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More Adults Wear Braces to Fix Smiles

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Cathy Rissler sits in the orthodontist's chair waiting to have her braces adjusted. She hopes the appointment doesn't take too long; she's eager to get on with her day.

Rissler isn't a teenager who has cheerleading practice to attend or homework to finish. She's a 41-year-old regional business manager for Ocean Spray Cranberries Inc. who has phone calls to make and reports to write.

She's also one of thousands of metro Atlanta adults undergoing orthodontic treatment, for a variety of reasons ranging from bite problems and tooth crowding to the purely cosmetic.

More than a million Americans age 18 and older are wearing braces, an increase of 125,000 over the past decade, said Pam Paladin, spokeswoman for the American Association of Orthodontists.

The increase is due at least in part to new technology and materials that have made wearing braces less painful and time-consuming.

One technological advance is nickel-titanium wire, an ultraflexible material developed by the National Aeronautics and Space Administration. Orthodontists are using it to make appliances that exert a steady but gentle pressure on teeth.

``It responds to body heat and becomes more flexible as the mouth warms up, so you don't get all the forces applied at once,'' explains Dr. Ron Parsons, a Lawrenceville, Ga. orthodontist.

As a result, the wires don't require as much tightening and don't wear out as quickly as did previous materials. ``Patients often can go 10 to 12 weeks between appointments with braces made from this material,'' said Dr. Paul Yurfest, whose Atlanta office caters mostly to adults.

Also, dentists today offer wire with a tooth-colored coating. ``Now, patients can get porcelain brackets and tooth-colored wire, so that braces virtually disappear,'' said Parsons.

Biting the bullet

In Rissler's case, braces are correcting an old bite problem. ``I had braces when I was 12, but it didn't take,'' she said.

Fast-forward almost three decades, when her gumline began to recede. Following periodontal surgery to repair the problem, her dentist told her she needed orthodontic treatment to prevent her gums from receding again.

So, at age 39, Rissler got braces - a mouth full of shiny silver with springs and bands galore. She thought about getting clear braces, she said, but opted for metal instead. ``It takes longer with clear, so I decided to bite the bullet and just get it over with.''

Linda Carver, 51, a marketing consultant from Marietta, Ga., also got braces at age 39, after developing symptoms of temporomandibular joint disorder, or TMJ, a potentially debilitating condition of the jaw and surrounding area.

Carver's dentist referred her to both an oral surgeon and an orthodontist. Following palatal expansion surgery, she got full metal braces on both her upper and lower teeth.

Almost immediately, Carver said, she could see a difference in her smile. ``When I first got braces, I had a large gap between my front teeth. Once that came together, I started seeing good results consistently.''

Adults often decide to get braces when their children require orthodontic treatment.

Alyson Gondek, president of Progressive Marketing in Snellville, Ga., got braces last summer at age 38 as a result of taking her 11-year-old daughter, Chelsea, to the orthodontist.

Gondek, now 39, had worn braces as a teenager, but her teeth started shifting in her late 20s. My dentist told me back then I should see an orthodontist, but I thought I'd deal with it later,'' she said.I didn't know if I wanted to go through with it. Then I started noticing a lot of adults who had braces. Then a neighbor got them. Then my daughter needed them.''

That was the push she needed. Gondek now wears traditional metal braces on her bottom teeth and clear ones on her uppers.

Ready for television

Yurfest, who is the founder of the American Lingual Orthodontic Association, said that adults - including executives, media personalities, sports figures and models - make up 80 percent of his practice. ``Today, it's not unusual to see people in their 30s, 40s and even 50s undergoing orthodontic treatment,'' he said.

Karen Minton, a meteorologist at WSB-TV in Atlanta, sought help from Yurfest several years ago when her dentist suggested she see an orthodontist for minor crowding.

Minton, 49, didn't want a mouth full of metal, and Yurfest came up with a solution: removable retainer-like devices that she could pop out before going on the air.

Treatment with removable appliances typically takes longer to complete - sometimes twice as long as treatment with traditional braces. But for some patients, it's worth the extra time.

Minton's treatment took 18 months to complete. ``Now my teeth are in line, and the process was easier than I thought it would be,'' she said.

And if adults want truly invisible forms of correction, they have several options.

Lingual braces, for example, are invisible, because the brackets and wires are placed behind the teeth. But lingual appliances typically cost more than regular braces and often affect speech, at least initially, because they get in the way of the tongue.

Another alternative is Invisalign, which uses a series of custom-made, removable clear plastic shells, similar to tooth-bleaching trays, to reposition the teeth. The shells, called aligners, are fabricated using 3-D computer-imaging technology. The aligners stretch slightly and apply pressure to the teeth.

Patients wear each set of aligners for about two weeks - removing them only to eat, drink and brush - and typically go through 18 to 30 sets during the course of treatment.

Worth the cost

Comprehensive adult orthodontic treatment typically runs $4,000 to $6,500, which covers everything from pre-treatment X-rays and impressions to follow-up visits. Most orthodontists charge a down payment and then spread the remainder of the fee over the course of treatment.

A few patients get help from insurance. Paladin, of the orthodontists' association, said that approximately half of all new orthodontic patients have dental insurance that includes orthodontic benefits. Some insurance plans pay a flat amount; others pay a percentage of the fee.

Every plan is different,'' Paladin said.Many of them cut off orthodontic benefits at age 18 or 19.'' And even plans that include adult orthodontic benefits often reimburse only treatment for medical disorders such as TMJ, Paladin said.

But for many patients, the end result is worth the cost, even if the money comes out of their own pocket. I would absolutely do it again,'' said Carver.If something will enhance your appearance and your confidence, I highly recommend it.''


(The Cox web site is at )

c.2003 Cox News Service

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