Reflections on My Braces

For more than two years, I’ve looked in the mirror and grimaced. This gives me the best view of the braces that were wired onto my teeth three Christmases ago. Why I had them put in I’m not sure sometimes. I joked with the oral surgeon who removed four of my teeth to make room for the realignment that it was a midlife crisis. “It was this or a Porsche,” I said. He smiled and replied, “I would have taken the car.”

But the silver charm bracelet of metal adorning my teeth is now a fixture, literally. I never knew what braces were all about, just that my parents couldn’t afford them for me when I was a kid. And my dentist at the time told me that my teeth were fine, that they had individual character. Of course, they weren’t, and much of my adult life I chewed a little crookedly and smiled a little less broadly, catching myself mid-laugh before showing the crowded palisade in my mouth to strangers.

So at age 54 I got braces.

And now I know intimately what braces are. They are a chain of brackets cemented to the front curves of my upper and lower bite, strung along a thick wire fastened onto them by a stretchy rubber chain of loops. The bracket shape is precision tooled to match the type of tooth. This customizing is relatively new in orthodontics and is one of the reasons that adults now can tolerate braces. Old school brackets were all similarly shaped and harder to keep on adult teeth. Or maybe grownups were less likely to put up with the pain that children submit to with resignation. Whatever the case, I’m not the only bald or gray-haired customer on the orthodontist couch at my monthly visits.

The wires are anchored to silver cylinders out of sight, wrapped around my four molar caps, necessary because bracket cement wouldn’t hold on the slippery cap surfaces. The molar rings are like the pylons on a suspension bridge. Without a solid mooring the teeth would move along an errant path of least resistance into a new but jumbled alignment.

That was the most remarkable part for me, that my teeth could move. It’s obvious now, but I had to read up on it to find that under gentle continuous pressure, teeth will move at a glacial pace. The bone on the advancing front slowly dissolves, while new bone fills in the trailing wake. I say the pace is glacial, which may be literally true, but a mouth is smaller than a mountain slope, and over the course of just a couple of months, my teeth slid into smoothly curving ranks, lined up with the precision of bowling pins.

The way it works is the wire has a memory, that is, it has kinks and bends added by the orthodontist. When threaded through the brackets, the wire is gently warped, and it exerts a constant pressure as it tries to recover its shape. Teeth that hide shyly behind their neighbors are forced forward. The tops are aligned when the wire pushes one down and another up. Anchored in the wire brackets, the wire flexes its tensile self, finding its original shape and dragging my teeth along with it, slowly, inexorably. And sometimes painfully.

But the pain is not bad, nor continuous. Once a month, when I go in to have a few more aggressively bent replacement wires installed, my teeth are very sensitive for a few days. But they quickly surrender to the incessant pressure of the wire and within a few days have moved a millimeter or two into place. The rest of the month, they probably move slightly, but I imagine the old bone melting away and the new bone filling in the space where the teeth used to sit. (More on this later.)

As I said, my teeth moved a lot in the first few weeks. Several teeth nearly hidden behind my canines seemed to jump forward, and soon occupied their proud new position, front if not center. But this rapid movement is what makes the process frustrating. After a few months, it seems that everything has moved where it should be, but it’s an oral illusion. With the painstaking patience and perfectionist obsession of Michelangelo, my orthodontist tweaked and sculpted my toothy profile for another 20 months. All one can do is grin (feeling a little like a middle schooler in the midst of adult workmates) and bear it.

Meeting old friends’ with my braces for the first time, I get various interesting responses of several types. Most didn’t say anything at all. But a few closer friends asked, “What’s with the braces?” The implied question was, why on earth did you think you needed them? I suppose getting braces is a visible admission that something about your appearance was bugging you for a long time and you finally worked up the nerve (or saved the money) to do something about it. It’s more obvious and sudden than going on a diet or exercising. It may make people wonder about your dissatisfaction with yourself. “Did he always worry about his teeth appearance?” The answer is yes. And it’s probably just one very visible instance of a common occurrence—no one is totally happy with what or who they are or the way they look.

The most uncomfortable thing about the braces is the food that catches on the exposed hooks and spiked wire tips, which my tender mouth quickly adapted to by forming calluses. But occasionally, when the teeth move, the ends of the wires stick out like the arms of a teenager wearing last month’s sweater. You can push globs of wax on the tips, or bend them to the side, but there’s no perfect way to blunt their sharp tips. The tips can be snipped off with wire clippers, but that requires a trip to the orthodontist, and I’m there all to often. The staff and I are know each other well after two years of visits.

But that will change. Tomorrow, I get my braces off. They will put in a small wire behind my lower front teeth so they don’t migrate back to their original positions. Like the wire, the mouth has a memory too. I will get a mold of my upper teeth for a retainer that I pick up next week. Until then, I’m free. I am a little worried that there will be stencils of coffee stains surrounding the spaces where the brackets were. But that is a short-term problem, and I doubt it will dampen the sense of liberation and clean toothiness that I look forward to.

To be continued, when the braces come off.

__________

Two days later:

I went in Tuesday morning and Peggy at the front desk greeted me with “Well Rick, it’s the big day!” I went to the sink alcove, brushed, took a last look in the mirror, and reclined on the patient couch. Sula, the technician, quickly clipped the wires and levered off the brackets. She had to push a little hard on my canines so it hurt just a little, but actually I didn’t realize they were off until they were done. She slid up the molar sleeves and pulled everything out. I was almost afraid to run my tongue over my teeth, but I did. The surfaces were rough with leftover glue, but the braces were gone. Gone. Sula polished off the glue and told me to brush if I wanted. I went in and smiled big in the mirror. Beautiful.

All day I waited for people to notice they were off, but of course no one did (since they were mostly strangers). I smiled a lot that day. Retainers next week.

_____________

Several months later:

I’ve had my retainers, upper and lower, for about two months now, and they are ungainly and a little uncomfortable but not too bad. I wear the upper ones as often as I can during the day and the lower and upper at night. The upper retainer comes out for eating, hot drinks, and discussions when I’d rather not have a lisp. This is actually quite a few times a day, so I worry a bit that I’m not keeping it in long enough. At night, after brushing and flossing (yes! no longer a marathon), I put them in before retiring and they seem to press a bit on my teeth. They don’t interfere with sleep, and by morning, my teeth seem to have surrendered to the conformations of the retainers. In another two months I go back for a retainer check, after which I may just wear the upper retainer at night. It take s a bit of discipline, and more than one friend has commented that they have had to re-visit the orthodontist because they lost their retainer and let things, teeth included, slide. I’m hoping to avoid that, but freedom from the retainer is a temptation.

In the category of teeth payback, the bone on one side of a tooth that moved a lot has failed to build up as much as needed, so there is a deep little fleshy pocket in the gum next to the tooth. It’s not painful, but my regular dentist found it and she worries that it will be a trap for bacteria, and that could cause big problems. So I went to a peridontist who sliced open the gum over the area, scraped everything clean, and implanted a piece of cow collagen to grow new bone. It’s surprising to me that it’s not rejected, but apparently it’s a common practice. A little synthetic membrane is wrapped over the top of the collagen to provide a contour for the new bone, the gum is stitched up, and what looks like a wad of chewing gum is plastered over the outer and inner sides of the teeth. I wipe antiseptic mouthwash over it several times a day and chew mostly on the other side of my mouth, but there’s no pain after the first day and it’s not even visible unless I smile very wide. The stitches will come out in 10 days and then we’ll see if the bone graft takes. They test it by poking where the deep pocket used to be. If the pocket is gone, and I don’t moo, apparently it’s a success.

While I wait for a verdict on whether the cow collagen agrees with my jaw, I think, “Was it worth it?” It’s not really a question worth answering, since I’m not going to move them back regardless. It was sometimes a bit painful, a bit embarrassing or at least smile-inhibiting, a bit protracted. But in the end it’s refreshing. What else can you do that actually calls upon your body’s resources to rebuild and reverse the ravages of time? Those floaters in your eyes—they’re with you forever. Arthritis, weak ligaments, losing a step in squash—you can’t fix those. But you can move your teeth around and make them look better. And, finally, smiling as often as possible is a good thing.

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