Is it ever too late for braces?

For almost 20 years, my dentist told me I should get braces and for almost 20 years, I ignored her.

It wasn’t that I was opposed to having straight teeth. Mine looked fine and as someone who spent nearly 35 years working as a television reporter, the thought of putting braces on my teeth was hardly appealing. But the problem wasn’t really what I could see when I smiled. It was my bite.

The way my teeth came together was causing me to grind my teeth, and over the years that grinding was wearing them down. Eventually, my dentist gave me a warning that got my attention: there wasn’t much tooth left on one of my back teeth to work with. That was the point when I finally decided it was time to listen.

At 57, I became an orthodontic patient and instead of traditional braces, I chose Invisalign.

It turns out I am far from unusual. According to Calgary orthodontist Dr. Claude Boutin, about 25 per cent of his patients are adults.

“It’s definitely a significant population,” Boutin says.

Many of those adults, he says, are referred by their dentists because of a functional problem rather than simply because they want a nicer smile. The cosmetic benefits may be welcome, but often they aren’t the main reason for treatment.

“One of the biggest misconceptions is that it’s for kids,” Boutin says.

Adults may assume that once they reach their 40s, 50s, 60s or beyond, their teeth are simply too established to move. That’s not the case.

“Adults don’t always believe that we can move teeth very much,” Boutin says. “In adult adults we can do pretty dramatic movements,” Boutin says. There are, however, some differences between moving adult teeth and the teeth of a teenager.

Adult teeth generally move more slowly. Boutin says orthodontic treatment takes about 30 per cent longer in older adults, on average. If someone has had orthodontic treatment before, it can take even longer because the bone may have remodelled and become denser. And there’s another issue that becomes increasingly important as we age: wear and tear.

“Most of the time it has to do with bite issues that cause excessive wear and tear on teeth,” Boutin explains.

That was my problem.

For years, I thought of braces as something that would make my teeth look better. I didn’t think of them as something that might help protect my teeth.

But excessive wear can eventually become much more than a cosmetic issue.

Boutin says teeth can become so worn that they begin to hurt. In some cases, dentists can’t simply place a crown over a damaged tooth because the bite continues to put excessive pressure on it. Sometimes, he says, the damage becomes so severe that even moving the teeth can’t solve the problem.

And in some cases, teeth may ultimately have to be lost.

That possibility certainly changed the way I looked at my own situation.

My Invisalign trays are removable, which was one of the reasons I preferred them to traditional braces. But there is a trade-off. Unlike braces, Invisalign isn’t working around the clock. Patients are supposed to wear the trays for about 22 hours a day and remove them for eating and brushing. “Braces work 24 hours a day,” Boutin says.

Traditional braces are also generally faster.

“For a patient with braces, it might take 25 months whereas that same person who wears Invisalign really well it might take 27 or 28 months,” he says. “That’s not a significant difference.”

Invisalign isn’t suitable for every case. Some teeth that are severely rotated or need to be moved significantly up or down can be difficult to treat with clear aligners. Sometimes orthodontists use a combination of braces and Invisalign.

For older adults, however, Invisalign can have another advantage. “A lot of time adult patients have a lot of wear and tear on their teeth,” Boutin says. “Invisalign has the bonus of covering the teeth and preventing further wear and tear.”

And age, apparently, is not necessarily the barrier many of us imagine.

Boutin says his oldest orthodontic patients have included an 84-year-old man and an 86-year-old woman. Both were treated for bite problems. He remembers what the 84-year-old man told him when treatment was finished.

“I didn’t think you’d be able to do this well. I’m glad it worked out,” the patient said.

Then came the part that Boutin says he remembers most: “I don’t have any idea why I didn’t do this years ago.”That sentiment is echoed by many adult patients, Boutin says.

“A lot of people when we finish the treatment, what they say is, ‘I should’ve done this sooner.’”

I understand that now. I spent nearly two decades being told I should see an orthodontist because I couldn’t see the problem.

The goal wasn’t to have a Hollywood smile. It was to protect the teeth I have and hopefully keep them healthy for as long as possible.

There is also an important reality to consider: straightening your teeth doesn’t mean they will stay that way forever.

Teeth can move throughout our lives, which is why retainers are so important after orthodontic treatment. Boutin says some patients return years later because their teeth have shifted.

“We spend a lot of time trying to get retainers fitting right and getting patients to wear their retainers so we can maintain the results that we achieved,” he says.

So if you’re an older adult who has been told you might benefit from orthodontic treatment, don’t dismiss the idea simply because you think braces are for teenagers.

You may not need braces at all.

And more importantly, the reason your dentist is suggesting orthodontic treatment may have little to do with how your smile looks.

It could be about what’s happening every time you bite down.

As I’m discovering at 57, sometimes the problems we need to fix aren’t the ones we can see in the mirror.

Watch the full story on Unison TV