Orthodontics, cosmetic procedures can make adult teeth shine

Apr. 13—Never underestimate the power of a smile.

Lindsey Kleinlin has been on quite a health journey over the last six years. She decided to lose weight after becoming borderline diabetic and experiencing other health problems. It took her a while and it wasn't easy, but she did it.

The 56-year-old St. Joseph woman started eating better and attended workout classes in addition to upping her skincare regime and social life. As she lost weight and began feeling better, she started getting her nails done and took an interest in fashion, something she hadn't done in decades.

Despite all of that hard work, she still didn't feel comfortable smiling in pictures.

"There was one thing left I wanted to do for myself," she said. "I've always been embarrassed of my teeth. They were yellow, crooked and just plain gross."

Cosmetic dentistry focuses on a more balanced, symmetrical and aesthetically pleasing smile. Common services include teeth whitening, dental bonding, veneers, tooth and gum contouring and braces or aligner systems.

"Most people can agree that a beautiful smile is important," said Dr. Andrew Baxter with Baxter Orthodontics. "For myself, having straight teeth made a difference in how I felt about myself and how others perceive me."

Kleinlin completely understands. The longtime secretary said she used to get very insecure about how clients would look at her teeth when she talked to them. She said that despite her education, cleanliness and overall appearance, she felt others judged her as being unhygienic.

Two years ago, she started the initial journey of restoring her teeth with whitening and braces.

There are several types of whitening, including at-home kits, charcoal toothpaste, coconut oil and laser procedures. While a majority of do-it-yourself options work just fine, laser teeth whitening is the most effective treatment, according to the American Academy of Cosmetic Dentistry.

Kleinlin used charcoal toothpaste for months before having her teeth whitened during an in-office procedure at her dentist's office.

"The toothpaste really worked but the office procedure got them to the level I wanted," she said. "And it's lasted for more than a year."

Another type of cosmetic dentistry is dental bonding and veneers.

Dental bonding uses a tooth-colored composite resin material. This procedure can repair chips, close gaps and change the shape and color of a tooth. Unlike porcelain veneers, dental bonding is reversible.

Porcelain veneers are custom-made ceramic shells that adhere to the front surfaces of teeth. Commonly, dentists will remove some enamel from the natural teeth. Once placed, porcelain veneers are not reversible. They'll need to be replaced every 10 to 20 years.

"It gives teeth not only lighter color but also gives them form and function back," Baxter said.

Tooth and gum contouring is another option to improve a smile. This procedure evens out the gum line, either raising or lowering it.

Dentists use scalpels, lasers and radiosurgery to perform the gum contouring procedure. A local anesthetic may be applied to numb the area. Sometimes, bone at the front of the tooth's root also must be removed during gum contouring to get the best long-term results.

"Don't ever think you are too old to have orthodontics," Baxter said. "I've had 70-year-old patients."

He said it's definitely easier to move teeth on an adolescent and work with growth, but 20 to 25 percent of his patients are adults.

"I wouldn't say there's an uptick in that but people just understand the importance of how they feel and how others perceive them. Or maybe they had treatment when they were younger but weren't responsible with their retainers. We see a lot of that."

Moving teeth is much easier in adolescents because adults aren't growing, their teeth do not move as quickly, there are missing teeth or they have crowding issues.

"It's more complicated and it takes longer than kids," Baxter said.

Orthodontics uses both braces and aligner systems, such as Invisalign. Both can be used but there are times that one is better for the patient than the other.

"It's not the tools that move your teeth, it's the expert behind it that moves your teeth," Dr. Baxter said.

The result desired and the patient determines which is used. And there are advantages and disadvantages to both systems.

Aligners are more for aesthetics and make it easier to clean the teeth, but compliance is a big issue.

"(Patients) have to wear them 22 hours a day," he said. "You only take them out to brush your teeth and eat."

They also can create a lisp, because they completely cover the teeth. But aligners are suitable for mild to moderate crowding or spacing. Baxter said it's not an option for someone who needs a lot of extractions or has severe crowding, lots of missing teeth or other jaw-related issues.

"I personally have used the aligner system for years," he said. "All of the systems are not equal."

He said that his office takes digital impressions which scan the teeth compared to the traditional "goopy" impressions, so they are more accurate and make for a better-fitting aligner.

However, teeth do not move like an algorithm in a computer. Once patients get to the end of treatment, more scans are taken and a new set of aligners is made.

Some advances have occurred in both braces and aligners but the care with both remains the same.

Patients should expect to visit their orthodontist every six to eight weeks and avoid eating anything sticky, chewy, hard or gooey. Avoid sugary liquids with either, but especially with aligners as the beverage can end up sitting in the trays all day.

Brushing and flossing are critical with both types of treatment, especially near the gum line, to keep plaque away.

Adolescents are not typically the right type of patients for compliance for aligners, Baxter said.

"Some adults don't get the results with aligner systems and opt for braces," he said. "For those that can't be treated with aligners, there are options of ceramic brackets. It's a clear or tooth-colored bracket so it's less noticeable."

Once treatment is completed, it's up to the patient to keep their teeth straight. The first year is critical, so regardless of which system is used, aligners need to be worn if patients want to keep their teeth straight. Aligners move from full-time to just nighttime over the years, but if a patient completely stops wearing them, the teeth will shift.

Never underestimate the power of a smile

Jenn Hall can be reached at jenn.hall@newspressnow.com. Follow her on Twitter: @SJNPHall.