Remember the kids in class who had silver, jagged hardware on their teeth? Back then it was just a flashy gadget. But once you're an adult and start looking into teeth, side profiles, treatment costs, insurance and family finances, it turns out to have been a pretty big long-term investment. That said, "start as a kid and you win everything" is wrong, and so is "face exercises can reshape your jawbone." Once you separate teeth from bone, the whole picture gets much clearer.
The 5-second answer: braces are powerful, but not magic
- The silver hardware you often see on elementary, middle and high school kids is mostly metal multibracket braces. A small bracket is attached to each tooth, and a wire moves the teeth.
- A mouth that "sticks out" (kuchi-gobo in Japanese) can have several causes: the front teeth, the part of the jaw that holds the teeth, the upper and lower jawbones, or the chin. Lump them all into one word and you'll pick the wrong treatment.
- Adults can still move their teeth. But you can't expect face exercises alone to shift a fully grown jawbone back or forth in any big way. If the skeletal mismatch is large, jaw surgery combined with orthodontics becomes an option. [1]
- In Japan, orthodontics for ordinary bite problems is basically paid out of pocket. One university hospital lists about 750,000 yen for full-mouth multibracket treatment in an adult, and another quotes roughly 800,000 to 1,000,000 yen. [1][2]
- Insurance applies only in limited cases: bite problems linked to conditions designated by the health ministry, certain cases where permanent teeth fail to come in, and jaw deformities that need surgery. [3]
- For kids, "the earlier the better" isn't true. The right starting time differs from case to case. Early treatment makes sense for some kids, but a two-phase approach isn't always better than a single phase. [9][10]
In short, if your teeth actually need treatment, braces can be a long-term expense on the mouth you'll use for decades. But the real investment isn't "starting early." It's a correct diagnosis, the right timing, finishing the treatment, and wearing a retainer afterward.
1. What exactly is "sticking out" when someone says kuchi-gobo?
"Kuchi-gobo" is a casual Japanese slang term for a mouth that looks like it juts forward. It's not a diagnosis with a single cause. Two people can look similar from the side and have very different things going on underneath.
| What causes the look | In plain words | Main approach |
|---|---|---|
| Front teeth tilt forward | The teeth stick out | Orthodontic treatment |
| The tooth-bearing part of the jaw bulges forward | Teeth and their base are forward | Braces to pull the front teeth back, etc. |
| Upper and lower jawbones are badly out of position | A skeletal jaw problem | Treatment during growth; for adults, consider jaw surgery too |
| Chin sits far back | The mouth looks forward by comparison | Skeletal evaluation, other treatment if needed |
The Japanese term "shisō" in the original sounds intimidating, but it simply means the part of the jawbone that the teeth are planted in. And "otogai" means the chin.
So when a doctor says "alveolar protrusion," that's no spell being cast.
It means the position or tilt of the teeth plus the bone holding them makes the mouth look like it's pushed forward.
Toss everything into one "kuchi-gobo!" box, and there's nothing left for a diagnosis to do.
2. "Teeth forward" vs. "bone forward": why does it matter so much?
Braces work because teeth can be moved within the jawbone.
Apply the right amount of force and the tissue and bone around a tooth get remodeled, so the tooth gradually shifts. If protruding front teeth are the main cause, the dentist may pull teeth to make space, or use anchoring to draw the front teeth back. Systematic reviews have looked at pulling the front teeth back together and at how extractions change the lips and side profile. [6][7]
Adults, though, can't have their jaw growth steered the way kids can. Tohoku University Hospital also explains that in adults, jaw growth can't be controlled, so the answer is to rearrange the teeth, or to add jaw surgery if needed. [1]
That's the limit of what effort can do.
Teeth move with medical force. The whole jawbone doesn't move with willpower.
Mix those two up and a claim like "change where your tongue rests and your adult lower jaw will grow by millimeters" suddenly sounds believable.
3. How far can tongue training, face exercises and massage take you?
I'm not saying mouth and tongue exercises are pointless. Orofacial myofunctional therapy is used for mouth breathing, tongue habits, swallowing and lip closure.
But it hasn't been established as a way to pull an adult's front teeth or jawbone back in place of orthodontic treatment.
A systematic review on whether adding myofunctional therapy to orthodontic treatment helps found few usable studies, a high risk of bias, and not enough evidence to show it clearly works. [8]
So you can absolutely end up here:
1,000 days of tongue training → jawbone: "..."
If you need function training, do function training. If your teeth need to move, move them. If the problem is skeletal, get the skeleton evaluated.
The most important thing is not to turn all of it into "you just didn't try hard enough."
4. Can braces really change your side profile?
In some cases, yes.
When the front teeth stick out a lot and treatment pulls them back, the position of the lips and the outline of the profile can change too. A systematic review comparing extraction with non-extraction treatment reported that the extraction group tended toward a flatter profile, with the lips set further back and a wider angle between nose and upper lip. [7]
But jumping from there to "pull some teeth and you'll be gorgeous" is going too fast.
A 2022 systematic review and meta-analysis found that facial attractiveness ratings after orthodontic treatment were about 9% higher on average than for untreated people. The authors, however, judged the clinical effect to be weak, and most of the studies had a high risk of bias. [5]
So:
Braces are not a beauty-making machine.
Still, it's true that teeth and mouth shape are part of how people judge appearance, and treating a bite problem that really needs treatment can remove one negative factor.
Think of it less as "generating a new face" and more as fixing bugs in your dental arch to polish the finished product.
5. Can you trust those "my profile changed completely in a few years" posts?
You need to be careful here.
In orthodontic research and jaw-and-face assessment, the head position is standardized as much as possible when comparing profiles. Even the method of recording in a natural head position has been studied for reproducibility. [15]
That's because all of these:
- Tucking your chin in a little
- Stretching your neck
- Pushing your chin out a little
- Changing the camera height
- Changing the shooting distance or focal length
- Tensing or relaxing your lips
make your profile look quite different.
Tuck the chin in for the Before and push it out for the After, and the camera becomes part of the treatment.
Social media Before/After photos are fine as a spark of interest. But if you want to know the actual cause, check what treatment was done, how many millimeters the teeth moved, whether teeth were pulled, and whether the photos were taken under the same conditions.
6. What were those "silver things" you saw in elementary school?
Most were multibracket braces: metal brackets attached to the front surface of the teeth.
A wire runs through the brackets and moves the teeth in three dimensions. It's the standard device for lining up permanent teeth in the end, and it's still in everyday use. [1]
That said, "kids' orthodontics" doesn't mean everyone gets the silver kind.
In the first phase for children, depending on jaw growth, where the permanent teeth will come in and how the teeth meet, dentists may use removable appliances, expanders, headgear or functional appliances. Some kids move on to multibracket braces as a second phase once all their permanent teeth are in. [1]
From the kid's point of view back then, it might have been:
Why am I the only one with silver teeth?
Looking back more than a decade later, it may have been:
Tooth alignment: done
Bite: adjusted
Retention: completed
A major maintenance job your parents finished for you ahead of time.
7. So how much do silver-wire braces cost?
In Japan orthodontics is a private, self-pay treatment, so there's no single national price. It varies with the appliance, treatment length, extractions, anchor screws, adjustment visits, retainers and examinations.
Published examples from university hospitals make it feel more real.
- Okayama University Hospital: a typical adult case with multibracket braces over 2 years is about 750,000 yen in total. [2]
- Tohoku University Hospital: self-pay multibracket treatment is roughly 800,000 to 1,000,000 yen in total. For children, the first phase costs about 500,000 yen including exams, diagnosis and adjustments, and a second phase may cost extra if needed. [1]
These aren't national averages. They're just concrete examples that university hospitals have published.
And here's the funny part about the "silver."
In Okayama University Hospital's price list for appliances, metal brackets for the upper and lower jaws cost less for the appliance part than plastic or lingual (behind-the-teeth) brackets. [2]
So that flashy silver, the look that shouts "I'm in braces!", is actually the budget-friendly classic option.
8. It costs this much and insurance doesn't cover it?
Orthodontics for ordinary bite problems is, as a rule, not covered by public health insurance. [3]
There are three main exceptions.
- Bite problems caused by conditions designated by the health minister
- Bite problems where 3 or more permanent teeth among the front teeth and premolars fail to come in and an operation to expose buried teeth is needed
- Orthodontics before and after surgery for jaw deformity that requires cutting the jawbone
On top of that, the clinic itself has to meet facility requirements to offer it as insured treatment. [3]
So this happens all the time:
I'm bothered by my teeth
→ around 800,000 yen
→ insurance: "Ordinary braces are self-pay."
That's the moment "silver wires in elementary school" turns into "wow, my parents were paying a lot."
9. No insurance, but the medical expense deduction follows different rules
Health insurance and the medical expense deduction are not the same thing.
Japan's National Tax Agency says orthodontics that is considered necessary by common sense, judging from age and purpose, can qualify for the medical expense deduction. Orthodontics done to improve looks or change one's appearance does not. [4]
So you can get this combination:
Insurance: not covered
Medical expense deduction: possibly covered if it's for treatment
"It's self-pay, so it's zero for tax purposes too" isn't necessarily true.
10. So is starting in elementary school always a win? No
This is the part I most want to correct.
Kids still have growth left, so dentists can consider guiding that growth, which isn't possible for adults. A 2025 systematic review summarized studies showing that, for some Class II cases (where the upper teeth and jaw sit too far forward), early treatment had benefits for the dental arch, the jaw relationship and the airway. [9]
On the other hand, early treatment isn't always the better deal.
A summary of a Cochrane review on Class II Division 1 found that a two-phase approach, starting around ages 7 to 11 and treating again in adolescence, showed no clear advantage over one phase in adolescence, apart from fewer new injuries to the front teeth. [10]
So the right move is not:
Elementary school! Mash the start-braces button!
Instead, check whether there's a problem that makes intervening now worthwhile, such as an underbite, a strongly protruding upper jaw, jaw growth, room for teeth to come in, or function problems.
What makes it a strong long-term investment isn't "starting as fast as possible." It's not missing the window when treatment is indicated, and finishing the necessary treatment.
11. "I feel like pretty people had braces from a young age." Just a feeling?
It's not all an illusion. But don't reverse-engineer the causes too far.
Braces can change part of your tooth alignment and mouth area. And whether a child gets access to orthodontic care is tied to the family's socioeconomic situation.
A 2023 systematic review, building on earlier evidence that higher socioeconomic status means better access to orthodontic care, looked even at inequalities during treatment. But the links with treatment outcomes themselves varied a lot between studies, and the conclusions were limited. [11]
A 2024 observational study of 173 people found no correlation between low socioeconomic status and the skeletal or dentoalveolar abnormalities themselves. It did find differences in staying with treatment, such as attending visits and managing the appliance. [12]
That matters.
It's not that "poorer people are born with worse jaws."
The gap can come from the "access to correction and upkeep" side:
- Parents notice the problem
- They take the child to a specialist
- They pay several hundred thousand to 1,000,000 yen
- They keep up years of visits
- They support brushing and appliance care
- They see it through to the retainer stage
Silver wire from elementary school is metal on the teeth, but it's also a trace of a family running a multi-year project.
12. Does "better looks" go all the way to "richer"?
Treating this as one-way causation is risky here too.
A study that followed a general population cohort in western Scotland for about 20 years found that people rated more attractive at age 15 tended to have higher socioeconomic status at 36, in employment, housing and income. The link remained even after adjusting for parents' class, intelligence, health, self-esteem and education. [13]
Labor economics has long studied how appearance ratings relate to wages and employment, the so-called "beauty premium." But the effect differs by occupation, gender and country, and it's hard to fully separate looks from confidence, personality, grooming, career choice and discrimination. [14]
So reality includes this direction:
Family resources → access to dental care, cosmetic care and health → part of one's adult appearance
and it can include the reverse direction too:
Appearance ratings → other people's reactions, career choices, the labor market → income
But this isn't a rule you can use to judge an individual, like "she's pretty, so she's rich" or "his teeth are crooked, so he's poor."
All you can say is money, health, looks and social evaluation don't live in completely separate worlds.
Society suddenly has its status screens linked together.
13. If you call braces an "investment," what are you investing in?
It's not a financial product, so you can't calculate a yield.
Still, for someone who needs it, you can see it as putting money into a body asset you'll use for a long time:
- Tooth alignment and bite
- How your mouth and smile look
- How easy your teeth are to clean and maintain
- A foundation for future dental treatment
- Resolving a looks problem you've worried about for years
During treatment, brushing gets harder, so managing cavities and gum health matters. After treatment, teeth try to drift back, so you need a retainer. Nippon Dental University Hospital generally advises a retention period of at least 2 years. [16]
So it isn't "pay 1,000,000 yen and you're done."
Diagnosis → treatment → keeping things clean → retention is one whole project.
If your parents were running that for you since elementary school, it's no surprise you only see its value as an adult.
Wrap-up: silver wire isn't "uncool hardware," it's a long-term project
As a kid it was just shiny and conspicuous.
Break it down as an adult and it looks different.
If the teeth are forward, teeth can be moved. If the skeleton is the main cause, teeth alone have limits. Adult face exercises can't freely move the whole jawbone. Ordinary orthodontics is self-pay, and even university hospital examples run from several hundred thousand to around 1,000,000 yen. Insurance has strict conditions, and the medical expense deduction is judged separately. Early treatment for kids depends on the case, and earlier isn't always better. And family finances can affect the ability to get treatment and see it through over the years.
So if you look back at the silver wire from elementary school, the closest way to put it is probably this:
"The kid sparkled for a few years. The parents paid for a few years. The finished product, the kid gets to use forever."
That's one solid long-term investment.
