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Braced for a Change
by Roberta Greenwood

Take a look around the Puget Sound area and you’ll see women of all ages, in all walks of life, wearing braces.

“We’re everywhere,” the attractive, middle-aged cashier at Safeco field laughed. Pointing to her metal-clad teeth she asked “Only two weeks left for me; how long ‘til yours come off?”

“Fifteen months,” I sighed. Uncomfortable in my braces after only three weeks of treatment, my mouth ached from the constant pressure the wires were applying to my teeth and my self-confidence was lagging.

“Oh, it’ll go so quickly – and you’re going to love the results!” She gave me a fabulous smile as she handed me my Ivar’s clam chowder and I walked away feeling a little less conspicuous and a lot more hopeful. Maybe getting braces at 52 wasn’t such a crazy idea after all.

Far from it, says Bellevue orthodontist Dr. Jacqueline Bunce, DDS, MS. She notes that studies show that correcting crooked teeth and improving a patient’s smile has a significant positive impact on self-confidence and success in business. Many of her adult patients report they’ve spent years hiding their smile or suffering from the teasing they experienced as children due to problems with their teeth. Bunce says almost half of her patients are adults – many in their thirties and older.

Getting Started

Nationally, adults make up 25 percent of orthodontia patients, with women getting braces at a much higher ratio than men. Like many others, I based my decision on the suggestion of my family dentist. Noting my crowded teeth, he explained that the ongoing struggle to keep my teeth free from plaque and the resulting bleeding gums could lead to potential tooth decay, which in turn could contribute to serious illnesses such as diabetes and heart disease and eventual loss of teeth. Even years of frequent deep-cleanings and preventive care weren’t achieving the results I needed to assure the highest level of oral hygiene; braces might. According to the Association of American Orthodontists (AAO), orthodontic treatment can restore good function and oral health to adults who’ve endured even long-standing dental problems.

I never considered my slightly crooked smile as anything but a minor issue. I assumed that with proper care, my teeth would last my lifetime – a relatively new concept. Just a few generations ago it was common for adults to have their teeth pulled and mouth fitted with dentures, sometimes as early as their mid-twenties. Now, with tremendous improvements in preventive care, it’s possible for most Americans to retain healthy teeth for life. Seattle orthodontist Elizabeth Lyons explains that braces not only correct cosmetic issues but also functional problems such as gaps, crowding and wear on teeth caused by “bite” issues. “Many times,” she says “patients will require braces to repair excessive wear on their teeth. Even some restorative care can’t be completed until the teeth are moved and correctly aligned.”

Cathy Cline, senior management assistant for the City of Bellevue, based her decision to get braces at 53 on subtle changes in her bite that resulted in constant chipping of her lower teeth. “I wore braces as a teen and a retainer until I was 25. Then I threw it away. Now I’m back in braces to correct this bite issue again. I wanted them as unobtrusive as possible, so I started with ceramic (clear) brackets.” Like Cline, patients today have a wide array of choices to consider before beginning orthodontic treatment. Improvements in materials have made braces more attractive, comfortable and affordable, while new procedures have decreased the time needed to complete treatment. “Treatment today certainly is more efficient,” says Bunce. “Thanks to the modern materials we use, patients can be fitted quicker and usually don’t need to come to the office as frequently.”

These new materials include NASA-developed alloy wires, ceramic or clear brackets, permanent retainers and, in some cases, “invisible” braces. Dr. John Moore, affiliate professor of orthodontics at the University of Washington and a Seattle orthodontist, says the introduction of these clear, plastic aligners is an important innovation. “Although not for every patient,” he advises, “they’re more aesthetically pleasing and comfortable; because they’re removable, cleaning is easier and oral hygiene is improved.”

Additionally, Moore credits new techniques and appliances for greatly reducing discomfort, decreasing the frequency of visits and shortening treatment time, making braces more acceptable to his patients, 60 percent of whom are adults.

Bunce agrees and is also excited about new technologies that allow doctors to better explain the various options to prospective clients. “We now have computer programs that act as teaching aids. We can illustrate outcomes for our patients and they can actually see what the results will be for them. It’s an exciting time, and patients can make informed decisions.”

Making the Investment

May Kulthol, media relations manager for Starbucks Coffee Company, made her decision to get braces at age 28. Noticing that her front teeth were moving slightly, she consulted with her dentist and decided that “traditional” braces were her best option. Her treatment lasted two years and she’s delighted with the results. “My orthodontist predicted I wouldn’t have lips if I didn’t get this problem fixed,” she laughs. “Although I don’t deny the cosmetic results are pleasing, I did this for my overall well-being. This was an investment and a major contribution to my health. I’m always smiling now and I’m more confident.”

Kulthol also says the procedure was much less painful than she had anticipated, adding that she never received any negative reaction in the workplace, something she feared might occur. “I had such a good experience,” she concludes, “now my brother and sister are considering braces.”

Not all patients find treatment as easy as Kulthol. “I underestimated the disruption the braces would cause in my life,” says Cline. “I experienced a high level of discomfort and soreness. Plus, you have to constantly adjust what you eat.” She coats her braces in wax daily and chooses her foods carefully, always conscious of the stray piece of lettuce that might remain lodged in the wires around her teeth. With her braces due to be removed in November, Cline can’t wait to feast on some of her favorite foods which have been off-limits during her treatment. “I can’t wait to eat corn on the cob and ribs again!” she exclaims.

Dietary changes are an important component of successful treatment; all orthodontic patients are given a comprehensive list of foods to avoid during the course of their procedure. Failure to adhere to the guidelines can cause broken wires, loose brackets and costly delays to treatment. “Generally, adult patients follow all the rules; they’re self-motivated and understand cause and effect,” Bunce says. “They’re also paying for their own treatment, and that makes a huge difference.”

Many dental health plans offer partial coverage for adult orthodontia. The full cost varies, averaging $3500 to $5000 for treatment which generally lasts about 24 months. During the course of treatment, patients are urged to see their dentist for regular checkups and cleanings. “It’s so important for successful treatment,” says Bunce. “Patients must also brush thoroughly and floss regularly to retain the health of their gums and teeth.” In addition to dental appointments, patients are seen by their orthodontist for periodic “adjustments” – replacing the flexible wires attached to the brackets which move the teeth into place.

Once the braces are removed, patients move into the retention stage. “Patients will wear a removable retainer (a device that keeps the teeth from returning to their former position) for the first six months, full-time,” Lyons explains. “We then suggest one year of night wear and finally one to two nights a week thereafter – for life.” Lower teeth can be held in place with a “fixed” wire, which is bonded to the teeth and doesn’t require removal for eating or cleaning. Lyons stresses that the retention stage is critical for long-term success. “All things change with time,” she says. “Teeth move throughout life; we take the patient’s lifestyle into consideration, their long-term goals, and develop a plan with them.”

After successfully completing 15 months of treatment, my braces were removed prior to my first trip to Paris in May 2005. Grinning broadly for the camera atop the Arc de Triomphe, I recalled the assurances uttered by my orthodontist whenever I complained or doubted my decision to start treatment: “All the struggles and sacrifices will be worth it because we’re building smiles for the rest of your life.”

Roberta Greenwood is a regular contributor to Seattle Woman and loves flashing her new smile throughout the Pacific Northwest.

©2005 Caliope Publishing Company