ST. LOUIS, Missouri – Orthodontic treatment has come a long way in its first century. Not too long ago, the process of putting braces on could take several long, uncomfortable appointments. Braces were attached to teeth with steel bands that had to be individually fitted around each tooth. The second century of orthodontics begins with major advances such as technology adapted from NASA, smaller braces applied directly to the tooth surface, high-tech adhesives and computer-software to make orthodontic treatment a much more comfortable and simplified process. "Treatment today is certainly more efficient and predictable," says Dr. James E. Gjerset of Grand Forks, N.D., president of the American Association of Orthodontists (AAO). "Thanks to modern materials and improved techniques, patients usually don't need to come to the office as frequently as was previously necessary."

One of the most dramatic breakthroughs in orthodontics came from NASA: heat-activated nickel-titanium alloy wires that effectively move teeth when the wires reach mouth temperature. These new wires apply gradual, precise and gentle pressures, and yet retain their teeth-moving abilities longer than their predecessors. In contrast, stainless steel wires were less resilient needed more frequent adjustments by the orthodontist.

Some of today's braces are translucent or tooth-colored. Additionally, metal brackets are now smaller and less noticeable. With multi-color elastic ties that attach the wires to the brackets, today's braces are also fun. Many young orthodontic patients enjoy color coordinating their rubber bands as a fashion accessory-but this is an accessory that will help them achieve a healthy smile that's good for life.

Bracket adhesives have advanced into the 21st century as well. Some continuously release fluoride to help protect tooth enamel underneath brackets, while others are formulated to withstand moisture.

Orthodontics in the 21st century can also provide a "glimpse into the future," showing the results that orthodontic care could provide for an individual. New computer-software programs can generate "virtual faces," helping orthodontists plan treatment and patients visualize potential results.

The AAO has a free computer-imaging program called "Smile Bank" available to people considering orthodontic care for themselves or their children. Interested individuals can send a photo of the potential patient smiling, and an orthodontist will prepare a computer-generated "after braces" picture.

Braces at Almost Any Age

"A beautiful smile in a healthy mouth is the most obvious goal of orthodontic treatment, but there's so much more to our specialty than meets the eye," points out Dr. Gjerset. "As teeth and jaws come into alignment, self-esteem increases too. Patients can look forward to a lifetime of improved dental health."

Today more adults are having orthodontic treatment because of greater awareness of the health benefits of a proper bite and the increased self-esteem that comes with an attractive smile. "Given today's technological advances and the affordability of treatment, patients of all ages are improving their smiles," Dr. Gjerset says.

Juliet didn't start treatment until she was in her 40s. She, like countless others who feel embarrassed about their crooked teeth, would reflexively cover her mouth whenever she laughed or smiled. Now she beams, and wonders why it took her so long to seek treatment.

More than five million people in the United States and Canada are presently in orthodontic treatment, according to the AAO. One in five is over age 18. Some patients are in their 50s, 60s and older. Less visible, more comfortable braces make treatment more appealing than ever. Healthy teeth, bones and gums of almost any age respond well to treatment.

Identifying Problems Early While orthodontic treatment can be successful at almost any age, early detection of orthodontic problems may prevent complications in the long run. Early guidance of jaw growth, in some cases, may decrease a patient's need for more involved procedures later on.

Many parents assume they must wait until a child has all of his or her permanent teeth before visiting the orthodontist, only to find treatment could have been less complex if started earlier. Some orthodontic problems are best treated while the face is still developing. Therefore, the AAO recommends that every child have an orthodontic check-up no later than age 7.

"This check-up can ease a parent's mind," says Dr. Gjerset. "As with so many things, one must know not only what to do, but also, when to do it. If early treatment is appropriate, the orthodontist has access to the full spectrum of interceptive, preventive or corrective treatment measures. He or she will make specific recommendations based upon the individual patient's unique set of circumstances," notes Dr. Gjerset.

Regardless of when orthodontic treatment is started, orthodontics can ease physical and emotional trauma. A child whose teeth are crooked or whose jaws obviously are out of alignment may suffer from more than just the thoughtless teasing of other kids. Teeth that aren't in the right position are also prone to injury.

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