Not that long ago, preteens were just about the only ones whose smiles sparkled with shiny metal, teeth-straightening braces.
Now: The look of braces—and the people who are wearing them—has dramatically changed. Braces are much more discreet than ever before, and about one out of every four patients who seeks this treatment is an adult.
There are a variety of reasons why more and more adults are now seeing orthodontists.* Many adults experience crowding of their bottom front teeth as they age. While this shifting of the teeth is perfectly normal, it’s usually not aesthetically pleasing. Crowded teeth are also harder for many people to keep clean because rotated and/or overlapping teeth tend to catch more food.
With age, structural changes to the gum and bone also tend to occur, shifting one’s normal bite. Orthodontic treatment can often help prevent the wearing down or chipping of teeth that would otherwise result…or, in some cases, guard against gum erosion and problems in the function and comfort of the jaw joint if a person’s bite is not properly aligned.
For other people, self-image is the driving force. Many adults have been self-conscious about the appearance of their teeth for years—perhaps even avoiding smiling as a result.
Fixed braces, “brackets” that are bonded to each tooth and linked with wires, have long been the gold standard. These brackets are extremely effective at straightening teeth because precise pressure can be applied by the orthodontist via a connected arch wire. Arch wires may be of varying size, shape and material depending on the stage of treatment. The orthodontist typically makes adjustments once every six to 12 weeks.
Depending on the severity of your condition, treatment for an adult typically lasts one to three years (more complicated problems can require more time). The price for fixed metal braces varies depending on your location, but they generally run about $5,000 to $7,000, according to the American Dental Association. Note: You may be able to use your Flexible Spending Account to cover orthodontic expenses.
Improved options: Today’s standard metal braces are about half the size they were even 15 years ago. So-called “mini braces” are even less conspicuous—about 30% smaller than today’s standard braces. Unlike the metal (stainless steel or titanium) that has been widely used, porcelain or ceramic braces are now available and appear tooth-colored or clear.
All of these options are equally effective, but tooth-colored braces placed on the upper teeth may be more expensive, adding about $375 to $500 to the treatment.
Important: For adults who need new crowns, root canals and/or cavity fillings, careful and coordinated planning between the orthodontist, general dentist and other dental specialists, such as periodontists, is often required to achieve an optimal outcome.
In addition, certain medications, such as estrogen hormone replacement therapy…nonsteroidal anti-inflammatory drugs (NSAIDs) and/or long-term aspirin therapy…and osteoporosis medications known as bisphosphonates, such as alendronate (Fosamax), can slow down desired tooth movement. With such circumstances, it’s crucial for your orthodontist to take a thorough medical history, including the use of any medications, before developing a treatment plan.
TO BE DISCREET
• Clear aligners, such as Invisalign or ClearCorrect, are less visible than traditional braces but more limited in scope. These removable, custom-fit plastic trays are created from 3-D scans of your teeth and can be removed for eating or brushing and flossing.
You’ll get a series of trays, which sequentially move teeth to the desired position. To be most effective, patients should wear their aligners at least 22 hours per day.
Patients usually switch their trays every two weeks with treatment lasting from seven to 10 months and up to 24 months for more involved plans. The fees for aligners vary but often are comparable to those for fixed braces.
• Lingual braces attach behind the teeth so no one knows that you’re wearing them. Some orthodontists consider lingual braces less efficient and less comfortable than front-of-the-teeth types. Lingual braces are usually more expensive—sometimes costing up to 50% more than traditional metal braces.
In addition to the advancements described earlier, adjunct therapies can potentially be used to improve orthodontic treatment cosmetics, speed and outcome. For example…
• SureSmile allows an orthodontist to create a 3-D computer model of your teeth, bite and jaw structures. A truly customized treatment plan is then created using software and virtual simulation tools. The arch wire, which is traditionally manipulated by the orthodontist, is shaped and bent robotically for greater precision based on the orthodontist’s prescription.
Use of this technology can reduce treatment time by up to 30%. Some practices may charge an extra $500 to $800, while others include it in your orthodontic costs. Other brace systems that integrate computerized planning and custom fabrication of braces and/or arch wires include Insignia, Incognito Hidden Braces and Harmony.
• AcceleDent is an FDA-cleared device that was introduced in the US in 2012. Resembling a bite guard, the prescription-only device delivers pain-free vibrations, or micropulses, to the teeth, which are thought to accelerate the bone and gum-remodeling processes.
Research findings are mixed, but some studies have found that treatment time may be reduced by 30% to 50%, depending on the type of treatment being provided. AcceleDent should be used for 20 minutes daily to achieve the desired results. Some practices charge an extra $600 to $1,000, while other practices include it in your initial orthodontic cost estimate.
*To find an orthodontist near you, consult the website of the American Association of Orthodontists, MyLifeMySmile.org.