ORTHODONTICS........for
Adults
Want
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 AAO estimates that more than 1,000,000 adults in the
United States and Canada are receiving treatment from orthodontists
who are members of the AAO. To learn about correction of
a specific problem, please consult your family dentist for
a referral to an orthodontist or find AAO member orthodontists
near you through the Orthodontist Locator service.
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.
Frequently asked questions
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.
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.
Gingivitis
The mildest form of the disease is called gingivitis (see
photo at right). 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.
Advanced periodontitis. Note the loss of gum tissue, which
makes teeth appear longer
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.
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. For detailed information,
please read the AAO brochure “Interproximal Reduction: Reducing
Tooth Widths for Form, Function and Stability.”
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.
COSMETIC DENTISTRY - ORTHODONTICS
