Nearly 1 million grownups are sporting some form of braces, double the number from 10 years ago, according to the American Association of Orthodontists (AAO).
A slew of technological advances have made braces less noticeable, less painful, and even less time-consuming. And as America's baby boomers become more health-conscious, they're rejecting the notion that dentures are a routine part of growing older.
"We want to maintain our body parts longer. People brag about working out, and braces are an outward statement that you care about yourself," says Jeffrey Schauder, D.D.S., president of the Midwestern Society of Orthodontists and practitioner in Green Bay, Wisconsin.
We also want to look better. Chris Carpenter, D.D.S., an orthodontist in Denver, says as people get older, their facial muscles begin to droop. "Your smile line drops and you see more of your lower teeth," he says. "I've had several patients say this is the first time they've noticed how crooked their teeth were."
Given this modern gadgetry, is treatment for adult orthodontics any different from treatment for kids? Well, yes and no. Essentially, the process of moving teeth is the same. But because you're dealing with a more mature mouth, you've got a different set of scenarios.
By age 35, three out of four adults have some form of periodontal disease, according to the American Dental Association. The affliction is caused by a buildup of bacteria in plaque. Periodontitis is significant because it can damage the underlying support structures that hold teeth in place. When gums and bone become soft or weakened, teeth begin to move around in the mouth.
And in severe cases, a tooth falls out or has to be removed. Open spaces result. Healthy teeth often tip into these expanses, causing an unattractive and askew line. Crooked teeth present their own problems. By making it difficult to properly brush and floss, uneven teeth can lead to an accumulation of plaque. And the cycle goes round and round.
Treatment for these conditions often involves the collaboration of a dentist, periodontist, and orthodontist. "We want to arrive at the same diagnosis and treatment to make sure that we're all on the same path," says Dr. Marks.
Sally Borla's dentist told her she'd reached the point of no return.
"I had a long history of heavy plaque buildup and gum disease," says the 56-year-old from Bloomingdale, Illinois. "I'd lost two teeth years ago and didn't have a spacer put in. My teeth had shifted around so much that I was biting into the sides of my mouth and tongue. My choices were surgery or braces." She chose braces.
Sally is delighted with the results. "I really look great, if I must say so myself," she says.
Some experts believe that braces can help with temporomandibular joint (TMJ) syndrome, a problem common among women. TMJ affects the joints at either side of the jaw, making it painful to open and close your mouth. Facial pain, headaches, and tenderness of the jaw muscles are a few of the symptoms. Some patients experience a clicking or popping sound when they move their mouths.
While many factors can contribute to TMJ, such as stress and hormonal influences, says Dr. Carpenter, braces may provide relief by correcting misaligned teeth. If you think you may have TMJ, talk to your dentist about treatment options.
When Do They Come Off?
How long you have to wear your braces depends on what's being done.
In general, adult corrections take slightly longer than kids' because an adult's mouth and jaw are no longer growing and problems may be more challenging. Generally, adults can expect to wear braces between 12 and 36 months.
Most standard employer-sponsored group dental insurance covers some portion of braces for adults. "Seventy percent of the patients in our practice have coverage," says Dr. Schauder. The AAO says 54 percent of all orthodontic patients are offered coverage. Individual insurance is not available. Fees are based on the severity of the problem and the complexity of the treatment. Most therapies range from $1,800 to $4,500.
Assuming you don't consume mass quantities of sticky candy on a regular basis, braces needn't change your lifestyle. The only difference is that you may have to do a bit of hygienic gymnastics, says Dr. Schauder. "A snack might require a trip to the bathroom with a toothbrush," he says.
The greatest risk facing adults with braces is gum disease. Since adults are more prone to it and often eat a diverse diet, they must be extra careful about brushing and flossing. Other than that, if patients are properly screened for gum and bone strength, there really is no age limit to a better and straighter smile.
"I recently treated a 74-year-old grandmother," says Dr. Carpenter. "She looks great."
Goodbye, Tinsel Teeth
Clear brackets have been the biggest lure for adults. Now, instead of separate bands of stainless steel being wrapped around each tooth, smaller translucent ceramic brackets are bonded directly to the front of the teeth. The ceramic brackets blend in with your teeth's natural enamel.
The old metal bands also often touched the gums, causing irritation, says David Kinser, D.D.S., an orthodontist in Des Moines, Iowa, and an adjunct professor at the University of Iowa College of Dentistry. The new brackets are much more "periodontally friendly," he says. And in certain cases where aesthetics are critical, brackets can be secured to the inside of the teeth, rendering braces invisible.
New high-tech wires have also made braces less time-consuming and more comfortable. Old-fashioned wires often required an office visit every few weeks during which the orthodontist tightened the wire. Patients would experience sudden intense force that would gradually diminish until it was time for their next appointment.
But newer wires -- developed by NASA for use in the space program -- apply an even, gentle pressure over a much longer period of time. The nickel-titanium wires are contoured to follow the line of the patient's teeth. Then, heat from the patient's mouth activates the wire to slowly regain its original shape.
Consequently, the on-again, off-again pain is eliminated. It's a notably more comfortable process, says Clifford Marks, D.D.S., an orthodontist in Miami. And treatment time is shortened because there's no pause in the tension exerted on the teeth.