DEAR DOCTOR K:
I’m in my 40s and can finally afford to straighten my teeth. Am I too old for braces? What are my options?
Adults have 32 teeth whose job is to break down the variety of foods in the human diet. Here is an illustration of the different types of human teeth, and what we use them for:
Your teeth and their functions
The adult mouth has three types of teeth:
Incisors: eight teeth in the middle front of the jaw (four upper and four lower) that have straight sharp edges shaped for cutting food.
Canines: four larger teeth, also called cuspids or eyeteeth, with sharp points designed for ripping or tearing.
Bicuspids and molars: the remaining teeth — eight bicuspids (sometimes called premolars) and eight to 12 molars, which have broad, flat surfaces with small mounds for grinding food.
If someone is born with crooked teeth, childhood is the best time to get teeth straightened. But adults can and often do opt for orthodontic treatment — with excellent results.
Braces can move the teeth in a variety of directions and treat many teeth at the same time. Braces consist of brackets, usually made of stainless steel, which are cemented or bonded to tooth surfaces. Wires are threaded through the brackets to direct the force being applied to the teeth. Elastic bands or springs may be attached to boost pressure. If it suits your style, you can opt for colored wires and elastics.
You can also choose tooth-colored ceramic or clear plastic brackets, which are less noticeable. These tend to cost more than metal braces. Ceramic brackets can break, and they may not be as comfortable on lower teeth as metal brackets. Plastic brackets aren’t as strong as stainless steel and may stain over time. Treatment with ceramic and plastic devices may take longer than with stainless steel braces.
Some orthodontists offer a lingual appliance. This device attaches to the back of the teeth so the brackets and wires don’t show when you smile. They can irritate the tongue and tend to be more expensive and require more care than traditional braces.
Another alternative to traditional braces is a series of removable custom-made, form-fitted trays made of clear plastic. These devices, known as aligners, exert slight pressure on the teeth, gradually moving them. Every two weeks you switch to a new set of trays until the teeth reach their final position. This system may be a good choice if you need only minor corrections.
I once had a patient who had suffered one hard knock after another as a child: no father, a mother getting in trouble with drugs, five younger siblings to help raise and no money. But she was determined to advance in the world. She completed high school and junior college, and was starting work as an administrative assistant.
The first time she came into my office, I noticed two things: how awkward and lacking in confidence she was, and her very crooked teeth.
A few years later, now in her early 30s, she told me she had taken out a loan so she could get braces. I wondered (to myself) if that was a wise decision, given the many other things she could have done with the money. I didn’t see her for two years.
Then one day she reappeared. Gone was the awkward, shy young woman. “So good to see you again, doctor,” she said, with a smile full of straight teeth. It was then I noticed something I’d missed before: She was transformed.