Salvatore J. Durante, DDS, FAGD

Braces aren't just for teenagers. No matter your age, it's never too late to improve your dental health and beautify your smile. About 1 million Americans and Canadians over the age of 18 are getting braces. As a result, general practitioners today are more familiar with potential concerns and special needs of their adult patients. Some general dentists have the training to diagnose and treat orthodontic problems.

Why do adults need braces?

Some adults never received orthodontic treatment as children to correct problems such as crooked or crowded teeth, overbites, underbites, incorrect jaw position, or jaw joint disorders. If left untreated, these problems can result in tooth decay, gum disease, headaches, earaches, as well as speaking, biting or chewing problems.

Is orthodontic treatment different for adults?

Like children, adults can receive the same benefit of an improved smile and oral health from wearing braces. However, since adults are no longer growing, treatment may take longer than it does for teenagers. The average adult wears braces for 18 months to three years. After braces are removed, you may need to wear a retainer to maintain the results of your treatment.

How can I find out if I need braces?

Consult with your dentist and ask for an evaluation. Many general practitioners have received additional training in orthodontics and have chosen to incorporate it into their practice.

Depending on the complexity of your case and whether or not your dentist performs orthodontic work, he or she may choose to treat you or refer you to an orthodontist, a dentist who specializes in the diagnosis, prevention and treatment of dental and facial irregularities. An orthodontist has completed two to three years of advanced education in orthodontics in addition to a four-year dental graduate program.

Most initial consultations provide an opportunity to ask questions about orthodontic treatment such as:

• What are the costs involved?
• How will the braces correct my problem?
• How long will I need to wear braces?
• What is the dentist's experience with my particular problem?
• Will I be able to schedule appointments at convenient times? If possible, obtain references from current or former patients.

What types of braces are available?

Braces are custom-made appliances that use gentle pressure to straighten your teeth and correct your bite. While some practitioners still favor metal braces as the most reliable, new materials and other advances offer smaller, less noticeable braces than were available a generation ago, and these materials are equally effective. Instead of metal, you can opt for clear or neutral-colored ceramic braces, or removable invisible aligners. Ask your dentist for a recommendation on which type of braces would provide the best results for you.

Options available:

Metal braces, made of high-grade stainless steel and attached to the front of teeth, are the most common. Some patients may complain about discomfort from metal brackets rubbing against the skin. If you experience any pain or discomfort, ask your dentist or orthodontist for some dental wax to place over the brackets.

Clear ceramic braces are worn on the front of the teeth just like traditional steel braces. Unlike metal braces, they blend with the color of the teeth for a much less noticeable appearance. They may look better but also may break more easily than metal braces.

How much do braces cost?

Cost depends on the type of braces recommended by your dentist and can range anywhere from $4,000 to $9,000. Check with your major medical or dental insurance provider to determine if your plan covers orthodontic work.

How do I adjust to life with braces?

You probably will experience some discomfort or difficulty speaking or eating at first. While wearing braces, keep your teeth and brackets clean. If you wear cemented, non-removable braces, food and plaque can get trapped between teeth and gums. To reduce your risk of cavities, follow a regimen of brushing, flossing and rinsing, and reduce your consumption of sweets and carbohydrates. Plaque and sugar combine to make acid, which can cause decalcification (white spots) on teeth and tooth decay if left behind.

Which foods should I avoid?

It's a good idea not to eat foods that can damage or dislodge braces. Hard foods such as candy, raw carrots, corn on the cob, pretzels, nuts, popcorn and crushed ice are off limits. Sticky foods to avoid include caramel, taffy and gum. These foods can get stuck between teeth and gums or bend wires and knock bands or brackets loose. If this results in damage to braces, treatment may be extended.

Do I need to see my dentist during orthodontic treatment?

Yes. Remember that going to the orthodontist is not a substitute for regular dental checkups. If you're going to invest time and financial resources in a healthy smile, be prepared to go the distance to achieve results. That means you should consult your dentist for a schedule that's appropriate for you.

The Academy of General Dentistry is a non-profit organization of more than 35,000 general dentists dedicated to staying up-to-date in the profession through continuing education. A general dentist is the primary care provider for patients of all ages and is responsible for the diagnosis, treatment, management and overall coordination of services related to patient's oral health needs. Learn more about AGD member dentists or find more information on dental health topics at www.agd.org/consumer.

Contact: The AGD public relations department at 312.440.4308 or media@agd.org.

Note: Information that appears in General Dentistry, the AGD's peer-reviewed journal, AGD Impact, the AGD's newsmagazine and related press releases do not necessarily reflect the endorsement of the AGD.