When “Ugly Betty”
premiered in 2006, the series’ namesake made a big impression with her chipper disposition, unique fashion
sense — and larger-than-life “train track” braces. An astute way to give Betty a trademark look, yes, but her
exaggerated mouthful of metal is most certainly not a reflection of modern orthodontic care, says the
president of the American Association of Orthodontists (AAO).
“You can see they’ve made those braces very large and bulky to draw attention to her, and certainly the show
has brought a lot of attention to orthodontists,” says Dr. Robert James Bray. “But the key there really is
that now today the braces, or brackets if you will, are getting smaller and smaller. So they’re much more
comfortable than before, meaning people are really very comfortable having braces on.”
With the help of the latest technology, orthodontists create dazzling smiles by ensuring that teeth, lips and
jaws are properly aligned. The importance of seeing an orthodontist lies in his or her education, says Bray.
Like dentists, they go through four years of dental school. But, they then undergo an additional two to three
years of specialized training to develop the skills required to treat the misalignment of teeth and/or jaws,
known as malocclusions. “They’re the ones who truly are the specialists,” says Bray. Together with your
dentist, orthodontists can provide comprehensive oral health care for a smile that will last a lifetime.
The AAO, which represents more than 16,000 members including 500 in Canada, recommends that children see an
orthodontist by the age of seven. “The reason for that is not so they begin treatment then, but just so the
orthodontist can actually spend the time to begin to analyse what kind of growth rate and development this
individual is going to have,” says Bray. The child will then visit the orthodontist for a checkup every six
months to a year to make sure their teeth and jaw are developing at the right pace and in sync with the rest
of the body. Treatment, if needed, usually begins between the ages of nine and 14.
Bray, who has practiced orthodontics for two-and-a-half decades, sees about 45 patients on a typical day. The
most common treatment he performs involves using metal braces to move teeth to a more desired position.
Straight teeth not only function better, helping an individual to bite, chew and speak more effectively, but
they also contribute to healthy teeth and gums, which may even reduce physical health problems. For many
patients, straight teeth is also an important self-confidence boost. “There are more and more people worried
about how they look and so they [come] to the orthodontist to get their smile enhanced so that they feel good
when they walk into a particular room,” says Bray.
Patients now have a range of options beyond the conspicuous silver braces of yore. Coloured braces are
available and a popular choice among patients who see them as fashion accessories, says Bray. On the other
hand, ceramic braces blend in with the natural colour of the teeth and are nearly invisible, while lingual
braces are hidden behind the teeth. Beyond braces, clear aligners fit over the top of the teeth, use no metal
or wires, and are removable. Patients should consult their orthodontist to decide on the option that works
best for them. And if you think braces are only for kids, think again. The AAO reports that one in five
orthodontic patients is an adult.
Orthodontists apply their expertise in procedures other than teeth straightening. Bray treats children with
cleft lips and palates, and those with thumb or finger habits that are beginning to change the position of
their teeth. Orthodontists also get involved with oral surgeons in treating patients whose upper or lower jaw
is either too far forward or too far back, commonly known as overbites and reverse bites. This past January,
the AAO and the American Association of Oral and Maxillofacial Surgeons held a joint conference in California
titled “An Interdisciplinary Update on Dental and Facial Esthetics.” Clearly, orthodontists look at much more
than just teeth. “[We] are an overall evaluator of what we call the dentofacial orthopedics… it’s the
individual jaws of the face as well,” says Bray. “That’s where that extra training comes into play because
you want to be able to move the teeth and change the face. It’s like if you picture a 3-D puzzle — you’re
trying to put together a whole face to make sure it looks better when we’re done.”
Now in its 109th year, the AAO is the oldest dental specialty organization in the world. Since its
beginnings, orthodontics technology has evolved to make getting the perfect smile a more pleasant and
informed experience. Besides smaller brackets and more flexible wires in braces, orthodontists also use
computer imaging to create customized brackets and clear aligners, and to show patients how their teeth will
look when treatment is completed. Technology has also made finding an orthodontist easier than ever. The AAO
website (braces.org) has a locator function that allows patients to find a
qualified orthodontist near their home
When asked what he enjoys most about his work, Bray is quick to respond. “That’s pretty easy — just seeing
the different people every day,” he says. “You take someone who may not feel as good about how they look, or
is concerned that their, let’s say, upper front teeth are sticking out… You can see even during treatment
they begin to smile more or feel better about themselves.” •
