A new era for adult braces
A Rutgers orthodontics professor discusses the latest advances and ethos. He recently was a patient, too -- at age 72.
There was a time, not long ago, when dental braces were predominantly for kids and teens.
Those days are over.
“I treated an 80-year-old, had braces in for his 80th birthday,” said Richard Bloomstein, an orthodontist and a vice-chair of the department of orthodontics at Rutgers School of Dental Medicine. “He said, ‘I gave it to my kids, I gave it to my grandkids, and now I want straight teeth.'”
Bloomstein knows from experience. He’s 73 years old and recently wore braces for a year to close the space and realign his teeth after having a troubled bicuspid extracted.
“After having gone through it as an adult, I would say every (dental school) resident should have braces on just to they can sit on the other side,” Bloomstein said. “Most of mine do.”
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An evolution in thought
An estimated four million Americans -- 1.2 percent of the population -- wear dental braces. Of those, one million are adults.
There used to be “a lot more resistance” among adults who needed braces, Bloomstein said.
“As we live longer and have fuller lives, it is equally or even more important to preserve our teeth,” he said.
For generations of Americans, missing or rotten teeth was part of the deal of getting older -- not a medical issue that required action.
“Without a doubt, the demand for adult braces has increased dramatically in recent years,” Bloomstein said. “The advent of more aesthetic and comfortable braces, multiple treatment options and faster treatment has made the prospect of improved aesthetics and better dentistry more appealing.”
Better dentistry includes advances in technology. There are options beyond the traditional fixed metal braces most often associated with orthodontics.
What’s trendy
Clear aligners are growing in popularity. The most well-known brand is Invisalign, which was approved by the Food and Drug Administration in 1998. It’s removable and hard to notice.
“Invisalign trays are made of a transparent material and are nearly invisible,” Bloomstein said. “As they are removable, success of treatment is dependent up the patient wearing nearly full time. Invisalign recommends 22 hours per day. Because the aligner trays are not secured to the tooth as are traditional braces, some movements are not as effective.”
Invisalign’s parent company, California-based Align Technology, claims more than three million patients worldwide.
“Invisalign treatment is generally more expensive than traditional braces,” Bloomstein said. “While Invisalign can provide significant improvement, in many cases the ‘gold standard’ is most often fixed appliances.”
He noted, however, that “there are many situations where the results are satisfactory with aligner therapy.”
There are other methods as well.
“The recent advances in braces that might appeal to adults but are also useful for adolescents include lingual braces, which are placed on the backs of the teeth, closer to the tongue, and are truly invisible,” Bloomstein said. “Other advances include devices and methods of speeding up treatment. Some require surgical intervention, varying from very slight to more significant. One device uses vibrations which activate bone metabolism thus speeding up tooth movement. Additionally, this device has been reported to reduce discomfort following adjustments.”
High priority
Braces for adults can be more costly than those for kids.
“Orthodontics may be excluded or limited to dependent children up to a certain age,” Bloomstein said. “Also, most plans limit orthodontics to a lifetime amount, typically $1,000 to $2,000 with coverage limited to 50 percent of the actual cost. As many cases are $5,000 or more, a significant part of the cost is the responsibility of the patient.”
But properly used orthodontics can improve one’s health and looks, and that combination has proved appealing to today’s adults.
When Bloomstein learned one of his bicuspids had developed decay underneath the crown, he faced three options: redo the crown, replace the tooth with an implant, or extract the tooth and close the space with braces.
He chose the third option, going with traditional braces to get the job done.
Now, he said, “the extraction space is closed and my front teeth are straight. Furthermore, the tooth that would have been retreated with a guarded prognosis has been removed. The need for an implant has been eliminated. And I have a much better smile.”
Staff writer Jerry Carino: jcarino@gannettnj.com.