Family and friends encouraged me to do it, but I had to ask myself: Was I too old for this?
The day before my 62nd birthday, I got braces on my teeth. Not the wire and metal variety I might have had 50 years ago, but clear “aligners” that I thought would be inconspicuous.
My smile had always bothered me, but I had given up on straightening my teeth decades earlier when an orthodontist said I needed surgery to correct my underbite. At the prospect of having my jaw wired shut for six weeks I thought, “I’m not looking that bad.” So, I dismissed the idea.
Why revisit it now? My crowded teeth were hard to floss and my upper teeth seemed to be getting more crooked, which is likely since teeth can change over time. For years I smiled for pictures with my mouth closed.
For years I smiled for pictures with my mouth closed.
Hearing my concerns, the dental hygienist suggested I consult an orthodontist.
I was skeptical, expecting to hear, again, that I would need surgery or that my three remaining wisdom teeth would have to be pulled to make room in my mouth. Any of these suggestions would have ended my quest for straight teeth.
In addition to traditional wire braces, newer options include wire and porcelain braces and appliances that fit behind the teeth to be invisible. After taking impressions, photos and a 360-degree scan of my jaw, Dr. F said I was a candidate for clear aligners, which fit over the teeth and work by slowly pushing them into place. I would still have an underbite, but my teeth would be straighter, no surgery or extractions required.
A long time ago?
A few weeks later, after consulting with the company that makes the custom aligners, Dr. F showed me a video simulation of how he expected my teeth to move. It felt like magic — albeit expensive magic. Besides a house and a car, getting my teeth fixed would be the most expensive purchase of my life.
Family and friends encouraged me to do it, but I had to ask myself: Was I too old for this?
“Oh, I have patients in their 80s,” said Dr. F.
The American Association of Orthodontists estimates that one in three orthodontic patients are adults, and a 2022 survey of the AAO’s nearly 10,000 members showed, on average, a 19% increase in patients over age 50 from 2018. Overall, the survey data suggest there are as many as 270,000 orthodontic patients age 50 and older in the U.S. and Canada, according to Melissa Palmer of the AAO.
I had to ask myself: Wasn’t I too old for this?
Why this wave of interest in straight teeth? Vanity drove my decision, but in an email, Myron Guymon, DDS, MS, president of the AAO, said improved function and stability are other important reasons to pursue orthodontic treatment. Straight teeth are easier to clean, which helps us maintain good oral health. “A well-aligned bite and straight teeth can help reduce future dental problems,” he said.
Shortly after starting the process, I learned that it is not as magical and inconspicuous as I thought. First, Dr. He bonded tiny composite dental resin “attachments” to some of my teeth to anchor the aligners. I would need 36 sets of upper and lower aligners, changing them every two weeks for at least 18 months as my teeth shifted.
‘Was it worth it?’
Teeth move more slowly in adults than in teenagers, but they begin to move immediately after pressure is applied. By the time they settle into their new position, they will snap back just as quickly, so the aligners must be worn 20 to 22 hours a day. Made of clear plastic, they stain easily and are not strong enough to withstand the pressure of chewing. I was told to remove them to eat or drink anything but water.
This leaves only two to four hours a day for meals, or even less, considering the brushing and flossing required before the strips are reattached. Say goodbye to a second cup of coffee in the morning or a glass of wine in the evening.
Not knowing how I was going to survive a year and a half of this, I joined a couple of online support groups, one of which, with 1,000 members, is specifically for the over 50s. Visiting these groups, I’m often greeted by a screen-filling photo of teeth. Many people post success stories, but just as many have problems that they highlight with circles and arrows in their photos.
As I near the end of treatment my friends ask, “Was it worth it? ‘
Older people are more prone to gum disease than younger patients and may have crowns, bridges or dental implants that can complicate treatment, Guymon said. Good communication between patients and their dentists is essential. For example, as my bite changed, an existing crown began to prevent other teeth from closing together properly. Solving the problem required a visit to a prosthetist, who “polished” a tiny section of the affected part of the rim.
For people using clear aligners, it’s not uncommon for them to need “touch-ups,” meaning the initial treatment didn’t do the trick, so an extra batch of aligners is needed — adding to the treatment time. Also common is interproximal reduction (IPR), which is a process of filing down a hair’s breadth of enamel to create space between the teeth. Everyone on the support team said it was no big deal, but I felt like Dr. F was flossing the equivalent of sandpaper.
After two years, I now only wear aligners at night, but I still have metal hooks on some teeth, to which I attach tiny rubber bands meant to pull some stubborn premolars into their final position.
As I near the end of treatment, my friends ask, “Was it worth it?”
Like most challenges, this one was the hardest at first. And in a sense, it will never end, because anyone who gets braces – of any kind, at any age – must wear a retainer at night for the rest of their day, lest those formerly crooked teeth return to their old positions.
Overall, I am grateful to have an orthodontist who was honest about what could be accomplished. My teeth aren’t perfect yet and I’ve had to adjust to my new bite, but for the first time as an adult, I’m learning to smile and laugh while showing my teeth.
