Braces are often associated with teenage growing pains, acne and bad haircuts.
But the market for adult braces is booming. Currently, about 32% of patients undergoing orthodontic treatment in the US and Canada are adults, according to data provided to Marketplace by the American Association of Orthodontists. This patient population has increased by more than 40% in the past decade.
In some cases, adult patients regress from the problems they had in their youth.
“After not wearing retainers for about 30 years … I couldn’t shut my mouth,” said Philadelphia mom Sophie Yang.
She had braces in her early teens to correct a protruding front tooth, but over time it began to erupt again. Yang started thinking about getting braces again in her 30s, but waited until her children needed braces themselves before taking up diving again.
Even after the second round, she admitted that she could be more serious about wearing her rack. “I hope my kids will be better disciplined,” Young said with a laugh.
Whether they’re returning to the orthodontist’s chair or getting braces for the first time, adult patients have different needs than teenagers, according to Dr. Peter Greco. About 60% of the patients at Greco Orthodontics in the Center City area of Philadelphia are adults.
“These patients require very sophisticated communication skills — not just from us, but from our staff,” he said.
Braces can affect self-esteem issues, for example, and adults also ask more questions about why they might need a particular treatment. To cater to this clientele, Greco’s offices feature private grooming areas, dad rocking on the speakers, and discreet decor.
The father-daughter clinic has seen a growing interest in more youthful-looking smiles, driving some of the newer demands.
“I think part of it has to do with the fact that baby boomers are getting older and they don’t like getting older,” Greco said.
Younger adults are also seeking therapy to look their best online. “With the pandemic, Zoom has been a huge boom for us,” said Dr. Alexandra Greco, daughter of Peter Greco.
Aesthetics are the main reason adults get braces, according to some recent international surveys. But adult patients also cite various dental or physical health reasons for getting braces later in life.
For example, “a bad bite that causes them to miswear their teeth, wear their teeth down in certain places — that causes them to hit the gums and the bone around their teeth,” said Dr. Dale Anne Featheringham, trustee in the American Association of Orthodontists and a practicing orthodontist in Ohio.
Other common problems include pain or problems with the jaw joint, as well as crowded teeth that make it difficult to clean certain areas of the mouth.
Regardless of the underlying cause, one technology has made it easier to sell adults on treatment: clear aligners. These are the clear, plastic trays that straighten your teeth.
Invisalign, a brand of aligners sold through dental and orthodontic offices; approved by the Food and Drug Administration in 1998. But 10 or 12 years ago, “they started to hit the tipping point where adults started seeing other adults getting Invisalign treatment or getting treatment with some sort of clear aligners,” Featheringham said.
Around that time, newer companies emerged and began selling aligners directly to consumers. The practice has caused some controversy and lawsuits brought from and against such companies.
However, Featheringham credits marketing campaigns from companies like SmileDirectClub and Byte with driving more interest in adult braces in general.
“That drove business to our offices because a lot of times we were the trusted source in the community for that,” he said.
For people like Sarah Bishop-Stone, a 41-year-old Philadelphian who works in the arts, aligners were the obvious choice.
“I just, at this point in my adult life, couldn’t mentally go back to having braces on my upper teeth,” she said.
A few years ago, a bottom canine started to fall out and her dentist warned her that if left untreated, it could change the shape of her face over time.
She decided to get Invisalign on her upper teeth and tooth-colored ceramic braces on the lower ones. Now she thinks of the few thousand dollars she paid in installments as an investment in her future health and appearance.
“The idea of the toothless crown with her face, like her face receding, really created the fear in me,” she said.
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