You're Never Too Old For Braces Article Date:JUNE 17, 2003 Reviewed by the faculty of The University of Pennsylvania School of Dental Medicine Tin grin. Metal mouth. Brace face. Anyone who had braces as a teen-ager 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 percent to 25 percent of orthodontic patients are adults, and more than half of those are women. Braces have always been an option for older people, but in the past most adults didn't want to concern themselves with the effort and stigma, says Michael Perillo,D.M.D., clinical assistant professor of orthodontics at the University of Pennsylvania School of Dental Medicine. "Now, the advances we've had in orthodontics — better wires, smaller brackets, stronger bonding materials — have made it a lot more aesthetically pleasing than it has been," he says. Also, people whose families may not have been able to afford braces when they were children can afford the expense as an adult. Orthodontic treatment will not necessarily be more painful or take longer for an adult, even though adults have denser jawbones and more developed tooth roots than do children or teen-agers, Dr. Perillo says. "The length of treatment is very individual in adults, just as it is in children." And as with children, adults get braces for a variety of reasons. "It's not just aesthetics," he says. "People can get them for better function or better stability, and sometimes orthodontic work complements other dental procedures — for example, if a dentist needs space to be created for a bridge or for veneers." There's no age limit for braces, which is an important consideration as people take better care of their teeth and keep them longer. "There are patients well into their 70s that are enjoying the benefits of orthodontic treatment," Perillo says.

Braces In Her 30s

Chicago software designer Alexandra Dreier got her braces when she was 30. She's 32 now, the braces are about to come off, and she's just as excited about it as any teen-ager would be. Dreier's teeth have always been straight. However, she is missing some permanent teeth and before she gets dental implants to replace them, the braces are correcting a slight overbite that could damage the thin porcelain coating on the implants. Dreier has clear, plastic brackets (the part that's cemented to each tooth), which have been around for several years and have become a popular alternative to metal brackets. 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 teen-ager 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."

Braces In Her 40s

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 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!" Adults may be more likely to practice good oral hygiene while they have braces, but they also may be more at risk of oral problems, said Dr. Perillo. "Adults can have an increased susceptibility to periodontal disease and root shortening," he said. "They may also be on medications that dry the mouth or have other oral effects. Children and teenagers usually don't have that issue." After 18 months the braces came off, and 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."

Braces In Her 50s

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, and regular braces on the bottom. The lingual braces, she says, "were wonderful. 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, and 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 teen-agers 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. Many adults, but few children, have crowns, says Perillo, and orthodontists have special cementing techniques to protect crowns from damage. 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."

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