The Biggest Myths About Braces – What’s Actually True

What this is about: the most common misconceptions about braces – especially among adults considering treatment. What a treatment costs and who pays for it is covered in What does a dental aligner cost? and Non-Contracted Services. About the treatment itself: Orthodontics for Adults.

During the initial consultation, we hear certain concerns over and over: too old, too visible, too expensive, too painful. We’ll go through the most common misconceptions one by one and explain what’s true and where there are limitations.

Myth 1: “Braces are only for kids and teenagers”

False. More and more adults are undergoing orthodontic treatment – and for good reasons. Whether for cosmetic reasons, to correct the bite, or to prepare for dental prosthetics: teeth can be moved at any age if the teeth and supporting structures are healthy. For adults, we often plan more closely with the dentist or periodontist, especially before dental prosthetics. In adults over 40, misalignment is often associated with bone loss in the periodontal structures: the greater the bone loss, the more pronounced were protruding and crowded front teeth in one study (Meyer-Marcotty et al. 2021)6. Periodontitis is therefore treated first. Many of our patients are between 30 and 70 years old. Thanks to modern, discreet systems like ceramic braces or aligners, treatment is often barely noticeable in everyday life.

Myth 2: “Braces are always visible and embarrassing”

This idea is long outdated. There are transparent ceramic braces, self-ligating mini-brackets, and clear aligners. Which option is suitable depends on the diagnosis; not every misalignment can be treated equally well with every system. Aligners are a private service; statutory health insurance does not cover them.

Myth 3: “Braces are always expensive and unaffordable”

The cost of treatment varies depending on the method, duration, and individual requirements. Important to know: For children and adolescents, statutory health insurance covers standard care if the misalignment is classified as at least treatment need level 3 of the orthodontic indication groups (KIG).4 The insurance covers 80 percent of the costs directly; the 20 percent co-payment is reimbursed after successfully completed treatment.5 Adults aged 18 and older generally pay for treatment themselves; insurance covers it only in cases of severe jaw misalignments that additionally require oral surgery. Supplemental dental insurance helps only if it was taken out before the treatment need was determined. With us, you can pay for private services in installments, interest-free for up to 18 months directly through the practice. Whether you have statutory or private insurance: diagnostics, consultation, and care are the same for all our patients.

Myth 4: “With fixed braces, I can’t eat anything anymore”

Of course there are restrictions — especially with very hard or sticky foods. However, your diet doesn’t need to become one-sided. Most favorite dishes are still possible without problems. The most important rule: cut rather than bite. Apple, bread rolls, or carrots go into your mouth in small pieces. Nuts, hard crusts, caramel, toffee, and popcorn are better avoided, as brackets can detach or food debris can get stuck. More examples are in Braces in Daily Life.

Myth 5: “Braces always cause severe pain”

A certain adjustment period is normal — especially right after placement or at follow-up appointments. However, today’s braces work with comparatively low forces. A review found less pain with aligners on the third and fourth day than with fixed braces, and no difference at other time points (Li et al. 2023)7. A feeling of pressure in the first days is normal. If that isn’t enough, pain medication is an option: a Cochrane Review sees a benefit compared to placebo, but rates the evidence as moderate to low.1 If severe discomfort persists, it should be discussed at the practice — not endured.

Myth 6: “Treatment takes forever”

How long treatment takes depends on the individual starting situation. We will tell you the expected duration after the examination and planning; it can be extended if appointments are missed or aligners are not worn long enough. More complex cases require more time; a systematic review of treatment with fixed braces cites around 20 months as a general range, with considerable variation depending on findings.2 With digital planning based on scans, we can show you the process in advance on the screen.

Myth 7: “Braces make oral hygiene impossible”

True: oral hygiene is somewhat more involved with fixed braces. False: it becomes impossible. With special aids — interdental brushes, floss with threading tools, electric toothbrush — thorough cleaning is quite manageable. However, it requires more time and more consistency than before. Whether additional fluoride protects against decalcification around the brackets has been examined in a Cochrane Review; the trustworthiness of the evidence there is explicitly low.3 How cleaning works in practice is explained in Cleaning Your Braces. Dental checkups and professional cleanings remain with your dental practice during treatment; we coordinate with them.

Myth 8: “Once the braces are off, the teeth stay straight on their own”

Unfortunately, no. Teeth have a lifelong tendency to shift back. That’s why every treatment is followed by retention: a thin wire bonded behind the front teeth, a removable night guard, or both. Studies show that both types hold the result well; in the lower jaw, the front teeth remained slightly more stable with the bonded wire, but more plaque accumulates on it (Bellini-Pereira et al. 2021)8. Retainers are typically a private service. For children and adolescents with statutory health insurance treatment, the insurance may cover retention for up to two years after active treatment. A fixed retainer on the lower front teeth may also be covered by insurance in cases of severe crowding (KIG E3/E4). How long and how often you wear the retainer is something we’ll discuss at the end of active treatment. We’ll see you for follow-up approximately 4 to 6 weeks after removing the braces, then every 6 to 12 months.

Myths debunked, decision made easier

Many of the misconceptions about braces are based on outdated information or half-truths. Which treatment is right for you is something we’ll clarify during your initial consultation at our practice in Cologne-Rodenkirchen, Hauptstr. 50. After booking, you’ll receive a link via text or email to our digital health questionnaire “Nelly.” Appointments also available at 0221 93 53 020.

Together we’ll find the path to a healthy bite — and a smile that suits you.

 

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Frequently asked questions about myths surrounding braces