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The Honolulu Advertiser
Posted on: Tuesday, December 4, 2007

Today's braces less painful — even cool

By Cynthia Hubert
McClatchy-Tribune News Service

SACRAMENTO, Calif. — Meghan Larson is no "Ugly Betty."

Sure, she has braces on her teeth. But not the clunky sort that actress America Ferrera flashes on her hit television show.

No, Meghan's braces are smaller and lighter. They're accented in pink and white. They are, she's willing to admit, sort of a cool fashion accessory.

"I was thinking it might be horrible to have braces," says Meghan, a seventh-grader at Holy Spirit School in Sacramento. "But almost everyone in my class has them, and that makes it fun."

FUN? BRACES?

Who would have guessed, a generation ago, that those two words could ever be uttered in the same sentence?

Not Meghan's mom, Sue, who sported a full "metal mouth" and headgear during her formative years.

"It was certainly embarrassing, uncomfortable and socially awkward," she recalls.

But in the end, her perfect smile made it all worthwhile.

Today's braces are more visually appealing and less painful, and wearers don't have to make as many visits to the orthodontist. But the basic function is the same: to straighten misaligned teeth and jaws.

Crooked teeth, overbites and underbites, among other orthodontic issues, are quite common. In fact, the American Association of Orthodontists estimates that about 75 percent of people could benefit from a visit to one of their specialists. Heredity, accidents and thumb sucking are a few common causes of orthodontic problems.

Braces work by putting pressure against the teeth, moving them gradually over time. Most of the pressure comes from a metal wire, called an archwire, that runs on the outside of the teeth. Latex bands apply a bit more pressure.

According to the orthodontic group, dental braces likely date back to ancient times.

Archaeologists have found mummified bodies with crude metal bands wrapped around individual teeth.

Braces stayed pretty much that way, until recently.

Baby boomers grew up with braces featuring stiff archwires connected to large metal bands wrapped and cemented to each tooth, creating the dreaded "tin grin" effect. For those with severe bite problems, headgear completed the look.

Some important breakthroughs occurred in the 1970s, most notably a technique called "direct bonding," in which orthodontists attach flexible nickel titanium archwires to tiny brackets made of metal or ceramic. The brackets are then bonded to the front of teeth.

"They move the teeth at the same rate but with much less discomfort," says Dr. Robert Boyd, professor and chairman of the Department of Orthodontics at the University of the Pacific's Arthur A. Dugoni School of Dentistry. "That's a major advance that has been evolving for the past 25 or 30 years. Things just keep getting better."

Aesthetically, modern-day braces-wearers have more choices than before. One company markets its braces as showy "jewelry for the mouth." Other braces are attached to the inner side of teeth, making them nearly invisible.

Archwires and elastic ties now come in a variety of hues, which have made visits to the orthodontic chair far more palatable to youngsters.

"They get holiday colors, they get school colors, they get rainbows," says Dr. Kelly Giannetti, an orthodontist who practices in Sacramento and West Sacramento. "They get colors to match their prom dresses.

"It's made it exciting and fun for them. They look forward to coming to their appointments as opposed to dreading them."

Matthew Speer, who at age 11 has had braces for nearly two years, chose Halloween colors during his most recent visit to the orthodontist. These days, his mouth flashes orange and black.

At first, the notion of braces worried Matthew. "I was like, 'Oh no, I'm gonna be a brace face,"' he says. But now he's perfectly fine with them.

"Most of the time I totally forget they're there," Matthew says.

Apparently, other wearers feel the same. More than half of teenagers recently surveyed about their braces report that they are not self-conscious about them. More than a quarter of them say their braces make them look cool. Nearly 60 percent say they've matched their outfits with the bands on their braces.

Young people are still the majority of brace wearers, but braces are not just for kids anymore.

The orthodontics association reports that more than 1 million adults have braces, up by nearly 40 percent from a decade ago. But they're less likely than their kids to show them off, says Sacramento-area orthodontist Mark Holt.

Most adults in Holt's practice opt for "Invisalign" straighteners, which substitute clear, removable devices for the traditional wires and brackets.

Invisalign can be used only in less-severe orthodontic cases and are slightly more expensive than metal braces, which run in the $4,000 to $6,000 range. Still, these pop-out "braces" have proved immensely popular and are the wave of the future, specialists say.

"A lot of adults, especially men, just won't do regular braces," Holt says. "But they'll do Invisalign."

With treatment, they can rid themselves of problems that have plagued them since childhood.

Adult orthodontic patients, Boyd says, typically are people who had braces as kids but failed to wear their retainers, or who needed early treatment but never got it, perhaps for economic reasons. Orthodontic care usually is not fully covered by insurance.

"These are people who have finally decided they don't like their smiles anymore, and now they have the means and the time to deal with it," Boyd says.

Typically, children get braces around age 12, although younger kids with certain problems may also be candidates. Braces usually stay on for 18 months to two years, followed by months or years of wearing a retainer. "Halos" and other types of headgear are still used to help correct certain jaw and tooth problems, though less frequently than in the past.

Whatever the circumstances, it's pretty clear that the whole process is less traumatic than it was way back when.

The most-common complaint that orthodontists get from kids today, says Giannetti, has nothing to do with the way their braces look. "It's about having to stay away from hard, sticky, gooey foods," she says. Those foods can break brackets, bend wires or get caught in braces, causing cavities.

The top three foods for brace wearers to avoid, orthodontists say, are corn on the cob, candy and apples.

Meghan Larson's not complaining about her culinary restrictions, although after about a month with braces she's already missing her dad's spicy popcorn. And she's actually looking forward, she says, to her next visit to the orthodontist.

"Next time, I'm going to go with neon green and silver," Meghan says of her mouth decor. "I'm going to go really crazy."