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Inside the Adult Braces Boom of 2021

Kevin Whipple

At 32, Lionel Foster finally got braces. He’d wanted them growing up, but his family couldn’t afford it. 

“My mom and I knew that braces should be in my future,” says Foster, now 40 and a senior associate at a venture capital firm in Washington, DC. “But the prospect of braces just sounded very expensive and like an unrealistic thing for us.” 

Foster says his pre-braces teeth looked like wings that had started to take flight: “Whenever I laughed or smiled, it was kind of an advertisement for how crooked my teeth were.”

Once he settled into a higher-paying job with decent health benefits that covered most of the cost of adult braces, Foster took the plunge. Getting braces was “very much like signing up for torture sessions several times per year,” he says, “but I raised my hand enthusiastically for it.”

Foster is one of a growing number of adults who, upon achieving financial stability, are buying themselves the braces their parents couldn’t afford.

According to the American Association of Orthodontists, 25 percent of all orthodontic patients today are adults, a considerable uptick from years ago. While the AAO did not offer a precise statistic for growth, a spokesperson told me that “according to the analytics and data, the number of adults seeking treatment with orthodontists continues to grow each year on a consistent basis.”

This adult-braces boom is likely explained by a combination of factors, including tech advances, a proliferation of direct-to-consumer dental products like SmileDirectClub, and growing awareness of possible cosmetic improvements fueled partially by the pandemic. 

Dr. Clark Stevens of Braces Omaha can attest to all of that. He’s been an orthodontist for 30 years, and he says when he first started working 10 percent of his patients were adults. Now that number is 35 percent, and growing. 

About half of his adult patients come in with cosmetic concerns. For the other half, the problems are functional. “Some people might be having a hard time brushing and flossing and maintaining their teeth because it’s really hard if they’re very crooked,” says Stevens.

A lot of his patients are like Foster. They’ve wanted braces since they were kids, but their parents couldn’t swing it, as the average cost of braces runs anywhere from $3,000 to $7,000. Stevens has also noticed more insurance plans covering adult braces. One example is Guardian Direct’s Managed DentalGuard DHMO plan, which offers adults 19 and older $2,800 for braces. As of early 2021, that plan is only available in New York, Florida, Illinois and Texas.

Then there’s the increased advertising for dental products like Invisalign, which in turn make people more aware of other, more traditional teeth-straightening options. Invisalign spent over $100 million on advertising in digital, print and national TV in the last year, and Stevens says those advertisements often get people into his office requesting Invisalign, but then deciding to get more traditional braces because they’re more effective.

Stevens also points to the rising median age of marriage as a reason for the burgeoning popularity of adult braces. In 1990, the average age of marriage was 23 for women and 26 for men. Those averages have jumped to 31 and 33, prolonging the phase of single adulthood. “During that period of time they have more ability to pay for a couple of luxuries for themselves and I think orthodontics is one of them,” said Stevens.

Dr. Jason Yang, of the Pennsylvania-based practice Yang Orthodontics, has been a dentist for six years. He believes the pandemic has turbocharged the popularity of adult braces. Before COVID, about 25 percent of his patients were adults. Now, it’s 35 percent.

“A lot of people are on Zoom right now, and they have to look at their own faces, and they notice their crooked teeth. So just like there’s a boost in sales in gym equipment, there’s also a boost in orthodontics,” he says. On top of that, some patients recognized the pandemic as an ideal time to get braces because their mouths had to be covered by masks.

But even before mask mandates and widespread WFH, Yang noticed an uptick in adult patients, in large part due to tech advances. A few decades ago, having braces meant flashing a mouthful of stainless steel, but now, with clear aligners like Invisalign, clear ceramic braces and lingual braces, it’s entirely possible to have braces without letting the world know.

Metal braces are still the oldest and most reliable type of braces. They’re also highly visible, which can be a turnoff. Ceramic braces are one alternative option. They have brackets colored to blend in with teeth, which makes them less obtrusive but prone to stains. Lingual braces go behind the teeth, rather than in front. While they’re invisible, they’re expensive to install and can affect the way a person talks. Invisalign uses clear plastic molds that fit over the teeth and can be worn and removed easily. The tooth alignment process is a lot slower than it is with more traditional braces.

Yang has also noticed that while some people might frown at the sight of braces, others think it’s cool. “It’s like the new grill,” he said. “Some people are actually coming in for old-school braces.”

Kathleen Brown wasn’t one of the people who wanted braces, old-school or otherwise. She’s a Chicago-based startup founder who speaks publicly for a living. After putting off braces for years, she eventually caved because her misaligned jaws were causing pressure headaches. “I really resisted,” she says. “I did not want them, especially being mid-30s and single, but it was a matter of not wanting to deal with the pain.”

One of the deciding factors for Brown was seeing people she respected with adult braces. “One of them was a former colleague who’s one of the coolest people in the world,” she says, “and she got them right before her wedding.” 

Brown’s braces were only supposed to be on for nine months, but she ended up wearing them for two-and-a-half years, from 2017 t0 2019. They were lingual braces, so most people didn’t see them. But the slight lisp they gave her was more noticeable. They also caused pain and required her to avoid certain foods. And she didn’t date the whole time she wore braces. “I didn’t know how that would even be, having someone else inside my mouth,” she says. 

Like many brace-faced teens, Brown fantasized about the day she’d get her braces off. Soon after that happened, she started dating someone she’d had a crush on for months. “I want people to know there’s literally no shame in getting adult braces,” said Brown, who feels some regret over delaying orthodontia for so long. “I would get braces again because I love my smile now.”

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Show Comments (9)
  1. Madeline BRENNAN

    I’m really surprised that you neglected to mention the significant risks in adult orthodonture such as bone loss. Older adults are no longer building bone. Bone loss that occurs due to braces in children can be replaced by bone growth but not in older adults. This is an important fact to point out to adults interested in orthodonture.

    1. samantha

      First of all, it depends on what age of an adult. Second (and most important), this is a decision to be made with one’s orthodontist. A scan of the literature available shows overwhelming support for a variety of ways to allow for braces in adults who have even severe bone loss.

  2. Jon

    I just finished my Invisalign treatment last year and it is great to finally have straight teeth. I got it when I was 35. It took about 60 plus trays. It’s easier to brush my teeth and to floss now that my teeth are all aligned. They we’re getting more crooked as I age that it caused me to talk a bit funnier. It was so embarrassing to laugh and talk to people up close. I’m so glad I did it. If anyone is hesitant to do it just go in for a consultation to a nearby orthodontist and hear what they have to say. The one I went to was really supportive. I thought that it was weird that a adult was getting braces but it’s not. If fairly common now adults get braces.

  3. Tori

    Great article. I was hesitant to get traditional braces because of how I thought I’d look. But I’d rather look like a brace face for a year than have a messed up smile for the rest of my life.

  4. Sean

    I’m concerned about one of your sources, Dr. Stevens. Are you sure Align spent exactly $100 million dollars in one year in marketing? And who is he to say braces are a more effective mode of treatment? I read in many other articles that braces are declining in spite of the boom in adult Orthodontics and clear aligners are growing. Which makes sense due to the hundred of clear aligner companies that have come into existence in the last 3 years. I don’t see née braces companies popping up every day. This article is not factually correct. If anything it’s outdated.

    1. NG

      I am a practicing orthodontist and I completely agree with you! The orthodontist who says that aligners are not as effective or slower at moving teeth does not know how to design a treatment plan using clear aligners. The effectiveness of clear aligner treatment depends on the design capability of the treating doctor and the wear time of the patient.

  5. Diane Mongiardo

    I got Invisalign by a new dentist because my old dentist had retired. Big mistake. I had a crooked snaggle bottom eye- tooth which new dentist explained could easily be moved into position in the lower left side after removal a a lower front tooth that was discolored due to a large filling. Long story (2+ years) continuing with more aligners due to tooth still being crooked. What an ordeal, I went to two orthodontists following the removal of the Invisalign brackets, neither could help me. I ended up with a very uncomfortable bite that took another 2 years to shift into a comfortable position on it’s own. Finally my bite is correct and TMJ pain lessened. Be careful and ask, how will this affect my bite? Teeth are not just cosmetic, they chew a variety of foods to keep your body healthy.

  6. Kristin

    Got mine at 42, just before Covid. New to the city, I was self conscious, but I had the $$, so I am doing Invisalign. 25 trays (50 weeks) and my functional issues were resolved and now I opted to continue with less brackets for another 15 (30 weeks), for cosmetics (the one price covered however many trays it would take, so may as well continue. But one blessing of Covid is being able to still them behind a mask

  7. CGB

    I had my braces put on the day after I turned 52. I have traditional metal brackets, which was my choice. I could have gotten Invisalign, but my job and lifestyle made braces a better alternative. It’ll be a week this afternoon that I’ve had them, and I’m happily surprised at how much I like wearing them. Now, when I talk to people I can sense when somebody is trying not to stare at them, but nobody has said anything negative to me. The people I work with don’t even seem to really notice them.

    And I only told two people that I was getting them, and it turned out both of them had worn braces as an adult as well.

    So, if you’ve been meaning to get braces, and your dental health is good, my advice is, Go for it. You’ll regret it if you don’t.

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