Crooked teeth can be fixed through several approaches, from traditional braces and clear aligners to veneers and, in severe cases, jaw surgery. The right option depends on how misaligned your teeth are, your age, your budget, and how quickly you want results. Most people will spend somewhere between 6 months and 3 years in active treatment, with mild cases resolving fastest and complex bite problems taking the longest.
Why Teeth Become Crooked
Teeth drift out of alignment for a mix of genetic and environmental reasons. Your jaw size is largely inherited, and if your jaw is too small for the number of teeth trying to fit in it, crowding is almost inevitable. Habits during childhood, like prolonged thumb-sucking or tongue-thrusting, can push teeth forward or create open bites. Losing baby teeth too early (or too late) disrupts the spacing that guides adult teeth into position. And even after your adult teeth are settled, wisdom teeth, gum disease, or simply the natural forward drift of teeth over a lifetime can shift alignment.
The types of misalignment dentists look for include overbites (upper teeth overlapping the lower teeth too much), underbites (lower teeth extending past the upper), crossbites (upper teeth fitting inside the lower teeth), open bites (front teeth that don’t touch when you close your mouth), and general crowding or spacing issues. Each of these presents different challenges and may respond better to certain treatments than others.
Traditional Braces
Metal braces remain the most versatile and reliable option for straightening teeth. They work by applying continuous pressure through brackets bonded to each tooth and connected by an archwire. That pressure creates areas of compression and tension in the bone surrounding each tooth root, triggering a controlled cycle of bone breakdown on one side and new bone formation on the other. This biological remodeling process is what physically moves teeth through bone over time.
Braces can handle virtually every type of misalignment, from mild crowding to severe bite problems involving significant rotation, vertical repositioning, or root movement. They cost between $2,500 and $7,500 in the United States, depending on complexity and where you live. Mild cases often wrap up in under a year, moderate cases take 12 to 24 months, and complex misalignment can require 24 to 36 months of treatment.
Ceramic braces work the same way but use tooth-colored or clear brackets, making them less visible. They tend to cost slightly more than metal braces and can stain if you’re not careful with coffee, tea, or red wine. Lingual braces attach to the back surfaces of your teeth, hiding them completely, but they’re harder to clean and typically the most expensive bracket option.
Clear Aligners: Strengths and Limits
Clear aligners like Invisalign use a series of custom plastic trays to gradually shift teeth. They’re nearly invisible, removable for eating and brushing, and generally more comfortable than braces. For mild to moderate crowding and spacing, they work well. They cost between $3,000 and $8,000, with most people paying in the $4,500 to $5,500 range.
But aligners have real limitations that are worth understanding before you commit. Research shows a roughly 50% gap between the tooth movement a computer simulation predicts and what actually happens in the mouth. One study found the overall accuracy of tooth movement with aligners was just 41%. Between 70% and 80% of aligner patients need mid-course corrections, and some end up switching to traditional braces to finish treatment.
Certain movements are especially hard for aligners. Root torque (tilting the root of a tooth while the crown stays put) achieves less than half of what’s prescribed. Deep bite correction has an accuracy of around 61 to 62%. Complex rotations, significant vertical movements, and large bite discrepancies are areas where aligners consistently underperform compared to fixed braces. One comparative study found that aligner patients scored significantly lower on a standardized orthodontic outcome measure, with a 27% lower passing rate than patients treated with braces.
If your case is mild, aligners are a convenient and effective choice. If you have a complex bite issue or need substantial tooth movement, braces will likely give you a better result.
Mail-Order Aligners: Proceed With Caution
Direct-to-consumer aligner companies offer treatment without regular in-person visits, relying on at-home impression kits and remote monitoring. The lower price tag is appealing, but the American Association of Orthodontists has raised serious concerns about this model. Moving teeth is a biological process that involves bone remodeling, and doing it without in-person examination and monitoring can lead to irreversible harm, including root damage, worsening bite problems, and gum recession that wouldn’t have been caught remotely.
In a 2021-2022 survey of orthodontists, 61% reported seeing new patients who needed retreatment after mail-order aligner use at least every quarter. If you’re considering this route, understand that skipping diagnostic imaging and hands-on assessment means problems may go undetected until they’re difficult or impossible to reverse.
Veneers for Minor Cosmetic Fixes
Porcelain veneers are thin shells bonded to the front surfaces of your teeth. They don’t actually move teeth. Instead, they create the appearance of straighter, more even teeth by changing the visible shape and size of each tooth. This makes them a faster alternative for people whose misalignment is purely cosmetic and minor: small gaps, slightly uneven teeth, or teeth that are mildly rotated.
Veneers are not appropriate for severe crowding, overbites, underbites, or any misalignment that affects how your teeth come together when you chew. Placing veneers on poorly aligned teeth creates uneven pressure that can crack or damage them. They also require healthy teeth with adequate enamel, since the veneer bonds to that enamel surface. If you grind your teeth, have active gum disease, untreated cavities, or teeth weakened by large fillings or root canals, veneers are either ruled out or need to wait until those issues are addressed. The tradeoff is speed: veneers can be placed in two or three appointments, while orthodontic treatment takes months or years.
Jaw Surgery for Structural Problems
When crooked teeth are caused by a skeletal problem (the jaws themselves are misaligned, not just the teeth), braces alone can’t fully correct the issue. Orthognathic surgery repositions the upper jaw, lower jaw, or both. It’s typically combined with braces before and after the procedure.
Surgery is considered medically necessary when the skeletal deformity is severe enough to impair chewing or swallowing and can’t be corrected with orthodontics alone. Specific thresholds include a horizontal overjet of 5mm or more, a reverse overjet greater than 3.5mm, molar relationship discrepancies of 4mm or more, open bites with no overlap of the front teeth, or facial asymmetries greater than 3mm. These aren’t numbers you’d measure yourself. They come from imaging and clinical assessment by an orthodontist or oral surgeon.
If your teeth are crooked but your bite feels normal and you can chew without difficulty, jaw surgery is almost certainly not on the table. It’s reserved for cases where the bone structure itself is the problem.
Adults vs. Children: What Changes
Children and teenagers have a biological advantage. Their jaws are still growing, their bone is less dense, and their periodontal tissues are more adaptable. This means teeth move faster and the orthodontist has more options for guiding jaw growth, using appliances like palatal expanders that work best before the bones fully fuse.
Adults can absolutely straighten their teeth, but the process is typically slower and has more constraints. Adult bone is denser, so teeth are harder to move. There’s no remaining jaw growth to harness, which means skeletal discrepancies that could have been guided during childhood may require surgery in adulthood. Adults are also more likely to have gum recession, bone loss, or prior dental work that complicates treatment planning. None of this means adults shouldn’t pursue orthodontics. It just means treatment may take longer and require more careful management.
Keeping Teeth Straight After Treatment
Teeth have a natural tendency to drift back toward their original positions after braces or aligners come off. Retainers are what prevent this, and every person who finishes orthodontic treatment needs one.
There are three main types. Hawley retainers combine an acrylic plate (resting on the roof of your mouth or under your tongue) with a metal wire that holds the teeth. Clear retainers look like aligner trays and fit over the teeth. Fixed retainers are thin wires permanently bonded to the back surfaces of the front teeth, working around the clock without you thinking about them.
The current consensus is that retention is essentially a lifetime commitment, though the frequency of wear usually decreases over time. You might wear a removable retainer full-time for the first few months, then transition to nights only, then a few nights a week. Your orthodontist will adjust the schedule based on how stable your teeth remain. Skipping retainer wear is the single most common reason people end up with crooked teeth again after spending years in treatment.
Comparing Costs and Timelines
- Metal braces: $2,500 to $7,500, treatment lasting 6 to 36 months depending on severity.
- Clear aligners: $3,000 to $8,000, with similar timelines but potential for refinement rounds that extend treatment.
- Porcelain veneers: typically $1,000 to $2,500 per tooth, completed in 2 to 3 appointments, but only suitable for minor cosmetic issues.
- Jaw surgery: $20,000 to $40,000 before insurance, often partially covered when medically necessary, with several months of braces on either side of the procedure.
Many orthodontic offices offer payment plans, and dental insurance often covers a portion of braces or aligners, particularly for patients under 18. Coverage for adults varies widely. Veneers are almost always considered cosmetic and rarely covered by insurance.