The orthodontic industry is on the rise. If anecdotal evidence of everyone from middle schoolers to working professionals donning braces and retainers was not enough, studies estimate that the global market for orthodontic services will reach $41.82 million by 2021. To gain a better understanding of sentiment closer to home, CivicScience asked U.S. adults about their experience with orthodontia.

As it turns out, 35% of U.S. adults have experienced orthodontic treatments of some kind. Although the majority of respondents indicate that they had these treatments as a child, a small but important minority indicate having these treatments as an adult.

It is also worth noting that another subset of respondents have not yet pursued orthodontic treatment, but plan to. This means that the percentage of those in the ‘experienced as an adult’ category is likely to grow.

Orthodontia May Have a Gendered Appeal

While childhood orthodontia experience is almost evenly split along gender lines, adult orthodontia experience and intent skew slightly more female.

There are a variety of reasons why this could be the case, but one major consideration could be the impact of the beauty industry on women’s perceptions of their own bodies. Past data has shown that image-consciousness is a very real concern. Especially given the way that the beauty industry targets and portrays women, it seems possible that the desire for perfect teeth in adulthood could largely stem from existing cultural pressure.

Orthodontia Skews Younger

When evaluating this question in comparison to age range, there is no denying the fact that orthodontia has experienced an incredible boom in the past several decades. While 15% of adults 65 or older underwent an orthodontic treatment at some point during their lives, 57% of adults 18-24 years old have already experienced or plan to pursue orthodontia.

Within this data, it is worthwhile to point out that U.S. adults in the 30-34 age range demonstrate the highest percentages of adult orthodontia experience and intent. This is especially noteworthy for a variety of reasons, not the least of which is because this marks a tipping point in the numbers. With this age range, for the first time, experience with or interest in orthodontia surpasses disinterest or lack of need, a trend that continues into those in earlier stages of life.

Data such as this speaks to certain social shifts that have resulted in changing priorities and, perhaps, changing definitions of normal. What might have been unusual 50 years ago in the world of dental health, is now far more mainstream.

And, as it turns out, for those in certain fields, this new normal is especially prevalent. Respondents seeking orthodontia as adults largely hold professional or managerial positions, perhaps influenced by the large percentage of their peers who already experienced orthodontia as a child.

In a world where perfect smiles are more common than ever, those who consider themselves the face of a team, company or brand, may feel an increasing interest in enhancing their appearance to better fit in with office culture.

Perfect Teeth for All…Who Can Pay

Of course, braces and other specialized orthodontic devices do not come without hefty price tags and dental insurance may or may not cover all treatments. The data reflects this, as income level has a direct impact on when an individual undergoes orthodontic treatment.

What is most clear is that for high-income earners, the numbers are fairly consistent. There is no barrier to orthodontia at any age, for those who can pay out of pocket or who have insurance that covers such a procedure. This changes in mid and low-income households. Those who earn $50-$100k were more likely to experience corrective dental treatments as a child, while those who earn under $50k are more likely to still have plans to pursue this as an adult.  So while experience of orthodontia during childhood is increasing, it is, upon closer look, primarily doing so for those with the means to afford it.

The data below further demonstrates that dental health is not only influenced by income and the access to insurance that financial security can bring, but also the specific type of insurance an individual holds. Those who are uninsured or on government-assisted insurance programs are the least likely to have had orthodontia as a child or adult.

The numbers paint a stark picture, one that requires a sober evaluation of the disadvantages that many Americans must face in attaining proper healthcare services, as children and adults.

Braces in the ‘Burbs  

Access to orthodontia is also influenced by the type of area an individual inhabits. Those who live in the suburbs are the most likely to have worn orthodontia as a child. This is followed by those in the cities, who happen to have the highest rates of adult orthodontic experience and intent.

These numbers are not necessarily surprising, given what the data has already revealed about the connection between wealth and access to dental care. However, what this could further highlight is the financial diversity of city dwellers–some who had the family means to undergo treatments as a child, others, who waited until adulthood– as compared to the financial homogeneity of their suburban counterparts, where childhood orthodontia was more prevalent.  

Straighter Teeth, Lower Self-Esteem

While, in many cases, the choice to get braces stems from a medical need, it is difficult to ignore the cosmetic improvements that many people enjoy as well. That said, orthodontia does not necessarily lead to improved self-perception, with the largest percentage of respondents who had orthodontia as a child reporting that they are much less physically attractive than most people of their age and gender.

Could childhood braces impart upon the individual an idea that their appearance is inherently less attractive than the appearance of others? Is there something to be said for learning to embrace perceived imperfections early on, as opposed to approaching every assumed flaw with the need to fix it? It’s an issue to consider, especially as the 20 and 30 somethings who begin to have children navigate their own experience with and desire for orthodontia while raising the next generation.

Orthodontia is a thriving industry in the U.S., and on the surface, it seems that experience with braces, palate expanders and the like is maintaining exponential growth. However, beneath the facade of aligned teeth and expanded palates is a much murkier reality. The interest from greater numbers of women, the income-based restrictions, potential lack of accessibility and the disconnect between perceived perfection and self-esteem shines a light on the more complex social concerns at play. While for some especially marginalized groups, the desire for orthodontia may symbolize an idealized version of self–one that may forever be out of reach– for others who have had the luxury of attaining a perfect smile, the reality of this vision achieved may lack the expected luster.