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Braces are for grown-ups too

The stigma on orthodontics for adults appears to be gone. The implements are higher tech and less visible than before, and research suggests having straight teeth helps in social life.

July 04, 2011|By Amanda Leigh Mascarelli, HealthKey
  • Dennis Hauptman, 44, gets ready for a checkup of his braces at the Upland clinic of Dr. Stephen Tracey.
Dennis Hauptman, 44, gets ready for a checkup of his braces at the Upland… (Irfan Khan, Los Angeles…)

Roger Grunwald's acting career has taken him to off-Broadway stages and the set of the soap opera "One Life to Live." He certainly has reason to smile. But in all seven of his professional headshots, his lips are sealed shut.

"Being in the performing arts, a crooked smile doesn't do you any good," says the middle-aged New York City actor. Most distressing was a particular tooth that protruded from his lower jaw. So about three years ago, he went to an orthodontist and got outfitted with braces. Now, he says, "I don't feel self-conscious about the snaggletooth."

Not long ago, braces were considered just for kids. But patients like Grunwald are now straightening their teeth without taking on a mouthful of metal.

Gone are the giant metal braces, big steel wires and unsightly headgear they remember from childhood. Instead, they can opt for braces with clear ceramic brackets or brackets attached to the backsides of the teeth. In some cases, they can forget about brackets altogether and go for Invisalign, which utilizes a series of clear plastic trays to coerce the teeth into place.

These higher-tech options are making orthodontics more appealing to older patients. The number of U.S. adults wearing braces topped 1 million in 2008, up about 25% since 1989, according to the American Assn. of Orthodontics.

"The stigma of being 'too old' for braces has diminished for the most part," says Dr. Stephen Tracey, an orthodontist in Upland whose oldest patient was 80.

Orthodontists cite a host of reasons for the growing acceptance of braces among adults. They're more affordable because insurance coverage for orthodontic work is on the rise. They're more comfortable and more discreet. Treatment times are shorter and fewer office visits are needed.

And there's ever-increasing pressure to look one's best.

"Whether we like it or not, we are often judged by our appearance," Tracey said. "Many adults are concerned about how their smile might affect their chances for employment or advancement in a competitive job market. Many are reentering the dating scene after a divorce and are looking for a more attractive, youthful appearance."

Just as bone density decreases with age throughout our bodies, the bones in our mouths lose density and shift with age. Teeth also shift due to wear and changing pressures in the mouth, Tracey says. Even adults who had braces as children sometimes need to return for orthodontic treatment in midlife or later, especially if they aren't diligent about wearing their retainers and their teeth shift out of alignment.

Orthodontic technology has improved significantly since patients like Grunwald were in junior high school. Unlike the days when braces were tightened down with stiff wires, many of today's braces use a lighter, more flexible arch wire made of nickel titanium. These wires can be custom-designed to fit the mouth of each patient, and they have shape memory so they don't require frequent adjustments.

"That allows for longer times between appointments, so it doesn't interfere as much with your work schedule," says Dr. Michael Rogers, president of the American Assn. of Orthodontists. "It moves teeth faster because it works all the time."

Some braces have no wires at all.

Braces typically cost between $4,000 and $8,000, depending upon the treatment. Insurance may cover part of this cost, and the number of new patients with orthodontic benefits has jumped from 54% in 1996 to 73% in 2008, according to the orthodontics organization.

Orthodontists say that the benefits of braces can affect the health of teeth for a lifetime. Teeth are easier to clean if they're not crowded, teeth wear evenly if they are properly aligned and patients learn how to take better care of their teeth.

Demand for braces can seem almost contagious.

Sometimes parents are inspired to get braces after seeing how effective they are for their kids, says Dr. Lee W. Graber, an orthodontist in Vernon Hills, Ill.

"People will bring children in, and the children will be successfully treated, and then the mom will see other adult patients in the office and recognize that she can have something done," Graber says. "Then they'll pull Dad in. That is not an uncommon sequence."

The contagion can spread through the workplace too, says Rogers, who practices in Augusta, Ga.


"I've got one company — I must be treating almost everybody in that company because one gets it and another gets it and they just feel like it's an acceptable thing to do," he says.

Ellen Adams, a marketing consultant in Somerville, Mass., was nervous about getting braces at age 30 to correct her bite and straighten her teeth. Though she opted for braces with clear brackets, she feared people would stare at her mouth or ask her awkward questions. Instead, she says, she discovered that adults with braces were a lot more common than she had realized.

"Once I had them, I'd notice other people and feel like, 'Oh, it's not so bad,'" she says.

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