When Gail Breen's dental hygienist noticed that some of her teeth were shifting out of line, she recommended that Gail visit an orthodontist. Gail made the appointment with some trepidation; not particularly brave in matters tooth-related, she even makes her husband take their two young children along for their regular dental checks. "I'd had problems for some time, but I kept putting off the appointment, partly because I was nervous, but also because I knew that if I had a brace fitted, I'd have to wear it for two years, and that seemed a long time," she recalls.
But when she finally went to see a Harley Street orthodontist, Les Joffe, in the summer, she was pleasantly surprised. "I was told that a few months ago, all that would have been available was a set of traditional train-track braces," she says. "I couldn't face them at the age of 46; I'm all for having things done to look good, but I don't want everyone to know about it. But now, there was a new technique that would straighten my teeth, painlessly and invisibly. It seemed like a miracle."
Gail was fitted with Invisalign, a new method of teeth-straightening recently introduced here from the US. The patient wears a clear plastic "aligner" that fits tightly over the teeth, rather like a sports guard, and gently but firmly moves them back into line. Every fortnight, the aligner is discarded and replaced with a new, slightly modified one, until the desired effect is achieved.
According to Les Joffe, Invisalign can move teeth by a third to a quarter of a millimetre every fortnight. "The orthodontist takes an impression, and then sends it off to Invisalign, where they use a computer program to make a virtual replica of your teeth and gums," he explains. The virtual mouth can then be manipulated on-screen to show how the treatment will work, and then each small movement needed is translated into an aligner, one for each shift. "If the problem is simple, you might need 10 aligners; for a more severe problem, as many as 28," says Joffe.
The aligners have to be slipped out when eating, but apart from that, to be effective, they must be worn for at least 20 hours a day. "There's no danger of swallowing them while you're asleep," says Joffe reassuringly. "They clip tightly over the teeth, which is why they are effective and comfortable; they don't move around." Clients, he says, are most attracted to the invisibility factor. "They add a very faint glaze to the teeth, but from 2ft away, you can't see them, unless you know exactly what you're looking for." Some patients, he says, can develop a slight lisp while adapting to their aligners; but it takes just a few days to adapt.
Gail Breen has been wearing her aligners for three months now, and claims she has a bit of a lisp, though in fact she sounds normal; she found it hardest to adapt to taking them in and out. "When I'd just had them done, I met a girlfriend for coffee, and said I just had to take my braces out; half an hour later, I was still fiddling. The first couple of weeks I broke all my fingernails getting them in and out, but now I can discreetly slip them out at the dinner table and no one notices." Nail damage apart, she is enthusiastic. She works as an interior designer, and has to look the part; having good teeth, she says, is the equivalent of "good lighting in a show flat".
Invisalign is not for everyone, says Les Joffe. Around 40,000 patients in the US and Canada have so far been treated; but, he says, it's not suitable if there is a jaw discrepancy or severe crowding. At the moment, Invisalign can only be fitted by specially trained orthodontists; there are currently 18 practices in the UK that can offer the service, all part of the OrthoWorld plc group. Invisalign can only be used when all permanent teeth are there, so it's for adults rather than children. And it is expensive; between £3,500 and £4,000 for one jaw, and £4,500 to £5,000 for both. Gail Breen sees the cost as an investment. "It's like everything else you have done; your hair, waxing, manicure. I pay by direct debit, over 15 months, so it's like paying out for gym membership."
It seems that having a neat set of teeth is becoming as important to us as to the Americans, long known for their obsession with oral perfection. Invisalign is just part of a wider trend towards bettering the state of the nation's teeth. British gnashers have long been the subject of some hilarity, particularly in the US. "Snaggletoothed Brits" are a long-running joke in The Simpsons. And when Mike Myers went into make-up for the film Austin Powers, he came out with crooked, stained teeth to make the lead character unmistakably British. A recent NOP survey showed that 21 per cent of Brits are self-conscious when being photographed, 19 per cent feel uncomfortable when smiling, and 11 per cent try to cover their mouths while talking. The same survey also found that 84 per cent of people felt that bad teeth detract from the rest of a person's appearance.
It was this kind of anxiety that led to the development of Invisalign; the original concept was developed by the CEO of the American parent company, Align Technology, while working as an investment banker. He had to wear braces to correct his teeth, felt uncomfortable wearing an obvious brace as an adult, and worked with computer experts and orthodontists to develop the system.
Feeling that a brace doesn't add to your business gravitas isn't uncommon, according to Lynn Brown, a career development coach at monster.co.uk, the online careers service. "If you aren't comfortable with your appearance, you don't feel confident." There is, she says, far more awareness among employers and employees of the importance of image. "Dress sense, glasses, teeth, overall style: they are all part of the 'fit factor' that makes you stand out."
The tribulations of having one's teeth fixed have been the subject of a number of essays recently, with Martin Amis writing most notoriously on the subject. Celebrities, from Margaret Thatcher to Catherine Zeta Jones to Jamie Oliver, have all had theirs done. But while straightening, let alone bleaching and veneering, were once the province of the rich or the vain (or the Yanks), corrective work has risen by two thirds in the past decade, according to the British Orthodontic Society. The telephone query line for Adapt, the aesthetic dentistry association, has taken up to 2,000 calls a month, and the organisation reports that the number of dentists working in the aesthetic field is going up by 25 per cent a year.
Dentics, Britain's first chain of cosmetic dentistry "boutiques", offers a smile simulator on their website; you send in a photo of your yellow tombstones, and they make a virtual image of how your smile could dazzle. The Dentics approach, with feng-shui-ed interiors of wood and glass, leather sofas and aromatherapy, has been endorsed by Melinda Messenger ("Thank you very much, a brilliant job") and Caroline Aherne ("Coming to Dentics changed my life").
"We pioneered cosmetic dentistry in this country when we set up on the Kings Road in 1990, when it was very much not the done thing in this country," says Jennifer Golden, Dentics' managing director. "Since then, we have opened more branches, but it's only in the last three years that it has really started to gain pace." Dentics plans to open two new branches a year. Jennifer Golden believes that British soap-opera celebs who have had their teeth done are encouraging the rest of us. "People think this kind of procedure is within their reach when they see accessible British celebrities having it done, because they are more approachable than Hollywood stars.
"And techniques have improved so much. Once, braces and crowns were the only options. Having braces could take years, and having a crown involves drilling away most of the tooth, but using veneers where only the front of the tooth is shaped means you can change your smile in a couple of weeks."
In more primeval times, having a functional set of teeth was linked to rather more than looks; it was a matter of life and death. If you didn't have strong teeth, you couldn't eat. Dreaming that all of one's teeth are dropping out is still a classic subject of nightmares. Going to the dentist, however, is less of a nightmare experience than it once was. Earlier this century, it wasn't uncommon for young people to have all their teeth extracted and a set of dentures fitted instead, to avoid pain later.
Happily, our dental health is showing genuine signs of improvement, says Joffe. "Young adults today have far better teeth than they did 10 years ago. People are starting to realise the social advantages of good teeth; if you have a nice smile you are more acceptable in all kinds of social and career settings." Having straight teeth, he says, isn't just a matter of vanity, though. "They are easier to clean and look after, so you keep them longer."
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