Orthodontic treatment can be successful at any age, and adults especially appreciate the benefits of a beautiful smile. One of every five patients in orthodontic treatment is over 21. Extraction of permanent teeth and jaw surgery are more often required for adult orthodontic patients because their jaws are not growing. Adults also may experience breakdown or loss of the bone that supports the teeth and may require periodontal treatment before, during and/or after orthodontic treatment. Bone loss can also limit the amount and direction of tooth movement that is advisable.