Symmetry is important to our facial structure, but sometimes our features aren’t perfectly aligned. With teeth, this is called midline misalignment (also a midline discrepancy or deviated midline). The center of your front teeth will typically line up with your nose and chin, but there are a variety of reasons that it might not.
Midline issues are fairly common and often harmless, just a cosmetic concern. 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.
Braces have long been the go-to solution for a broad scope of orthodontic issues, midline 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 against braces.
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Are Braces Effective for Midline Misalignment?
Absolutely. Braces have proven 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 may be able to 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 more complex and lengthy 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 or drastic teeth and jaw movements. Plus, braces are sturdy, durable, and always on, so they ensure consistent and predictable movements. They are, however, a bit pricey, and can cost between $3,000 and $8,000 (on average).
As an adult, you might be hesitant to wear metal brackets to work, dates, or other special occasions. The good news is that advances in dental technology have developed multiple less visible but equally-effective types of braces. If appearance has you questioning braces as an option, there are a few other options you might want to consider.
What Types of Braces Can I Choose From?
Twenty years ago, traditional metal braces were pretty much the only show in town if you wanted to change something about your smile. However, in recent years, there’s been a whole lot of innovation around this dental technology. From ceramic braces (designed to blend in with your teeth) to sublingual braces (placed discreetly on the back of the teeth), there’s now a whole range of options to choose from. Below we’ll discuss the 4 main types of braces that are available today.
Traditional Metal Braces
The end result of a long history of innovation in orthodontistry, metal braces in their present form came onto the scene around the mid-1970s. Over 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, standard metal braces still have a whole lot going for them. For one thing, treating patients with standard braces doesn’t require an orthodontist to obtain any extra training or purchase special equipment, and these savings are often passed along to the customer. Along these same lines, it’s often easier to find an orthodontist who can confidently administer your treatment, as orthodontists typically have the most experience working with this style of braces.
The average cost for treatment with braces ranges between $3,000 and $7,000, and the average treatment time is 18 to 30 months. Where you fall in this range depends on how complex your case is. If your midline issue is caused by crowding in your front teeth, for example, you might fall near the lower end of those price and time ranges. But if it’s caused by crossbite or another law misalignment, treatment might take longer and be more expensive.
The earliest clear braces were introduced in 1987 by 3M (makers of Scotch tape and many other popular consumer brands). While early models of clear braces were known to be less effective at adjusting teeth, the technology has come a long way in the past 30+ years. Today, clear braces are able to achieve adjustments quite comparable to their metal counterparts.
Clear braces work just like metal braces, but offer a sleeker aesthetic preferred by many adults. This difference in appearance is achieved by replacing the standard metal brackets with translucent, ceramic ones that blend in with the teeth. Although clear braces typically incorporate a metal archwire, and the brackets tend to be a bit larger, they are overall much less noticeable than standard metal braces. Some people also find that the ceramic brackets are less sharp on the gums and therefore more comfortable to wear.
On the downside, not all orthodontists offer this type of treatment, so it may be somewhat difficult for you to find a local provider if there aren’t many clinics to choose from in your area. Clear braces also tend to be more expensive (around 10%-20% more) than standard metal braces. That said, clear braces have approximately the same treatment duration as standard metal braces (18-30 months), and are just as effective for correcting most cases of midline misalignment — provided that you’re able to locate a qualified orthodontist to administer them!
Unlike clear braces, and even invisible aligners, lingual braces are truly hidden from the rest of the world: these braces are placed on the back of the teeth instead of the 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 this treatment option. This style of braces is more difficult to affix and adjust, and requires specialized training and equipment. From the patient perspective, lingual braces can create uncomfortable pressure around the tongue, which often results in a minor lisp. Maintaining good oral hygiene takes more effort as well, as it can be tricky to brush and floss around the inward-facing brackets.
All that said, if you are able to find a local orthodontist who is willing and able to administer them, lingual braces are just as effective as standard braces for correcting gaps in the teeth. Given the extra work involved, they tend to be more expensive than other options, often costing upwards of $10,000 for a full course of treatment. However, if your case is mild and unaccompanied by any other complications, you may end up with a price quote that’s a bit easier to swallow.
If your top priority is keeping your treatment completely invisible and you have the financial means to afford it, lingual braces may be the right choice for you.
Six Month Smiles
Six Month Smiles is a unique brand of clear braces that can be applied by a standard family dentist rather than an orthodontist. As the brand name implies, these braces come with the promise of straighter teeth in 6 months (although sometimes treatment can take an extra month or two to achieve the desired results).
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 tend to be less expensive than the other options above, averaging between $3,500 and $5,000 for a six-month course of treatment.
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 treating 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 likely good to go. But if it’s accompanied by a crossbite or requires shifts in your back teeth, the braces listed above might be more effective.
What Is it Like to Wear 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 foods that are particularly hard or sticky (like chips, taffy or hard candy) and certain behaviors (like nail-biting and gum-chewing) for the duration of your treatment. It’s also important to properly care for your teeth as they move, 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 decision to make at any age. Plus, between ceramic braces, lingual braces, and other alternative treatment options (which we’ll discuss in the next section), there are more ways than ever to adjust your smile discreetly.
In the end, if corrective treatment is something you’re pursuing 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!
Can Midline Misalignment be Treated Without Braces?
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.
Invisalign: There are two big reasons for Invisalign’s popularity. First, it’s able to achieve similar results and correct the same types of conditions. And second, it’s much less visible, barely noticeable at all.
Invisalign’s trays are customized to fit your teeth and can be paired with supplemental appliances to induce more complex movements. Like braces, they’re effective in treating not just teeth conditions, but jaw misalignments as well. On top of that, Invisalign can be administered by your general dentist, not necessarily and orthodontist, so you can likely get your treatment administered at the same place you go to get your teeth cleaned.
When it comes to midline discrepancies, Invisalign can treat many of the same cases 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, just like braces.
To learn more about treating midline misalignment with Invisalign, check out our comprehensive guide.
At-Home Teeth 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 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 aren’t able to 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 is confined to your front teeth and just requires minor shifts, home aligners could be a great option.
Veneers: This is the quickest option listed here, delivering a brand new smile in just one office visit. How? Veneers 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, to effectively place them, your dentist needs to shave down your real teeth, which is an irreversible process. And they don’t last forever. You’ll need to have them replaced every 7-20 years.
At $500-$2,000 per tooth, that’s not exactly cheap. So, if you want instant results without any teeth movements, veneers might be worth a look. But if you’d rather permanently correct the underlying problem, you should consider one of the other options listed here.
Braces are the most tried and true orthodontic treatment available. There’s a reason that orthodontists still recommend them for a wide variety of conditions, like midline misalignment. But treatments are always evolving and braces are now just one of several viable options. The most important part of choosing a treatment, however, is evaluating your own unique condition and goals. Is your midline causing you discomfort or is it purely a cosmetic concern? What’s your ideal timeline? 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. As you do, remember to consult your dentist, as certain conditions might necessitate 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.