More adults in Singapore are opting for braces. But is getting one after 30 – or even 50 – worth it?

Bernard Lim was 35 when he finally decided to fix something that had been bothering him for a while: His overbite, or as some call it, buck teeth.

A cracked molar and a series of dental issues pushed him to get braces fitted for the first time. For three years, Lim, who works in aviation, adjusted to life with ceramic braces; cleaning out food stuck between the gaps and enduring the discomfort and soreness that followed each tightening session.

But all the effort – even the “crazy” amount of time spent brushing – was worth it, he said.

Like Lim, Gu Jiashun’s braces journey started when he was an adult to correct his severe underbite, where the lower jaw juts beyond the upper.

The 27-year-old recruitment consultant got braces fitted last year as part of a more comprehensive treatment at the National Dental Centre Singapore (NDCS), which includes jaw surgery.  He felt that his crooked teeth and jutting lower jaw hindered his professional image.

After having six teeth removed to make way for his metal braces, he too, wrestled with the hassle of cleaning out food debris after every meal and frequent mouth ulcers. Yet, Gu has no regrets. “To adults considering braces, I’ll 100 per cent recommend it,” he said. 

MORE ADULTS GETTING BRACES

Once thought of as a treatment for teenagers, braces are now increasingly popular among adults seeking straighter teeth, a better bite and more confident smiles. Orthodontists told CNA Lifestyle that they are seeing more grownups at their clinics, including some in their 60s or even 70s.

At the NDCS, the number of adult orthodontic patients jumped by more than 50 per cent between 2011 and 2017, from 244 to 375 patients.

NDCS will be conducting a follow-up study to gather more recent data, particularly to examine trends post-COVID-19. Dr Elaine Tan, senior consultant and head of department of orthodontics at NDCS, shared that preliminary data suggests a 4 to 5 per cent increase in adult patients since the pandemic began in 2020. Over the past six years, the centre has averaged 312 adult orthodontic patients annually.

KK Women’s and Children’s Hospital’s (KKH) Dental Service, which sees children and adult patients aged 18 and above, also notes an increase in adult patients in the past decade. Some patients are referred for orthodontic treatment to correct more complex conditions, such as complex teeth misalignment and cleft lip and palate, while others are more straightforward cases seeking a confident smile.

“We notice an increasing trend of adults in their 20s and 30s seeking orthodontic treatment. This could be due to them experiencing major life events like getting married, securing a job interview or simply wanting to look good overall to boost their confidence,” said Dr Koo Chieh Shen, consultant at KKH’s Dental Service and Cleft and Craniofacial Dentistry Unit.

WHAT’S DRIVING DEMAND?

Despite the cost, which can run into thousands of dollars, and the discomfort, many adults are undeterred. Lim, for instance, paid around S$5,500 to get ceramic braces at Align Braces Clinic and is thrilled with his results.

Now at 38, he can finally smile without hesitation and eat comfortably. “Honestly, it was just three years of pain. Now I can smile with more confidence and chew properly using both sides,” he said, adding that he wishes he had done it earlier.

Financially, adults are in a better position to invest in their smiles. For both Lim and Goo, braces were not an option when they were younger due to financial constraints. 

“Adults who could not afford braces during their younger years are now in a better financial position to invest in orthodontic treatment,” Dr Tan from NDCS said.

According to Dr Lydia Yong, an orthodontist and director of Align Braces Clinic, the cost of braces varies, depending on the complexity of each case and the type used.

For example, clear aligners can cost anywhere between S$3,000 to S$10,000 while metal braces may be in the range of S$4,500 to S$6,000. Ceramic and self-ligating braces cost around S$5,000 to S$7,000.

Another driving factor? Greater emphasis on aesthetics and personal appearance, amplified by social media. “With visual platforms becoming more prevalent, some adults have increased self-awareness after noticing imperfections during video calls or in selfies, and have opted for orthodontic treatments,” Dr Yong said.

For many, straighter teeth not only improves their smile but their overall confidence and professional image.

According to Dr Koo, who is also the president of the Association of Orthodontists (Singapore), research has shown that post-braces, adults have increased self-confidence and experience a positive impact in their professional life. For instance, a study in The Angle Orthodontist in 2016 found that over 70 per cent of adult patients reported improved self-esteem after orthodontic treatment.

NOT ONLY FOR AESTHETICS

While many people straighten their teeth for cosmetic reasons, there are significant functional and practical upsides, too. Misaligned teeth can make it difficult to maintain good dental hygiene as they are more challenging to clean.

Braces can also help correct dental problems and gum-related issues. For example, it could be used to prepare patients embarking on restorative procedures, such as crowns and implants.

Dr Koo shared that in cases where patients may have missing teeth due to previous extractions in the past, braces may be used to optimise the spacing for future dental work.

“When left alone and untreated for a period of time, the adjacent teeth can slowly move and migrate into the extraction space, preventing the restorative dentist from ‘filling’ the space with dental implants or crowns.

In this case, a short course of braces is commonly done to ‘open up’ the space to an optimal size, before the restorative dentist can put in a crown or implant of a normal width and dimension,” he explained.

In adults with gum disease, braces can be used in combination with gum treatment to bring teeth back to their original position and close large spaces between teeth, Dr Koo added.

For Lim, a cracked molar and a subsequent failed root canal led him to choose braces over an implant and crown. Instead, he opted to use braces to close the gaps and improve his teeth alignment at the same time.

IS THERE AN AGE LIMIT FOR BRACES?  

No one’s ever too old for braces, the experts said. Some of the oldest patients at NDCS were between 65 and 70 years old. “For these patients, the primary goal was to improve oral health,” Dr Tan said.

She adds that braces may also benefit people with obstructive sleep apnoea – a common sleep disorder where the person repeatedly stops and starts breathing. When combined with jaw surgery, orthodontic treatment can improve airflow and reduce airway obstruction during sleep by expanding the dental arch and aligning the teeth.

While age isn’t a barrier, there are a few conditions to fulfil prior to getting braces. “Healthy gums are essential for proper tooth movement as they provide the support needed for treatment. Additionally, having enough teeth to anchor the braces is necessary to ensure successful alignment of teeth,” Dr Tan said.

Adults considering braces should be aware that their treatment may take longer than that of younger patients. “This is on a case-by-case basis, but on average, we will inform the patient that the treatment will take at least six months longer than a child or teenaged patient,” Dr Koo shared. 

Teeth movement may be slower due to denser bone structure in adults, making patience, commitment and perseverance key to achieving desired results, Dr Tan higlighted. The typical treatment duration is around two to three years, with regular follow-up visits every one to three months.

OPTIONS, OPTIONS, OPTIONS

Unlike the metal braces of the past, today’s orthodontic options are far more diverse.

For adults concerned about their appearance, discreet options such as clear aligners are a solution. Dr Yong said these are generally suitable for adults who want to maintain a professional appearance and the flexibility to remove them to simplify dental hygiene.

Lingual braces are another discreet option as these are placed at the back of the teeth. Dr Tan shared that they are as effective as traditional braces and can treat complex orthodontic issues including severe overcrowding and bite problems.

However, traditional fixed braces (such as metal and ceramic braces) may still be required in some complex cases as they provide the strength and control necessary to correct these challenges, she added.

Ceramic braces, while similar to traditional metal braces, are a more aesthetic option. The brackets are made from a ceramic material, which can be either transparent or tooth-coloured to blend in with the natural colour of the teeth.

Regardless of the type of braces, finding a qualified orthodontist is crucial. Dr Koo advised anyone considering braces to visit the Association of Orthodontists (Singapore) website to ensure their orthodontist has undergone specialised training. All members listed have completed a three-year full time postgraduate specialist training in orthodontics to equip them with the necessary skills.