Month 0: Adult Braces vs. Invisalign vs Surgery?

tldr;

I never expected to get braces in adulthood. All I thought I had to fix were a few crooked teeth on the bottom. But as I learned more through consultations, that was not the case. Eventually, I was also pleasantly surprised when braces also solved the bulk of my chronic health issues related to breathing and allergies. However, it took me a while to process and take the plunge to be ok with metal braces for up to 2 years.

Most people are surprised to see that I got braces. Me too.

Braces were never part of my plan. Especially since most of my teeth naturally grew out straight, everything looked fine on the surface. So when I thought about straightening the few slightly crooked bottom teeth, I thought it would be an easy generic Invisalign case. Since everyone I knew achieved great results with more complex cases, I just assumed it would work for me too. However, the more I researched, the more I learned about how extensive my underlying symptoms were to the extent that one doctor said I was potential jaw surgery candidate (sliding genioplasty). What was hiding behind a seemingly “nice” smile was a laundry list of health symptoms that I have silently and slowly learned to live with for nearly three decades.

Braces over Invisalign?

Although I could have chosen Invisalign, braces were the more effective solution for my specific case. I had a crowded deep overbite (Class 2 malocclusion) that was left to develop unchecked for a long time. Invisalign would have been a good option if I had braces as a child, but I didn’t. My case required more drastic structural changes (especially the jawbones) whereas Invisalign was better suited for milder movements, such as tilting and shifting teeth and mild gaps.

Three Decades of Misunderstood Symptoms

By the tender age of 12, I had been diagnosed with heartburn by multiple ENT (Ears, Nose, Throat) doctors. Up until recently, I also believed I had severe spring allergies (which are now more manageable with OTC allergy medicines) to the point where I needed a concoction of allergy shots, steroids, nasal rinses, and a strong and steady supply of Kleenex. In reality, all of these “symptoms” were disguised variations of breathing difficulties from my lower jaw pushing against my pharynx (throat) thus restricting proper air flow and causing mouth breathing.

Throughout my life, I felt a need to constantly clear my throat because I always felt that something was lodged in my throat and causing constant irritation. After enduring multiple rounds of laryngoscopies (rope camera via nostril entry), doctors eventually diagnosed me with heartburn, prescribed OTC medication, and a diet change (my diet admittedly was not the best but it was definitely not the worst either). I adhered to the entire regime but as time went on and with little progress, doctors concluded that I was just throat clearing out of strong habit, which was frustrating. So, to move on with life, I just tried to time throat clearing when no one was nearby. Not only was that challenging because I was always around others in school, extracurriculars, and work but it was also extremely uncomfortable for me to suppress incessant irritation. 

But the real kicker is that this decades-long “habit” disappeared virtually overnight when I started wearing a bite plate, the first step of my orthodontic treatment, which created more airway and stopped my mouth breathing. Another benefit is that a wider airway also materially improved my sleep quality and significantly reduced morning congestion and sinuses after sleeping.

To combat my extensive allergies, I committed to weekly allergy shots for 3 years in my early-20s. I was exhausted by very average pollen levels and OTC allergy medicines unfortunately provided little relief. The shots did help but whether or not they were worth the financial and time investment is perhaps a different story. When the world went into Covid lockdown, I stopped because it became too inconvenient. But guess what? The culprit behind my severe allergic reactions were due to obstructed breathing caused by my bite. By mouth breathing, allergens that would have normally been filtered through my nose were just getting an easy entry into my body and causing my immune system to go into overdrive.

Turns out a large portion of my chronic health challenges were just silent consequences of a poor bite.

Facial Changes

Since I never had braces or wore night retainers, my teeth continued shifting and I started noticing unwanted facial changes that were becoming increasingly pronounced in my 20s.

The two issues I picked up on were (1) prominent gums and (2) crooked smiling.
Over time, I noticed that my gums were showing more and more when I laughed. And a few times when I took a trip down memory lane in my photos, I started to notice slight facial asymmetries that were not as pronounced a few years prior. I’ve always liked my smile but it was gradually morphing into something less ideal over time.

So then, I committed immediately, right?

Absolutely
…not.

Candidly, I was quite disappointed to learn that I fell in the metal braces camp instead of Invisalign. Braces are not inconspicuous at all. However, in fairness, I could have chosen Invisalign but a few high-quality consultations helped me understand why braces were the better path. After all, I wanted to achieve jaw surgery-like results without undergoing surgery itself so this is a fine compromise.

The other dilemma I wrestled with was that I did not want to look like a metal brace-faced teenager for two years at this age. How would people take me seriously from a professional, personal, and romantic sense? While it seemed like a reasonable trade-off to settle on braces instead of surgery, I instead conjured up fictitious scenarios of how I would be negatively perceived. In hindsight, it was not a big deal at all.

Actually, I would argue now that I probably chose the best time to start braces – old enough that my peers are no longer children who will tease me for looking different but young enough to reap the health improvements for decades to come. Isn’t mindset quite interesting?

Since I am only human, I naturally get influenced by societal constructs and expectations. For a few weeks, I had to remind myself that braces are only temporary. And that I was confident that it was the right decision towards bettering my health, which is the top priority.

To conclude, I started my braces journey in late 2022 and I look forward towards the end of 2023 or early 2024 when I can debut a healthier and more beautiful smile. Whether you are debating adult orthodontics or found my essay via the Internet rabbit hole, I hope my experience was helpful, or at the very least, interesting. Stay tuned for periodic updates!

My Takeaways:

Get opinions from both dentists and orthodontists.
Ask every question you have. I certainly did.
If you need extractions, make sure you clearly understand why. These are permanent teeth you are voluntarily removing.
Understand the financial investment. Although braces are pricey, that does not mean you should look for cheap shortcuts. Your teeth are not fast fashion.
Given the proliferation of easy data nowadays, don’t blindly trust medical advice from the Internet. Consult a professional.
And lastly, don’t forget to look forward to a better bite ♥

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