As a self-conscious adolescent, the idea of having braces horrified Caroline Bishop — the thought of the pain and the ugly metal ‘train tracks’ made her cringe.
So, against dentists’ advice, she chose to live with her wonky teeth and overbite.
But, as we age, our gums can weaken and teeth move — so, over the years, Caroline’s overbite became far more pronounced.
That’s why, two years ago, at the ‘grand old age of 55’, Caroline decided to take her oral health seriously and spoke to her dentist about a brace.
Did you know? Crooked teeth can be hereditary, where insufficient space in the jaws for the full complement of teeth is genetic
‘I just couldn’t put it off any longer,’ says Caroline, a mother of two who lives with her partner in Reading, Berkshire.
‘As well as hating how they looked, I was told my teeth could cause health issues in the future, too.’
Overlapping teeth are more difficult to clean, especially as dexterity and eyesight diminish with age, so plaque and bacteria can build up in hard-to-reach crevices of the mouth, potentially leading to gum disease. This has been associated with an increased risk of cardiovascular disease and lung infections.
Even the pressure exerted by one tooth pushing against another at the wrong angle for years can cause a tooth to crack or fall out.
‘If you have overlapping teeth, cleaning or flossing can be difficult and becomes even more so as you age,’ says Dr Richard George, of the British Orthodontic Society.
‘So plaque builds up and the gums become inflamed — and this can increase vulnerability to gum disease and potential tooth loss. For some people, it may be that having braces finally gives them the chance to clean their teeth properly and prevent gum disease and tooth loss.’
Teeth grinding can also be a problem, adds dentist Dr Biju Krishnan, of The London Centre for Cosmetic Dentistry.
‘This can cause the teeth to crack, shorten or move under pressure, which is why some people may require braces.’
Caroline’s issue was a ‘deep’ bite or overbite — where the upper front teeth almost completely overlap the lower. This can cause the teeth to wear down quickly.
Side-effects: Orthodontic treatment isn’t usually available for adults on the NHS, although it may be approved for health reasons
Crooked teeth can be hereditary, where insufficient space in the jaws for the full complement of teeth is genetic.
However, aggravating this is a phenomenon known as mesial drift, the natural tendency of the ligaments connecting teeth to shorten and pull forward. ‘Over time, this results in overcrowding,’ says Dr Krishnan.
Some orthodontists advise adults who have straight teeth and have never worn braces to wear a retainer — a custom-made plastic shield costing around £100 — at night to keep teeth in their current position.
And those who did wear braces as teenagers may still face problems if they failed to use a retainer to keep their teeth straight after the braces were removed.
‘What we are now seeing [in our surgeries] are adults who had orthodontic treatments in the Seventies and Eighties, when retainers were an afterthought,’ says Dr George. These days, when it comes to braces, the options are more discreet than those of 40 years ago and include ceramic brackets with tooth-coloured wires.
‘Even less visible are lingual appliances — braces that are fixed to the back of teeth, rather than the front,’ says Dr Trevor Hodge, from the Beverley Orthodontic Centre in Yorkshire.
Finally, there are removable, clear aligner systems, such as the one Caroline had.
‘These mouthguard-style, clear plastic aligners are custom-made from moulds or scans of the patient’s teeth,’ says Dr Hodge. ‘A new aligner is used every couple of weeks to move teeth into position gradually.’
However, treatment does tend to be costly — Caroline’s Invisalign braces cost £3,000.
Orthodontic treatment isn’t usually available for adults on the NHS, although it may be approved for health reasons.
‘There is an advantage with these removable aligner systems for patients who already have some gum disease,’ explains Dr George. ‘If they have fixed braces, they may struggle to maintain a good standard of oral hygiene while their teeth are being corrected. But, as these aligners can be removed, the wearer can floss and clean their teeth easily.’
Treatment spans for all braces typically range from nine months to two years. Caroline, whose treatment took two years, says: ‘It wasn’t easy — the braces were tight and uncomfortable. But I was determined to persist because I knew if I didn’t, my teeth would only get worse.’