September-October 2014 | ORAL REPORT

Dr. Michael TilghmanORAL REPORT



Dr. Michael Tilghman answers readers’ questions about state-of-the-art orthodontics

Written By: Nick Brandi | Photographer: Grant L. Gursky

If you look around, you can’t help but notice that there seems to be a dramatic increase in the number of adults wearing braces these days. We were wondering why, so we decided to ask Dr. Michael Tilghman of Tilghman Orthodontics, to gain some insight as to the underlying causes of this trend and to see if perhaps we should be thinking along these lines, as well.

Q: Dr. Tilghman, is it our imagination, or are there more adults than ever wearing some form of braces? 
A: No, it’s true. According to the American Association of Orthodontists, the number of adults wearing braces has increased almost 15 percent since 2010. In fact, adults now make up an unprecedented 25 percent of all orthodontic patients nationwide.

Why the sudden increase?
Several reasons, actually. One is for purely cosmetic reasons. Many people are self-conscious about things like crooked teeth, and they’re realizing now that adult orthodontic treatment can eliminate those concerns in a relatively brief period of time. Another reason has to do with the need to make room for things such as dental implants and bridges. I often get patients referred to me by other dentists for this very reason.

Are there multiple approaches to straightening the teeth of adults?
Definitely. The options for straightening adults’ teeth include traditional metal braces, clear braces and Invisalign®. There is also a variety of ways to retain a correction, such as permanent retainers that are actually bonded right to the teeth.

Can orthodontics help resolve or relieve TMJ?
As a matter of fact, yes. As you may recall, TMJ is a muscle-related condition that can cause painful chewing, earaches, shoulder pain and facial swelling, as well as other unpleasant symptoms. We have some very effective techniques to deal with this problem, which include special jaw exercises, muscle relaxers, massage therapy and custom-made night guards. In some cases, trained providers will even use Botox to treat TMJ.

Another rapidly growing area of orthodontic medicine is in the treatment of sleep apnea, a common, chronic disorder in which one experiences interruptions in respiration during sleep. This disruption of sleep during the REM stage can be especially deleterious, causing not only daytime fatigue but also more serious health issues, including high blood pressure, weight gain, stroke and depression. People with severe sleep disruptions also tend to look older and recover from injury more slowly, as a good night’s sleep is essential to the healing process.

How are you able to help them?
I work with their primary care physicians, pulmonologists or sleep centers to create custom-designed appliances that keep the lower jaw forward during sleep.* These appliances not only provide extremely welcome relief but are also affordable and usually covered by health insurance.

Is there an upper age limit for the adults who may want to seek out orthodontic treatment?
If there is, I haven’t found it yet. I routinely treat patients who are in their 70s and 80s. Ultimately, though, I think it’s important to keep in mind that orthodontics is more than just braces. Proper alignment of one’s teeth, bite and jaw is an important factor in one’s overall good health, so paying attention to the warning signs and getting an orthodontic evaluation is a really good idea.

*Dr. Tilghman is the only member of the American Academy of Dental Sleep Medicine serving the Salisbury–Berlin area.



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