By Cindy Atoji Keene
The bite is a complex system that includes up to 32 teeth, gums, upper and lower jaws, and facial muscles. A healthy bite has not just aesthetic impact but also functional benefits, said orthodontist Sam Levine of Levine Orthodontics in Lexington. Crooked teeth and a bad bite can contribute to tooth decay, wearing of tooth enamel, and even headaches and jaw joint pain. “We think of braces as merely straightening of the teeth, but teeth that are properly aligned can enhance your overall health – as well improving confidence and self-esteem,” said Levine, 37, who uses the Damon system of orthodontics made by Ormco, based in Orange, Calif. And as braces become more comfortable to wear and better at repositioning teeth, Levine is seeing patients from ages 7 to 70, as more and more adults opt for orthodontic treatment. Rather than the metal-mouth look of a generation ago, new materials and other technological advances have made smaller, less obtrusive braces available. Braces today range from translucent to tooth-colored ceramic braces, clear aligners that can be worn at night, and other devices.
Q: What are the most common conditions that you see?
A: Overbite, overjet, and buck teeth – are common, and more rarely, underbite. And hand-in-hand with these bite issues are crowded teeth, or when teeth twist and turn. There is largely a genetic component to these conditions, along with environmental factors such as thumb sucking or other habits. One national study found that approximately 60-70 percent of the population have a problem that could benefit from orthodontic treatment.
Q: How has treatment advanced?
A: Braces have gone through a revolution of sorts. Braces used to be bands tightly attached with a ligature tie or wire around teeth, which caused a lot of pain and discomfort. But instead of pushing teeth as hard as you can, the concept now is low-force and low-friction, with a brace made up of sliding mechanisms which generate forces and gradually move the teeth over time. Dental appliances continue to make improvements, and now clear braces are virtually invisible.
Q: There have been reports of younger and younger kids seeing the orthodontist. Are you experiencing this in your practice?
A: There is cultural pressure to have that perfect celebrity smile, as seen in magazines and movies. Sometimes patients or their parents are eager to get started on orthodontic treatment. The American Association of Orthodontists does recommend that initial evaluation should occur no later than age 7 or at the first signs of problems. But it’s important to understand that starting treatment early doesn’t necessarily mean finishing early. There is the certain age when treatment is most effective.
Q: Why did you choose to become an orthodontist?
A: . I think of orthodontics as the ultimate mix of art and science. As an orthodontist, I’m able to have a long-term relationship with patients – and I don’t have my hands in their mouth the whole time. I also had a Jewish mother, so I joke that my choice was to be a lawyer, doctor, or dentist. As a kid, I was a tinkerer and liked to work with my hands a lot. And it helped that I had a really good dentist who inspired me.
Q: What’s the future of orthodontics?
A: Braces are currently a stock product; we have a box of braces that we choose from, then individualize by bending wires and our other skills. But customization is a big step; we can take a tooth impression, make a 3-D model on the computer, then design a smile and create custom braces for that patient. Custom braces can reduce treatment time.
Q: What’s the record for someone losing a retainer?
A: Too many to count. One patient lost his retainer three times in the first month. We’ve had retainers that travel the world and get lost overseas somewhere; retainers put in the washing machine or dryer. Dogs love retainers – it’s the most expensive dog toy you can buy. Retainers have the smell or scent of the owner, so if a dog likes the owner, he likes the owner’s retainer.
Q: How do you resist not judging someone’s teeth and the work they need to get done?
A: A smile is the first thing you notice when you meet someone, whether you’re a professional or not. As a dental resident, when I was still learning, I would always think, ‘How can I fix that?’ Now I still see smiles, but my thoughts are limited to diagnosis and not the treatment.