Adult
Orthodontics
Information about adult orthodontic treatment?
Today,
orthodontic treatment is a viable option for almost any adult.
It is well recognized that when left untreated, many orthodontic
problems may become worse. When you have a malocclusion (“bad
bite”), your teeth may be crowded, excessively spaced or may
not fit together correctly. Such conditions may lead to dental
health problems. Crowded teeth are hard to clean and, given
time, may contribute to tooth decay, gum disease and even tooth
loss. Bad bites can also result in abnormal wearing of tooth
surfaces (see photo below), difficulty chewing and damage to
supporting bone and gum tissue. Poorly aligned teeth can contribute
to pain in the jaw joints.
Abnormal
tooth wear in an adult
You’ll
be pleased to learn that orthodontic treatment will fit in with
your current lifestyle – you can sing, play a musical instrument,
dine out, kiss, and even have your picture taken. One in five
orthodontic patients is an adult.
The rate of toothlessness has declined over recent decades.
Our great-grandparents, for the most part, lost their teeth
around age 40. Today’s 25-year-old has the potential of another
75 years of keeping and using their teeth. This is a major change
in dental health care (and life expectancy). Teeth that do not
fit well often wear down more quickly—another reason to make
sure that your teeth are in good alignment and well maintained
in your adult years.
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Frequently asked questions
about adult orthodontics:
Can orthodontic treatment do for
me what it does for children?
Yes.
Healthy teeth can be moved at any age. Many orthodontic problems
can be corrected as easily for adults as for children. Orthodontic
forces move the teeth in the same way for both adults and children,
but adult treatment may take longer due to the maturity of the
bone. Complicating factors, such as lack of jaw growth, may
create different treatment planning needs for the adult. This
is why a consultation with an orthodontist, the dental specialist
who aligns teeth and jaws of patients of all ages, is essential.
How
does adult treatment differ from that of children and adolescents?
Adults
are not growing and may have experienced some breakdown or loss
of their teeth and the bone that supports the teeth. Orthodontic
treatment may then be only a part of the patient's overall treatment
plan. Close coordination may be required among the orthodontist,
oral surgeon, periodontist, endodontist and family dentist to
assure that the treatment plan is managed well. Below are the
most common characteristics that can cause adult treatment to
differ from that of children.
No
jaw growth: Jaw discrepancy problems, including
both width and length, in the adult patient may require jaw
surgery. For example, if an adult’s lower jaw is too short to
match properly with the upper jaw, a severe bite problem results.
The amount that the teeth can be moved in some cases, with braces
alone, may not correct this problem. Establishing a proper bite
relationship could require jaw surgery, which would lengthen
the lower jaw and bring the lower teeth forward into the proper
bite.
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Gum
or bone loss (periodontal breakdown):
Adults are more likely to have experienced damage or
loss of the gum and bone supporting their teeth (periodontal
disease). Periodontal disease is a chronic bacterial infection
that affects the gums and bone supporting the teeth. The word
periodontal literally means “around the tooth.” Many people
are unaware that they have gum disease because there is usually
little or no pain.
Periodontal
disease can affect one tooth or many teeth. It begins when the
bacteria in plaque (the sticky, colorless film that constantly
forms on your teeth) causes inflammation in the gums.
The mildest form of the disease is called gingivitis.
The gums redden, swell and bleed easily. Gingivitis is often
linked to inadequate oral hygiene. Gingivitis is often reversible
with professional treatment and good oral home care.
Untreated
gingivitis can advance to periodontitis (see photo below), a
more severe form of gum disease. With time, plaque can spread
and grow below the gum line. Toxins produced by the bacteria
in plaque irritate the gums. The toxins stimulate a chronic
inflammatory response in which the body, in essence, turns on
itself, and the tissues and bone that support the teeth are
broken down and destroyed. Gums separate from the teeth, forming
pockets (spaces between the teeth and gums) that become infected.
As the disease progresses, the pockets deepen and more gum tissue
and bone are destroyed. Eventually, teeth can become loose and
may have to be removed.
The good news is that teeth that are properly aligned are less
prone to gum disease.
Special treatment by the patient’s dentist or a periodontist
may be necessary before, during and/or after orthodontic treatment.
Bone loss can also limit the amount and direction of tooth movement
that is advisable. Adults who have a history of or concerns
about periodontal disease might also see a periodontist (a dental
specialist who treats diseases of the gums and bone) on a regular
basis throughout orthodontic treatment.
Worn,
damaged or missing teeth: Worn, damaged or missing
teeth can make orthodontic treatment more difficult. Teeth may
gradually wear and move into positions where they can be restored
only after precise orthodontic movement. Damaged or broken teeth
may not look good or function well even after orthodontic treatment
unless they are carefully restored by the patient's dentist.
Extra space resulting from missing teeth that are not replaced
may cause progressive tipping and drifting of other teeth, which
worsens the bite, increases the potential for periodontal problems
and makes any treatment more difficult.
I
have painful jaw muscles and jaw joints - can an orthodontist
help?
One
of the problems commonly associated with jaw muscle and jaw
joint discomfort is bruxing, that is, habitual grinding or clenching
of the teeth, particularly at night. Bruxism is a muscle habit
pattern that can cause severe wearing of the teeth, and overloading
and trauma to the jaw joint structures. Chronically or acutely
sore and painful jaw muscles may accompany the bruxing habit.
An orthodontist can help diagnose this problem. Your family
dentist or orthodontist may place a bite splint or nightguard
appliance that can protect the teeth and help jaw muscles relax,
substantially reducing the original pain symptoms. Sometimes
structural damage can require joint surgery and/or restoration
of damaged teeth. Referral to a TMJ specialist may be suggested
for some of these problems.
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My
family dentist said I need to have some missing teeth replaced,
but I need orthodontic treatment first - why?
Your
dentist is probably recommending orthodontics so that he or
she might treat you in the best manner possible to bring you
to optimal dental health. Many complicated tooth restorations,
such as crowns, bridges and implants, can be best accomplished
when the remaining teeth are properly aligned and the bite is
correct.
When
permanent teeth are lost, it is common for the remaining teeth
to drift, tip or shift. This movement can create a poor bite
and uneven spacing that cannot be restored properly unless the
missing teeth are replaced. Tipped teeth usually need to be
straightened so they can withstand normal biting pressures in
the future.
My
teeth have been crooked for many years - why should I have orthodontic
treatment now?
It’s
never too late! Orthodontic treatment, when indicated, is a
positive step—especially for adults who have endured a long-standing
problem. Orthodontic treatment can restore good function. And
teeth that work better usually look better, too. A healthy,
beautiful smile can improve self-esteem, no matter the age.
Is
orthodontic treatment affordable?
Patients
are finding that braces are more affordable today than ever.
The cost of orthodontic treatment will depend on many factors,
including the severity of the problem, its complexity and the
length of treatment. Your orthodontist will be glad to discuss
the cost with you before treatment begins. Most orthodontists
have a variety of convenient payment plans. Often there are
combined plans available for parents and children who have treatment
at the same time. In addition, many dental insurance plans now
include orthodontic benefits. Dollar for dollar, when you consider
the lifetime benefits of orthodontics it is truly a great value.
I
am pregnant and want to begin orthodontic treatment. Is this
OK?
Pregnancy
brings on bodily changes that can affect the mouth. Soft tissues
such as gums become much more susceptible to infection. The
possible need for x-rays during the pregnancy is not advised.
Discuss this question with your medical practitioner/physician
and orthodontist before you start orthodontic treatment.
My orthodontist wants to do something called enamel stripping
to make my teeth smaller. I have never heard of this. Is this
something new? Is it safe?
This
procedure goes by many names: enamel stripping; interproximal
reduction; slenderizing; reproximation and selective reduction.
The goal is to remove some of the outer tooth surface (enamel)
to acquire more space for your teeth. The procedure has been
used in orthodontic treatment since the 1940s and has been shown
to be safe and effective. Some studies among patients who have
had this procedure show that it neither makes teeth more susceptible
to tooth decay nor does it predispose patients to gum disease.
I see ads for perfect teeth in
only one or two visits to the dentist. Will that give me straight
teeth?
Crooked teeth should be evaluated by an orthodontist so that
the most appropriate treatment plan can be suggested.
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