BRACE YOURSELF TIMES WERE, KIDS HAD THE ORTHODONTIC WORK A Philadelphia Inquirer (c) 1996 Philadelphia Newspapers Inc. All rts. reserv. 07581052 BRACE YOURSELF TIMES WERE, KIDS HAD THE ORTHODONTIC WORK AND PARENTS JUST FOOTED THE BILL. BUT MORE AND MORE, ADULTS ARE PUTTING TIN GRINS ON THEIR OWN FACES. Philadelphia Inquirer (PI) - MONDAY March 21, 1994 By: Gloria Ringel, FOR THE INQUIRER Edition: FINAL Section: FEATURES MAGAZINE / HEALTH & FITNESS Page: C01 Word Count: 1,077 TEXT: Think orthodontics and the picture that comes to mind is that of a teenager, smiling through a mouthful of metal. Look again. The picture includes another part of the population. Nationwide, about 22 percent of all new orthodontic patients are adults, says Robert Van Arsdall, chairman and professor of orthodontics at the University of Pennsylvania. And, he adds, the growth has been significant - in the 1960s, the number of adult patients was only about 4 percent. Plymouth Township orthodonist Gerald Ginsberg says he has seen that growth in his practice. Twenty-two years ago, his patients were almost all children; now, almost 35 percent of them are adults, including some qualified to join senior citizens clubs. Why the interest in braces among adults? There's a variety of reasons, with cosmetics a big one. "There's no question that people come in because they'd like to have their teeth look better," says Van Arsdall. "The added bonus is that what looks good usually works a little better, too." Some people grew up in families where money was tight and orthodontics weren't a priority. As financially successful adults, says Ginsberg, they can buy better smiles. But the main reason for adult braces is the same as for children's: They help correct problems with tooth placement, as steady pressure moves both the teeth and their sockets. There are various methods of treatment and, in recent years, braces have become a more attractive possibility by a more versatile range of appliances. Porcelain braces are the choice of many adults, for aesthetic reasons. The brackets are clear, making them much less conspicuous. Less often used are lingual braces, which have even more of an "invisible" look. These attach to the back, or lingual surface, of teeth. A combination of types of braces often works best. For example, some adults opt for porcelain on top and metal on the bottom. Lafayette Hill lawyer Victoria Senior, who recently got her braces off after two years, chose lingual braces on the top and porcelain for the lower teeth. "I'm an adult, I'm a professional," says Senior. "I didn't want to have the metal showing." When smiling or talking, the lower lip covers the bottom teeth, so having the lingual braces on top gave the desired no-brace look, she explains. Donna Rothman of Media, who works with a management consulting company, recalls going to work with new braces on her teeth. "OK, I've got braces on - everyone take a good look," she announced, to head off the deluge of questions she expected. There wasn't much reaction, she recalls, adding that now she sometimes forgets that she's wearing braces. One who remembers the bad old days of braces went back anyway. Beth Ladenheim, an Ardmore dance-movement therapist, says that having braces was better the second time around. Due to shifting teeth and a tongue-positioning problem, Ladenheim, who wore braces as a teen, chose to wear them again for two years as an adult. "I think it was less traumatic as an adult than as a kid," says Ladenheim. "It didn't seem as important and nobody called me 'brace-face.' " Tinsel Teeth, Metal Mouth and Brace-face. Those barbs of childhood are something most adults do not hear. But while adults escape cruel jibes, they still need to make a big commitment for the process to be successful: Adults spend an average of two years wearing braces. Some say the biggest drawback is the restrictive diet. No gum, no caramels, no popcorn - all can damage the appliances and lengthen treatment. So apples and raw vegetables are cut into small pieces, and anything that might catch onto or bend the braces has to be avoided. Another bother is retainers. When the braces come off, these devices help prevent the teeth from rebounding to their former positions. "Adults," says Van Arsdall, "are never completely done with retainers." Patients generally wear retainers full time for three to six months after treatment, explains Van Arsdall. After that, adults pretty much have to wear their retainers at night from then on. Adults who have braces also face the same day-to-day worry that kids do: cavities. Careful cleaning of the teeth is vital because braces offer hiding places for food. The thought of winding up with a lot of cavities when the braces came off was a big fear for Ladenheim, although she says she avoided the problem by becoming a pro at flossing. Potential patients often have a basic but important question: Do braces hurt? "Patients leave my office in hardly any pain at all - six or seven hours later they start to feel the pressure of teeth moving," says Arthur Stein, a Lansdale orthodontist. Over-the-counter pain relievers are usually recommended for this temporary soreness, which also may be felt after periodic visits for adjustments. John Grady, a Bensalem business owner, says the soreness and other discomforts were worth it. To correct a bite problem that was wearing his teeth down abnormally, Grady wore braces and underwent a surgical procedure to move his lower jaw to correct a significant overbite. Besides preventing early tooth loss because of his malocclusion, Grady liked the change in appearance after the braces and surgery. The difference, he says, hits him when he sees a pre-treatment photograph. He compares it to looking at an old photo and being struck by your out-of-date clothes or bad haircut and wondering how you could have looked that way. To Grady, the physical change was striking. "I never thought my teeth were really bad before, but now I think - what a difference." FOR MORE INFORMATION * Contact the American Association of Orthodontists, a group to which approximately 95 percent of practicing orthodontists belong. The association will provide a list of professionals in your area. Phone 1-800-787-2444. CAPTION: PHOTO PHOTO (3) 1. Braces have become less conspicuous; clear versions are one option, as well as "lingual" braces, which attach to the backs of teeth. 2. It's never too late for braces these days: A woman of 63 (who asked not to be identified) has hers adjusted by orthodontist Robert Van Arsdall and assistant Wendy Adamczyk. (The Philadelphia Inquirer / J. KYLE KEENER) 3. The braces should be off by the time summer vacation rolls around, Van Arsdall tells his 63-year-old patient. But she will probably have to wear a retainer at night indefinitely. (The Philadelphia Inquirer / J. KYLE KEENER) Copyright Philadelphia Newspapers Inc. 1994 DESCRIPTORS: TREND; STATISTIC