The Smile Revolution

Kathy Steiger had lived with twisted teeth and bite problems all her life. The fifty-seven-year-old retired business consultant, who never got braces as a child, was afraid of needing dentures the way her siblings did. But her dentist kept telling her that losing her teeth wasn’t inevitable, and now the Minneapolis woman sports a set of braces—metal ones on the bottom teeth and porcelain ones on the top. “I’ve had some people who have said, ‘Why would you do that now?’ ” says Steiger. “And I say, ‘I’m going to live with these teeth for another twenty or thirty years, and it will be nice to have them straight for at least part of my life.’ ”

Advances in dentistry and orthodontics are allowing more people to keep their teeth and fix problems that their grandparents wouldn’t have considered correcting midlife. New products like invisible braces mean no one need know about it. “There are a lot more choices for adults now than there have ever been,” says Brent Larson, DDS, director of the division of orthodontics at the University of Minnesota School of Dentistry. “You can sit down with the patient and really tailor a situation to work for them.”

The ability to retain natural teeth relies on early diagnosis of decay and cracks, and new equipment and techniques have given dentists the tools to do that. Finding problems when they can be fixed by a small filling helps avoid such unpleasant and expensive procedures as root canals and caps or crowns, says David Cook, a general dentist at Smiles @ France in Edina. For example, the Diagnodent laser helps dentists detect decay, which has become more difficult because of the widespread use of teeth-whitening procedures, which remove the color dentists previously relied on to see these defects. Cook routinely uses the Diagnodent, which produces a reading when it detects decay. Similarly, he uses a fiber-optic flashlight in a darkened room to flush out fractures. “If it’s a deep crack, it stops the light,” he says.

But one of the most helpful new tools is something as ubiquitous as the digital camera, Cook says, because it allows him to show patients things that can’t be seen with the naked eye. This is important because people are much more likely to want to fix a problem if they can see it for themselves. “Today’s consumers need to be shown, because they’re more discerning, more savvy,” he says.

Braces are not just for teenagers anymore. Many adults who didn’t have braces as children, or didn’t wear their retainer as recommended, or encountered tooth crowding later on are now straightening out the problem. “The actual percentage of adults hasn’t increased that much in the last ten years, but now we’re seeing just as many forty-five-year-olds as twenty-year-olds,” Larson says.

And the offerings are more diverse than ever. “Even the conventional metal braces are much smaller, and they’re designed in such a way that they reflect less light,” Larson says. Many adults opt for the less obvious tooth-colored porcelain or ceramic braces. But the most popular option in Angela Ross’s orthodontics practice in St. Louis Park is invisible braces that can be taken out for brushing and flossing and before a patient eats. INVISALIGN braces, which consist of a series of clear plastic shells that look like the trays in home tooth-whitening kits, need to be worn twenty-two hours a day. “They’re so snug they feel like your own teeth,” she says. They are especially popular with men, who tend to be particularly discreet when it comes to braces. “They can be straightening their teeth, and no one ever has to know about it,” Ross says.

People who do lose one or more of their teeth don’t necessarily have to have a bridge anymore. Dental implants are a popular and more natural-looking alternative, says Paul Olin, DDS, associate dean for clinical systems and director of the implant program at the University of Minnesota School of Dentistry. A hole is drilled into the jaw bone and a titanium implant is inserted. An implant can replace a single tooth. If all teeth are missing, several implants permanently secure a lower denture, which otherwise “floats” over the gums; suction keeps the upper denture in place. “For healthy patients without any teeth, it’s the treatment of choice today to help anchor the dentures,” Olin says.

With life expectancies lengthening, people approaching midlife still have several decades of life ahead, and having teeth pulled and dentures fitted is becoming less common. “You can definitely say that people are keeping their teeth longer,” says Mary Seieroe, DDS, director of the general practice residency program at the Hennepin County Medical Center Dental Clinic. “We’re seeing people retaining their teeth into their nineties.”