Brace yourself: Orthodontics has come a long way

November 17, 2009

By David Hayes

Dr. Nadine Egger (left) shows a patient her new Invisalign clear braces tray, created from a full, 3-D computer image of her mouth. Contributed

Dr. Nadine Egger (left) shows a patient her new Invisalign clear braces tray, created from a full, 3-D computer image of her mouth. Contributed

Jennifer Lee, 43, always wished she’d taken corrective action on her teeth as a child.

“I would have loved as a kid to get braces,” said the longtime Issaquah resident now living in Cle Elum. “They weren’t that crooked, but the cost was such that it wasn’t a huge priority. Plus, like most kids, I didn’t want a mouth full of silver.”

But a funny thing happened on the way to her orthodontist in Issaquah with her two sons, Cody, 17, and Cooper, 12. Lee learned that she, too, was a candidate for Invisalign, the newest in clear-braces technology.

According to the American Association of Orthodontists, Lee is one of over a million adults wearing braces, twice the number from just 15 years ago.

Lee’s orthodontist, Dr. Nadine Egger, has been practicing in Issaquah since 1998 and she has been working with her father since she was 14. So, she’s seen technology change a lot over the years.Egger said there are many reasons to need braces, and there really isn’t anything you can do to avoid it.

“The biggest reason to get braces is overcrowding in the mouth as the baby teeth get replaced by permanent teeth,” she said. “Sometimes, in the mouth, the upper or lower jaw just doesn’t have enough room for them to come in.”

Another reason is straightening crooked teeth to fix a misaligned bite, which could lead to problems with the jaw if ignored. Also, breathing problems may develop from crooked teeth. And then there’s the vanity factor — many get braces just to improve their smile to look more perfect.

Egger estimates that more than 70 percent of the American population needs orthodontic correction. This factor was not lost on Lee.

“My kids needed braces. I fought my 17-year-old tooth and nail to get Invisalign. His teeth weren’t that crooked, but I knew he’d regret it later,” Lee said.

When he learned he wouldn’t have to get a mouth full of metal to improve his smile, Cody was excited. The excitement was contagious. Jennifer got them, too.

Egger said technically, Invisalign are not braces at all.

“They’re clear trays that move teeth gradually,” she said. “They work really well in more than 80 percent of cases.”

Other advantages of the clear trays over traditional metal braces are no food restrictions — you can eat popcorn or chew gum with them in — they can be removed for easy brushing and flossing, and they initiate gentler tooth movement, causing less pain.

In the office, the doctor creates a full, 3-D panoramic picture of the teeth, used to create the custom-fit trays.

As advanced as the technology is, Egger said only about 20 percent of orthodontic patients use Invisalign. Essentially, that’s because of a lack of knowledge in them or because patients don’t qualify as a candidate due to certain jaw alignments.

Lee’s youngest son, Cooper, had an underbite, making his corrective needs more severe, so he had to go the more traditional metal braces route. But even so, technology has advanced so he doesn’t have to be a “tin grin” or “metal mouth” to get correction. The same results are achieved these days with fewer wires and less metal.

“Plus, they make it fun, too, with color bands you can choose, that are real small, compared to the old style that gave you a mouthful,” Lee said.

Egger said a final benefit to orthodontics today versus years past is the cost has come way down. Lee is now grateful she finally received corrective treatment, not only for herself, but for her sons as well — which has them all anticipating a better smile down the road.

David Hayes:, 392-6434, ext. 237. Comment at

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