Getting Braces as an Adult-(Improvement of my eyesight)
Aug 06 '00 (Updated Jan 26 '01)
The Bottom Line If you're an adult, don't get braces unless you don't have any other choice!
The 2-part Disclaimer:
First, I had some trouble finding a place for this, so I found a related editorial and, although this isn't about kids it is about health. Please also refer to the excellent points brought up by dustygold regarding care of your braces.
Secondly, rather than to do a lot of research for this topic, I decided to write this primarily from my own experience. I don’t claim to be an orthodontist or an expert in this area other than my first-hand knowledge. It is meant to give you something to think about if you are considering getting orthodontic braces as an adult. I never thought that braces would affect my vision, but do you know that expression “Hindsight is 20-20”? I wish I knew then what I know now.
Why I even considered doing this
A few years ago my dentist mentioned to me that more and more adults are getting braces. When I asked him why, he mentioned the typical point of cosmetics, but he also told me that there are 2 other things that I hadn’t really thought of. First, that if you have TMJ (Temporo-Mandibular Joint) problems that it might be helped by orthodontia. And secondly, that as we get older it is harder to keep our teeth clean if they are not straight due to loss of manual dexterity. As for the cosmetic part, if that is the main reason a person is considering braces it’s not the best reason because you’ll most likely be disappointed that your life doesn’t change because your teeth are straight.
I figure I had no expectations for that type of change. I certainly hadn’t ever considered the second point and I was having some TMJ issues of clenching which led to neck muscle tightness and, in turn, trouble sleeping. (I also happened to be going through a divorce at the time which may have led to some of my insomnia, but who am I to state the obvious?) My teeth are somewhat crowded, making flossing very challenging (and giving me a built-in excuse whenever the dentist would bug me about it.) I should say that at 41, I was not that old at the time, but I thought that was as good a time as any to look into orthodontia as a solution for me.
Why didn’t I have this done as a teenager when my parents would have paid for it? Doh!
So, being the over-planner and good consumer, I decided to get two opinions. I went to my nephew’s orthodontist and one that my own dentist referred me to, as well. Since both professionals pretty much said the same thing I decided to heavily consider it. Not that I should have been surprised, but they both recommended that I get braces and the length of time, goals, and price were very comparable. I had (well, I still have) an overbite and some misalignment, although just about every non-orthodontist that I talked to about this said “Your teeth aren’t that crooked” or “You don’t need braces.” But I thought I’d weigh the recommendations of the professionals heavier than those of my friends.
Both of the orthodontists said that in my case they would expect that the process would take a year and a half (Oh goody!), and they each quoted a price around $5,000. (Gasp!) They both talked about the possibility of having to extract one tooth, depending upon how things progressed, although both preferred avoiding that, if possible. I subsequently learned that, although I have pretty good dental insurance, it is not typical for most average policies to cover adult orthodontia, regardless of reason. If you’re lucky enough to have that coverage your policy is more the exception than the rule.
Brace Face
I found out that there are primarily 3 types of braces used today. (There might be variations on these, and there even might be more, but I’ll talk about the ones I've heard about.) First there are the braces that consist of bands around the molars with cemented brackets on the other teeth and then one (or if you’re lucky, two) wires that fit in those brackets. These come in metal or ceramic (clear) and the wire is held in place by rubber bands that come in a variety of colors (some of which resemble pieces of food stuck in your teeth, but hey, I’m not 10 so I might not appreciate tomato red or lettuce green).
There are also lingual braces which fit on the inside surfaces of your teeth. I thought about those briefly because of cosmetic reasons, but being a speech pathologist, I thought that they might make it more difficult to speak (since we use the tongue to teeth movement in making a lot of sounds). And it’s sort of important for my speech to be a good example to my patients. The third type I heard about (but didn’t really consider) is the “invisible” braces, which is a clear appliance that is worn covering the teeth and gradually realigning them. These were just coming out at that time and my orthodontist didn’t mention them.
No one will be looking at me anyway
For about 4 months I considered the expenses and inconveniences, and finally decided that now was as good a time as ever to go ahead with it. I wasn’t planning on doing a lot of dating right then and didn’t care if I’d look like a geek for a little while. It was also one of those times in my life that I was going through so many changes, what was one more? I decided upon my nephew’s orthodontist because of his years of experience, and, I have to say the fact that he offered a significant professional discount made a difference too. Other things that I thought about were the fact that his reputation is that he is very up-to-date on the latest advances in orthodontia and that his office was convenient to my home and work. I also found out that both sons of my good friend had gone to this same orthodontist and she was satisfied with him and his office.
I thought I’d be their easiest patient. Ha!
So, I began the process by making my first appointment. They told me that they start by taking extensive x-rays, digital pictures, and dental molds. I recall that just the x-rays alone cost $300 or so. (This could possibly be a covered expense for you even if the braces aren’t.) I then had the bands put on my molars. I never knew just how close together my teeth were until that day. (Ouch!) They had 3 or 4 different people trying to put the spacers there so that by the next appointment they’d be able to put the bands on. (I’m told this isn’t typical.) But they then gave me some paperwork and supplies along with some cursory instruction about keeping my teeth clean. I hated flossing before, and now I’d have the extra-added joy of having to use a floss-threader to get into that space.
The fine print
I will admit that I didn’t read each and every word of the 4-pages that they gave me. I did hit the high points, but didn’t notice this one important sentence that would make all the difference to me in the last year and a half (and who knows how long in the future). There it is, on the last page entitled “Potential Risks and Limitations of Orthodontic Treatment” after it says “These are seldom enough to contraindicate treatment but should be considered in making the decision blah blah blah”. (Yes, that’s a direct quote.) In the 5th paragraph it talks about how “in some cases” there might be shortening of the root ends (root resorption), but that if the teeth are healthy this shouldn’t be a problem. So, silly me, I assumed that since I had been a good dental patient, keeping my teeth clean and going to the dentist regularly, and never being told of any problem by my (now former-) dentist, that this wasn’t even a concern. But the paragraph goes on to say (funny how I can see it really well right now) “however, in the event of gum disease in later life, root resorption………could present a problem.”
Why he’s my former-dentist and how I got to know yet another dental professional
So, not to belabor a point (I know, too late for that), about 5 months into the process, I found out (by way of an infection) that I do have periodontic disease. My (now former-) dentist had never referred me to a periodontist when the spaces between my teeth and gums were large enough to indicate that I should have seen a specialist (probably a year before). The orthodontist’s assistant (who, funny-enough doesn’t happen to work there any more) never seemed to have looked at those expensive x-rays which clearly showed bone loss, which indicates periodontic disease. (I was able to have that charge removed from my bill when I nicely pointed out that I didn’t want to pay $300 for some x-rays that apparently no one examined.) So, now I've had the lovely experience of getting to know the folks at my periodontist’s office and going through the joys and expenses of gum surgery, bone graft and double dental exams for the rest of my life. I also spend half of my morning using every dental tool known to man (Waterpik, interdental brushes, electric toothbrush, rubber tips, floss-threaders, just to name a few). In the process of recovering from my gum surgery, my periodontist wanted to allow time for healing so he suggested that the orthodontist stabilize my teeth for about 7 months. Basically what this means is that I still have had to wear the braces (with wires poking me at every opportunity and food sticking in them) but that my teeth weren’t being moved in that time. (Aren’t you jealous?)
Time, time, time. See what’s become of me. (a rare musical reference)
I’ve also found out that typically it takes longer for the teeth of an adult to move (compared to kids). As for me, remember that estimate of a year and a half? Well, it's already been that long and I'm just now due to have the lower braces put on in a few weeks. When I asked my orthodontist if I’ll have the braces off by the time I’m 90 years old, he could only promise me 86. (And I’m not positive he was kidding.)
That 20-20 thing (and I don’t mean Hugh Downs or Barbara Walters)
In looking back, I’m pretty sure I wouldn’t have gone through all of this if I had it to do over again. I may have looked into an appliance for preventing clenching at night or some other alternatives. I’m not saying that everyone should make the same decision, but if you are considering braces as an adult, feel free to ask your dentist or orthodontist as many questions as you like. That’s why they get the big bucks. It’s worth it to have that vision improvement before it has to get to the point of relying on your hindsight.
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jsaunt
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Member: Leslie
Location: Southern California
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It's not the place, it's the people.
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