Contemporary Orthodontics & Dentofacial Orthopedics

James R. Waters, DDS, MSD, PA

Board Certified Treatment for Children, Teens and Adults

Braces to Improve Self Esteem

There have been many studies to demonstrate and quantify the benefits of correcting any number of malocclusion. We may correct crowded teeth to improve alignment and allow teeth to be cleaned better; we can close the teeth together better in some cases to improve a patient’s ability to chew food and we can close gaps that would otherwise trap food and lead to periodontal bone loss (gum disease) which eventually can lead to loss of teeth. We can correct poorly fitting teeth and even jaw positions for better function to prevent excessive wear/fracture of teeth and we can improve joint function and prevent future TMD or chronic joint pain (sometimes accompanied by chronic headaches). And of course we can provide a beautiful smile.

What we normally do not stress is the psychological effects on children (and adults) when their smiles are transformed from something they normally hide to something they want to show off. It’s not always “polite” to discuss behavior and self-esteem with the parents and patients due to unsightly teeth; after 20 years in dentistry I have learned that some parents (not all) do not appreciate you pushing your view of “beauty” onto their perfect children and I understand this view. And in most cases the function is so bad in these cases that we can focus on the more acceptable reasons to treat knowing secretly that we also get to provide a great smile that will change that patient’s life in many more ways.

Imagine the following person walks into a general physician’s office:

By all accounts a healthy young lady however your eye is immediately drawn to a cleft in her nose. The physician determines no medical problems but should he mention the cleft nose if he feels it can be “corrected”? Should he bring attention to such a minor issue on an otherwise beautiful young lady? Without answering this, now look at the picture of this same young lady:

I don’t think anyone will miss the new look with a corrected nose. I am guessing this young lady is quite happy that her physician did send her to the appropriate specialist to have the correction performed (see side-by-side comparison below).

Similarly, we can relate this to our smiles. Consider the pictures of the teen below:

At 15 years old, this patient is shy and withdrawn, she is not happy with her smile and rarely shows her teeth when smiling. If you look closely, you will even notice that her two lateral incisors (the teeth next to the upper front teeth) are actually missing as well. Braces were placed to correct alignment and correct her underbite as we opened space for the missing teeth to be replaced:

At about 12 months into treatment

Once space was made available, artificial teeth were placed onto the wire with braces until treatment was completed. Once completed, artificial teeth were made into the retainer so that the patient would have a full smile until implants could be placed.

But for the purpose if this discussion, focus instead on the before and after facial pictures below:

Notice now following the correction how her entire face is smiling, revealing her new, improved and beautiful smile; look at her overall appearance with hair well-kept and made up. There was no scheduled picture for the patient to prepare herself, it is a genuine representation in her over-all appearance reflecting a new personality full of self-esteem and a contagious positive energy.

As an Orthodontist for 15 years and a dentist for 20 years, I can tell you this is a very common and happy occurrence I have seen hundreds of times over and most Orthodontists will tell you that it is the greatest part of what we do for our patients. In fact, there have been considerable efforts to quantify these self-esteem and self-image changes in the literature using well established psychological testing during and after treatment. It should be no surprise to anyone that one’s appearance greatly affects self-esteem and confidence not only with one’s peers but also when looking for jobs (some scientific papers have even demonstrated that the appearance of one’s teeth reflects on judgements of intelligence which is of course nonsense). Even Hollywood has this tendency to cast characters of poor intelligence and/or ill manner with actors showing poor dental alignment (I immediately think of the Harry Potter series with multiple characters seen as dim due to their facial pattern or dental malocclusion. Read enough novels and you will even see dental malocclusions described in detail to describe unsavory stereotypical characteristics. In the art world this was also very common throughout the 18^th and 19^th century genere scenes with the handsome hero with broad smile and the dim witted bar figures or sinister characters with gnarly teeth and a bump on their nose. There was even an entire science (Physiognomy) devoted to correlating facial appearance to temperament and intelligence prior to modern science which led to (and reflected) many incorrect and hurtful stereotypes.

We may not admit it, but we are a society that can’t help but judge ourselves on appearance and this translates to our children and their peers. For better or for worse, this is mirrored in films, literature and modern culture.

Luckily today, it is a relatively easy fix so we accept it and we work to correct our smiles with braces (or aligners in more mild cases). The positive side effect is that we get healthier and longer-lasting smiles; heathier joints and significantly less damage/wear to our teeth. Perhaps in this case, vanity may be a good driving force to correct problems that otherwise may go untreated.

Regardless, setting the faults of our society and culture aside, braces can and do help self-esteem. Straight teeth are a sign of beauty and even though a smile won’t guarantee a successful future full of job-offers, long walks on the beach with a beautiful partner or happiness in general, the confidence a smile provides certainly can help!

If you have questions or comments concerning this or any orthodontic question, please feel free to make a complimentary new-patient appointment at either my Steiner Ranch location or my North-central Austin location on West 35^th street and MoPac.

Dr. James R. Waters is a 1996 graduate from UTHSC Dental School in San Antonio, 1997 graduate of Advanced Dentistry from the UNMC in Nebraska and the 2001 Valedictorian graduate from the prestigious Saint Louis University Orthodontic Program receiving the J.P. Marshall award for clinical excellence in 2001. He holds a Bachelor’s Degree in Science, Doctorate in Dental Surgery, a post-doctorate certificate in Advanced Dentistry, post-doctorate Degree in Orthodontics & Dentofacial Orthopedics and a Master of Science Degree in Orthodontics. Dr. Waters and his wife of 20 years live in Austin, TX with their 4 children where he has a thriving, multi-faceted Specialist practice with locations in Steiner Ranch and North-Central Austin. You can learn more about Dr. Waters at BracesAustin.com.

Central Austin

1814 W. 35^th Street

Austin, TX 78703