Walk into any middle school or high school across the country, and you're probably going to see dozens if not hundreds of kids with braces affixed to their teeth. And when it comes to adults, orthodontic procedures can be just as common.
There are plenty of options for grown-ups who want to straighten out their smiles, with varying price points and degrees of visibility.
“Essentially, they're all different types of braces," says Dr. John Buzzatto, an orthodontist and the current president of the American Association of Orthodontists. These braces are pretty much the kind you would see on those schoolkids, too, but the options for adults tend to be a bit more discreet than the stainless steel variety. “That’s where we come into the more aesthetic, or less notable braces," says Buzzatto.
The first type (and most common) are ceramic. They work just like the stainless steel kind, wherein braces are affixed to the teeth to hold a wire, which is what actually applies the pressure. Unlike the stainless steel kind, however, ceramic braces (also called clear braces) are "tooth-colored" and appear much less noticeable in the mouth. “Some manufacturers mask the color of the metal wire too,” Buzzatto says, but claims that this disguise makes the wire less efficient, as the coating takes up valuable space that could be used for a stronger gauge.
Due to their incognito qualities and relatively affordable price — a typical treatment costs from $4,725 on the low end to $6,940 on the high, according to the American Dental Association — ceramic braces are the most popular choice among adults, and sometimes celebrities. Tom Cruise wore ceramic braces while attending the premieres of the 2002 film "Minority Report," and Faith Hill was spotted with a mouthful of ceramic braces at recent awards ceremonies. “She has been great for raising the awareness of orthodontic treatment for adults,” adds Buzzatto.
“Also available are the clear aligners,” says the doctor, "which are custom-made trays for the teeth, which apply pressure from the shape." A patient typically uses a series of these clear aligners over a recommended period of time, as each aligner slowly pushes the teeth into a predetermined shape. “How many aligners would be necessary would depend on how badly the teeth are crooked," claims Buzzatto, with minor procedures utilizing three to four trays and more major jobs taking 20 to 30. They're also virtually invisible, which might be why celebrities such as Justin Bieber and Katherine Heigl chose this option for straightening their teeth.
Clear aligners do have downsides, but they vary from patient to patient. As Buzzatto explains, these aligners "don’t have the same capability or efficiency to correct the bite,” which is the way the top and bottom rows of teeth fit together. This problem may not be a concern for the patient, though it can be corrected by wearing traditional braces after the clear aligners. The only other downside of these aligners is the temptation to take them out, as they are not bonded permanently to the teeth.
According to Buzzatto, the costs of clear aligners (such as Invisalign) are "probably in the same range as the ceramic," but again, these prices range depending on a patient's teeth and area of the country.
The final and most expensive option are lingual braces. “The lingual braces are [also] custom-made, and they fit on the tongue side of the teeth. You don’t see them at all,” says Buzzatto. Perhaps that's why this treatment is the preferred method of certain celebrities and public figures whose smiles are constantly on display, including Miley Cyrus and Kate Middleton, reportedly.
And because hidden lingual braces are custom-made and so discreet, "they’re actually the most expensive,” notes Buzzatto. "The anatomy [of the teeth] on the tongue side varies greatly from one patient to another … you’re looking at $10,000 or more.” And singers or voice-over artists may also find problems with this treatment option, as lingual braces "would interfere with the tongue, and actually cause some more speech difficulties,” says Buzzatto.
But all of these options — stainless steel, ceramic, clear aligners and lingual — would take about the same amount of time to correct a smile ("Most treatments would take between a year and a half to two years,” Buzzatto says) and cause the same amount of discomfort in the mouth (after each orthodontist visit, an adult's teeth can be expected to feel sore for three to five days). Patients can also expect to wear some type of retainer, be it removable or fixed, following their orthodontic procedures, "ideally forever," says the doctor.
That being said, it's really up to the patients and doctors to decide which option is for them, explains Buzzatto. "Based upon what the chief complaint is, the orthodontist would be able to recommend the best course to rectify the complaint," he says, including whichever procedure suits a person best.
And that's great news for smiles of all sizes, from smirking school students to grinning grown-ups.