Brace yourself for a real mouthful

Adults are enduring the railway track look to straighten their teeth, Anna Maxted reports

FOR MANY people, wearing a dental brace was a misery of adolescence. As if acne wasn't enough of a setback, we were expected to attract the opposite sex with our mouths full of scrap metal. While we fantasised of drowning our orthodonist in a barrel of pink, foul-tasting, quick-set material, our parents told us how lucky we were. They never had this opportunity and now it was too late for their teeth. Well, they wouldn't get away with that line nowadays. In the past 15 years the number of adults wearing "train-track" braces has more than doubled.

Hilary Reade, 55, is happy to be sporting a full-metal bracket. She says: "All my life I have been extremely conscious of how ugly my teeth are. I never showed my teeth in photographs. From when I was a teenager I learned to smile with my lips closed. When your teeth are extremely crooked you lose confidence."

She assumed she was doomed to a life of grimacing until, 18 months ago, she visited a new dentist for a check-up. "I was saying how fed up I was and that I wished I could have had some treatment." To her surprise, he suggested she book a consultation with an orthodontist.

"The first time my husband came with me for moral support," says Mrs Reade. "The orthodontist said I would have to have a fixed appliance, and would I feel embarrassed because it was more often for teenagers?

"It didn't worry me at all. I thought, I may as well get on with it and have it done properly. I run a playgroup, so I'm in contact with children and parents. The children have never mentioned my teeth and as for the parents, they are extremely interested to know how I am getting on. I have never had anyone saying, 'Good heavens, fancy having that done at your age.' "

Mrs Reade is in good company. According to records of the Dental Practice Board for England and Wales, in the year ending March 1994, around 10,000 adults completed courses of appliance treatment. The DPB concludes: "As a course of orthodontic treatment lasts on average about two years it can be estimated that around 20,000 adults at one time are undergoing active orthodontic treatment." These figures only relate to NHS patients, who, says Chris Kettler, secretary of the British Orthodontists Society, make up a small minority of adult brace-wearers ,as the vast majority prefer to go private.

Mr Kettler explains: "If you can get it done on the NHS, you pay the maximum charge of pounds 300, but I think it would be very hard to find a dentist who would do it for you, partly because adults prefer to have so-called 'aesthetic brackets' - ceramic brackets - which are clear and tooth-coloured and not stainless steel. They are much more expensive to provide and more expensive to use, because they tend to make the treatment take longer. So no one will make these available on the NHS, because you can't charge extra."

He also points out that when patients fork out private fees of approximately pounds 2,000, they are far more likely to remain committed to the treatment, which, with frequent orthodontic visits and a ban on certain foods, demands dedication.

Rebecca Gould, 27, isn't exactly overjoyed with her fixed brace, but the Holy Grail of straight, evenly spaced teeth has kept her going.

She says, "I've always hated my wonky teeth, but I also hate dentists, and as a teenager I point-blank refused to see an orthodontist. Now I've just about managed to overcome my fear, hence the iron jaw."

This is a familiar story. According to Mr Kettler, a fair number of young adults now opt for train-track treatment, whereas 15 years ago they were "very, very few. If they hadn't had it done as children, they were likely to leave it."

Improved standards of dental health and a sharper awareness of personal appearance are obvious reasons for swelling numbers of adult brace-wearers. A less obvious reason, Mr Kettler says, is the financial acumen of North American orthodontists: "In the 1960s most found themselves short of work because there had been a drop in the birth rate about 12 years previously and there were far fewer child patients, so they pushed it at adults quite hard. I'm sure some of that has come across to Britain."

But the zeitgeist and pushy dentists take joint second place to health and vanity. Mr. Kettler says: "I don't think braces are a fashion statement. People are not doing it because it's the done thing. They are doing it because they want a result."

Consequently, when the perfect smile of Cindy Crawford was briefly wired up with stainless steel to advertise the glamorising qualities of a brown, sugar-laden soft drink, the mature brace-wearers of Britain were not magically transformed into fashion victims. As Mrs Reade says: "A fixed brace looks extremely unsightly," and no amount of metallic supermodel grinning will alter this fact. Yet the stigma of resembling Jaws from the James Bond Movies when you're old enough to remember Sean Connery with hair does not seem to be an issue. Mr Kettler says: "Some people are concerned that they'll look odd, but because more people do it, it's entirely acceptable."

The experience of Paul Bamberough, a 37-year-old secondary school teacher, bears this out. He suffered a fixed brace to prevent his teeth from becoming distorted, and is now wearing a "single line" retainer brace to complete the job. Given his occupation, one would assume that a brace would render him fair game for mickey-taking, but no. He says gratefully: "The younger people have been curious but not really much more than that."