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Mark Mappes, DDS, MS, is an orthodontist with offices in Bellevue and Dickson. He explained, “Orthodontics is a specialty of dentistry treating tooth irregularities, improper bites (malocclusion), and disproportionate jaw relationships. In short we create straight teeth and the best possible bite for a beautiful smile and healthy mouth. When you get a mouth that is healthy and functional, good looks just come along.”

In America’s mass media society filled with Hollywood-worthy smiles, some patients may be more motivated by the “looking good” part rather than maximizing their oral-maxillofacial health, but the end result is still a more functional bite.

Mappes said a pretty smile has become an increasingly important part of the face and is now perceived to actually impact job and social opportunities. This higher expectation has led more and more adults to seek orthodontic correction.

Mappes noted that 15 years ago, “about 15 percent — maybe 20 percent at the most — of my patients were adults. Of that percentage, I’d say 90 percent were women. Now,” he continued, “about 50 percent of my practice is adults, and of that 50 percent probably 60 percent — over half — are men.”

Improvement in the aesthetics of braces has also made it much more palatable for patients of all ages to wear the appliances.

Fairly recent advances have updated the more traditional fixed appliance. Instead of the “metal mouth” look, clear braces worn on the outside are much less noticeable; and lingual braces, which are metal but worn on the back of the teeth, aren’t visible at all from the front.

Unlike mass-produced standard brackets, lingual braces are completely customized and require an orthodontist to create a mold of the teeth. Brackets are then made individually for each tooth. Once they are in place, the orthodontist installs an arch wire that is shaped in the ideal position for a patient’s teeth. When placed on the lingual brackets, the wire moves the teeth into correct alignment.

Although lingual braces are invisible from the outside, some patients spend a little more time becoming accustomed to them because they are positioned next to the tongue. However, recent design improvements have made it easier for patients to get used to the appliance.

Another new option is Invisalign, a removable appliance that does the job of metal wires and brackets without really being braces at all. Mappes said Invisalign is actually a series of up to 20-30 trays numbered sequentially.

He explained that an orthodontist takes a computerized impression of a patient’s mouth, which is digitized so that the teeth can be manipulated on the computer screen. The orthodontist then makes the necessary adjustments “online” to bring the bite into alignment and straighten the teeth. The computer file is sent to Invisalign where the manipulations are translated into a series of clear trays that slowly, and in a step-wise fashion, shift the teeth to the computerized endpoint.

Mappes said each tray is worn an average of two-three weeks. “They are meant to be worn 22 to 23 hours a day. You take them out to eat, and you take them out to brush your teeth … that’s it.”

Because newer approaches such as lingual braces and Invisalign are customized, the cost may be higher than traditional brackets. For many, however, it’s a small price to pay for unobtrusively achieving a healthier, prettier smile.



June 2008

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