Why Modern Orthodontic Treatment Takes the Time it Takes

Image by  @Nile  and Pixabay.

Most of my patients have a common question: How long will I be in orthodontic treatment? Unfortunately, my answer is a very unsatisfying: It depends. Or maybe something even worse: As long as it takes.

The answer is different—and frustrating—because the length of your modern orthodontic treatment varies based on several factors. The usual range is around one to three years, with many falling on the later end of that range. Per the American Board of Orthodontics, the average time for treatment is a little over 24 months.

Let’s take a closer look on different aspects of treatment and how that affects your orthodontic treatment timeline. In other words, let’s see if we can show you why it takes the time it takes.

Let’s start with the things that are not in your control:

  • The position of your teeth: How crowded, rotated, or spaced out your teeth are will affect your treatment time. For example, light crowding in the uppers and lowers takes less time than more significant rotations of teeth that are more severely out of alignment with the surrounding teeth. Another tooth position that creates longer treatment times are adults that have impacted canine teeth, per a 2020 study in Progress in Orthodontics.
  • The severity of your malocclusion: The way your teeth come together when you bite is called your occlusion. Malocclusion is when the teeth do not line up the way we want them to for good oral health. For example, if your top teeth line up behind your bottom teeth, that is an example of an underbite, which we would correct with your treatment.
  • The treatment you choose: I have several methods to correct your smile including braces, clear aligners, and lingual braces (braces that go on the inside of your teeth). The treatment style you choose combined with the other two factors already mentioned can affect how long you are in orthodontic treatment.
  • Whether we need to extract teeth: If you need teeth removed to correct your smile, that can prolong your treatment. However, that is not something that every orthodontic case needs to be successful, so for many patients this is not a contributing factor.
  • Any additional orthodontic tools needed: Sometimes I need to adjust more than your teeth spacing or bite. In those cases, I might need additional orthodontic tools, which can add time to your treatment. For example, if you need help adjusting your jaw alignment, I might use rubber bands with braces to realign it. If you need to widen your jaw, I might use a palatal expander (although that is usually in children who are still growing). And let’s not forget headgear, which can help adjust complicated jaw alignment issues.

There is not much you can do about any of these elements because they are out of your control. Using these factors, and understanding your expectations, and I will carefully plan the phases of treatment to give you a treatment time estimate.

However, at this point, we still only have an estimate for treatment time. There are two more essential factors regarding how long your orthodontic treatment will take.

  1. The time between appointments: Studies suggest that shorter time between appointments contributes to the orthodontists’ ability to control the treatment, and, ultimately, the treatment time. It allows me to check in more often and adjust as needed before any problems get out of hand.
  2. Your compliance: This one is the factor over which you have the most influence. Coming to appointments, wearing your appliances, being diligent about your home oral care, and taking care not to break or lose an appliance are all ways that you can contribute to the shortest treatment time possible.

Something that isn’t a factor might surprise you. Age does not appear to affect the treatment time, provided that the patient in treatment has all their permanent teeth.

Treatment times vary, just like smiles do. That means, I don’t have a neat and tidy answer I can tell you in an article that will explain how long your treatment will be. Many factors, including those in both out of and in your control contribute to why modern orthodontic treatment takes the time it takes. However—and I cannot stress this point enough—the part you can control, like showing up for your appointments and taking care of your appliance and oral health, can make it go as fast as possible. Working together, we can give you the treatment you want in the shortest time possible for your mouth and your goals.

And that is something to smile about.


Silver, Natalie. “How Long Do Braces Take?” healthline.com. 11 January 2021. Web. 15 March 2022. <https://www.healthline.com/health/how-long-do-braces-take#average-duration>.

Abbing, A., Koretsi, V., Eliades, T. et al. Duration of orthodontic treatment with fixed appliances in adolescents and adults: a systematic review with meta-analysis. Prog Orthod. 21, 37 (2020). https://doi.org/10.1186/s40510-020-00334-4

Moresca R. Orthodontic treatment time: can it be shortened?. Dental Press J Orthod. 2018;23(6):90-105. doi:10.1590/2177-6709.23.6.090-105.sar https://academic.oup.com/ejo/article/30/4/386/392296

Dimitrios Mavreas, Athanasios E. Athanasiou, Factors affecting the duration of orthodontic treatment: a systematic review, European Journal of Orthodontics, Volume 30, Issue 4, August 2008, Pages 386–395, https://doi.org/10.1093/ejo/cjn018