The Whole Tooth

A healthy, confident smile is a gift for life. Often the first noticeable attribute about a person following a first-time introduction, it comes as no surprise that many of us are more comfortable opening up once when accompanied by a dazzling — and straight — pair of pearly whites.
Dr. Lee Graber, president of the American Association of Orthodontists, demystifies a number of common (as well as lesser-known) myths that are sometimes misunderstood as facts in the dental world.

Contrary to popular belief, wearing braces isn’t just a trademark of adolescence. Not all issues take years to correct. Nor will seeking orthodontic treatment break the bank. With numerous paths toward maintaining good oral health, there are more options today than ever before.

Here, Graber outlines the real tooth (truth) if you or a loved one may be considering seeking the help of an orthodontist.

Myth one: Age
The experience for most people, the doctor explains, is that those who actually have visible braces are adolescents. “They’ve usually been the customary focus of orthodontics,” Graber says. Adults, however, account for one out of every five patients. “Many of them have cosmetic braces that hardly show, and so their friends and family may be unaware they are undergoing orthodontic treatment.”

Generally speaking, treatment varies from patient to patient, depending on how quickly they’re growing up (for children and teens) and what kind of problem they have. An orthodontist will be able to assess the broad range of interferences that can occur with concerns such as crowding, spacing and guiding jaw growth. Put another way, the purpose of orthodontics is to restore good dental function, which is possible at virtually any age.

“Today, most adults have most of [their] natural teeth and are interested in keeping them for a long time,” says Graber. “What’s more, with our increased lifespan and focus on health, they are planning on use of their teeth into their eighties and nineties. It is possible to maintain a person’s natural teeth over a lifetime.”

While there is no magic number at which someone may seek treatment, the association advises that most children should be seen for a checkup no later than age seven.

“This is the age where children are exchanging baby teeth for permanent teeth and the orthodontist is able to evaluate potential treatment needs,” he says. The fact of the matter, the doctor continues, is that most kids do not get care until the ages of nine to 14. Nevertheless, an early checkup allows the orthodontist to time treatment precisely to the best time for the child or adolescent in their developmental pattern, thereby maximizing the treatment outcome and minimizing time in their therapy.

With adults, the doctor notes that some patients may have already had braces before due to normal aging changes, but in the long term, after-treatment precautions like retainers help to reduce this problem.

“Some adult patients we see didn’t get that message 25 years ago when they had braces as a teen and are back now for a tune-up,” says Graber.

Myth two: Appearance
One’s self-perception when they are wearing braces may vary, but many more people have braces, Graber says. 

“Many orthodontic treatments are hard to see externally. You really have no clue. It can be that unnoticeable.”

Certain options range from clear small brackets that are applied to the front surfaces of the teeth, to braces on the tongue side, and for some, removable clear aligners that can align teeth, says Graber. The type of alignment problem a patient has and the goals of treatment are the controlling factors for deciding what type of orthodontic treatment works best.

Then there are those patients who visit Graber, he laughs, who are more interested in showing off their braces. Most commonly, they are teenagers who want to convey their school spirit by wearing their school colours on their teeth, or matching a homecoming dress, which makes the whole process more fun, he says.

With more findings demonstrating how oral health care is part of one’s physical health, Graber adds there is supporting research that reveals adults who wear braces are perceived in the same manner as someone who exercises regularly, as someone who takes good care of themselves.

“People judge you and your health to some degree based on what you look like,” he notes. “We’re not supposed to, but sometimes it’s there. There’s also a sense of self-judgement, because you look good with your new smile.”

Myth three: Time
The type of problem the patient presents to the orthodontist and their mutual goals for treatment largely determine both the type of “braces” and the length of time the “appliances” are worn, Graber explains. It is also true that with improvements in technology, the duration of treatment has been reduced, which ends up being a great benefit to patients.

Myth four: Qualifications
For Graber, there is indeed a misconception about the difference between a dentist and an orthodontic specialist. An orthodontist receives an additional two to three years of specialized education after dental school to learn the correct method to align teeth and jaws. In addition, says the doctor, orthodontists focus their yearly continuing dental education on new technologies and therapies in the orthodontics field.  To ensure that one is seeing an orthodontist, go to braces.org for the American Association of Orthodontists or cao-aco.org to reach the 

Canadian Association of Orthodontists.
The orthodontist is a key member of the dental team. Regular dental checkups and fillings are centred around the general dentist with specialty orthodontic care performed when needed.

“Just as one would see a surgeon for surgery versus one’s primary care physician, one sees an orthodontist for orthodontics,” says Graber.

Myth five: Affordability
“It is interesting for me, as when I was a kid braces cost the same as a mid-sized car,” recalls Graber.

The relative cost of braces has gone down, and it represents a key and affordable investment in oral health for one’s lifetime. In addition, many people today have insurance that helps to cover a part of their orthodontic care. Pair this with customary in-office budget programs and even third-party financing programs, and you will find few people for whom braces cannot be made an affordable part of their overall health-care program.

De-fogging the myths
As for the doctor, he says he believes age and cost are the biggest myths that have progressively become elucidated. By the same token, adults show the greatest excitement — after having gone through some irregularity, they may not have liked the way they looked or thought they could never be a candidate to have braces. Or perhaps they didn’t realize they could budget it out, while raising a family. All in all, Graber and by extension his colleagues are clearing up one misconception — and smile — at a time. •