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Are you ever too old for ortho?

Date: July 2021

Author: Louise Sinclair

As orthodontic treatments become increasingly accessible and discreet, more and more adults are seeking to straighten their teeth. In a study published in the Journal of the American Dental Association, 31.5% of participants expressed a desire for treatment to improve the alignment of their teeth. However, lots of people still believe that orthodontics is for children and teenagers.

The American Association of Orthodontists (AAO) supports orthodontic treatment for adults, reporting that their U.S. and Canadian members were treating 1,690,000 adult patients as of 2016. With orthodontic treatment a viable option for most adults, we discuss the importance of providing orthodontic evaluation for all patients.

The truth about adult orthodontics

It is a common misconception that adult teeth cannot be moved in the same way as the teeth of children and teenagers. The truth is that regardless of the patient’s age, applying force to the teeth with the use of an orthodontic appliance will cause the teeth to move. It may take longer in an adult patient due to higher bone density, but it can be done successfully in the majority of cases.

Adult orthodontic patients may present additional challenges due to missing, damaged or restored teeth, medications, bruxism, or habits like smoking. In some cases, this may mean additional treatment to restore optimum oral health before undergoing treatment, potentially requiring support from other dental specialists. While this may make orthodontic treatment more complex, such patients can still enjoy a very positive outcome.

The orthodontic evaluation

While many patients might daydream about a straighter smile, not all of them will realize that aligner treatment may be a viable option for them. By incorporating an orthodontic evaluation into your routine care, you can identify patients who might benefit from orthodontic treatment and help guide them towards a suitable solution.

Revise Dental provides a helpful reference sheet for conducting an orthodontic assessment, covering occlusion, soft tissues, jaw function and facial alignment. Using your findings as a conversational starting point, ask your patient questions like:

“I can see you have some crowding here. Have you ever considered orthodontic treatment to straighten your teeth?”

“I can see that your bite is misaligned. Do you ever have trouble chewing or biting properly? Any jaw pain at all?”

“How do you feel about your smile? Is there anything you’d change if you could?”

Oral care during orthodontic treatment

No matter the age of the patient, nor the type of orthodontic appliance used, the need for meticulous oral hygiene is universal.

Traditional fixed orthodontic appliances make it more difficult to remove biofilm and food debris from around the wires and braces, increasing the risk of dental caries and gingivitis. For patients choosing this option, you might recommend an orthodontic toothbrush like the Colgate® SlimSoft™ Ortho Toothbrush, with ultra-slim bristles in a U-shaped configuration to clean tight spaces around the brackets and wires.

Aligners are removed to eat and to perform oral hygiene. Plaque levels are lower and it is reported that there is much less risk for dental caries in patients wearing aligners compared to wearing fixed orthodontic appliances, but some risk does still exist. It is recommended by the AAO that patients should only drink tap water while aligners are being worn. If patients are noncompliant with this advice and leave aligners in while consuming sugary drinks, the liquid that seeps in under the aligner can remain there and dental caries can develop. In the case of acidic drinks, this increases risk for erosion.

Orthodontic patients can benefit from fluoride therapies throughout treatment. Colgate® PreviDent® 5000 ppm Ortho Defense Toothpaste is a prescription-strength fluoride toothpaste specially formulated to help prevent caries, offering increased protection. Other options include Colgate® Phos-Flur® Rinse, a daily orthodontic mouth rinse that guards against orthodontic white spot lesions in patients with fixed orthodontic appliances, or PreviDent® Dental Rinse, a 0.2% neutral sodium fluoride that provides anti-caries benefits with weekly use. Removable aligners can be taken out to eat and do not hinder brushing or interdental cleaning, aiding oral hygiene.

A power brush can also be helpful for orthodontic patients. Electric toothbrushes like the Colgate hum feature timers to help to make sure your patient brushes for long enough and pays equal attention to all areas of the mouth – ideal for making sure those hard-to-reach spots aren’t neglected. The hum toothbrush also connects to a smartphone app, giving the user insights about their brushing habits and tips to improve brushing. Research has found that app-connected brushes such as these reduce biofilm in the mouth during a single use by 60%, compared to 44.9% for power brushes without an app.

While adult orthodontic treatment is not without challenges, there’s no reason adult patients, including mature adults, can’t enjoy straighter teeth. Start incorporating orthodontic evaluations into your adult dental care today and give your patients one more reason to smile!