How much is your smile worth?

Years ago, Mary Azer, now a USF junior, had no intention of fixing her already-straight smile. However, when teeth began crowding her bottom jaw, gums opened up and revealed delicate roots. There was a chance her teeth would fall out. Her dentist extracted four teeth and left behind a collection of brackets, wires and rubber bands to tighten up the new spaces on Azer’s gum line.

She laughs, describing friends’ reactions to her braces (“Awww!”) or when her boyfriend said, “I talked to you because you had a goofy smile.”

Wearing braces increased Azer’s own awareness of her mouth’s appearance. She folds pizza slices and cuts up sandwiches before biting into them. She used to practice different degrees of smiling. Sharp-edged brackets and clear bands — a mouthful guarding each tooth — draw all sorts, colors and sizes of catchy material into their clutches.

For the newly braced individual, daily habits such as brushing, flossing or ensuring there is “no yellow” around each metal bracket or band after every meal can occupy several minutes of the day.

Orthodontists treat more than five million Americans each year, and the growing availability and social acceptance of braces has increased the number of participating adult patients (18 years and older) to 1 million.

For college students looking to break into an increasingly competitive job market, two years of playing “metal mouth” may be worth it in the long run. In fact, 40 percent of the college-aged adults who visit Michael L. Abdoney, a local Tampa orthodontist, request Invisalign — an 8-12 month invisible braces option for milder orthodontic cases — perhaps for merely cosmetic reasons.

“There are probably many reasons people go for treatment,” said Pam Paladin, communications coordinator for the American Association of Orthodontists.

Paladin added that more people get braces at any age compared to her high-school class, where two out of 300 kids wore orthodontic braces. American society is viewing treatment at any age as acceptable nowadays, she said.

“It’s becoming more a rite of passage,” Paladin said.

Types of Braces

Depending on the severity of the orthodontic problem and how tight the patients’ budgets are, patients have the choice of at least five different types of braces, according to, a Web site dedicated to people with or who need braces.

One style is Nitinol, a thinner, “smarter” alloy wiring designed by NASA. The strong, yet flexible, heat-activated alloy, which is frequently compared to traditional metal wires , is not easily bent out of shape. Within the hot temperatures of the mouth, the alloy slowly bends and reshapes itself back to its original tension and placement between teeth.

Traditional metal braces can come in gold- or silver-colored brackets. Patients can choose from a variety of colors for the tiny, elastic rubber bands that wrap around each bracket and help keep the connecting wires in place.

Brackets for ceramic braces are a bit larger than metal brackets, but are made of a smooth, whitish material and blend in with the natural color of teeth. Rubber bands, or ligatures — not the brackets themselves — can be easily stained by foods such as pizza, spaghetti sauce, coffee or reddish-colored juices. Although ceramic braces are just as effective as metal braces, they can cost about $500 more with a couple of extra months of treatment time and perhaps extra trips to the orthodontist to get the ligatures changed more often, depending upon how “clean-looking” a patient wants to keep his or her smile.

Another type of braces are lingual brackets ,which are attached to the back of the patient’s teeth and are close to the tongue, so outsiders cannot see them as easily. However, they may crowd the tongue and cause speech to become slowed or slurred at first.

Recent computer technology has found a way to make braces seem invisible. Invisalign braces are strong, hard plastic trays perfectly fit by a computer program to a patient’s own teeth. It is virtually impossible to tell that people wearing Invisalign have anything on their teeth. Patients receive and change out these computer-engineered clear teeth jackets every couple of weeks. Invisalign is not for severe cases and can take longer than, or can be accompanied by, time in traditional braces. Although there are no metal brackets or wires to irritate or cut into the inside of the mouth, there is still discomfort involved with treatment due to the shifting of teeth.

Other treatment, introduced within the past decade include Damon Brackets and Viazis brackets, which use innovative techniques that can decrease the patient’s time spent in office for attending regular adjustments.

The price to pay for braces

Generally, traditional metal brackets cost the least and can be applied to most orthodontic problems in need of braces.

However, increased dental hygiene awareness is key to ensuring an effective treatment, says Abdoney.

Abdoney said his office, Abdoney Orthodontics, receives about eight new “college-aged” patients monthly.

“Parents come in with their kids who went off to college, didn’t wear their bands and say ‘I paid good money for this, I want my kids’ teeth straight,'” Abdoney said.

While some parents are willing and able to pay for an offspring’s first or second orthodontic treatment, Abdoney said the basic effort on the patient’s part, such as staying away from tough, chewy or sugary foods/candies that easily break off or get lodged between braces, decreases time spent in unnecessary office visits and removes the heightened possibilities of dental plaque growth, tooth decay and bad breath or repeated treatment.

Financially, the treatment is more feasible than it was 30 years ago. Depending on how necessary health care providers, dentists or orthodontists determine a patient’s braces to be, insurance may cover up to half the cost. “Flexible Spending Accounts” or direct reimbursement plans may reduce or compensate office fees for certain employees. Yet, even with various financing options (monthly payments or by credit card) individuals should be sure of the necessity and effectiveness of a several-month, $5,000-$6,000 commitment.

In the end

The AAO estimates that 50 to 75 percent of the population could benefit from orthodontic treatment lasting anywhere from 12 to 36 months. Orthodontists claim patients are effectively treated at nearly any age, from toddler to senior years.

Azer jokes about her plans to celebrate come December, which is when the braces are marked to come off. She can’t wait to bite right into a sandwich or other favorite forbidden foods.

“Apples — oh, I love apples. Whole, crunchy apples! Forget the sliced kind,” she said.