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Never too late to create a perfect smile

For health and cosmetic reasons, more grown-ups are enduring the inconvenience and expense of orthodontia.

October 28, 2002|Benedict Carey | Times Staff Writer

A life on camera will expose even the most subtle imperfections in appearance, as Renee Spei knows. An actress who does work in film, TV and voice-over, she saw her face on screen several years ago and noticed something she hadn't before. Her smile wasn't right. Once pristine as pearls, her front two teeth now overlapped a bit; several in the lower row leaned and bunched together.

"I don't think I lost any jobs because of it, but you never know," she said. "It was bugging me. You know how it is: It may seem a very small thing to everyone else, but if it's bugging you, it's not so small anymore."

At a time when people regularly visit cosmetic surgeons to alter the shape of their lips, noses and breasts, Spei found herself contemplating in her mid-20s a cosmetic procedure that's so routine, safe and socially acceptable that it's almost invisible -- on 13-year-olds. By adulthood, we're supposed to be beyond braces.

A mouthful of steel scaffolding goes much better with ponytails than with business meetings, car payments and dinner parties. Yet even people who had straight, clean beauties into their teens often discover years later that a few of their teeth, especially lower teeth, are listing noticeably, said Spei's orthodontist, Dr. Patrick Turley, a professor emeritus at UCLA now in private practice in Santa Monica. Teeth tend to drift toward the front of the mouth with age, and may eventually press together and slightly overlap, he said.

It doesn't take much misalignment to cause food buildup, uneven wear on the teeth and, eventually, gum disease. The number of adults getting braces has increased about 30% since 1994, to more than 1 million in the United States and Canada, and many get them to combat creeping gum problems, according to the American Orthodontists Assn.

Spei learned that her alignment would only get worse with time and decided that a spell in braces would ultimately help her career rather than hinder it. She wasn't too worried about the shock value. Her good friends would hardly care, and there was no one role that would need rewriting because of the braces. "Most of all," she said, "I knew in the end it would make me feel better about myself."

Her biggest concerns were money and time.

Compared with children's jaws, which are still developing, adult jawbones may as well be cast in concrete, and correction typically takes more time. Where youngsters often get their braces off in a year or 18 months, adults may be smiling silver for months longer. Costs range from $3,000 to $7,000. In her case, Spei learned that doing the job right would cost about $6,000 and take three years -- putting her into her late 20s. The news was hard to digest, but there was a small loophole: "If I got a big part, I could have them taken off temporarily during filming," she said. "That made me feel better about it."

The first few days scored by far the highest on the discomfort meter. "Your mouth is very sensitive, very tender, especially the first 24 hours," Spei said, "and you stick to softer foods, soft bread, ice cream, that sort of thing." After that, the teeth and gums quickly adapt to the new rigging. Typically, adult wearers visit the orthodontist every two months or so for tightening, followed by a day or two of soreness, Turley said.

In between visits, there's cleaning and more cleaning. This is no less labor-intensive with modern braces than it was a generation ago, when schoolchildren wore the full-metal-jacket bands and brackets. After each meal, orthodontists say, wearers should brush and floss carefully. "You're talking about five to 10 minutes or more every time," Spei said. "It's a lot of work, and probably the most annoying thing about this."

Though clear, ceramic and plastic braces are effective, the steel bands work faster and more precisely, Turley said. As a rule, orthodontists say, young, single people tend to be more interested in clear braces than those who are middle-aged and married. Clear braces can cost 10% to 30% more than the steel variety and are usually worn for longer, orthodontists say. Spei decided on the steel; she would be upfront about it. "I lost one job because of them, I know that for sure," she said.

It wasn't long, either, before some people at her local store and gym and the Beverly Hills Playhouse, where she's a regular actor, tagged her affectionately as "Renee-with-braces." Some of her friends even questioned why she did it at all; they saw no problem with her teeth.

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