Adult Orthodontics: What’s Changed Since We Were Kids
Written by Melissa Schenkman, MPH, MSJ
When Tyler Rathburn, DMD, got braces as a teenager like his fellow millennials, he was used to trying not to gag while orthodontic assistants took his impressions– where our teeth adhered to “cement” or what he now tells me was a mix of old alginate and water. It was both miserable and memorable, as those of us who had that experience have not forgotten about it.
But now a practicing orthodontist in his 30s at Atlanta Orthodontics Specialists, he is able to offer a completely different experience. Not just to the elementary schoolers and teenagers that frequent his practice but also to the surprising number of people closer to his age and older who he now more commonly treats. This noticeable shift in the demographics of orthodontic patients, with a growing number of adults seeking orthodontic treatment has been evolving over the past decade throughout Dr. Tyler’s (as he is called by patients) career.
He shares his perspective on why more adults and fellow millennials in particular, are opting for orthodontic care, how the move can benefit you, and all that has changed since your last time in the orthodontist’s chair.
Why Adults Want Orthodontic Treatment
Unlike many teenagers who may undergo orthodontic treatment because their parents initiated it, adult patients choose orthodontics willingly, tending to be more motivated by and interested in their orthodontic treatment.
Often adults seek orthodontics for both cosmetic and functional reasons. One significant reason behind the rise in adult patients is the convenience and effectiveness of current orthodontic treatment.
In recent years, clear aligners (a type of plastic tray that moves your teeth) and other innovative options have made orthodontic treatment less invasive, aesthetically appealing, and convenient to get, all which is particularly appealing to busy, on-the-go adults who may have hesitated to fix teeth that have become misaligned or hesitated to get braces in their younger years.
Benefits of adult orthodontics
Pursuing orthodontic treatment as someone in their 20s, 30s, or 40s can have major benefits, including:
Improved appearance
Improved oral health
Improved function
While Rathburn didn’t encounter many adult patients during his residency training, he enjoys seeing more and more of them in his office now. It provides a nice variety in patient care.
“Adult patients want to participate and learn about their teeth, and I enjoy teaching and guiding them through their treatment. They are excited to see changes and motivated because they brought themselves,” Rathburn said.
He emphasizes that most adult patients are a pleasure to treat and work with. Finding it rewarding, as adult patients are invested in transforming their smiles and appreciate the opportunity to address long-standing concerns they may have had about their teeth.
Ortho Technology and Innovation
Their enthusiasm skyrockets as new adult patients are introduced to the high-tech world of orthodontics today that did not exist in the 1990s and early 2000s, when millennials first got braces.
“Technology has changed a lot, and it continues to change. Every few months, there's something new on the market, which is really cool,” Rathburn said. “Digital scans have been the biggest thing obviously that we’ve been doing the last couple of years, and I think the most noticeable change for patients.”
Tyler Rathburn, DMD, is an orthodontist at Atlanta Orthodontics Specialists with his parents Drs. Michael Stewart and Melisa Rathburn.
Advances in orthodontic technology
Along with eliminating that delightful cement mixture for impressions and replacing them with digital scans, here are some of the great advances in technology that await your mouth in orthodontic treatment as an adult:
3D imaging and modeling
Intraoral scanning
Digital treatment planning
Robot-assisted orthodontics
Orthodontic software
Adult braces and aligners
The evolution of X-ray technology has significantly improved orthodontic care, providing orthodontists with advanced tools for diagnosis and treatment planning. Traditionally, orthodontists relied on two-dimensional X-rays to assess a patient's dental and craniofacial structure. These 2-D X-rays were taken from multiple angles and “kind of in our mind’s eye,” Rathburn said, had to be stitched together to form a comprehensive view. Recent advancements in X-ray technology, such as Cone Beam CT (CBCT), have revolutionized the field of orthodontics.
One reason: adult patients typically have greater concerns than younger patients about radiation exposure, and CBCT offers a low-dose radiation form of a CT scan specifically designed for head and neck imaging. It allows orthodontists to capture a full 3-D X-ray image of the patient's head and neck with a radiation dosage comparable to or even lower than that of traditional 2-D X-rays, making it very valuable. The information derived from 3D X-rays is also vastly superior to its 2D counterpart, enabling orthodontists to visualize intricate details of the dental and skeletal structures.
As if having digital scans instead of impressions and low-dose radiation, yet sophisticated x-rays were not enough to excite millennials about no longer putting off long overdue orthodontic work, there are the wonderful, super clear options of aligners to move your teeth into place.
The company, Invisalign, initiated this process, originally patented it, and is still a dominant player in the market today.
“Invisalign basically digitized the orthodontic process, making it possible to move the teeth digitally and incrementally at every step along the way. There's an algorithm that divides the movements into a series of steps and then you get a certain number of trays to wear based on that.”
Rathburn and his colleagues have been offering patients SureSmile technology– a similar yet more affordable high-tech option than Invisalign–since 2007. It provides a faster and more efficient way of offering orthodontic treatment by enabling orthodontists to customize traditional braces and aligners for each patient. His team can even print models or aligners right in their office.
For Atlanta Orthodontics Specialists, patient demand for SureSmile technology grew the practice from two offices with three doctors to six offices and seven doctors.
Examples of innovative orthodontic technology companies
Aligner companies continue to innovate the types of plastics they use to compete with one another in offering the most successful orthodontic treatment possible. Some of the major players are:
Invisalign
SureSmile
3M Unitek
Ormco
Align Technology
Benefits of innovation in orthodontic technology
There are many advantages to today’s advanced orthodontic treatment options, including:
Improved accuracy and precision
Shorter treatment times
Greater patient comfort
Reduced treatment costs
Increased treatment options (dental monitoring)
More specifically, incorporating CBCT X-rays gives orthodontists the ability to zoom into any part of your 3-D image to examine specific areas of interest.
This capability is particularly valuable when dealing with complex cases involving impacted teeth, cysts, or other challenging orthodontic issues. Another benefit is that the dosages or radiation in dental CBCT are extremely low compared to medical CT scans, making them a safe and indispensable tool in orthodontic diagnosis and treatment planning.
“It gives us more comfort because it not only enhances patient care, but also aligns with the ALARA principle in dentistry which stands for As Low As Reasonably Achievable. CBCT allows orthodontists to follow this by keeping radiation exposure as low as reasonably achievable, but still being able to see what you need to see about a patients’ teeth,” Rathburn said.
As a result, the integration of advanced X-ray technology like CBCT has become a standard in modern orthodontic care, offering a powerful tool for achieving successful and safe treatment outcomes.
Aligner technology also offers several significant benefits. One notable advantage being their lower likelihood of causing emergencies compared to traditional braces. With braces, loose brackets and wires can occasionally lead to discomfort and require immediate attention. In contrast, aligner-related issues are typically less severe, often involving cases of lost or broken aligners or minor attachment concerns.
Finally, there is the very cool technology of dental monitoring that Rathburn’s practice offers. It makes it possible to even treat patients who do not live in the state of Georgia. In fact, he had one patient who lived in London and came to Atlanta for business (and treatment) less than a handful of times.
Traditionally, patients receive a batch of aligners and return for periodic check-ups to ensure their treatment progress. However, dental monitoring leverages smartphone technology through various apps allowing patients to take weekly panoramic images of their teeth using a mouthpiece connected to their smartphones. These images are then sent to your orthodontist for evaluation.
Dental monitoring is a huge time-saver because it means fewer visits to the office. It empowers patients to have more control over their treatment, potentially speeding up the process. Plus, it allows orthodontists to detect any issues promptly and provide guidance to patients.
Aligners vs. Braces
The choice between aligners and traditional braces hinges on six key differences, Dr. Rathburn shares:
Aesthetics: Aligners, being nearly invisible, excel in providing a discreet option for those concerned about the appearance of orthodontic treatment. Ceramic brackets on traditional braces offer some discretion, but aligners are superior in terms of noticeability.
Efficiency: Traditional braces, with their super elastic archwires, have the upper hand when it comes to significant tooth movements, rotations, or vertical adjustments, as they can move teeth extremely quickly. Aligners can be highly effective but require multiple tray changes and may take more time for certain types of movements.
“You can customize aligners so that you can move certain teeth and not others, whereas in braces because they have brackets on every tooth and a wire going between each tooth, certain teeth may move that you don’t want to move,” Dr. Tyler said.
Convenience and ease of use: On a day-to-day basis, aligners are easier and more convenient to use. Unlike traditional braces, aligners are designed to be removed during meals, making eating more comfortable and without restricting food choices. Patients can often enjoy beverages like wine, soda, or sports drinks while wearing aligners, as long as they rinse their mouth with water afterward to minimize the exposure of sugary and acidic substances to their teeth.
Compliance: Aligners require patients to be dedicated to consistently wearing them for 18 to 22 hours a day for results to be successful. Patients wearing aligners need to adhere to a simple set of guidelines: wear them consistently, keep them clean, and ensure they are not lost. While initial compliance is typically high, it can decline over time, potentially affecting treatment outcomes.
Comfort: Patients with braces might face discomfort from brackets or wires rubbing against their lips or tongue, potentially causing more emergency visits. Aligners offer a more comfortable and less intrusive orthodontic experience.
Hygiene: Traditional braces may require more meticulous oral hygiene and management due to the presence of brackets and wires. In contrast, aligners offer minimum day-to-day management.
At his practice, Rathburn’s work involves aligners probably 90% of the time now for adults and 30% for teens. That’s how much the industry has changed.
“In my mind, you've got multiple tools on your tool belt. You just have to find the right one for the job. I don't think patients want to have to work any harder than they need to make the job done, and if they are a better aligner patient, then we should treat them with that option,” Rathburn said.
Factors to consider before undergoing adult orthodontic treatment
Dr. Tyler recommends you ask these questions of your prospective orthodontist before moving forward with the process for your teeth:
Questions to Ask Your Orthodontist
Is it too late for me to get braces?
We have patients from age 6 to 86. It is truly never too late to consider braces and/or orthodontics!
Will braces affect my speech?
Believe it or not, braces are not likely to affect your speech on a day to day. In some cases, aligners, particularly the upper aligner, can cause some very minor speech challenges. That said, the tongue typically adapts after a few days and the impact is minimal.
Can I still eat my favorite foods?
With aligners, there are very few, if any, food restrictions. With braces, to prevent breakage, you want to try to avoid anything hard and crunchy (such as chewing on ice, raw carrots etc.) and things that are chewy and sticky (gum and gummy candies etc.).
How long will I need to wear braces?
It is really hard to say without reviewing a case. On average, for someone who has never had braces 18 months is about average. That said, if you have had previous treatment, the time is often significantly less.
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