Richelle Mahar of East Greenbush is smiling more now.

This wasn't the case a little more than a year ago. As she aged and her jaw settled, her teeth began to crowd. But when she started biting the side of her cheek when chewing food, she knew her bite was off. Instead of just driving her daughters to their orthodontist, Dr. Brendan Cooney.in Troy, she decided she needed to spend some serious time in Cooney's treatment chair.

Mahar is just one of a million U.S. adults who get braces annually. In the past 20 years, according to the American Association of Orthodontics, about 25 percent of all orthodontic patients have been adult, with women outnumbering men approximately three to one. Most adults brace their teeth because of aesthetics, but others are beginning to understand that straight teeth and a perfect bite keep teeth problems -- decay, bone loss and periodontal disease leading to teeth loss, caps, bridges, implants, dentures -- at bay.

"It's gratifying to work with adults," Cooney says. "Braces make life-altering changes, and adults are very motivated to make those changes happen, as quickly as possible."

Orthodontists decide -- along with the patient -- which type of brace to use. Factors that come into play include:

-- the severity of the teeth and bite problems;

-- if surgery is required before or during orthodontic treatment;

-- the amount of time treatment will take;

-- how disciplined the patient is; and

-- how much the patient can afford. Typical treatments cost between $5,000 and $6,500.

Orthodontists emphasize the importance of free consultations to discuss treatment options. And since you'll be spending a year to 2-1/2 years in treatment, the patient should feel comfortable with the doctor, and able to ask questions. New products and treatment methods mean fewer sore mouths and spread-out office visits, terrific for busy adults juggling life's demands.

"Don't miss the opportunity to at least investigate what can be done for your teeth and your bite," says orthodontist Dr. Marianne DiCerbo, who has offices in Albany, Delmar and Latham. "Never underestimate the beauty of a healthy smile."

The main types of braces are metal, aesthetics (ceramic and saffire) and Invisalign. Another type, lingual, sounds good in theory: braces are secured to the backs of teeth. But there are issues, primarily cut tongues and speech problems -- reasons enough for many adults to discount linguals.

Metal braces are the least expensive, and the "favorite" of kids and teens. Thanks to science and technology, the days of full metal bands encircling each tooth are long gone.

Small metal brackets are attached to each tooth with special cement. All brackets have slots, into which arch wires slip. At each appointment, the orthodontist makes adjustments to slowly move the teeth into alignment. Small O rings -- available in lots of colors -- hold arch wires to brackets.

Some adults avoid metal braces because, well ... you can see them. That didn't bother Patti Bette, 44, of Delmar. "I wanted to do Invisalign, but Dr. DiCerbo explained that they wouldn't work for me," she says. "Once I had the braces on, I never felt self-conscious. I was happy I had the opportunity to get braces."

Bette decided to get braces because her dentist told her she would probably develop temporomandibular joint disease (TMJ). "As I got older, my teeth in front were straight, but they just started to go backward. My dentist told me the teeth would continue to shift more, and I would have problems with my bite." Brace-free since March, Bette wears her retainer as often as she can, and is so happy she spent 18 months in braces. "When the braces came off, all I could say was 'Wow.'"

The principle behind aesthetic braces is similar to metal braces: brackets and wires. Ceramic brackets are tooth-colored and made of strong composite material. Inspire brackets are made of translucent monocrystalline saffire, which makes them virtually invisible. Brackets do not stain; although the O rings -- often white or clear -- can, they are changed at every adjustment. Both are as effective as metal, but cost a few hundred dollars more.

Susan Scherer of Voorheesville decided to give herself a 50th birthday present: braces. She decided on metal on the bottom, ceramic on top, and got braces because her bottom teeth were crossed and out of alignment, which meant she would eventually face some serious dental issues.

Scherer's case turned out to be a bit more technical. When the braces were attached, DiCerbo realized that because of her bite, the top braces would knock the bottom ones off. "I had turbos glued on to the back of my two front teeth, which suspended my bite so my teeth didn't touch," she remembers.

She could not chew, which meant she ate lots of pureed foods and oatmeal. She also lost 15 pounds. "I thought to myself, 'How great is this! I get to have straight teeth and lose weight."

Many orthodontists say Invisalign has revolutionized their field. Invisalign treatment consists of wearing a series of aligners, each one manufactured to gradually shift teeth into place. The aligners are similar to bleaching trays, except that they are clear. An orthodontist decides the course of treatment for the patient, and the trays -- which can be as few as 10 or as many as 40, depending on the severity of the case -- are computer-fabricated by Invisalign's manufacturer. The patient begins treatment with the first set of trays. About every two weeks, the patient returns to the orthodontist for the next tray.

The downside: Patients must wear these removable trays from 22 to 23 hours a day. "The longer patients wear their Invisalign, the quicker and the better the results," Cooney says.

Patients must remove Invisalign to eat and brush their teeth. They can drink clear beverages, but anything with color is a no-no, unless it is during a meal. So people who drink coffee or tea throughout the day need to drastically cut back on drinking, give it up, or chose another brace.

And one more thing: Sometimes after Invisalign treatment ends, orthodontists might put metal or ceramic braces on their patients for a few months, to refine the teeth and make them perfectly straight.

When we spoke with Mahar, she had one more set of Invisalign trays to go, but already was receiving compliments. "Before I had braces, I would try to hide the bottom of my teeth," she says. "My smile is bigger and more pronounced now. I really put it out there."

Of course, treatment doesn't end when the braces come off. There's also the issue of retainers!

"I tell my patients that when their hair is gray and their face wrinkled, they still have to wear their retainer," Cooney says. "Popping your retainer in at night must become a habit, like brushing and flossing your teeth before bed."

If patients put on their retainers and they feel tight, that's the first clue a trip back to the orthodontist is in order. For those treated with Invisalign, patients can resume treatment with their old set, prompting some orthodontists to call this method "forever braces."

Still on the fence? Remember Scherer's weight loss? It might happen to you. Since food gets caught in metal, aesthetic and lingual braces -- and you can't eat while wearing Invisalign -- patients tend to skip snacks and eat only during meal time. That's truly food for thought!