Author Topic: Arguments for Removable Appliances (and against the rest)  (Read 1081 times)

Offline foobar

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Arguments for Removable Appliances (and against the rest)
« on: 13. January 2018, 20:16:14 PM »
tl;dr: I'm looking for arguments to convince my ortho to treat my minor issues with removable braces.

Long time reader (and enjoyer), but I just recently registered, because I'll have my first ever orthodontist appointment in 2 days. I'm 21 and finally got the courage to try getting braces (after at least 7 years). I'm more into removable appliances and while fantasizing about fixed appliances is a lot of fun, I don't actually want to get them.
Anyway, I have several minor issues with my teeth's position (you can really only see them if you look very closely), none enough to have been referred to an orthodontist. The main issue is a small gap (right <0.5mm, left <1mm) in my upper jaw between my cuspid and first bicuspid, in which meat or fish gets stuck literally every meal. The cuspids overlap the lateral incisors slightly, pushing them inwards slightly.
In the lower jaw, I have slight crowding in my incisors, which seemed to have gotten a little worse over the last 2 years while my lower wisdom teeth grew in (both without problems). Comparing radiographs from before my wisdom teeth started to grow in and a current one, both wisdom teeth moved forward about half a tooth while growing in. My dentist told me back when taking the first radiograph to see if there's enough space for my lower ones, that there isn't too much space and should they not start to become visible for another 3 months I should consult with a surgeon to get them removed (the upper ones had already finished growing in for over 3 years and have enough space). Both teeth did start growing in, though, and are now pretty much full-size. Additionally, my bottom left wisdom tooth is rotated outwards a bit and all 4 wisdom teeth are tilted outwards a little, making them not interlock correctly.
Moreover, my midline is shifted to the left on the lower jaw by ca. 1.5mm resulting in my left lower teeth not being in the middle between two upper teeth.

I'm also a heavy grinder and clencher, which wears down my teeth significantly (my dentist called me a "world champion grinder"). I clench so hard that the only filling I ever had broke in a matter of weeks (it was for a small tooth eriosion, so it's not needed). I do wear a guard every night.

All in all just very small things, which aren't really noticible, but annoy me slightly (especially the food getting stuck). Also I want a long wanted dream to come true ;)

As I said, I don't want any sort of fixed braces and preferrably removable plates or the similar. That's why I'm looking for arguments to convince my orthodontist to treat me with those. I also think that my upper jaw could be treated well with a removable plate. I'm not too sure on the lower front / regarding my wisdom teeth. I guess that the ortho wants to pull my wisdom teeth, which I don't really want. I don't have any problems with them, the upper have more than enough room, I don't know about the lowers though. (Also one of them has root which'll make it horrible to pull out).

Here is a list of arguments I currently have:

* No fixed braces because I have multiple large festivities this and next year, where I don't want to have braces.
* No invisalign (and similar) because of heavy clenching / grinding (the thin material might break).
* Removable plates can have an occlusal plane to prevent grinding similar to guards.
* Money

Offline Bracesluvr

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Re: Arguments for Removable Appliances (and against the rest)
« Reply #1 on: 14. January 2018, 21:40:35 PM »
Compliance, knowing you want this treatment plan makes you willing to comply with the type of treatment you want. If you’re paying for orthodontics you should get what you want as long as it is a realistic option. All dentist want patients that comply. Removable appliances mean you can change to different appliances as needed that follow your evolving treatment model. You need to follow through with required wearing schedules though. Put your money where your mouth is...literally
It could be more costly if you need a series of different appliances to achieve your goal
Good luck

Offline foobar

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Re: Arguments for Removable Appliances (and against the rest)
« Reply #2 on: 16. January 2018, 00:37:17 AM »
I was at the ortho today. First, he verified some of the small misalignments, but also found 2 other problems. Here's what he said to each "issue":
1. Upper Jaw Gaps between cuspid and premolar: He said that this is due to the cuspids being rotated to the front. It might be fixible, but he can't guarantee it. If they are fixed, he wants to stabilize the result with a permanent retainer glued on the first premolar and cuspid.
2. Upper Jaw lateral incisor slightly inward: He said that they are located perfectly, but in fact point backwards. So it should just be a bit of tipping. Easy to fix.
3. Lower Jaw slightly crowded incisors: It's slight and doesn't influence my occlusion se he would only tackle it if I wanted. And noone cares about the lower teeth anyway, especially because my lower lip covers them completely.
4. Midline shift: At its current 1.5-2mm the effort to change it wouldn't be worth it. In adults he only corrects midline shifts if it's larger than that or incluences the bite negatively, which is not the case for me.
* Wisdom Teeth: They have enough space and in fact didn't cause any movement in the lower incisors according to the radiographs. He doesn't want to touch them anyway.
5. My upper left central incisor is rotated towards the upper midline (in the roll axis).
6. The upper right teeth are longer than the upper left teeth. There is a height difference of more than 3mm between my left and right canine. This is also the case for the lateral incisor and for the first premolar, but with less difference.

He doesn't want to touch any tooth further than the canines, maybe the first premolar. This is due to my bite matching very well, which he doesn't want to interfere with.

His treatment options were either 1 year in brackets (normal, ceramic or lingual) or 30-40 weeks in invisalign. When I told him that I don't want brackets, he explained, that problem 6 can't be solved fully without fixed braces. But he accepted it and got into more details regarding invisalign. He said that I would need attachments at least on my left central insicor, but maybe on up to 4 of my social 6. For my lower jaw he suggested stripping to fix the slight crowding. Regarding bruxism / clenching he said that he never saw a patient working through their aligner in 2 weeks.

When I carefully asked him about the possibility of removable plates, he responded that he doesn't use them on adults, because most movements are not possible with them, especially not rotations and "pulling down teeth" as needed in my case.

Retention would be a permanent retainer between the first premolars in the upper jaw to keep the gap closed, and between the canines on the lower jaw. Additionally, I'd get removable plates, a kind, which I have not seen previously. They have clasps on the molars, but both the upper and lower plate have an occlusal bite plate over all teeth. The acrylic goes over the front teeth similar to a bruxism night guard. If only he knew that I'd nearly accept treatment for these plates alone  ;)

Total cost of treatment including retainers would cost 5500 to 7000€ with normal brackets or invisalign, which seems pretty high to me for such small problems and such a short treatment time. But who am I to judge, I don't have any reference prices.

Anyway, I definitely don't want fixed braces. I don't want anything that's visible at all when I attend important social festivities. I think most people here share the same feeling about invisalign. Additionally, I don't want visible attachments as discussed above.

So this is where I'm at. I don't want to go for any of these treatments, but I also don't want to give up yet. I'm thinking about calling them for a second consultation, where I explain that I don't want any of those treatment methods and that I read about inman aligners and if they would be an option.

What do you think? Should I go for it? Push my luck? I'm really unsure right now, because this was already quite a step for me with a rather negative result.

EDIT: At this point, should the title be changed and this thread moved to "Orthodontic Treatment"?

Offline besinger

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Re: Arguments for Removable Appliances (and against the rest)
« Reply #3 on: 02. March 2018, 19:56:54 PM »
...why you do not research an orthodontist who is more specialized on old school treatment types like removable retainer alike braces? just check for an other option!

Offline retained

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Re: Arguments for Removable Appliances (and against the rest)
« Reply #4 on: 03. March 2018, 08:13:27 AM »
So what about the on-line braces shop?