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Thursday, February 15, 2007

Brace yourself for 'Life 2' Look

'Mouth jewelry' is latest trend for aging baby boomers who are embracing what used to be an adolescent ordeal

by Denise Ryan

A mid-life successfully negotiated was, at one time, all about trading in and trading up. Decline was inevitable but the pain could managed with a trip to the analyst's couch, a zippy little sports car or a trophy wife.

Such embarrassments are no longer necessary. Thanks to popular reality shows such as Extreme Makeover, self-improvement has become a spectator sport and the mid-life crisis has been supplanted by the "mid-life upgrade."

And in an ironic twist, the most embarrassing of all adolescent ordeals, braces, have become a proud rite-of-passage for upgradists as they move into middle age -- or, as some prefer to call it, "life 2."

"Psychiatrists are out, and braces are in. That's what a friend at my book club told me when I got my braces on," says Rosanne Moran, a Vancouver communications specialist who got "banded" at the age of 45.

According to the American Association of Orthodontists, from 1994 to 2004, there was a 37-per-cent increase in adult patients in the U.S. and Canada. Adults account for a full 25 per cent of new patients overall.

Maple Ridge orthodontist Dr. Amanda Maplethorp says that these days it's not unusual in some urban practices to see a ratio of "up to 90 per cent adults to 10 per cent kids."

Not only are adults crowding orthodontists' offices in record numbers, they are showing off their "mouth jewelry," tracking their progress on blogs and trading information on websites like Archwired.com.

Despite the availability of discreet options such as lingual braces, which run along the insides of teeth, and Invisalign, an almost undetectable system of clear plastic retainers, there are plenty of adults who like to show off this particular self-improvement choice.

Psychologist Dr. Joyce Brothers is one of many celebrities who have had braces in their adult years -- Tom Cruise, Venus Williams and Cher are also on the list.

Brothers, who had braces along with full headgear to correct a severe overbite that made her "look like a bunny," said in an interview from her New Jersey home that she is thrilled with the trend.

"People don't downgrade braces anymore. I've seen so many women, beautifully dressed with a mouth full of metal. They are saying, 'I like to look my best.'"

Brothers believes improved health and a longer life expectancy plays into the trend, as well as our own expectations for continuing to life a full life as we age.

Maintaining what we have had becomes more important than ever before.

"For older people now since we're living such long sexual lives these days," said Brothers, "it can be a wonderful thing.

For those who may be worried that the 12 to 24 months they'll be wearing braces might harm their love lives, Brothers got straight to the point: "Having braces didn't harm my sex life at all."

The desire for a higher quality life is also influencing the trend. "Our teeth have to last longer," said Dr. Maplethorp. "People don't want to end up with dentures. What was a given 30 or 40 years ago is no longer acceptable."

Barbara Mitchell, professor of sociology at Simon Fraser University, who also had braces as an adult, says it's not a stretch to see braces as a mark of having arrived at a certain point of both personal and financial maturity.

Braces have finally become a status symbol.

"These procedures cost a lot of money, so to some extent it's a sign of affluence and prestige," she said. "Mid-life women are more likely to be able to afford to buy these procedures -- Botox or braces -- because they have moved up in the workforce."

Mitchell, who is 45, had braces in her early 40s. "I came from a large family with a British background and grew up in a rural area. It just wasn't something my family could do but as a child I wanted them."

Although Ugly Betty may be our most beloved brace-faced television character, Mitchell cites the influence of actresses who look younger than their years, such as the cast of Desperate Housewives, as having more influence than the so-called Ugly Betty effect.

"For women, looking young is a way to compete in the job and relationship market. With these role models, the stigma of getting procedures or braces has diminished. It almost becomes normative rather than deviant."

"You do your nails, you go to the gym, you do your smile," said Maplethorp who has been through two rounds of braces as an adult.

Dr. Barry Cutler, an orthodontist who practises in both downtown Vancouver and Coquitlam, said in an interview that the increase in "banded" adults is "part of the trend of self-awareness of the jogging and fitness generation."

With our aging population, dental care has become big business -- and not just because the "California smile" we see on celebrities has become our measure of beauty.

"Dental changes in the position of the lower teeth sometimes occur with age. Teeth move forward microscopically," explained Cutler. "Having straight teeth makes it easier to maintain the health of your teeth and gums."

Cutler, whose patients range in age from seven to 70, also credits advances in technology that have created a "faster, kinder treatment."

"New materials like titanium wires and new types of braces that are more esthetically acceptable have helped. Treatment is more efficient and less uncomfortable.

"A very significant development in the year 2000 was the introduction of Invisalign, a series of clear plastic shells that are provided to patients and changed every two to three weeks."

While Invisalign is not appropriate for every case, Cutler said its high-profile advertising brings patients who would not have otherwise considered braces into the office.

"Once they are in the office, if they are not a suitable candidate for Invisalign, we can offer them cosmetically or esthetically appealing alternatives."

Gone are the old-fashioned metal brackets that wrapped around the entire tooth, had to be hammered on and were painfully screwed tighter every two weeks.

For those who work in the public eye there are lingual braces although their downside, Cutler said, is that treatment takes longer, can be uncomfortable and costs slightly more.

(An average treatment with regular braces runs about $6,000.)

Low-visibility ceramic braces worn with white wires are another popular option for adults.

Most people get the basic -- simple tiny brackets affixed to the front of each tooth, fitted with a wire in the front, secured and embellished with a brightly coloured elastic "tie."

Colours can be changed at every visit, which adds to the appeal.

Moran decided to pursue a mouth makeover when she turned 45 and started experiencing pain and clicking in her jaw.

She also noticed that the space she had never liked between her two front teeth was, horrors, getting bigger as she got older. Her teeth had been slowly and subtly shifting as she aged.

Although she wanted braces as a child, she didn't have them -- money was the issue.

When her sister, who is now dean of law at the University of Toronto, got braces as an adult, Moran was inspired. And the time was right.

She didn't have a wedding around the corner, she was established in her career and had a job that offered terrific dental benefits.

"I got full metal," says Moran with a touch of pride. "Upper and lower. Nothing pretty."

To offset the metal mouth, Moran opted for coloured elastics, a fashionable touch that has also revolutionized the appeal of braces.

The braces had the added benefit, she said, of shaving a few years off. "The first thing my husband said was, 'You look like a teenybopper.' "

Catherine Eely, who had an underbite before getting treatment, also started in her 40s.

"Sometimes you just wait long enough," Eely said in an interview. "The kids didn't need them, we had the [dental] benefits. My jaw would get sore if I chewed gum, I was self-conscious."

Eely was suffering from some of the normal problems aging brings about. "I ground my teeth and I was wearing them out. As you age, there are serious complications."

The changes that come with age can shift teeth that were straightened decades before, or make minute changes to never-treated teeth that cause new problems.

Although Eely's three teenaged children laughed out loud when she arrived home with braces, and her treatment will take a relatively lengthy three years, she wouldn't turn back.

"It's very inconvenient on pub night," she said, "there are some foods you can't eat. But there's an amazing camaraderie with other adults that have braces."

The greatest surprise, said Eely, is that strangers who have had braces, who regret not having had them or who are considering taking the plunge won't hesitate to approach her.

"I say, 'Go for it,' if they ask. I have more confidence and I feel way better. My only regret is that I didn't do it sooner."

For orthodontists like Maplethorp and Cutler, the growth in the adult patient industry has an added benefit -- their jobs have become more interesting.

"Adults are 100 per cent there because they want to be," said Maplethorp. "Plus they're interesting to talk to."

Cutler finds adult patients slow him down a little, simply because they have such interesting conversations. "They are more demanding, there's more communication, which makes the process more enjoyable."

Cutler, who has been known to surprise his more conservative patients with rainbow-coloured ties in an effort to help them loosen up and have fun with the process, finds treating adults "deeply gratifying."

"I've had ladies when I've removed their braces just burst into tears. I just melt when I see that."

BRACES ETIQUETTE

- It is permissible to discuss the reason for your braces if you are asked.

- It is not permissible to advise someone with braces what they can and cannot eat.

- At the table, those with braces must do whatever is necessary to allow others to enjoy their meals. This means that rubber bands, headgear and retainers are removed in privacy and reinstalled in privacy afterward. In the meantime, they are kept in their cases, not parked next to someone's dinner plate

- After eating, any cleaning up that can be done by the tongue with the mouth closed is legitimate. A quick scrape with the thumbnail in the mouth isn't legitimate, but if Miss Manners doesn't see you do it (the napkin goes up to the mouth with four fingers visibly holding it, so that it appears the lips are merely being wiped), it doesn't count against you.

- Serious picking with tools must be conducted away from the table.

Miss Manners

TO VENEER OR NOT TO VENEER

We've all seen the makeover shows in which the most dramatic moment of the "reveal" is the parting of the lips, the unveiling of a dazzling revamped smile.

Veneers -- "da vinci veneers" are the brand of choice on Extreme Makeover -- seem to be everywhere. They are a popular choice for celebrities, newscasters and public figures whose smiles seem to be constantly getting bigger and whiter.

To create veneers, thin shells of porcelain are bonded to the front of your teeth to replace chipped or crooked teeth and create a new smile.

The process can be completed in as few as two visits.

Veneers can be an excellent solution to chipped, crooked or discoloured teeth, don't stain easily and are very strong.

One of the downsides is that they often require original tooth material to be removed or ground down in order to fit the veneer -- and even cosmetic dentists prefer not to remove living tooth structure.

"The first question we ask anyone who wants to improve their smile is 'Would you be willing to have orthodontic treatment?' " says Dr. Michael Drance, a Vancouver dentist whose flair for cosmetic work has made him the go-to guy for veneers in Vancouver.

If a patient is not willing or able to go through with orthodontics, then Drance will work with them to create a new smile.

Veneers have a lifespan on average of about 10 to 20 years, run about $1,000 per tooth and, because they are considered cosmetic, are not as likely to be covered by most dental plans.

Another more visible downside is badly fitted veneers.

Singer Hilary Duff was widely ridiculed on Internet sites for her "chompers" and "horse teeth" after having veneers done last year, and Ellen Fein, author of The Rules, blamed her divorce on a botched job that left "gigantic teeth."

But Drance said there is no reason for such errors. "We walk a fine line between giving people what they think they want and what will look nice." Fitting patients with temporary veneers for a two-week trial run gives patients a chance to see whether they've got the look and fit they want.

Copyright 2007  The Vancouver Sun, CanWest Interactive, a division of CanWest MediaWorks Publications, Inc. All rights reserved

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