More adults flash metal-mouth smiles

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The girl in the next exam chair is 13, the same age Carolyn Harmon was at the beginning of her dental journey.

As a teenager, Harmon had a problem tooth removed, which led to shifting, and, now at 65, to this spot in Dr. Edward Altherr's orthodontics office. Today, he's adjusting her braces.

As the doctor takes a break and an episode of "Ellen" drones on the TV above her head, Harmon says the idea of braces seemed a little silly at first. But after exploring all of her options, she decided to go for orthodontics and an implant to fill the space vacated by that tooth.

Harmon's plan is to "increase my chances of being able to maintain the ability to eat normally for as long as I can."

Young people still make up a large majority of patients seen by orthodontists, but more adults are getting braces. According to the American Association of Orthodontists, nearly 1.1 million adults were treated by its members in 2004, the last year for which statistics are available. That's up almost 38 percent over 1994.

About 15 percent of the patients Altherr sees in his Apex office are adults. Some want aesthetic fixes. Others, like Harmon, are more concerned with their long-term dental health. "If you can keep the teeth you have, it decreases the maintenance of them over the long haul," Altherr says.

Adult patients have a substantial effect on the practice of Dr. Henry Zaytoun Sr., who operates three Triangle clinics with his son and daughter, also orthodontists. The doctors provide adult-specific literature to prospective patients, and at one time set aside a more private examination room for adults. But Zaytoun realized that mature patients aren't much different than his younger ones.

"Patients are patients," Zaytoun says. "They all like to be treated well."

In his four decades as a practicing orthodontist, Dr. Raymond George Sr. has seen the percentage of adult patients he treats more than quintuple.

George, who practices in Rhode Island and is president-elect of the American Association of Orthodontists, says people tend to their overall health better than they used to. "We're much more health conscious then we were even 30 years ago," he says.

That, coupled with advances in orthodontic technology, mean more patients are willing to endure the discomfort and look of braces. "They know they want to keep their smile until the end of their days," George says.

Improvements in technology and technique mean that patients today don't need to wear braces for as long as people once did. Clear brackets provide an alternative to the metal-mouth look so many remember.

Many adults are wearing Invisalign, a series of clear aligners that are molded to each patient's teeth and look nothing like traditional braces.

The average treatment time for an adult is 18 to 24 months, Zaytoun says.

Sometimes, adults see that their children are dealing well with braces and decide it's time to fix their own teeth. "They find out it's not such a bad time after all," he says.

But that doesn't mean everything is equal. Altherr said adults can expect to spend more for braces -- from $2,000 to $7,000, depending on the treatment needed.

Dental insurance may cover some of the cost; $1,000 to $2,000 is typical for orthodontics, Altherr says.

Still many consider braces preferable to what might have been their parents' or grandparents' solution.

Years ago, "people approached their dental problems by getting rid of teeth," says Zaytoun, who has had several patients in their 80s get braces. "That was never a good solution."

Which brings us back to Harmon, who travels to Apex from her home in Greensboro to see the orthodontist. Her son and Altherr are old friends.

She got plenty of moral support from her family after deciding to get braces. At one point, she was in braces at the same time as her daughter-in-law and granddaughter.

But it hasn't been fun. The brackets irritate the inside of her mouth. She figures treatment will cost about $5,000.

 

But is it worth it? "That remains to be seen," she says. "I was willing to take the risk."