You're Never Too Old for Braces

Anyone who had braces as a teenager probably will recognize at least one of these taunts. Today, advances in orthodontics are making braces less obvious, teasing less likely, and adults more willing to undergo treatment. These days, 20% to 25% or more of orthodontic patients are adults. More than half of those are women.

"Some adults have postponed orthodontic treatment for a variety of reasons that include cost or being embarrassed about the prospect of wearing braces," says Thomas Cangialosi, D.D.S. Dr. Cangialosi is chairman of the Section on Growth and Development and director of the Division of Orthodontics at Columbia University College of Dental Medicine.

"Many adult patients, however, are pleasantly surprised to find that orthodontic treatment is affordable," he says. "Also, braces today tend to be less uncomfortable and are smaller and less visible than they used to be. In fact, some conditions may be treated with clear brackets or clear aligners. so they no longer need to be concerned about how they will look in braces."

Your orthodontist will tell you what options are available for the treatment of your particular problem.

The use of implants also has made treatment possible for many adult orthodontic problems that could not be treated in the past, Dr. Cangialosi says. "If you have healthy teeth and gums and strong supporting structures, you are never too old to receive orthodontic treatment."

Some adults express concern that delayed orthodontic treatment will be more difficult or painful or will take more time than a child's treatment, Dr. Cangialosi says.

"This is not necessarily true. Moving teeth at any age involves the same process. So the amount of time it takes to successfully complete treatment depends more on the severity of the problem, patient cooperation and jaw growth than it does on age," he says.

Adult treatment may take slightly longer because an adult's facial bones are no longer growing, he says. "However, adults tend to be more compliant with their treatment and follow the orthodontist's instructions in wearing some treatment aids such as elastics. This may actually lessen treatment time."

There's no age limit for braces. This is an important consideration as people take better care of their teeth and keep them longer.

Chicago software designer Alexandra Dreier got her braces when she was 30. Two years later, when the braces were about to come off, she was just as excited about it as any teenager would be.

Dreier's teeth have always been straight. However, she was missing some permanent teeth. Before she could get dental implants to replace them, she needed braces to correct a slight overbite that could damage the thin porcelain coating on the crowns placed over the implants.

Dreier has clear, plastic brackets (the part that's bonded to each tooth). Clear brackets can be an alternative to metal brackets for treatment of some orthodontic problems.

Still, "in the beginning I felt self-conscious," she admits. "But [the clear brackets] make a huge difference. People say they can hardly see them."

She sees both pros and cons to having braces as an adult.

"In a way, I guess it's easier if you're a teenager and all your friends have them," she says. "But people are much more mature and supportive about it when you're an adult. It makes you wonder about dating, though, because guys aren't really seeing what you look like."

Debbie Schaffer, a Malvern, Pa., homemaker in her 40s, says her teeth weren't straight as a child but "the dentist told my parents I didn't need braces." So she didn't get them … until she turned 40, and her daughter started visiting the orthodontist. "My daughter was going through it, so I went through it too," she says.

Because she also had several friends who either had braces or were about to get them, Schaffer didn't feel self-conscious. She also had clear brackets, but would sometimes ask the orthodontist to use colored rubber bands to "jazz them up."

Like many adults with braces, Schaffer was diligent about caring for her teeth and gums.

"When I first got [my braces], they showed me photos of what happens when you don't brush properly. That was enough to gross me out!" she says.

After 18 months, the braces came off. Shaffer is still happy with the results. "It gives me self-confidence in my smile," she says. "I didn't realize how much [the appearance of my teeth] bothered me until I got them fixed."

Carole Bland, Ph.D., is a professor of family practice and community health at the University of Minnesota, Twin Cities. Bland, 56, needed braces when she was younger, but "people didn't get braces that much back then, and it cost a lot. My parents couldn't afford it."

For two years in her early 50s, Bland had lingual braces (brackets on the inside of her teeth) on the top of her mouth. She had regular braces on the bottom. The lingual braces were "wonderful," she says.

"I had to work with my speech a little bit, because your 'T's sound different. And I couldn't bite into apples or corn on the cob. But as a college professor, I do a lot of presentations and speaking to groups. I think I would have felt a little uncomfortable with braces on the outside [on my top teeth]."

And the regular braces on the bottom were hardly noticeable. "Most people didn't even know I had braces," she says.

Oral hygiene was also a priority for Bland. "There's no question I take better care of my teeth than the teenagers I talked with. After all, I knew what this cost and I was paying for it," she says.

Now that the braces are off, she's noticed that her teeth stay cleaner: "When [the teeth] were crooked, it was hard to keep them clean. But I've had zero problems since they were straightened."

Before she got the braces, Bland needed some teeth extracted and some crowns placed. If possible, it may be a good idea to delay major restorative treatment such as crowns until after orthodontic treatment.

"Because adults who are receiving orthodontic treatment may already have crowns, orthodontists take precautions to protect the crowns from any damage that may occur when attaching the brackets to the teeth," Dr. Cangialosi says.

In some cases, crowns may need to be remade after orthodontic treatment is complete. This depends on the position of the teeth and the material used in making the crowns.

Bland also shopped around for some time before starting treatment. "I went to quite a few dentists and got pricing from them and estimates on how long it would take. I wound up with a dentist and an orthodontist that knew each other well and would communicate a lot," she says.

Despite the time, effort and cost, she's happy with the results. "I can hardly remember what I looked like before," she says. "And for the first time in my life, people will say they like my smile. Most people probably take that for granted, but I don't. It's nice."