By Dr. Dante Gonzales
This is a question I get from a lot of parents and older adults that I come into contact with. In the past orthodontic treatment was mainly for children and adolescents. But within the last 20-30 years there have been many advancements in orthodontic treatment. And at the same time there has been an increased desire among adults to not only look their best, but feel and function at their best. With the convergence of these two factors, we now see many orthodontic offices seeing upwards of 50-60% of their patients as adults. This is a huge change from 35 years ago when adult orthodontic treatment was less than 10% of the market. Adults are realizing that the benefits from orthodontic treatment need not be for adolescents only. Adults can also gain these benefits from orthodontic treatment, and these days it doesn’t have to be with big metal braces. These days we can treat patients with very discreet appliances like clear braces, or lingual braces (cemented on behind the teeth), or clear aligners (eg. Invisalign).
Two of the biggest deterrents to adults getting orthodontic treatment were always the aesthetics and duration of the treatment. Adults were faced with the fact that metal braces are so obvious and make your smile full of metal. The other concern was the length of time in treatment. In many cases orthodontic treatment could take 24-30 months. That’s a long time to have a “tin-grin”. However, the field of orthodontics has undertaken a lot of research and every few years make significant advancements in orthodontic treatment. Treatment has become more efficient and doesn’t take as long as it used to. Today, there are adjunct procedures that can help increase the rate of tooth movement. Combining these procedures with more efficient treatment can result in patients finishing their treatment in 30-50% less time than it took 35 years ago. Some patients may finish orthodontic treatment within as little as 6 months. All of these factors have made adult orthodontic treatment more appealing, and made more adults more attractive in the process.
Even with all of these advancements many adult patients still wonder “am I too old for braces?”. “Can my teeth still move at this age?” “Will it negatively effect my teeth?” “Could I lose my teeth if I go through orthodontic treatment at my age?” These are all questions older patients tend to ask. These are all valid questions. However, these questions have to be answered on a case by case basis. The bottom-line is that almost anyone over the age of 6 or 7 can benefit from orthodontic treatment. The main factor in qualifying someone for orthodontic treatment is not the age, but the health of the teeth, gums, and the surrounding bone. If the teeth, bones, and gums are all healthy then you are a great candidate for orthodontic treatment.
Whether you’re young or old, treatment is the same physiological process that moves teeth through the bone. Adults may have denser bone tissue than children, so the teeth may move a little slower and treatment take a little longer, but age does not keep them from moving. Nor, does it increase the risk of complications. However, adults can have more wear on their teeth, have missing teeth, crowns, bridges, and even implants. These factors can complicate treatment, or cause the results to be slightly less than perfect. But one should never let perfection get in the way of achieving something excellent, or at least very good. All of the complicating factors that adults may present with are well within an orthodontist’s realm of treatment experience. Most orthodontists have undergone an extra 24-36 months of training. That extra 5000-7000 hours of training and experience is just one of the reasons why it’s so important to undergo orthodontic treatment with a trained orthodontist. While some general dentists perform orthodontic procedures in their offices, they do not have near the training or experience that a new orthodontic graduate has in regard to the training and knowledge of moving teeth.
To move your teeth an orthodontist can use traditional metal braces, clear ceramic braces, or clear removable aligners, like Invisalign. All of these appliances can move teeth and achieve the same result in the same amount of time. All of these appliances will deliver a controlled force to the teeth that gently and predictably move the teeth into the most ideal position for function, comfort, and aesthetics.
If you’re considering orthodontic treatment to correct longstanding cosmetic or bite problems or to remedy the effects of tooth loss, keep a few things in mind:
- The bones of adults have stopped growing, so some structural changes may not be accomplished without surgery. However, in most cases skeletal structural changes are not necessary to achieve great results.
- The entire process may take longer for you than for a child or adolescent. While the time it takes to straighten teeth varies from person to person, on average, treatment lasts about 12-24 months. These treatment times can be reduced with procedures that accelerate tooth movement.
- If you are undergoing orthodontic treatment, you may also need to see a periodontist as well as your general dentist and orthodontist to ensure that the treatment is not complicated by bone loss resulting from gum disease.
One of my oldest patients that I ever treated was 78 years old. I was treating her grandkids at the time when she approached me to ask if she could get braces too. The first question she asked me was “am I too old for braces?”. To which I replied, “of course not, as long as your teeth and gums are healthy we can straighten your teeth.” Her main concerns were the crowding and crooked teeth, and her two upper canines that stuck out and were very obvious. She had said that those canines and her crooked front teeth had bothered her since she was a adolescent. After a thorough examination of her teeth and bones, we determined that her mouth was healthy enough to undergo orthodontic treatment. She wound up going through 18 months of braces alongside her grandkids. And finishing treatment, she was overjoyed with the result. She said that her only regret was that she didn’t do this treatment sooner. During her visits to check her retainers and make sure the result was maintaining, she would tell me that in her entire life she had never smiled so much. Her entire demeanor had changed. She felt like she had become a better version of herself. Even her friends and family noticed the change, not just in her smile, but in her attitude. She lived for another 12 years after the braces were removed and she probably smiled more in those last 12 years than in the previous 78. So if you are an adult the question you should ask yourself is not “am I too old for orthodontic treatment?” , but instead ask “is there anything about my bite or smile that I would love to improve?” If there is, then you may be a great candidate for a new smile from orthodontic treatment.
Dr. Gonzales grew up in southern California. He has always had a passion for learning and for sports. After graduating from U.C.L.A., his love for science drew him to work in immunology research for one year at Veteran’s Hospital in Los Angeles. Dr. Gonzales then went on to receive his dental degree at Tufts University in Boston. There he graduated at the top of his class with the honor of Summa Cum Laude. Following his passion for orthodontics, Dr. Gonzales attended the University of the Pacific Orthodontic program in San Francisco. The world class orthodontic training at U.O.P. helped Dr. Gonzales become a Diplomate of the American Board of Orthodontics, an honor bestowed upon only 1 in 5 practicing orthodontists.
After graduating from his U.O.P. residency in orthodontics, Dr. Gonzales worked with several orthodontists around the Bay Area. Working for a year with several orthodontists gave him great insight into what was working well in private practice. Taking all of the best aspects of each office, Dr. Gonzales decided to go into private practice on his own. In September of 1998, Dante Gonzales Orthodontics was founded. In those first years of private practice, Dr. Gonzales noted that both the clinical side of orthodontics as well as the business of orthodontics are forever evolving. In order to provide patients with the best clinical orthodontics and the best office experience, it takes a constant commitment to learning not only what is new in orthodontics, but what is working and what is not. It’s this commitment and passion for learning that keeps Dr. Gonzales and his practice at the forefront of orthodontics, and this helps him provide not only excellence in orthodontic treatment, but also excellence in service for his patients.