Intro + a question about ratio of men vs. women in braces

[shortcircuit]

Hi all,

A short intro, I'm 40/M and sporting a significant Class III with a very narrow upper jaw, bad crowding, and all of my upper teeth are in crossbite all the way around. Never had braces before, I was taken in for one consult at around 12 years old and was told that it was already too late at that point to get anything fixed without surgery. Maybe that was good advice and maybe it wasn't; I've read several sources that state surgery isn't necessarily appropriate before your jaws stop growing, but back in the early '90's I guess the standard protocol was that everyone was wired shut for 6+ weeks pretty much across the board so I shot down the whole idea without ever getting a second opinion.

In the early 2000's, I was getting really fed up with an upper lateral that kept moving backwards and making it very difficult to speak, so I talked to three different ortho's who were unanimous about the need for surgery. It wasn't an option at the time financially, so I had the lateral extracted, which was a massive improvement. I never thought about getting this fixed again until I went to a new dentist this summer, and she asked me if I wanted a referral. I said oh hell no, I know it's going to be a double jaw case, I'm aware of the recovery issues, and I'm just not interested.

In the meantime, everything's been getting much worse since I had the lateral pulled out. At that time, there was a ~2mm gap between the two adjacent teeth, now those two are starting to overlap. My premolars (especially the second ones) keep drifting inward, probably because I have a chronic mouth breathing habit while asleep that I haven't been able to break.

My speech difficulty has returned in a big way and it's a much bigger problem now that I'm spending 4, 5, 6 hours in the front of the classroom, because I'm constantly biting my tongue on the sides when I try to speak clearly (there simply isn't enough room in my upper arch for my tongue, my thumb is one inch wide and it touches the premolars on both sides when I put it in between my upper teeth). I pulled out some old portraits from 20 years ago...wow, what a difference and not for the better.

Cue about a month into this semester, I'm really struggling with speaking because all it takes is one hard bite on my tongue and a sore starts, then I keep biting the same place repeatedly which makes it worse and worse. Two choices: either mumble with my jaws clamped shut, which isn't acceptable, or continue eating my tongue and see students wondering why I'm wincing and my eyes are watering in front of the class.

So after many nights tossing and turning and endless hours spend reading, my general dentist has sent in the referral and I'm calling for a consultation tomorrow. I'm not really clear on the insurance picture yet; my dental covers adult ortho treatment with a copay of around $1600 + records fee and I've confirmed that my medical does cover the surgery with a $3.5k out of pocket max as long as certain criteria are met, however there don't seem to be any surgeons in-network within four hours from me according to their website.

I couldn't say right now whether I have the guts to go through with this or not. Half the time I can't wait to get started, especially after seeing some of these before/after pictures; half the time I'm seriously questioning why I'm even wasting time considering major surgery because it's just teeth, it's not something like an aneurysm where your choices are to either get it fixed or make sure your will is up to date.

On the other hand, the fact that my teeth won't stay put is a huge problem. If I'm going to do this I have to pull the trigger now, I have no idea how much worse it's going to get in another 10 years and I will be that much older, and it will be that much harder to recover. The missing lateral will be a problem, but I don't regret having it taken out because I had no choice and it had to go, it was driving me crazy.

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tl:dr: I'm trying to eat my tongue when I speak and it's getting worse, I like meat but it's better if I buy it at the grocery store. Can't decide if it's worth the recovery struggles and the surgery risks, afraid of exchanging one set of chronic problems for a different and meaner set.

My question: does anyone know what is the gender ratio of adults in braces? It seems like blogs and forum posts are almost all from women, I found one survey from the UK that found 70+% women in a sample size of about 600, but nothing else. It's hard to draw any conclusions from who is online, how do you know if there are more women discussing it online because there are more women in braces, or if it's just because women might be more likely than men to "go public"?

Thanks to everyone here, this site is a huge wealth of information.

[djspeece]

I think there are about a half-dozen men who post regularly on this site, and I would say that men are in the distinct minority of adults with braces. I have not seen any statistics on the ratio of men vs. women in braces, but in the three years I was in braces I think I only encountered one or two men with braces over the age of 21. So, I definitely think there are many more women in braces, and I also believe they are more likely to discuss it openly on a forum such as this, and to express their feelings. I think that the ratio is more like 90% female in the adult brace universe. In my casual observation, men tend to discuss procedures, alternatives, and treatments vs. feelings associated with them. It seems to me that a lot of the men here have undergone surgery, or are candidates for surgery, and I am thinking that in general their cases may be more complex and that braces are an adjunct, not the sole therapy - but again, I am trying to remember off the top of my head, and that generally comes with a poor outcome.
You may want to reach out to sirwired if he does not chime in on your thread. He had an interesting case, not sure as complex as yours, but he is exceptionally well-informed about orthodontics. Best of luck to you!

[SinkFullOfDinner]

I commented awhile ago about how I didn't buy into the marketing data about how many guys were getting ortho treatment. I'd seen something from the AAO (American Assoc of Orthodontists) when I was researching treatment that indicated something like 40% of adult ortho patients were male. However, that's US and it sounds like you might be UK-based.

Like @djspeece above, I just haven't seen anything close to that IRL. I've noticed lots of women with braces over the last almost-two years, but only a couple guys. Maybe men are more likely to go with Invisalign or nothing, I don't know. Maybe it's because the AAO defines adult as anyone over 18, and perhaps college-age "adults" are closer to 50:50, leaving the rest of the age groups closer to 33% male. Again I have no idea other than it doesn't sync with what I see, and you can be darn sure that I notice if/when I see another guy with braces.

I was a bit older than you when I started, but still in my 40's. Yes, I was bothered by the idea of having braces at my age and especially as a guy since it seemed so much less common than for women. I'm sure that most of my concerns about what others would think were unwarranted, but that didn't change the fact that I was freaked out by the idea. Ultimately, however, I was convinced by my dentist and the ortho consultations that the consequences of doing nothing were worse than just sucking it up and getting it taken care of. It sounds like you might be in the "I really don't want to do this, but the current and future situation of do-nothing is worse, so here goes" category as well, but that's a decision you need to make for yourself. Sometimes it's hard to be clear-headed about these things, but do your best and good luck with whatever you decide.

[shortcircuit]

Thanks for your thoughts, I'm actually in the US and maybe it's because I'm not in a major metro area but the only adult in braces I can remember seeing in the past year or more is actually one of my students (who is also a very obvious Class III case, so I know what he's headed for), although I haven't been paying any attention to this at all except for the last month. It's true what they say, you never see a specific model of car until you buy one, then they're everywhere.

I teach at a university and virtually everyone I see on campus has obviously finished this up long before they graduated from high school. I also wonder how much of the gender imbalance is due purely to the desire for cosmetic enhancement, being that it's often more socially acceptable for women to pursue this than men. Look at the double standards...if a woman gets a pedicure then she's staying groomed and taking care of herself; if a man gets a pedicure then he's probably gay and/or who knows what else.

There is a recent post on Reddit by someone who is fairly worked up about a ~1mm gap between her front teeth, and everything else is pretty much perfect.....ok, let's trade places for a day and you'll see what real problems look like (and that would probably erase any indecision whatsoever on my part).

[SingleJawMelb]

Ask your ortho if women have worse bone structures or something? I must say I rarely see men in braces. Maybe their face shape changes it.

[sosomoto86]

I'm a woman and getting braces but not noticed any gender bias. The patients at my dentist are both male and female.

[verso]

The only other "adult" patients I've seen in my orthodontist's office have been men. Hmmm...

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[quote="SingleJawMelb"]Ask your ortho if women have worse bone structures or something? I must say I rarely see men in braces. Maybe their face shape changes it.[/quote]

I will, you would think that women have smaller teeth at the same time as smaller jaws, but I don't know if they're related or not.

[quote="sosomoto86"]I'm a woman and getting braces but not noticed any gender bias. The patients at my dentist are both male and female.[/quote]

[quote="verso"]The only other "adult" patients I've seen in my orthodontist's office have been men. Hmmm...[/quote]

I'm seeing an ortho next week (actually the only one around here who accepts the insurance that I have...well, there's two, but the other one doesn't look like he's been practicing for very long) and I'm also going to ask what is the ratio of adults to children that he sees. I think I read somewhere that you can't push things along as fast with adults like you can with kids, but some orthos will treat both the same way.

Unfortunately, I'm probably going to have to go out of network if I want a different ortho, there is only one who is board-certified around here and he isn't listed as in-network on the insurance company's website. I saw both of them back when I got the three consultations, I really liked the one who was board-certified but the other one that I'm going to see again? Not so much at that time, although he was the last one I saw and probably sensed that I wasn't going to go through with it then anyway so he didn't want to spend much time at all. I'll give him another try though.

Oh, and I saw another adult student with braces, female this time, so it's at 50/50 now with a sample size of 2....(eyeroll)

Question: let's say one orthodontist has four different offices spread over a 60 mile radius versus another one who has only one office....does that even mean anything? I'm guessing that the one with multiple offices is probably a new practice trying to gain a foothold in the market? That's an awful lot of space rent being paid every month though.

[SingleJawMelb]

Ask your ortho if women have worse bone structures or something? I must say I rarely see men in braces. Maybe their face shape changes it.

I will, you would think that women have smaller teeth at the same time as smaller jaws, but I don't know if they're related or not.

I'm a woman and getting braces but not noticed any gender bias. The patients at my dentist are both male and female.

The only other "adult" patients I've seen in my orthodontist's office have been men. Hmmm...

I'm seeing an ortho next week (actually the only one around here who accepts the insurance that I have...well, there's two, but the other one doesn't look like he's been practicing for very long) and I'm also going to ask what is the ratio of adults to children that he sees. I think I read somewhere that you can't push things along as fast with adults like you can with kids, but some orthos will treat both the same way.

Unfortunately, I'm probably going to have to go out of network if I want a different ortho, there is only one who is board-certified around here and he isn't listed as in-network on the insurance company's website. I saw both of them back when I got the three consultations, I really liked the one who was board-certified but the other one that I'm going to see again? Not so much at that time, although he was the last one I saw and probably sensed that I wasn't going to go through with it then anyway so he didn't want to spend much time at all. I'll give him another try though.

Oh, and I saw another adult student with braces, female this time, so it's at 50/50 now with a sample size of 2....(eyeroll)

Question: let's say one orthodontist has four different offices spread over a 60 mile radius versus another one who has only one office....does that even mean anything? I'm guessing that the one with multiple offices is probably a new practice trying to gain a foothold in the market? That's an awful lot of space rent being paid every month though.

It would depend on the issue with the teeth, but generally children are quicker and easier to treat because their jaws are still growing and bone isn't formed. Children get free ortho in some countries, but adults generally pay worldwide. So in recessions business is bad. Invasalign changed dentistry to a degree cause now adults can pay for sub standard results

My ortho has been practicing for 25 years. The other person at the clinic is very young looking so prob recently qualified. I think both orthos would give good results, but my ortho is mighty fast and running on time, that's important to me. Plus if I have breakages etc he can fit me in.

I don't know the set up and why the dentist is covering four locations. My ortho covers two clinics but he's also not the only ortho at the clinics. He works around 4 days a week. I don't know how they are paid and I don't think he owns the clinic, so could be a salary. I knew a specialist dentist who would rent a chair a clinic, so went every two weeks because that made him money.

If the ortho has four locations and he's renting the premises by himself, doesn't seem cost effective but maybe it works for his business.

My questions:

You need to choose a clinic that you can get to easily and the ortho that has 4 clinics, can you see him at all four clinics or do you have to stick at one?

What treatment plans have they given you? Eg extractions, braces used, cost, time.

Can you find any negative press about the ortho via google/google reviews.

Why isn't your insurance covering other orthos?

Each ortho will get a slightly different result, but from a patient POV I don't think it's noticeable. I'm very laid back with my dental work, but my mental health team I'm very proactive. I need to be part of the process with my mental health, teeth I don't need to play a part in the treatment. I think this is wise to bare in mind.

[r1r1r12000]

I was travelling by plane yesterday and noticed two adults with braces (other than me). They were both women. I'd say in the US that adult ortho patients are at least 75% women, maybe more. That said, as a guy nearly three weeks into braces, nobody seems to care or comment.

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[quote="SingleJawMelb"]It would depend on the issue with the teeth, but generally children are quicker and easier to treat because their jaws are still growing and bone isn't formed. Children get free ortho in some countries, but adults generally pay worldwide. So in recessions business is bad. Invasalign changed dentistry to a degree cause now adults can pay for sub standard results :lol:

My ortho has been practicing for 25 years. The other person at the clinic is very young looking so prob recently qualified. I think both orthos would give good results, but my ortho is mighty fast and running on time, that's important to me. Plus if I have breakages etc he can fit me in.

I don't know the set up and why the dentist is covering four locations. My ortho covers two clinics but he's also not the only ortho at the clinics. He works around 4 days a week. I don't know how they are paid and I don't think he owns the clinic, so could be a salary. I knew a specialist dentist who would rent a chair a clinic, so went every two weeks because that made him money.

If the ortho has four locations and he's renting the premises by himself, doesn't seem cost effective but maybe it works for his business.

My questions:

You need to choose a clinic that you can get to easily and the ortho that has 4 clinics, can you see him at all four clinics or do you have to stick at one?

What treatment plans have they given you? Eg extractions, braces used, cost, time.

Can you find any negative press about the ortho via google/google reviews.

Why isn't your insurance covering other orthos?

Each ortho will get a slightly different result, but from a patient POV I don't think it's noticeable. I'm very laid back with my dental work, but my mental health team I'm very proactive. I need to be part of the process with my mental health, teeth I don't need to play a part in the treatment. I think this is wise to bare in mind.[/quote]




The ortho with four clinics isn't the one I was referred to, my dental insurance is an HMO setup so it looks like I don't get a lot of choice in who does the work if I want it covered. You can't even get any specialist work covered with this plan unless your general dentist gives you a referral. There is no yearly maximum and they do cover adult orthodontics with a co-pay, virtually everything else except implants is also covered with zero co-pay and zero deductibles, so it seems pretty darn good in that regard.

No treatment plans yet, I'm going in next week to get the process started. The ortho I was referred to has been around for at least 15 years but there is virtually nothing online as far as reviews, nothing on Yelp and he doesn't even have a website. I guess no news is good news? Most ortho's websites look like they're taken from the same generic template anyway. He has two locations in different cities, one is two miles from where I work and the other is two miles from where I live.

I wish I could turn off all the questions and just let the professionals do what they do, but I can't help being addicted to all the details (typical engineer).

[SingleJawMelb]

Haha. Yeah engineers are the worst. My orthos don't have anything online either. I think practicing for 15 years will provide a high level of experience. Making a choice is never easy.

What did the dentists tell you when you spoke to them? You need to find out what brace they use (eg Damon, clear ceramics) and if they thought you needed teeth pulling.

I only saw one ortho because he was referred to by another dentist. They are just like seeing hairdressers, one suits you more than the other IMO. Just make sure he is a specialist ortho as some qualifications are given in a weeekend.

Your general dentist giving you a referral isn't a big issue... more of a satefty net so specialists don't see patients unnecessary?

[shortcircuit]

[quote="SingleJawMelb"]Haha. Yeah engineers are the worst. My orthos don't have anything online either. I think practicing for 15 years will provide a high level of experience. Making a choice is never easy.

What did the dentists tell you when you spoke to them? You need to find out what brace they use (eg Damon, clear ceramics) and if they thought you needed teeth pulling.

I only saw one ortho because he was referred to by another dentist. They are just like seeing hairdressers, one suits you more than the other IMO. Just make sure he is a specialist ortho as some qualifications are given in a weeekend.

Your general dentist giving you a referral isn't a big issue... more of a satefty net so specialists don't see patients unnecessary?[/quote]




Many insurance companies here have that policy in place requiring referrals for any care not provided by the primary doctor, after all they are in business to make money and they won't be in business long if claims exceed premiums long enough, so this acts as a filter to keep people from getting unnecessary care.

Back in 2000-something when I got the three consults, we didn't go into any detail at all because I never had records done, but there wasn't any doubt about the need for surgery and for me there still isn't. Even as a layman, just looking at the difference between my bite and a normal bite is enough to convince me; my lower incisors are really slanted backward but I suspect that if everything is decompensated I'll have a negative overjet approaching 1cm.

Issues like clear vs. metal, etc. get really insignificant in comparison to the surgery (and I don't really care one way or the other which brackets are used, I don't make decisions based on the opinions of people I don't even know), the cosmetic improvement in the end will be a huge plus but it's the worsening functional issues that are the main problem. I suspect that the insurance won't cover anything more expensive than basic metal, but that's fine with me.

I'm definitely going to see specialists only, there is one dental office in-network that claims to be a specialist but they also do a bunch of other things so it's obvious they're just a general dentist, with a bunch of negative reviews online on top of that.

[shortcircuit]

Ugh.....looks so much worse in pictures, Houston we have soooo many problems

Maybe I shouldn't have started taking care of them a while back, then I could justify getting dentures instead of going through all this........

Consult is on Friday, from looking at blogs and other stuff I guess the only "wobbler" here is whether or not the surgeon is going to call for a SARPE first before anything else then DJS somewhere down the line. Once is bad enough, not sure if going under the knife twice is going to be a deal-breaker but it's possible

Liquor bottle, allow me to become intimately acquainted with thee

[shortcircuit]

Records done this morning, I asked the assistant about their ratio of kids to adults and she thinks it's around 20%. As far as the numbers of men vs. women they didn't really know so I'll have to ask the doctor later when they have a treatment plan ready (or maybe I won't, it 's not like that's what would stop me from going ahead with this). Lots of guys in the waiting room but it looked like they were all parents, in fact I can see why there is no website or advertising, judging from the amount of traffic they don't need to. This practice is actually a partnership between two orthos and they're going to take a team approach and bounce ideas off of one another, sounds good to me

Some years ago I had a third molar extracted due to deep decay, the dentist I had at that time spent a huge amount of time digging and said he finally had to give up because he didn't want to hit the nerve, so he would have to leave a root behind. So, I'm looking at the pano, and it's not just A root, it looks like ALL of them are still there and from my ignorant layman's perspective all he did was break the crown off of the tooth and leave everything else behind He prescribed antibiotics but I didn't take any and didn't get an infection, probably got pretty lucky there.

This happened to my dad when he was getting what was left of his uppers extracted in preparation for a plate, the dentist left behind numerous pieces of roots and he had to go to a specialist to have everything cut out