The bite is a complex system that includes teeth, gums, jaws, and facial muscles. A healthy bite has not just aesthetic impact but also health benefits, said orthodontist Sam Levine of Levine Orthodontics in Lexington. Crooked teeth and a bad bite can contribute to tooth decay, wearing of tooth enamel, and even headaches and jaw joint pain.

As braces become more comfortable to wear and better at repositioning teeth, Levine, 37, is seeing patients from ages 7 to 70, as more adults opt for orthodontic treatment. Rather than the metal-mouth look of a generation ago, new materials and other technological advances have made smaller, less obtrusive braces available.


What are the most common conditions that you see?

Overbite, overjet, and buck teeth are common, and more rarely, underbite. And hand-in-hand with these bite issues are crowded teeth, or when teeth twist and turn.

How has treatment advanced?

Braces have gone through a revolution. Braces used to be bands tightly attached with a ligature tie or wire around teeth, which caused a lot of pain and discomfort. But instead of pushing teeth as hard as you can, the concept now is low-force and low-friction, with a brace made up of sliding mechanisms which generate forces and gradually move the teeth over time.

There have been reports of younger and younger kids seeing the orthodontist. Are you experiencing this in your practice?

There is cultural pressure to have that perfect celebrity smile. The American Association of Orthodontists does recommend that initial evaluation should occur no later than age 7 or at the first signs of problems. But it's important to understand that starting treatment early doesn't necessarily mean finishing early.

Why did you choose to become an orthodontist?

I think of orthodontics as the ultimate mix of art and science. As an orthodontist, I'm able to have a long-term relationship with patients. As a kid, I was a tinkerer and liked to work with my hands a lot. And it helped that I had a really good dentist who inspired me.


What's the future of orthodontics?

Customization is a big step. We can take a tooth impression, make a 3-D model on the computer, then design a smile and create custom braces. Custom braces can reduce treatment time.

What's the record for someone losing a retainer?

One patient lost his retainer three times in the first month. We've had retainers that travel the world and get lost overseas, retainers put in the washing machine or dryer. Dogs love retainers — it's the most expensive dog toy you can buy.

Cindy Atoji Keene can be reached at cindy@cindyatoji.com.