soft food helps — your pharmacist can point you to what’s safe for you. Wires can rub the cheeks early on, and orthodontic wax handles most of that.
• Teeth drifting back (relapse). Teeth try to go home — that one gets its own section.

Will my teeth stay straight afterward?

Only if you keep them there: teeth drift toward their old spots, so plan on retainers — usually at night — for as long as you want straight teeth. Better to hear it up front: wearing retainers isn’t a phase of orthodontics, it’s the rest of it.

Two forces work against the new smile. The stretchy fibres anchoring your gums to your teeth take many months to settle after teeth move — some the better part of a year — and until they do they tug the teeth back like elastic; rotated teeth and closed gaps pull hardest. And teeth shift naturally through life, lower front teeth especially tending to crowd with age, braces or not. A retainer defends against both.

In practice that’s full-time wear for the first six to twelve months, then nights only — indefinitely. Two tools, often used together: a bonded retainer (a thin wire glued behind the front teeth) and a removable retainer (usually a clear tray worn while you sleep). They wear out and get replaced over the years — maintenance, not failure.

The long-term follow-up is blunt: most people who stop wearing retainers see enough drift within about ten years to consider re-treatment. The ones who come back at thirty with the smile they had at sixteen are almost always still wearing their night retainers.

Dentist or orthodontist?

Both, often together. As a general dentist I assess every patient’s bite, manage selected cases, and refer complex ones on. An orthodontist is a dentist with several more years of specialty training in tooth movement and jaw growth; big jaw-size differences, stuck canines and severe bites belong in their hands — I’d rather refer you well than treat you adequately. What stays with us either way: the assessment that spots the problem, the cavity checks and cleanings that must continue through treatment, and the long retainer years afterward.

This guide is part of our Child Patient Information library. If you’re wondering whether your teeth — or your child’s — would benefit, the starting point is an examination, not a guess: we’ll read the bite, say plainly whether treatment is worth it and what it involves, and refer you on if your case needs it. Call Prince William Way Dental Care at 705-721-9229 or book an appointment online.