How long does orthodontic treatment take?
The average duration in research, the factors that lengthen and shorten it, the role of visits and what the patient can change.
AuthorDr. Fidan AliyevaOrthodontist, Pitts Masters graduate
Short answer: according to a systematic review, treatment with braces takes about 20 months on average. But this is an average: simple cases can take less than a year, complex ones more than two years. Duration depends most on how complex the case is, whether extractions are needed, the method chosen and the patient’s cooperation. At the consultation I tell you the approximate duration for your case.
"How long will treatment take?" is one of the most common questions at a consultation. The honest answer is that there is no exact duration that is the same for everyone. But knowing what the duration depends on helps set the right expectations and shows that you can influence the process too.
What the average says
In a systematic review of treatment time with fixed appliances the average duration was about 20 months, that is one year and eight months. But the differences between studies were large: in some the duration was much shorter, in others longer. In my practice too there are cases finished in six months and cases that took two years. In one patient living abroad we corrected crowding and the bite in only 6 adjustments. This is not the same for everyone, but it shows what a good plan can do.
What the duration depends on
| Factor | How it changes the duration |
|---|---|
| Complexity of the case | Aligning teeth only is shorter, bite and jaw problems take longer |
| Extractions | Closing spaces takes extra time |
| Age | In children growth can be used, in adults bone may respond more slowly |
| Method | Braces and aligners work at different speeds for different movements |
| Regular visits | Long gaps lengthen treatment |
| Cooperation | Not wearing elastics or aligners lengthens treatment |
| Broken brackets | Every loose bracket sets the movement back a little |
A plan shortens treatment
What shortens treatment most is a precise plan. Moving teeth "roughly in the right direction" and then correcting takes time. Knowing in advance where each tooth will go reduces unnecessary movements. This is one reason I chose the Pitts philosophy: the plan starts from how the smile will look at the end. More: what is the Pitts philosophy.
Accurate bracket placement during bonding also matters. When a bracket is in the right place, there is less need to rebond it later or add extra bends to the wire.
The patient’s role
- Come to visits on time: every adjustment starts the next stage
- Wear elastics as prescribed: a few hours a day is often not enough
- Avoid hard and sticky foods so that brackets do not come off
- Look after hygiene: inflamed gums make movement harder
- If a bracket comes off or a wire pokes, do not wait for the next visit, message me
In patients who wear elastics well and come to visits on time, treatment is usually shorter than in patients who do not work as a team. More about daily rules: daily braces care guide.
Can treatment be sped up
Vibration devices, lasers and some surgical procedures are offered as "fast orthodontics". According to Cochrane reviews, the evidence that these methods shorten treatment in a clinically meaningful way is weak. I wrote about this separately: can orthodontic treatment be sped up.
After active treatment
Removing the braces is not the end of treatment. Then the retention phase begins, and it is at least as important as active treatment for keeping the result. More: why retention matters.
Treatment stages and their share
| Stage | What happens |
|---|---|
| Alignment | The teeth come into one line, rotations are corrected |
| Bite correction | The relationship of the upper and lower teeth is built, elastics are often used here |
| Space closure | If teeth were extracted or there are gaps, they are closed |
| Finishing | The smile arc, root positions and small details |
| Retention | The result is protected with a retainer |
Patients often see fast changes in the first months because alignment is clearly visible. The later stages are less noticeable, but that is where the stability of the result and the beauty of the smile are built. That is why I do not rush the finishing stage.
Typical mistakes that lengthen treatment
- Postponing visits by several weeks
- Wearing elastics only in the days before a visit
- Not reporting a loose bracket until the next visit
- Repeatedly breaking brackets with hard foods
- Wearing aligners for fewer hours a day than recommended
What the science says
- Systematic review (2016): the average duration of treatment with fixed appliances is about 20 months, with large differences between studies.
- Cochrane reviews: the certainty of evidence on the effect of additional methods to speed up treatment is low.
What matters most is not the duration. What matters most is a result that stays with you for many years.
If you want to know the approximate duration for your case, see the braces treatment page or book a visit.
Frequently asked questions
Can you tell me the exact duration at the consultation?
After diagnosis I give an approximate range. The exact duration may vary somewhat depending on how the teeth respond and on cooperation.
Is treatment shorter with aligners?
In some simple cases yes, but not for every movement. Wearing aligners for the recommended hours directly affects the duration.
How often are the visits?
Usually every 1-2 months. For patients living abroad we plan the interval around their travel schedule.
Does treatment take longer in adults?
Not necessarily. In adults the bone no longer grows, so some problems are solved differently, but in many cases the duration is comparable to that in children.
Can I stop treatment halfway?
Technically yes, but the teeth stay in an unfinished position and may move back. We make such a decision only together, after discussing the risks.
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Scientific sources
The information in this article is based on the following peer-reviewed scientific articles and systematic reviews.
- Tsichlaki, A., Chin, S. Y., Pandis, N., & Fleming, P. S. (2016). How long does treatment with fixed orthodontic appliances last? A systematic review. American Journal of Orthodontics and Dentofacial Orthopedics, 149(3), 308-318. [PMID: 26926017] | [DOI: 10.1016/j.ajodo.2015.09.020]
