Teeth – an emotive subject! The Americans have always been the gurus of perfect, straight, gleaming white teeth. Across the pond, the Brits used to be known for rather crooked smiles. State-side movie stars and TV celebrities boasted the whitest, brightest smiles—flashing their dazzling gnashers in Hollywood movies and on glamorous soaps, while the Brits were noted for sporting less perfect pearlies. However, times have changed! Straight, perfectly aligned teeth are today well within reach for most in the developed world. Rewind forty years and correcting teeth was mainly an orthodontic treatment performed on children. Nowadays, grown ups too embrace the braces. Aesthetic dentistry is big business today, though, and advancements in technology and technique have brought a host of newer, refined offerings that dentists and orthodontists use to create head-turning smiles.

ARE YOU HAPPY WITH YOUR SMILE?

Contrary to what you might believe, most people are actually happy with their smiles (take those Brits; three-quarters are happy according to dentaly.org¹) yet despite this, many of these people are less satisfied when they see their smiles in photographs. This could well be because of the rise of social media, especially as the same resource cites that 31% of people feel anxious about their teeth due to social media pressures.

Thankfully, fewer need to hide their smile and suffer in silence with crooked teeth, gaps or overcrowding. There is plenty that can be done. With nearly 704,000 dental practitioners in the world², connecting with a dentist or othodontist and chatting through the options has never been easier.

THE FACTS

We definitely know for fact that more and more adults in the UK and around the world are turning to orthodontics to correct their teeth. According to the British Orthodontic Society, 75% of orthodontists and dentists are experiencing an increase in private treatment for adults and 80% of those patients are in the 26 to 55 age bracket. If you’re considering orthodontic treatment, you’re not alone³. Did you know that over 200,000 people are fitted with braces every year in Britain?⁴And four million Americans are currently wearing braces⁵.

The most popular treatment is still fixed braces with clear brackets (75% of dentists and orthodontists supply this treatment) and 70% supply clear Invisalign, a modern clear-aligner type of treatment.

A BRIEF HISTORY OF ORTHODONTICS

Before we go into the options available, it’s interesting to learn some of the history behind orthodontics and teeth correction.

Actually, it was the Ancient Greeks who first got to grips with orthodontics. Correcting teeth was first mentioned by Hippocrates and Aristotle back in approximately 300 BC when those handsome Ancient Greeks dreamt of acquiring a perfect smile! In fact, the Egyptians used to use metal bands to push their teeth back (we know this because of archaeological discoveries on Egyptian mummies).

It wasn’t just the Ancient Greeks and Egyptians that practised orthodontics: the Romans used to recommend pushing emerging teeth into position using fingers (800 BC) and another Roman, Pliny the Elder, recommended filing to correct elongated teeth (AD 50 approximately). The Romans continued their fascination with correcting teeth and the earliest example of a wire was found on a Roman citizen when his body was uncovered in a tomb.

Fast forward a few thousand years to the 17^th and 18^th centuries and dental impressions appeared, invented by Matthaeus Gottfried Purmann and later on, in 1756, Phillip Pfaff used plaster of Paris to take his dental impressions.

One of the first practising orthodontists that we know about was Pierre Fauchard who in the middle of the 18^th century used his own invention of a metal horseshoe-shaped piece of metal that he called the bandeau. This fitted around teeth and corrected their positioning, the first ever metal brace. A little later, in the 19th century, another Frenchman, Christophe-François Delabarre corrected overcrowding by pushing used threads and wooden wedges in between teeth (sounds terribly painful).

During the 1800’s, orthodontic practitioners in the UK started using gum elastics and dental dams and towards the end of the century, an American dentist, Henry A Baker created the “Baker Anchorage” which blended the use of gum elastics with wire. This was the first contraption that realigned teeth without extraction.

The end of the 19^th century saw the introduction of X-rays which helped with orthodontics because impacted teeth could clearly be seen and subsequent removal helped to reduce overcrowding. In the 20^th century braces became more commonplace and the term “braces” was adopted by orthodontists and dentists alike. From the 1970’s, braces became more and more popular and today, we have virtually invisible braces that work hard to realign and correct teeth.

THE RIGHT CANDIDATE FOR ORTHODONTICS

You might wonder if orthodontics is right for you. Your orthodontist or dentist will tell you but you are likely a candidate for braces if your teeth are crooked or misaligned, you have a significant overbite (or underbite) or you have gaps in your teeth (although Madonna has a gorgeous gap and she’s been entirely happy with it and so does Zac Efron). However, there are other reasons why you should seek help; for example, you should definitely have a chat with your dentist if you find you’re experiencing regular headaches, your speech is affected by your teeth position, you have difficulty chewing your food or if your teeth are more prone to damage due to their misalignment. Don’t feel you can’t speak to your dentist or orthodontist if you do feel self-conscious about your teeth. Restorative dentistry, aesthetic dentistry and orthodontics exist to help people gain back confidence by bringing (beautiful) smiles to peoples’ faces!

CORRECTING YOUR TEETH - THE OPTIONS

What are the options though? When considering correcting teeth, most of us conjure up images of mouths stuffed full of metal with pinging elastic bands at the back. The type of braces that so many of us grew up with – even if you didn’t actually wear one yourself, you can bet your bottom dollar that you had teenage friends that did and were constantly moaning about those pinging elastics while worrying about kissing with metal on their teeth.

Orthodontics has thankfully moved on and while there are still hundreds of thousands of people that rely on metal braces, generally, for adults there are other options that you could explore. As mentioned, an increasing number of adults are correcting their crooked teeth, closing their gaps and getting that flawless smile they dreamt of.

THE COST OF BRACES

The cost of teeth straightening and beautification depends on the extent of work. Some public health systems such as the NHS in the UK won’t perform cosmetic dentistry on adults unless it’s the result of an accident or if you have a cleft palette⁶ so you will likely need to find a private orthodontist. Your dentist should be able to refer you, although some dentists themselves can fit braces. You should expect to pay anything from approximately $2,000 to $5,000 in the US for metal braces⁷ and an invisible Invisalign brace/aligner system is approximately £3,000 or $3,000 to $7,000. This might sound steep but many dentists and orthodontists offer flexible payment plans – it’s definitely worth asking.

METAL BRACES

Let’s start with regular, metal braces, considered the “old-fashioned” way of correcting teeth. Now let’s be blunt, they are certainly noticeable. However, they do deliver excellent results and if you’re prepared for the short-term inconvenience then you’ll achieve a fabulous smile. Treatment time varies depending on the severity of your problem. For mild cases, you could be looking at 12 months of metal in your mouth but for severe bite problems and realignment, 24 months of wear is not out of the question!

These braces consist of small, metal pieces that are cemented onto the teeth and fixed together with wires, they “pull” and “push” teeth into position. Expect to visit your orthodontist every couple of months to check the repositioning of your teeth and to have the brace tightened. These types of braces are excellent for you if you have an overcrowded mouth, your teeth stick out (you have an overbite issue) or if your teeth are in the wrong position. Mostly, these types of fixed metal braces will be right for you if your dental work is extensive, there’s often a clinical need for them. The good news is that they deliver fantastic results and once they’re off, you’ll be quite literally beaming!

There are other options worth considering though that deliver equally impressive results.

SELF-LIGATING BRACES

These are similar to the metal braces mentioned above but they are slightly less noticeable because their cemented brackets are clear or a pale ceramic. They don’t require those dreaded elastic bands either (so no pinging!)—instead, they use clips. These braces can treat severe problems too and they’re easier to keep clean than traditional fixed metal braces but you can still see them, so if that’s a problem for you, read on for alternative treatments.

LINGUAL BRACES

This is another type of brace but an excellent, discreet option. Lingual braces attach to the underside of your teeth. They are fixed to the teeth using cement, brackets and wires and slowly move your teeth into place. These braces are another great way of straightening teeth and if you don’t want people to notice your dental work then it could well be for you. Be aware that generally, they’re more expensive than other fixed braces and if you do get them fitted, you’ll take a little time getting used to the way that they feel in your mouth (this is temporary though).

RETAINERS, FIXED OR REMOVABLE

If you wore one of these as a child then you’ll know exactly what they are. Retainers have a piece of wire at the front and a palette shape on top that fits snugly to the roof of your mouth while the wire fixes over your teeth. Some of them are removable; you might be given one just for use overnight, usually following a fixed brace. Some retainers are fixed semi-permanently, attached behind your front teeth. A retainer isn’t advised for severe dental work because they don’t actually move teeth; really, they’re there to keep your teeth in place so they’re usually given to patients after teeth have been fixed. Retainers aren’t as noticeable as fixed metal braces as the wires are transparent but beware, if you stop wearing your retainer, your teeth will likely move back to their old position.

CLEAN ALIGNERS

Invisalign is the most well known brand of clear aligner and is able to correct or improve up to 90% of orthodontic problems. The innovative concept uses no wires, no metal and no permanent fixings⁸, so you can barely see them. These clear aligners may be indicated for numerous orthodontic issues, except for severe issues. They look just like whitening trays, perfectly fitting your teeth (you will have to have a set of impressions made so your aligners are precise). They fit over the teeth and they’re transparent too.

Clear aligners such as Invisalign move your teeth into place slowly but surely; you can take them out to clean them and even while you eat but you must wear them for at least 20 hours a day for best results and you might find that they take a little getting used to.

In summary, if you do want to address your overcrowding, you have gaps that you don’t feel comfortable with or you want to straighten crooked teeth, you can do it. Always do your research, have a consultation with a trusted dentist or orthodontist, and compare your options. Just think, by this time next year you could have that perfect Hollywood smile.

References

www.dentaly.org
https://pubmed.ncbi.nlm.nih.gov/11042819/
www.bos.org.uk/News-and-Events/News
https://www.telegraph.co.uk/science/2017/10/05/braces-should-worn-life-stop-teeth-going-wonky-warn-dentists/#:~:text=Around%20200%2C000%20people%20are,of%20people%20discontinue%20wearing%20them
https://www.theatlantic.com/health/archive/2015/07/braces-dentures-history/397934/#:~:text=Today%2C%20some%204%20million%20Americans,U.S.%20between%201982%20and%202008.
https://www.nhs.uk/conditions/cleft-lip-and-palate/
https://www.thedentalguide.net/braces-cost-uk/
https://invisalign.com/

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