Adult orthodontics

In North America, approximately 25% of all orthodontic patients are adults. In some practices, this percentage may be as high as 50%. In today’s society, with the constant demand for a more esthetic, youthful and healthy dentition and with the introduction of less visible orthodontic appliances, it is not surprising why adult orthodontics has gained so much in popularity.

The adult population presents unique characteristics that often require a different treatment approach than with adolescents. First, the absence of growth complicates the correction of malocclusions resulting in part from discrepancies in the size and/or relationship of the jaws. In selected cases, orthodontic treatment needs to be combined with jaw surgery to achieve the treatment objectives. A consultation with an oral and maxillofacial surgeon is required before undergoing this type of treatment.

Another condition occasionally encountered in adults but extremely rare in young patients is the loss of bone and gums around the teeth. Periodontitis is a chronic infection that causes the loss of supporting tissues around the teeth (bone, ligament and gums). Untreated, this condition can lead to the loss of teeth. Since periodontitis is often a painless condition presenting without obvious symptoms, affected adults are usually unaware of their condition. At our office, a periodontal examination is always done by one of our orthodontists before initiating orthodontic treatment in adults. Occasionally, referral to a periodontist (a specialist in the diagnosis and treatment of gum problems) is required before starting treatment. Patients with controlled periodontal disease can receive orthodontic treatment but need to be followed by a periodontist on a regular basis during treatment.

Adult patient may also sometime present with the loss of one or several permanent teeth. As such, your dentist may have referred you for orthodontic treatment to move teeth in a better position to replace the missing teeth with a bridge or an implant. Teeth that are fractured, worn or poorly proportioned may require alterations in their shape and color following the orthodontic correction. This requires a collaborative effort throughout the duration of treatment between the orthodontist, the general dentist and sometimes also the periodontist and the oral and maxillofacial surgeon to obtain the best results possible. You will be informed at the onset of treatment if a multidisciplinary treatment approach is recommended for you.

Finally, the presence of temporomandibular joint (TMJ) problems and/or pain of the jaw muscles are also present more often in adults and can occasionally be diagnosed and treated by the orthodontist. Conditions such as bruxism (grinding of teeth), clenching and an unstable occlusion can cause TMJ problems. An acrylic plate that covers the teeth can be made to allow the muscles of mastication to relax. Medications can also sometimes be required. More complex cases must be referred to a TMJ specialist.