Adult Orthodontics: Braces Revisited

The age old story

The most common adult patients we see in our practice are those who had braces as a teenager, wore their retainers for a few years and then lost track of them at some point in college. Unfortunately our teeth are never static – they’re constantly changing and the previously corrected crowding or spacing generally returns and becomes more visible at some point in our late 20’s and 30’s.  Our patients will often refer to a recent photo of themselves and say, “I never realized it had gotten so bad until I saw this picture!” Or sometimes our patients will walk in with an old retainer that they’ll try to force on their teeth periodically – which will often do more harm than good! Excess intermittent pressure from an ill-fitting retainer can damage your teeth and gums. A good retainer should fit passively to hold your teeth straight, they aren’t designed to force your teeth back to your teenage straight smile.

The dilemma

However many of our patients are generally busy, active young professionals who don’t want to go through years of braces again. And they want their teeth perfectly straight as soon as possible with minimal visibility.

How to get there

What are the best options these days? Your best options are primarily dependent on your specific malocclusion (bite) and the severity of the dental relapse. We’ll discuss the pros and cons of your treatment alternatives during your initial consultation. Remember that the treatment options presented to you are customized for your teeth and your specific bite.

Metal or Clear Braces

Services - Ceramic Braces2
Quite often I still recommend standard metal braces (stainless steel) or clear (ceramic) braces to most efficiently treat with optimal results.  Braces allow us to control each tooth in all three dimensions with the most precision and efficiency (reduced treatment time).   Treatment time is generally the shortest and costs are the lowest for our patients. (Our clear brackets (Radiance) are by American Orthodontics – they offer optimal translucency, and the smallest bracket size with high durability.)

Lingual Braces

Services - Lingual Braces2Lingual brackets are another great option especially for certain mild relapse cases.  We place lingual brackets behind your teeth to correct the crowding or close the spacing. While these “hidden” braces may take some getting used to since the lower lingual braces are adjacent to the tongue and create some initial irritation, they are nearly completely invisible to everyone else. (Read more about the brands of lingual braces we use here and here.)


Screenshot 2014-08-10 19.09.45Invisalign is another popular option among our patients since the trays are removable enabling easy hygiene and maintenance throughout treatment. We do still have to bond clear attachments (composite buttons) onto select teeth to which the trays engage, otherwise it’s a very esthetic option. The control of the teeth generally isn’t as precise or as efficient as with braces- however for mild relapse cases Invisalign is an excellent option – especially if you tend to clench or grind, as the trays protect the enamel of your teeth and can alleviate some TMD symptoms.

Partial treatment

Depending on your case we may discuss an option to start your treatment with a fixed appliance like braces or an expander, and then finish with Invisalign – giving you the efficiency of fixed appliances and the esthetics of Invisalign for the remainder of your treatment. This is a popular option among our patients since they get the best of both worlds – limiting their time in treatment and finishing with optimal results.

What Sets Us Apart

Our specialty at King Street Dental Wellness Center is in working with and accommodating the needs and lifestyles of our busy adult patients while delivering excellent results with efficiency. Our practice provides individualized patient care in a modern, private and spa-like environment-likely not reminiscent of your childhood orthodontics experience. Orthodontics not only gives the benefit of a beautiful straight smile but dental and periodontal health are also enhanced due to improved dental function, reduced wear, and improved oral hygiene that accompanies dental alignment. I hope this post helped to clarify the best options available to you if you’re considering orthodontics. I’m happy to answer any further questions specific to your case during your initial consultation.


Friday Favorites

Happy Friday! Here are some of my favorites from the week. Enjoy!

1) Favorite Quote:
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2) Favorite Ortho-friendly meal idea:
Miso Soup with rice & poached egg. Although we’re in the 80’s here in southern california, a warm soup, nourishing grains (use brown rice) and a poached egg (try to get organic pasture raised eggs if possible)- is not only full of nutrients, but is super easy to prepare for a quick weeknight dinner. Click the image to link to the recipe.

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3) Favorite ortho-friendly sweet treat:
Remember to stay away for excess refined sugars- it’s okay to have a sweet treat, but make sure you brush right afterwards- it’s primarily the duration of exposure to the sweets that expedite tooth decay and white lesions. Try this recipe, for a sweet treat full of healthy whole ingredients, and nothing processed/refined- which cause a lot more damage long-term.

This recipe for 5-minute healthy frozen yogurt is quick and versatile. substitute the frozen peaches for any frozen fruit you like (mango is super yummy). Try to buy organic yogurt to avoid the hormones, antibiotics and such added to conventionally produced dairy-which you’re much better off avoiding.

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4) On Career choices- do what you love, make a positive difference.
Read the full New York Times article here.
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“The traits that lead people to love their work are general and have little to do with a job’s specifics. These traits include a sense of autonomy and the feeling that you’re good at what you do and are having an impact on the world. To people who constantly wonder if the grass might be greener on the other side of the occupational fence, I offer this advice: Passion is not something you follow. It’s something that will follow you as you put in the hard work to become valuable to the world.”

5) Ortho tip: loose bracket, what to do?

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From the AAO website:
“A Bracket is Knocked Off, What do you do?
The bracket can be knocked off if the patient has eaten one of those hard or crunchy foods orthodontic patients are instructed to avoid, or if the mouth is struck while at play. (wear a protective mouth guard while playing sports.

To put the bracket back in place, use sterile tweezers to slide the bracket along the wire until it is between two teeth. Rotate the bracket back to the proper position, then slide it back to the center of the tooth.”

As long as it is comfortable, and the loose bracket is still attached to the wire, leave it as it is, and avoid eating in this area until you can see your orthodontist for a bracket repair.

Have a wonderful, restorative weekend.

Sweet Tooth: PB & Banana Breakfast Cookies


These soft-batch style cookies are basically as healthy as a bowl of oatmeal.  They’re just sweet enough, with a cake-like consistency- perfect for satisfying your sweet tooth, especially during orthodontic treatment.  If you don’t have time to sit down for a proper breakfast, these can be swiftly dropped into baggies for a great breakfast on the go, or they’re the perfect pre or post workout snack when you need an energy boost without the sugar-slump.

In this recipe, sugar is replaced with ripened bananas & a touch of maple syrup, and processed wheat is replaced with whole oats, unsweetened coconut flakes & a 1/4 cup of whole grain gluten-free flour.  Organic eggs and a good dose of your favorite nut-butter, provide protein and staying power.


PB & Banana Breakfast Cookies


2 ripe bananas

1/3-1/2 cup peanut butter

1 tsp vanilla extract

2 tbsp maple syrup (optional)

1 large organic egg

2 cups quick-cooking or rolled oats

1/2 cup shredded unsweetened coconut

1/4 cup gluten-free wholegrain flour

Dash ground cinnamon


Preheat oven to 350°F. Blend together all wet ingredients (in a food processor if you have one available).  Add the remaining  dry ingredients and stir until well combined.

Drop a tablespoon of dough onto a cookie sheet lined with parchment paper. Press a hazelnut-sized ball of your favorite nut butter into the center of the dough- and for an added touch press in a bittersweet chocolate chip if you have them on hand.  Sprinkle with cinnamon.  Bake for about 15 minutes.  Enjoy!

Recipe Fav: Pumpkin Almond butter Smoothie from


This is a great recipe for when you’re craving something dessert-like, rich and satisfying- and it’s full of nutrients and wholefoods!  From one of my favorite healthy-living & recipe sites:

1/2 cup organic pumpkin puree
1 banana
1 tsp cacao powder
sprinkle of cinnamon
sprinkle of pumpkin pie spice
1 tsp maca powder
2 tbsp chia seeds
3/4 -1 cup unsweetened almond milk
1 – 2 stalks of kale

Blend everything. Add an extra sprinkle of pumpkin pie spice on top and enjoy!

Chilled Avocado & Cucumber Soup


Soups are a great, braces-friendly way to get your vegetables & nutrients in and have a satisfying & easy meal within minutes- all you need is a good blender.  This recipe is from Tartlette, a favorite blog featuring healthy gluten-free recipes, and beautiful photography.   (recipe & photos from Tartlette)


Chilled Cucumber and Avocado Soup
Makes enough for 4 as a main course

2 large cucumbers, peeled, seeded, and roughly chopped 
1/2 medium avocado, peeled and roughly chopped
1 small sweet onion, roughly chopped
1 cups sour cream
1/2 cup buttermilk
1 tablespoon each lemon verbena and lemon thyme
salt and pepper to taste

Place all the ingredients for the soup in a blender or food processor and puree until super smooth.  Top with fresh chopped herbs and or feta/parm. cheese, and serve chilled.