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Brace yourself
BY ROGER ANDERSON
Journal Times
It turns out the tooth fairy looks out for adults, too.
He goes by a different name - Dr. Dwight Damon - and instead of leaving a few goodies under your pillow, he delivers straighter smiles with less pain and in less time.
About 10 years ago, Damon converted an idea everyone knew about into a product that everyone could use.
"It takes very little force to move a tooth. But with conventional braces, which is pretty much 70-year-old technology, there was so much friction in the system between the braces and the wires that we were using, that we had to use very heavy forces to overcome that friction."
Damon System braces operate under unique guidelines. The reduction of friction is achieved by self-ligating, or self-binding, braces that eliminate the need for elastics and use shape-memory wires to move teeth.
in 1986.
"What's really amazing is to see adult teeth move as if they were teenagers again," Chu said. "Teenagers are at the optimal age for orthodontics. They're getting great metabolism and they're healthy and they're growing still, so everything is set to go, and when we're moving teeth everything just responds naturally, and with adults it seems like we're getting a very similar kind of response."
For Chu, the decision to change from standardized braces to the Damon System was as easy as brushing after meals.
Chu started using the new bracketing system when it first became available a decade ago. After putting Damon System braces on 20 patients and seeing the results, he decided to completely switch over to the Damon System.
The complete switch is one that Lenz made five years ago, after first running a mini-test in his office to gauge patient pain with the system.
"In our study what we did was asked patients, on a scale of one-to-10, their pain level. And most patients were between a 1.5 and a two, and no one was above a four. And with conventional braces we were up in the six-to-10 range in a lot of patients."
Traditional orthodontic brackets require elastomeric rings that tie the arch wire into the bracket slot, according to Conlon Orthodontics Ltd. in McHenry, Ill. These ties actually inhibit tooth movement with friction and require higher forces to overcome the friction at each bracket.
The reason there is less pain using the Damon System is because there is less force being exerted onto the teeth. The wiring between the braces is able to flow and tighten in a continuous manner. So instead of painful appointments to have braces tightened, patients return to have the wire replaced. The continuous motion also allows the time between visits, which with conventional braces can be every four to six weeks, to be extended to 10 weeks.
"Forty-five to 60-year-old adults grew up with a certain perception of orthodontic treatment," Lenz said. "They grew up with the perception of braces being large and unsightly, not real attractive. They have the perception that it takes many, many years to have their teeth straightened. They grew up with the idea of having their braces tightened, and a lot of soreness and pain and extractions of teeth and wearing funny things like headgear ¦ that was kind of the stigma of having braces.
"It's a completely different ballgame today. The braces are small and aesthetic. They're very comfortable inside the mouth. They're not these big, bulky, clunky appliances that they used to be in the past."
And for adult patients, which Lenz says makes up about 30 percent of his client base, the differences are immediately recognized.
"I didn't even know half the time that I had the braces on," said Donnell Kastenson, 35, a patient of Lenz'. Kastenson first had braces when she was 12, and used Damon System braces from April 2005 until October of last year.
"My niece got (traditional) braces at the same time I got mine and she was telling me how painful it was, but it wasn't at all."
In conventional methods using ligature ties and bent wires, doctors are continually bending the wire throughout treatment, which in effect creates concentrations of force in the mouth, which can actually thicken the bone around the teeth, Chu said. The thickened bone then slows down the movement of the teeth and requires more force to break through it.
"The biggest difference is the size of the wire we start with. The first wire we use is 14,000th of an inch in diameter. It's really thin and it's made out of super-elastic nickel-titanium," Chu said of the system. "With zero friction, it's able to start stimulating the metabolic activity in the ligaments surrounding the roots of the teeth. That's what gets the whole system moving."
The orthodontists aren't just using the Damon System braces to give people pretty smiles.
Cathy Dehling, 40, wears the Damon System braces to help alleviate pain in the temporomandibular joint, the complicated joint that enables the jaw to open and close.
"(The system) seems to move constantly so your teeth are not being pulled a lot, the bands kind of move around," Dehling said. "After the first day I thought maybe I made a mistake, because there was a lot of pain. But after I got used to just having the braces on ¦ then it was fine. I've had them adjusted about three or four times and generally its been sore for maybe a few hours and then I don't really notice it after that."
The changes in the technology have altered the way orthodontists handle adult patients.
"It's really making a big impact with adult treatment," Chu said. "We can move adult teeth a lot further than we could before. We used to typically have to recommend orthodontic surgery for adults, a repositioning of the jaw, but because we can move teeth so much more effectively now we don't have to recommend surgical orthodontics as frequently."
The system's developer, Dr. Dwight Damon, is working on a planned fourth edition of the system at his Spokane, Wash., office, but Lenz said the system is the future of adult orthodontics.
"The mouth is the most expressive part of the body," he said. "And whether you're conscious of it, or subconsciously, when you're communicating with somebody, that's where you're focused, right on their mouth."
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