Braces and Mental Health UK — What to Expect

The psychological benefits of orthodontic treatment

Research consistently shows that successful orthodontic treatment improves psychosocial wellbeing. Studies in the UK and internationally report increased self-esteem, greater willingness to smile, improved confidence in social and professional settings, and reduced anxiety about appearance following treatment completion. For patients who have long been self-conscious about their teeth — a common experience in a culture where smiling is central to social interaction — the downstream psychological effects of treatment can be profound and lasting. The anticipation of a better smile is often one of the primary motivators for seeking treatment, and most patients report the outcome was worth the temporary disruption.

Body image concerns during treatment

While the long-term outcome is positive, the treatment period itself can present body image challenges. Patients adjusting to visible appliances — whether metal brackets, ceramic braces, or even the lisp sometimes associated with early aligner wear — may feel conspicuous. This is particularly common in adults who have not worn braces before and are navigating professional and social environments where appearance feels scrutinised. Research suggests these concerns are typically most acute in the first few weeks of treatment and diminish significantly as patients habituate to their appliances. Knowing this trajectory in advance can help patients frame early discomfort as temporary rather than permanent.

Anxiety about the appearance of braces

Fear of how braces will look is one of the most common reasons patients — particularly adults — delay seeking treatment. Many overestimate how noticeable their appliances will be to others. In practice, most people report that colleagues and acquaintances notice far less than anticipated, and that when braces are noticed, reactions are generally positive or neutral. Clear aligners have reduced this barrier considerably, but even fixed braces are far more socially normalised than they were two decades ago. Adult patients in professional roles frequently report that braces were a non-issue in their workplace. Addressing this fear directly — ideally before treatment begins — can significantly reduce anticipatory anxiety.

How to discuss mental health concerns with your orthodontist

Orthodontists are experienced in supporting patients through the emotional dimensions of treatment. If you have significant anxiety about appearance, a history of body dysmorphic disorder (BDD), or concerns about how treatment will affect your daily life, it is entirely appropriate to raise these during your consultation. A good orthodontist will adjust the pace of treatment where clinically possible, explain what the appliance will look like, show before-and-after examples, and may be able to offer appliance options that reduce visibility. Patients with BDD require particular care — orthodontic treatment alone does not resolve BDD, and these patients should ideally be supported by a mental health professional throughout.

Support strategies for teenagers

Teenagers are at a developmental stage where peer perception and social comparison are particularly salient, making body image concerns during orthodontic treatment especially significant. Parents and orthodontists can support teenagers by normalising the experience — pointing out how common braces are in their peer group, discussing the endpoint of treatment, and celebrating progress at adjustment appointments. Choosing appliance colours can give teenagers a sense of agency and identity within the process. Monitoring for signs of significant distress — withdrawal, refusal to eat in social settings, avoidance of school — is important, as these may indicate the need for additional support beyond orthodontic care.

When to seek additional mental health support during treatment

Most patients manage the psychological aspects of orthodontic treatment without specialist input. However, some indications that additional support may be beneficial include: persistent anxiety or low mood that has not improved after the first few weeks; avoidance of social situations specifically because of brace appearance; disordered eating driven by appliance discomfort or embarrassment; or signs that appearance concerns are disproportionate to the objective clinical picture (which may indicate underlying BDD). GPs can refer to appropriate support, including NHS IAPT services for anxiety. Orthodontic practices that regularly treat complex cases or anxious patients may have links to clinical psychologists or can advise on local resources.

Useful related pages

This guide is for general information only. It is not a diagnosis, treatment plan, or substitute for advice from a registered dentist or orthodontist.