Braces or aligners make cleaning harder. Without extra care, you can develop gum disease, gum recession (gums pulling back), bone loss, tooth decay, or permanent white marks on teeth. Good brushing, flossing, and limiting sugary foods and drinks are essential.

As your jaws and facial bones continue to grow, it can affect how your teeth fit together. This may make treatment take longer or, after you’ve finished, may change your bite enough that more treatment or even jaw surgery is needed to get the best result.

In some people, the roots of teeth may shorten a little during orthodontic treatment. This is usually harmless, but in very rare cases it can affect the long-term health of the tooth. X-rays may be taken during treatment to check root health.

Teeth that have been injured before, have decay, or have large fillings are more at risk. Moving these teeth can sometimes aggravate the nerve and, in rare cases, lead to nerve damage, discoloration, or the need for a root canal.

Your treatment may take longer than the original estimate. Missed appointments, broken appliances, not wearing elastics or aligners as directed, or poor oral hygiene can delay progress or affect your final results.

Some people develop clicking, pain, headaches, or ear problems related to the jaw joint. These can happen with or without orthodontic treatment and may last days, weeks, or sometimes longer.

Sometimes small gaps are created to fit orthodontic bands. After treatment these usually close on their own or with a retainer, but in some cases gaps remain and may need fillings or other dental work to close them.

Occasionally, your dentist or orthodontist may need to change the plan during treatment to achieve the best results. This may include referral to a specialist for additional care.