Braces and Self Esteem: Smile and Mental Health

By Melissa Hed

May 15, 2023

We all know how awkward the teenage years can be. Changing bodies, acne, moods, elevated expectations — it’s a lot to navigate. One small physical difference that sets you apart from your peers can feel catastrophic to a teenager, especially if those peers deem that difference ugly. Worse is when they tease you about it.

A patient who came in to see Dr. Philip D. Bomeli at Solon Orthodontics in Solon, Ohio was being teased by her peers because she had a high impacted canine tooth. The kids at school said it made her look like she had fangs. Because of their teasing, she became shy and self-conscious and she kept her teeth hidden so that no one would notice them. Can you imagine never seeing your child smile again?

Your Teenager’s Smile Is Important

Stating the obvious here: teeth are functionally important. We need them to help us consume the food that provides us with energy to live. But also, they’re aesthetically important. When we see a captivating smile, our minds automatically link to good oral health, hygiene, and self-care. Smiles convey warmth and acceptance. They’re beacons for connection and inclusion. A good smile can also influence whether an employer will hire you and, more importantly during the teen years, whether someone wants to approach you and be your friend. A good smile, in other words, is important beyond whether your teenager’s teeth are perfectly aligned.

Can a Better Smile Help Your Teenager’s Self Esteem?

Survey says … YES! Teeth can affect mental health. Dr. Bomeli shared that during his orthodontic residency, the patients he treated were part of a longitudinal study about whether there is a link between oral health and mental health. They wanted to see if changing a person’s appearance with orthodontia improved how they thought about themselves. Patients ranged in age from 11 to 14 years old, and they spanned the breadth from more involved treatments, like with cleft lip and palate patients, to more run-of-the-mill (such as patients with teeth that are crowded or spaced too far apart, or that have pronounced overbites or underbites), to a control group that received no orthodontic treatment at all. On all accounts, the patients surveyed reported improved self esteem and a greater quality of life. And, interestingly, the levels of satisfaction after treatment increased for patients that needed more orthodontic care. This is one reason why teens get braces.

Dr. Bomeli has seen those same results with the teenagers who come to his practice for treatment. “When patients first come to our office, they’re shy, they’re afraid to smile, and they don’t want to show people their teeth. But as their treatment progresses, we start to see a transformation. By the end of treatment, when they finally get their braces off, they’ve become more confident and their smiles are more radiant.” He says the difference between their pre and post treatment photos is remarkable. “The difference is night and day. It’s amazing!” Dr. Bomeli says.

Okay, But I’ve Heard Orthodontia Is Expensive. How Can We Afford This?

We want our children to smile. That’s been a parenting goal since day one. And if we can get them to smile during their moody teen years? Well, that’s gold star material right there. If your kid isn’t smiling because of a deformity, large or small, that can be fixed with orthodontic care, then maybe it’s time to see an orthodontist and see how they can help make your kid’s smile radiant again. According to Dr. Bomeli, you shouldn’t let the financial cost of treatment dissuade you. Here are his suggestions for managing the costs of orthodontic treatment:

• Check with your insurance.
• Check your dental plan.
• Check with Medicaid.
• Ask your orthodontist to write a letter explaining why orthodontic treatment is a medical necessity from a functional perspective.
• Ask your orthodontist to divide treatments into smaller steps so you can spread your payments over time.
• Ask your orthodontist if you can agree to a payment plan.

Is Orthodontic Care Really Worth the Investment?

For the patient who had an impacted tooth stuck in the roof of her mouth, orthodontia was a medical necessity. The canines are some of the most important teeth and misalignment impairs their function. If left untreated, that patient would have a problem down the road; teeth would get worn down prematurely, for example, and need extensive dental work, such as fillings and crowns.

Functional impact aside, let’s talk about the mental health impact of improving this girl’s smile. Dr. Bomeli says over the course of several months her demeanor improved with each appointment because she could see a little bit more of her tooth every time. Pretty soon, she said it didn’t look like a fang anymore and her face just lit right up. And, by the end of treatment a couple of years later, she was proudly displaying her beautiful smile to not only herself in the mirror but to her family and friends.

That girl’s treatment was somewhat unique, but Dr. Bomeli reports that even when treatment is elective, patients and their families report improvements to their quality of life that significantly outweigh the financial outlay when insurance won’t cover the cost of care. In a word, he says his patients are grateful.

Dr. Bomeli says, “People come back for retainer checks and they say, ‘Wow, I’m so glad I did this. I get so many compliments on my teeth, they look great. Thanks so much for what you’ve done for me.’ And it’s just a continued verification that, yeah, we’re doing some good stuff here.”