Having a regular smile and a harmonious jaw are now part of everyday concerns. This is why more and more adults are taking the step of orthondontics. Misalignment can range from the functional gene to the true complex. We take stock with Dr. Sabrine Jendoubi, dental surgeon.

Braces are an orthodontic device that corrects misalignment of teeth and sometimes changes the structure of the jaw.

He can correct:

• An overbite: this is when the upper teeth abnormally cover the lower teeth,
• Infraclosion: that is, the upper teeth are not in contact with the lower ones, even when the mouth is closed and the patient closes the jaw,
• A cross bite: the upper teeth do not cover the lower ones;
• A dental overlap: the teeth overlap each other.

However, maxillofacial and orthognathic surgery is sometimes an essential prerequisite for wearing the device to treat an irregularity: this is particularly the case with jaw anomalies. For prognathism (the lower jaw more advanced than the upper jaw), surgery is the only solution. 

It is not uncommon for dental misalignment and / or untreated jaw defect in childhood to become bothersome in adulthood. This is why orthodontists note that adults (in particular those in their thirties1) no longer hesitate to push their doors to find out about existing devices to correct their dental malpositions. Having a balanced jaw and regular teeth have a number of advantages:

• aesthetically: the smile is more pleasant;
• speech and chewing are improved;
• oral health is optimal: in fact, good alignment allows better brushing and dental maintenance.

“Misaligned teeth predispose to oral diseases (due to the difficulty in brushing) such as periodontitis, abscesses and cavities, but can also induce gastric problems (linked to poor chewing) as well as chronic pain in the body. back and cervical level. », Explains Sabrine Jendoubi, dental surgeon at doctocare (Paris XVII).

Finally, it is sometimes relevant to correct an overlap defect before fitting dentures. Indeed, the missing teeth can be used as additional space thus promoting the alignment of the teeth when fitting the appliance.

 There are three types of dental appliances in adults:

Fixed braces 

These are fasteners fixed to the external face of the teeth (or rings): they are therefore visible. For greater discretion, they can be transparent (ceramic). However, if this does not upset the patient, metal rings (gold, cobalt, chromium, nickel alloy, etc.) are also available. A wire connects the rings between them (the color is variable, white is preferred if the patient apprehends the aesthetic aspect of such a device). This type of device is not removable and the subject will therefore have to endure it permanently (even at night) for the prescribed duration. The appliance will exert a permanent force on the teeth in order to align them.

Linguistic orthodontics

This fixed and invisible appliance is placed on the internal face of the teeth. Here again it is ceramic or metal rings fixed on each tooth. The only drawbacks: the patient must maintain oral hygiene and follow strict dietary guidelines. Finally, the first few weeks, the patient may feel discomfort and have difficulty speaking and chewing.

The invisible and removable gutter

This is the wearing of a transparent plastic gutter. It must be worn at least 20 hours a day. It is removed during meals and during brushing only. The advantage is that the tray can be removed, which makes chewing and brushing easier. This method is discreet and minimally invasive. The patient changes aligners every two weeks: “the shape is slightly different, over the weeks and between the aligners. The alignment is gradually taking place, ”explains the specialist. At the end of the treatment, the dentist can place a compression thread on the inside of the teeth or even prescribe a night splint to be worn permanently in order to maintain the new position of the teeth.  

Any adult (person who has gone through puberty until the age of 70) who feels the need can consult for the installation of dental braces. The discomfort can be aesthetic as well as functional (chewing, speech, difficulty in brushing, chronic pain, etc.). “Sometimes, it is the dental surgeon who suggests the fitting of this device to the patient, when he deems it necessary. He then referred him to an orthodontist. It is very rare to put a device on the elderly (after 70 years) ”, explains the expert. The people concerned are those who suffer from a dental overlap, an overbite, an inflaocclusion or a crossbite.

It is recommended to consult a dental surgeon who can himself treat the problem, if it turns out to be minor. However, if the problem is more serious, the latter will refer you to an orthodontist.

The fastest treatments (especially in the case of aligners) last at least six months. Usually the splint treatment lasts 9 months to a year. “But for fixed appliances or for major dental anomalies, the treatment can last up to 2 to 3 years”, according to the practitioner.

The prices differ depending on the nature of the device:

Fixed dental appliance:

• Metal rings: 500 to 750 euros;
• Ceramic rings: 850 to 1000 euros;
• Resin rings: 1000 to 1200 euros;

Lingual dental apparatus:

• 1000 to 1500 euros; 

Gutters

Prices vary between 1000 and 3000 euros (on average 2000 euros per patient).

Note that social security no longer reimburses orthodontic costs after the age of 16. Some mutuals, on the other hand, cover part of this care (generally through half-yearly packages of between 80 and 400 euros).