I am writing from Scottsdale Arizona where I am teaching this week at the Spear Education/ Scottsdale Center for Dentistry. The topic of this week’s course is “Occlusion” or in normal speak: “the bite”- effects of tooth grinding, uncomfortable bites, nightguards etc. In truth, occlusion, or the bite, is in play with whatever treatment that I do on every patient because, whatever I do affects how the teeth meet and function. Now being that I am a self professed nerd, I can openly say that I have been fascinated by the subject of Occlusion since Dental School where I wrote a graduate paper on the latest theories at that time….and since that time was 1982, it now qualifies as a museum piece!
One form of treatment that is commonly used to correct bite issues is orthodontics, also known as “you want me to get braces??!!” I’m thinking of a patient I saw last week, Stephanie, who I have had the privilege to treat for 25 years. And over that time I have watched her front teeth become increasingly worn and chipped. Now the temptation would be to simply suggest some porcelain veneers to replace the tooth structure that has been worn away. But that would be fixing the immediate need without correcting the cause of the problem.
The reason I love teaching at the Spear Center is that all discussions revolve around the concept of Complete Dentistry. In Stephanie’s case, if you placed veneers without any other treatment, odds are, she would continue to clench/grind her teeth and pretty quickly start to chip and/or break the veneers. A Complete Dentistry approach would be to identify the grinding habit that has created the front teeth wear and correct it before making the final veneers. And in many cases, the easiest and most effective way to “fix” the grinding is with braces.
So let’s clear up a couple common misconceptions about braces. First, in the case of adults, forget about the notion that braces are cosmetic. As crazy as that sounds, in my practice, most of my adult patients who have had braces did it to correct bite issues….it just so happens that the teeth look a heck of a lot better after the braces come off! Additionally, in many cases, by moving the teeth into better positions, much less restorative treatment is needed. Instead of needing crowns/veneers to give the illusion of straight/ even teeth, braces move the teeth into more aesthetic positions and give a much more natural result. Yes, I know that I said that most braces are done for bite issues and not cosmetics but the fact of the matter is that the two go hand in hand. If braces are utilized to straighten the teeth without sufficient regard and respect and knowledge about the occlusion, the final result will be compromised in terms of bite/chewing comfort as well as the longevity of the work itself.
The old expression that “age is just a number” has never been more true than in the case of braces. We have patients in their 50’s and 60’s who have gotten braces as a first step towards creating the smile they desired. In other words, porcelain veneers or any other cosmetic work looks more natural and less artificial if the teeth are in the right place. Additionally, chewing ability and muscle joint comfort are directly related to teeth that are aligned properly and meshing efficiently. Braces can also be used to move teeth to a better position to correct gum issues.
In Stephanie’s case, after we went over her study models and digital photos of her teeth, I walked her through some options and zeroed in on the benefits of braces. The look of surprise on her face was to be expected because she is 58 and has always thought of braces as being for kids. However, after some further discussion, she agreed to visit my favorite orthodontist for adults and listen to what is possible. I don’t know for sure if she will proceed with treatment, but I hope so because the results will be amazing.
When teeth are moved into ideal positions for these reasons, they look much better as a result! With all the options available to us today, such as clear Invisalign or braces bonded to the backs of the teeth, there is no reason not to make your teeth straighter, healthier and more comfortable. You deserve it – at any age!
