Braces have long been the go-to solution for a broad scope of orthodontic issues, midline misalignments included. And today, you have more options than the traditional metal brackets and wires. For adults seeking midline correction, braces can be a fantastic option.
Why? Read on. We’ll lay out everything you need to know about braces as a midline treatment option, as well as some alternatives if you decide they’re not right for you.
Table of Contents
What Is Midline Misalignment?
Symmetry is important to our facial structure, but sometimes our features aren’t perfectly aligned. With teeth, this is called midline misalignment, midline discrepancy, or deviated midline. The center of your front teeth will typically line up with your nose and chin, but there are various reasons that it might not.
The condition had a brief moment in the spotlight in 2002 when Tom Cruise famously sported braces to correct his midline. You might not be a Hollywood superstar, but a midline discrepancy can still make you less than confident to flash your smile.
Midline issues are fairly common and mild cases are often harmless, just a cosmetic concern. However, more severe cases can alter your backbite or occur alongside a posterior crossbite, which can wear down your enamel unevenly, putting you at greater risk of tooth decay, gum disease, and jaw pain.
What Causes Midline Misalignment?
A few of the most common midline misalignment causes include missing teeth, oversized teeth (macrodontia), undersized teeth (microdontia), the early loss of baby teeth, crowding, and jaw misalignments.
Midline discrepancies can also stem from certain habits. For example, excessive childhood thumb-sucking can cause teeth shifts that alter the midline. Uneven chewing can also, over time, induce similar shifts. Or, they can occur after dental trauma like tooth loss or jaw injury.
Can Braces Fix Midline Misalignment?
Braces are a highly effective treatment for midline misalignment, regardless of its root cause. Still, it’s helpful to know the different causes, as they can determine the length and total cost of your treatment.
Sometimes, midline misalignment is fairly simple, the result of crowding, spacing, or missing teeth. These cases require minor teeth movements and, if your bite looks good, little to no jaw realignment. Braces can potentially correct these cases in a matter of months. But in more severe cases, your midline discrepancy could stem from a posterior crossbite (in your back teeth) that would require a longer, more complex treatment.
Fortunately, braces have the power and versatility to handle just about every kind of midline misalignment, even ones accompanied by a severe bite issue. Your orthodontist can pair them with additional appliances to help achieve more complicated teeth and jaw movements. Plus, braces are sturdy, durable, and always on, so they ensure consistent, predictable movements. They are, however, expensive, costing between $3,000 and $7,000 on average.
As an adult, you might be hesitant to wear metal brackets to work, on dates, or at other special occasions. The good news is that advances in dental technology have developed multiple less visible but equally effective types of braces.
Types of Braces
Twenty years ago, if you wanted to alter your smile, traditional metal braces were pretty much the only option. However, the orthodontic industry has come a long way in the past couple of decades. Now, you have a whole range of options to choose from. Here are the four main types of braces available today.
Traditional Metal Braces
The result of a long history of innovation in orthodontia, metal braces in their present form came onto the scene around the mid-1970s. In the decades since, traditional braces have remained orthodontists’ go-to treatment for crafting beautiful smiles.
Though many adults today opt for more discreet straightening appliances — like clear aligners — standard metal braces still have a lot going for them. Treating patients with standard braces doesn’t require an orthodontist to obtain any extra training or purchase special equipment, and those savings mean they can often offer lower prices. Plus, it’s often easier to find an orthodontist who can confidently administer your treatment, as orthodontists typically have the most experience working with metal braces.
The average cost of braces is $3,000–$7,000, and the average treatment time is 12–30 months. Where you fall in this range depends on the complexity of your case. If your midline issue comes from crowding in your front teeth, for example, you might pay less for a fairly short treatment. But if it’s caused by crossbite or another jaw misalignment, treatment might take longer and be more expensive.
3M — the company behind Scotch tape and Post-Its — introduced the first clear braces in 1987. While early models were less effective at adjusting teeth, the technology has come a long way in the past 30+ years. Today, clear braces can match the power of their metal counterparts.
Clear braces work just like metal ones, but offer a sleeker aesthetic that many adults prefer, since the translucent ceramic brackets blend in with the teeth. Although clear braces typically incorporate a metal arch wire, and the brackets are often slightly larger, they’re still less noticeable than metal braces. Some people also find that the ceramic brackets are less sharp and abrasive on the cheeks and gums.
On the downside, not all orthodontists offer clear braces, so it could be difficult to find a provider. Clear braces are also typically around 10%–20% more expensive than metal ones. That said, they have approximately the same treatment duration as standard metal braces (12–30 months), and are generally just as effective for correcting most cases of midline misalignment.
Unlike clear braces, lingual braces are totally hidden from the rest of the world, since they’re situated behind your teeth instead of in front. You may be thinking, “that’s brilliant, how is this the first I’m hearing of it?” Well, there are a few reasons lingual braces aren’t more popular.
First of all, most orthodontists don’t offer them, since they’re harder to affix and adjust, and they require specialized training and equipment. From the patient perspective, lingual braces can create discomfort around the tongue, which can give you a minor lisp. Maintaining good oral hygiene takes more effort as well, because it’s harder to brush and floss around the brackets.
All that said, lingual braces are just as effective as standard braces for correcting midline issues. Given the extra work involved, they’re typically more expensive than other options, often costing upwards of $10,000. Again, if your case is fairly mild, you may end up with a price that’s slightly easier to swallow. If your top priority is keeping your treatment completely invisible and you have the financial means to afford it, lingual braces might be the right choice for you.
Six Month Smiles
Six Month Smiles is a unique brand of clear braces that doesn’t require an orthodontist, just a standard family dentist. As the brand name implies, the average treatment plan is around six months, but that’s because they’re only viable for milder cases.
Six Month Smiles braces utilize clear brackets and tooth-colored wires, making them one of the least noticeable types of braces available. Plus, due to the shorter treatment time, they’re typically less expensive than other braces, averaging between $3,500 and $5,000.
Because of their shorter timeframe, Six Month Smiles is most effective at treating issues of crowding and spacing in the front teeth and may not be as effective for bite issues, which typically take longer to correct. So, if your midline misalignment is confined to a milder issue in your front teeth, you’re probably good to go. But if it’s accompanied by a crossbite or requires shifts in your back teeth, braces might be more effective.
Check out our full review of Six Month Smiles for more information.
Wearing Braces as an Adult
Regardless of your age or the type of braces you choose, braces can certainly cause some discomfort, especially as your teeth adjust to initial placement and periodic tightening.
To minimize pain and reduce the risk of breaking a bracket, you’ll need to stay away from particularly hard or sticky foods — like chips, taffy or hard candy — as well as habits like nail-biting and gum-chewing. It’s also important to maintain good oral hygiene and use all dental appliances as instructed.
You may perceive some added stigma around getting braces as an adult, but the truth is, it’s a very common treatment at any age. Plus, between ceramic braces, lingual braces, and alternatives like clear aligners, there are more ways than ever to adjust your smile discreetly.
In the end, if you’d like to correct your midline misalignment for the sake of your own comfort and happiness, it should be easy to remember that the long-term payoff will be well worth the temporary discomfort!
Other Treatment Options
While braces are a fantastic option for treating most cases of midline misalignment, some people don’t love the idea of wearing braces, or are put off by the price. If that sounds like you, there are a couple of other unobtrusive treatment options available.
In-Office Clear Aligners
Clear aligner treatments like Invisalign, which involve regular in-person supervision from a dentist, are an effective solution for midline misalignments. Like braces, clear aligners are compatible with tooth shaving, extraction, and additional dental appliances to help correct more complex alignment issues. However, unlike braces, Invisalign and many of their competitors are available to standard dentists (rather than just orthodontists), so there’s a good chance you can get treatment at the same place you go to get your teeth cleaned.
Of course, the most notable differences between these treatment methods is that clear aligners are 1) removable, and 2) much more discreet than traditional braces. In-office clear aligners can treat many of the same midline misalignments that braces can, although your dentist or orthodontist still might recommend braces for more consistent movements. Either way, the price is going to be fairly similar. Invisalign can range from $3,500 to $8,000, similar to braces.
However, Invisalign isn’t the only option. ClearCorrect, 3M Clarity Aligners, and SureSmile are among several equally effective alternatives. If you’re interested, learn more about some of the top brands in our guide to the six best clear aligners.
At-Home Clear Aligners
Maybe you like the idea of clear aligners, but don’t want to schedule regular dentist visits for Invisalign. Companies like SmileDirectClub and Byte will deliver clear aligners straight to your home. By eliminating office visits, these companies make their treatments more convenient and affordable, typically running between $1,800 and $2,000.
The downside is that without a dentist’s oversight, home aligners can’t treat severe conditions, specifically bite misalignments like overbite, underbite, and crossbite. This means that they might not be a good option for every case of midline misalignment, especially ones caused by posterior crossbite or another backbite issue. But, if your midline discrepancy concerns only your front teeth and just requires minor shifts, home aligners might be a great option.
If you think at-home aligners might work for you, check out our recommendations for the top five brands.
The quickest option listed here, veneers can deliver a brand new smile in just one office visit. How? They don’t actually move any of your teeth — they just give the appearance of a new smile. They’re sturdy porcelain tabs that your dentist can affix to your real teeth, instantly transforming your smile.
Like home aligners, veneers typically only work with milder cases that are confined to your front teeth. Plus, your dentist might need to shave down your real teeth before placing them, which is an irreversible process. And they don’t last forever. You’ll need to replace them every 7–20 years.
Traditional veneers’ average price is $500–$2,000 per tooth, so they’re not exactly cheap. So, if you want instant results without moving your teeth, veneers might be worth a look. But if you’d rather permanently correct the underlying problem, consider one of the other options listed here.
If you like the idea of an instant smile transformation, but the permanence of traditional veneers worries you, snap-on veneers could be a great option. These removable appliances clip onto your teeth, hiding your gaps, along with stains, cracks, chips, missing teeth, and other cosmetic issues.
Companies like Shiny Smile and Removable Veneers USA customize these veneers using molds of your teeth, so they’re a perfect match. They often come in different shades and models — some for everyday use and others for occasional wear.
Snap-on veneers are much more affordable than traditional veneers and many orthodontic treatments, but they’re also not permanent, and they can be slightly uncomfortable to wear. That said, they can work for people with very mild misalignments who want a quick and inexpensive solution. Check out our guide to the five best snap-on veneers to learn more.
There’s a reason that orthodontists still recommend braces for a variety of conditions, like midline misalignment — they’re the most tried and true orthodontic treatment available. But treatments are always evolving and braces are now just one of several viable options. The most important part of choosing a treatment is evaluating your own unique condition and goals. Is your midline causing you discomfort or is it purely a cosmetic concern? What might work with your budget? How severe is your condition?
By asking these questions, you’re not just finding a good treatment, but the best treatment for you. Just remember to consult your dentist, as certain conditions require a certain type of treatment. Do all of this and whether you choose braces, aligners, or no treatment at all, you can be confident that you’re doing what’s best for your beautiful smile.
Frequently Asked Questions
How do you fix a midline misalignment?
If you want to treat the underlying condition that’s causing your midline discrepancy, most orthodontic treatments are good options. But if you have a mild case and you’d rather simply hide it, traditional or snap-on veneers can provide an instant smile makeover.
What causes a midline misalignment?
Common causes include missing teeth, oversized teeth (macrodontia), undersized teeth (microdontia), the early loss of baby teeth, crowding, and jaw misalignments. Excessive childhood thumb-sucking, uneven chewing, or dental trauma like tooth loss or jaw injury can also contribute.
Is midline misalignment a problem?
Sometimes. Mild cases that don’t stem from a bite misalignment rare present serious medical concerns. But severe midline discrepancies, specifically ones that affect the back bite or are accompanied by a crossbite, can wear down your enamel unevenly, potentially leading to tooth decay, gum disease, and jaw pain.
How long does it take to correct a midline discrepancy?
It depends on the severity of your case. A powerful orthodontic treatment like braces or clear aligners can sometimes correct mild misalignments in just a few months. More significant misalignments, however, often take 12–30 months.
Is midline misalignment noticeable?
For many people, the discrepancy is so slight that it’s barely noticeable. But more serious misalignments are typically more visible when you speak or smile.
Do I have to wear a retainer after braces?
If you want to keep your teeth straight, yes. While you’ll steadily wear your retainer less and less often over time, if you stop completely, your teeth will go back to their old positions.
Can clear aligners fix a midline misalignment?
Yes! Clear aligner treatments that involve in-person care from a dentist — like Invisalign or SureSmile — can handle just about any misalignment that braces can. At-home aligners like Byte or SmileDirectClub might be good options too, but only for mild cases.
Are braces the best treatment for a midline discrepancy?
Sometimes, but not always. If your case requires significant jaw shifts to fix a bite misalignments, braces typically work the best. But Invisalign can treat many of the same issues while maintaining a low profile, and at-home aligners are a more convenient and affordable option for fixing mild cases.