Braces: It's Never Too Late for a Great Smile!

Lynn S.

Adults are often shocked and dismayed when their dentist suggests that they consult with an orthodontist to get braces. I sure was. But I had to face the fact that my teeth were crooked and hard to clean - and it was getting worse. I knew that I had to do something about it -- but braces? I was worried about the pain, the inconvenience, and the embarrassment of being braced in my 30's.

I hedged on the idea of braces for 10 years, all throughout my 30's. I had many orthodontic consultations and they all told me the same thing: I had an open bite, would need 4 extractions, and would be in braces for about 2 years.

Finally, in my early 40's, I decided that it was "now or never." I finally found a local orthodontist that I liked and I took the plunge. That was almost 5 years ago. It was one of the best decisions I ever made. I was in braces for almost three years. Now my teeth are straight and white, and I am not ashamed to smile anymore. I'm also proud that I can flash a natural smile, not a bunch of veneers.

Along the way I started an online orthodontic journal to document my smile's transformation. That journal evolved into the website archwired.com- the premier site on the web for adult orthodontic information. In the years that ArchWired has been running, I have heard many stories just like mine, from adults who are scared, hesitant, embarrassed, or just plain unsure about getting braces. If you are in that boat, welcome to the regatta; there are many adults out there just like you. Some never had braces as children and can finally afford to get their teeth fixed. Some didn't wear their retainers and their teeth shifted as they aged. Some have children in braces and, seeing the dramatic results, want to "finally do something" about their own teeth. Treating adults with braces is becoming more and more common as orthodontic technology evolves. According to the American Association of Orthodontists, there are now over a million adults in the U.S. and Canada in braces! If you are considering braces, here are some pointers to help you make an informed decision.

Get Multiple Consultations
There's an old saying: "There's more than one way to skin a cat." Well, the same applies to straightening teeth. Every orthodontist has a slightly different idea and treatment plan that will often lead to the same result. This is why I suggest getting at least 3 consultations from different orthodontists. Consultations are usually free of charge and obligation. If you don't know whom to see, ask your dentist, your child's dentist; or friends, neighbors, or associates who have braces or have kids in braces. If you don't like what you hear from any of the three orthodontists, then see a few more, until you are comfortable or have reached a consensus of opinion.

How to Choose?
Take the following into account before you sign up for treatment:

Do you think you could follow the prescribed treatment for the length of time suggested? (Average time in braces is 24 months).
Do you like the personality of the orthodontist and the staff?
Can you afford the cost of the treatment? Most treatment requires an initial deposit and then monthly payments for the length of your treatment. (The average total cost of braces is $5,000).
Is the orthodontist's office in a convenient location, close to your home or office?
Do you feel that you can talk to this orthodontist? Communication is very important!
If you have dental insurance, does it cover adult orthodontics? Most plans do not, but you should always double-check. Also realize that if you sign up for a new plan, it usually doesn't pay for treatment that is already underway. So if you are considering signing up for some insurance or discount plan, do it before you get your braces on! Also realize that, with some dental plans, you may be limited to their list of dentists.
And finally, you must ask yourself: "Am I willing to put up with some discomfort and a lot of oral hygiene for the next couple of years?"

More than Just Straight Teeth
Braces are all about straightening the teeth, right? Well, it's actually a bit more complicated than that. An orthodontist not only wants your teeth to be straight, but your bite (also known as your "occlusion") to be optimal. What is a "bite?" It is the way that your top and bottom teeth line up and function together - which goes hand in hand with the way your jaw functions. If your bite is "off" and your teeth are not aligned properly, it can cause TMJ, headaches, pain, and other problems such as wearing down or cracking of the teeth. This is main reason that Tom Cruise got braces a few years ago! So, when an orthodontist draws up a treatment plan for you, he or she takes this all into consideration. Remember: when you embark upon orthodontic treatment, a "good bite" is just as important as straight teeth!

Invisible or Not?
Many adults hope that their teeth can be straightened with invisible braces - the type with the clear plastic aligner trays. The truth is: those invisible braces are not for everyone. If you have a complicated case, the orthodontist will probably suggest traditional braces. Or, you may be able to start off with invisible braces and then finish your treatment with traditional braces. If you feel that you can tolerate braces behind the teeth, another option is lingual braces. "Lingual" means "surface of the teeth toward the tongue;" in other words, behind the teeth. Lingual braces are invisible to others when you smile and talk, but they can be more uncomfortable for your tongue than traditional labial braces ("labial" means "near the lips;" or at the front of the teeth). There have been a lot of advances in lingual braces in recent years, helping to make this a more comfortable option. The downside is: not every orthodontist has been trained in lingual technique, so it may be a bit harder to find an orthodontist who does lingual treatment.

Traditional Braces and Beyond
Traditional labial braces have also made many technological leaps in the past 10 years. There are several types of ceramic brackets that seem to disappear visually on the teeth. In addition, there are new types of wires and brackets that use different types of force to move the teeth more quickly - which means that you'll be in braces for less time. Some brackets require little elastic rings (known as "ligatures") to hold the arch wire to the bracket. And some have a little trap door that eliminates the need for ligatures; this type of bracket is called "self-ligating." Another type of bracket system claims that it can slowly help to build new bone in your jaw, possibly eliminating the need for extractions. Orthodontic companies are constantly trying to come out with new and better products to expand the array of treatment options, both functionally and aesthetically. In your research, you may learn about all the different types of bracket systems out there, but remember: the ultimate authority on your treatment is your orthodontist, who has had many years of training and expertise in this field!

Questions to Ask
Here is a list of questions you may want to ask an orthodontist when making a consultation. Take this list with you to the orthodontist as a handy reference:

Will those "invisible" braces work for me?
Can I have ceramic braces? On just uppers, or both uppers and lowers?
Will I need metal braces? On the uppers, lowers, or both?
Do you do lingual or self-ligating braces?
Will my braces go on all at once, or will I get uppers first and then lowers a few weeks later?
Will I need rubber bands at some point?
Will I need palate expansion? If so, what does that entail?
Will I need springs or other special hardware?
Will I need headgear or other appliances? If so, how long will I need to wear it, and how many hours per day? When, in the treatment process, would the headgear be introduced?
Will any teeth need to be extracted?
Will the treatment change my facial profile in any way? If so, how?
Will I need jaw surgery? If so, when (before or after?) What will the jaw surgery entail, and who would do it?
Will braces only straighten my teeth, or will they also improve my bite?
How long (how many months/years) will the total treatment take?
How often will I need to come to your office for adjustments? What do the adjustments entail?
If a wire is poking me, can I drop in to get it clipped, or do I need to make an appointment first?
What is the total cost? Do you accept insurance? How is the cost broken down?
How much pain and discomfort will I be in?
What are the risks of treatment?

Best of luck in your orthodontic journey! Here's wishing you the "Hollywood Smile" of your dreams!

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