Adult Braces and Orthodontics in Smithtown, NY
Medically Reviewed by Dr. Duane S. Shank, DDS, Board-Certified Orthodontist
Roughly one in three orthodontic patients today is an adult. Braces and clear aligners work the same way at 45 as at 14, though treatment usually takes a little longer once jaw growth is finished. Dr. Duane Shank has treated adults in their fifties, sixties, and seventies at his Smithtown practice, and consultations are free.
Most adults who come in have been thinking about it for years. Something specific triggers the call: a photograph, a wedding, a dentist mentioning that crowding is making a lower tooth impossible to clean, or the realization that the bottom front teeth are not where they were twenty years ago.
Braces work at any age
The biology does not change. Teeth move through bone in response to steady, gentle force, and that does not switch off at eighteen.
What changes is speed and context. Adults are no longer growing, so a skeletal problem cannot be corrected by guiding growth; it is corrected by moving teeth, or in severe cases with surgery. Adult treatment therefore often runs somewhat longer than the same case would in a teenager. Adults are also more likely to have gum disease, restorations, crowns, missing teeth, or previous dental work to plan around. None of that rules out treatment. It means the plan has to be made by somebody who knows what they are looking at.
Why adults do it
Appearance is a real reason and nobody should be embarrassed by it. There are also clinical ones.
Straight teeth are easier to clean, and teeth that are easier to clean decay less and lose less bone over decades. Crowded lower incisors trap plaque where a toothbrush cannot reach. A bad bite loads certain teeth harder than others, which shows up as wear, cracks, and recession.
Before treatment begins, existing gum disease, heavy plaque, and active decay have to be treated by your dentist. Braces make all three worse if they are left in place, so this sequencing is not optional.
Your options as an adult
Ceramic braces. Tooth-colored brackets, far less visible than most people assume, with the full capability of metal braces. The elastic ties can pick up staining between visits and are changed at every appointment.
Metal braces. Smaller and more comfortable than the ones you remember. Strong, they do not stain, and they handle difficult mechanics most reliably.
Invisalign and clear aligners. Removable and nearly invisible, which is why most adults ask about them first. Excellent for crowding, spacing, and rotation; less predictable for bite correction and extraction cases. They need 20 to 22 hours a day of wear.
Dr. Shank treats with all three and recommends based on the case rather than the product. If aligners will not give you the result you want, he will say so.
Complex cases and second opinions
The difficult cases are where thirty-four years of practice earns its keep. Cases that need real planning include missing teeth where space has to be opened or closed, teeth already crowned or bridged, impacted canines that never came in, bite collapse after tooth loss, skeletal discrepancies severe enough to involve jaw surgery, and treatment coordinated with a periodontist, an oral surgeon, or a restorative dentist before the final restorations go in.
Dr. Shank practiced general dentistry for five years before specializing, which is what made him comfortable planning cases that involve other specialists. Dr. Shank is a Diplomate of the American Board of Orthodontics, and he teaches at Stony Brook University School of Dental Medicine.
If you have a treatment plan from another office and you are unsure about it, bring it in. A second opinion is a free consultation with no obligation attached.
Retreatment: braces for the second time
Teeth move throughout life. That is not a failure of your original treatment; it is what teeth do, with or without braces, as part of normal aging. What accelerates it is stopping retainer wear, which nearly everyone treated in the 1980s and 1990s was told to do after a year or two. Guidance has changed since: retainers are now recommended indefinitely, at night, for exactly this reason.
So if your lower front teeth have crowded back in, or a gap has reopened, or your bite feels different from when the braces came off, you are describing the normal course of events rather than something that went wrong.
The good news about retreatment is that it is usually short. The teeth have been moved once already and the case is understood. Many relapse cases are corrected in a fraction of the original treatment time, sometimes with a short course of aligners, sometimes with braces on only the teeth that moved.
The first step is an examination and a straight answer about whether treatment is needed at all. Sometimes the honest recommendation is a new retainer rather than a new course of treatment.
What it costs
One fee covers records, all appliances, every appointment including emergency visits, and your first set of retainers. In-house payment plans carry no interest and start around $150 a month. The practice accepts most dental insurance plans and is not in-network with any carrier. Many adult dental plans have limited or no orthodontic benefit, so we verify yours before treatment starts. HSA and FSA funds can be applied. Published Long Island ranges are on the financing page.
Book a free consultation
Call (631) 265-3666 or request an appointment online.
Smithtown Orthodontics 200 E Main St. Smithtown, NY 11787 (631) 265-3666
Frequently Asked Questions
Many adults are exploring orthodontic treatment for the first time, or returning to improve their smile. Here are some common questions to help you feel informed and confident about your options.
Is 40 too old to get braces?
No, and neither is 60. Tooth movement depends on bone biology that does not stop with age. Dr. Shank has treated patients in their fifties, sixties, and seventies. What matters is the condition of your gums and existing dental work, which the examination assesses.
Why are my teeth moving 20 years after braces?
Because teeth move throughout life as part of normal aging, whether or not you ever had orthodontic treatment. Lower front teeth crowd most visibly. The usual accelerant is stopping retainer wear, which patients treated decades ago were routinely told to do. Current guidance is nighttime retainer wear indefinitely.
Is it common to get braces twice?
Common enough to be a regular part of this practice. Most people who had braces as teenagers and stopped wearing retainers see some movement over the following decades. A second round is usually much shorter, because the case is understood and the teeth have less distance to travel.
How long does orthodontic retreatment take?
It depends on how far things have drifted. Minor lower-incisor crowding sometimes takes a few months with aligners; a bite that has changed substantially can take close to a full course. You get an estimate at the consultation, and it is worth asking whether a new retainer alone would hold what you have.
Are adult braces covered by insurance?
Sometimes, and less often than children’s treatment. Many dental plans limit orthodontic benefits to dependents under a certain age; others carry a lifetime orthodontic maximum that applies at any age. We verify your coverage before treatment begins and bill your carrier for you, and HSA and FSA funds can be used regardless.
