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Author Topic: New Normal  (Read 1941 times)

Offline TrainTrack

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New Normal
« on: 03. November 2022, 04:37:43 AM »
I borrowed this topic form duncombec’s Guy’s with Braces forum. Imagine you got to choose a new normal for what people would think when they heard the word braces.

Currently, that would be right around 2 years of braces with elastics and Essix retainers when treatment is over. It is performed on 12 or so year olds.

If you could make a new normal, what would it include? How long would it take? What would the standard age for this? Go all out! Be creative!

Offline TrainTrack

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Re: New Normal
« Reply #1 on: 03. November 2022, 05:30:55 AM »
As an example to get this started:
Braces are put on for an average of 4 years at age 16-17 while parents can still be there. There are large brackets on the social six, the only teeth not banded. Generally, you will have an activator/Bionator beforehand at age 10ish and to retain that there is a permanent retainer. Orthodontists will use any colored ligatures they want, and are known to use embarrassing colors. Headgear is often used, with 16-18 hour minimum. At most orthodontists, adjustments are made every 3-4 weeks. To retain that, you are given Hawleys to be worn full time for two years.

When they get the braces, you are subjected to an audio/eye exam. If you score below 75% on either, you get subjected to hearing aids and/or glasses.

This is just an example, you can do whatever you want.

Offline Tin_Grin8444

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Re: New Normal
« Reply #2 on: 03. November 2022, 08:03:14 AM »
Ooh I like this!

I'd start by making braces as a whole a lot less common. Reserved particularly for those who have a great need for it, but aren't excited about it at all, and those who may not need them as badly, but seem to want them in an almost strange way.

I'd make it uncommon just enough so that when someone DOES have them, people notice. People talk, and that person becomes "that one with braces". You're instantly the metal mouth of the crowd.

In terms of the metal itself, full bands are used in conjunction with garishly bright colors chosen by the patient. They'll have a say in what colors they get to sport, but all the options will be bright and eye catching. In addition to full bands, every patient gets a bulky tongue crib that's continually adjusted to maintain a patient's lisp, with the idea that tongue thrust is such a serious concern for how it can distort the bite once braces are installed, it's better to prevent it outright with a tongue crib cemented to the molars for the duration of treatment.

Upon the very first appointment, before bands are cemented, the patients vision is tested. Even if their eyes are fine, prescription glasses are assigned and made to be worn. Don't worry, their eyes will adjust.

What's more, everyone who has to go through the ordeal of "becoming a braceface" knows that headgear is inevitable. After all, it supposedly moves teeth faster, and even if you dont have an overbite that's THAT bad, they'll just use the lowest traction possible and use the Anchorage to stabilize the movement of teeth. Once it's your time to get headgear, you know it's going to either be worn 12-18 hours, or the orthodontist might just up and decide to wire it in. It's a coinflip's chance. Everyone knows they'll end up getting headgear, but no one ever knows when. It could be at your first appointment, it could be after 3 years of braces, but you'll never know until that appointment where without warning they're placing the facebow into your mouth.

Being a braceface would be an ever present atmosphere that follows you, marks you, and you're stuck like that for as long as it takes.

Offline jay82

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Re: New Normal
« Reply #3 on: 03. November 2022, 17:14:39 PM »
In my "new normal" braces would be more common, with almost everyone getting braces at some point.  People would get braces as adults, with most beginning treatment sometime between their late teens and mid twenties, but some would get braces even later than that.  Treatment times would be longer, with two and a half years being the average, and as long as four years not being uncommon.  Most people would get braces only once, but it would not be unusual for someone to go through it twice or even three times.

As for the braces themselves, they would be all metal, no clear brackets or aligners, certainly nothing like Invisalign.  Everyone would have large double tie-wing brackets, and about one in five would have all metal bands.  Even the ties and ligatures would be all metal wire, no rubber O-rings or power chains.  Most people would require headgear twelve to sixteen hours a day, so it would be common for people to wear headgear away from home, while at work or shopping for groceries, etc.  Other orthodontic accessories such as elastics, tongue spurs, and expanders would be common, and most people would have at least one of those, in addition to headgear.  The really bulky and cumbersome appliances that make it nearly impossible to speak clearly would be very rare.

There would be no stigma or embarrassment associated with getting braces.  It would just be one of those things that almost everyone goes through, like wearing eyeglasses.

Offline braces37

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Re: New Normal
« Reply #4 on: 05. November 2022, 09:06:39 AM »
I really like your idea jay82. Particularly about braces being completely normalized. The stigma around braces has certainly decreased in the past couple decades, but there's definitely a ways to go.

Offline TrainTrack

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Re: New Normal
« Reply #5 on: 05. November 2022, 18:18:22 PM »
@braces37 what’s your new normal for braces?

Offline Bryce

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Re: New Normal
« Reply #6 on: 08. November 2022, 00:54:07 AM »
I think a new normal would everyone has to go to a dentist, and the dentist decides if you're getting orthodontics or not.  So you go to the dentist like normal for year, you start to think nothing of it then one day you go and walk out with metal braces and whatever appliances you require.  They didn't need to explain the treatment, you just got what they believed you needed when you needed it.

Clear braces or Invisalign don't exist, and it's a pretty sure bet that they will choose the non-compliance version of treatment, such as getting springs installed instead of getting to use elastics.  Most treatment would be slow to ensure proper treatment.  The orthodontist usually did metal ties but if you got lucky and got colored ligeratures, the color would be picked for you.  Same color rule applies to if you got headgear or a facemask.  Whatever appliances you were given, you had to wear leaving the orthodontist office, and put on before you entered.

Offline m1090y

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Re: New Normal
« Reply #7 on: 08. November 2022, 11:14:44 AM »
In my new normal, Invisalign is far too expensive for most patients.  Costs of installing brackets have come way down so a technician does it in about ten minutes.  The mouth is scanned as with Invisalign and this allows the dentist, yes – not an orthodontist, to drag each tooth to the desired position on the monitor.  A custom tray is created as is used with teeth-whitening kits the dentist sends home with patients.  The tray is used to quickly apply etching compound to upper and lower arches in less than a minute.  The computer has created an installation arch with all the brackets perfectly placed on it to get the final result.  The installation arch is like a large plastic inner arch of a face now.  Brackets have inactive adhesive already on the tooth side of the bracket and it is activated as it touches the etching material, which then reacts to form part of the adhesive.  The installation arch releases all the brackets, UV light cures the glue and the mouth is rinsed of excess etching material.  Molar bands are standard with three tubes and a hook, with possibly an expander being installed if necessary.  Bands are installed on second molars more traditionally with spacers but have the inactive adhesive that reacts with etching compound.  Brackets have sliders for arch wire installation.  There are no more donuts and power chains are created with ligature wire when needed.

After ten minutes and less cost in hardware than a decent restaurant meal with drinks, a patient has two arches of braces installed along with molar bands.  Ceramic brackets are still an option; however arch wires are always steel.  There are no tooth coloured arch wires.  Acrylic appliances are created with an automated system in which lab technicians are given schematics of how the wires are formed in 3-D printed molds of the arch and then acrylic is 3-D printed into the molds by the computer.  This works for bite plates, retainers and even twin blocks.

Face bows are pretty much as before, but traction systems have been updated.  A pad has release modules, but instead of flexible strips with multiple holes in them, coming out of the release modules, additional bars just like the face bow is made of, come out of the release modules and form a triangle where they hook onto the face bow.  Face bows have outer bars that are varying in length so that where the bars from the release modules connect; they cause the correct line of force to be applied.

With bracket installation being so cheap, re-treatment for a relapse is more akin to someone whitening their teeth every six months or so.  Retainers are restricted to Hawley.  Essex retainers can't be created as cheaply.  Bonded retainers are too expensive to install so seldom used.  Just to keep costs down, molar bands are seldom removed if headgear was ever used, or if it may be in a future treatment.  As a re-treatment starts, the patient may be instructed to wear their old headgear for a while, or perhaps a lot, if it was not worn enough in the previous treatment.  All-day wear of headgear is quite common, even in adults, however it is often only required for a month or so, and this sometimes happens between treatments.  Patients that had ceramic brackets for one treatment, often decide to go to all steel on subsequent treatments.

Offline duncombec

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Re: New Normal
« Reply #8 on: 08. November 2022, 23:50:35 PM »
I borrowed this topic form duncombec’s Guy’s with Braces forum. [...]

Thanks for feeling inspired enough by it to copy it here as well! (And for posting your response in both places!) I kept my initial thoughts very simple, but I like the ideas posted here - I see m1090y and I have already had the same idea about surcharges for some of the more "cosmetically orientated" types.

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My new normal would be 4 years of metal brackets, usually fitted late teens (17 or 18). Ceramics would still be around, but with a heavy surcharge so they got a sort of 'too posh for metal' stigma. Hawley retainers for at least a year full time would be standard.

Headgear would be used, with minimum wear times of 14-16 hours a day. Not excessive outside wear, but quite difficult for anyone who got it to never be seen with it in public at least occasionally.

My most common second-grade additions would be every bracket having an elastic hook (including the front incisors), and additional molars being banded.

Offline radian

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Re: New Normal
« Reply #9 on: 09. November 2022, 17:59:37 PM »
First, My New normal would not be a normalisation of adult braces because I like the idea that having braces as an adult is not common and is a result of the brave decision to overcome the embarrassement.

So I would let the teenagers to be the usual 2 years metal braces wearer (ceramic or Invisalign becoming far too expensive for 95 % of the population)

But I'd like a new kind of orthodontic treatment be created, not only to straighten teeth, but also to avoid strong medical issues (back and head aches, dental loosening) appearing suddenly at any age of adult life on 4-5 % of western population (majority of women), whether if they had braces before of not. This would be the only way to treat the symptoms and persons concerned would have no real choice to avoid the treatment (except those who accept to lose their teeth and bear the growing pain).

This treatment would be with low force (to avoid complications) metal braces (or ceramic if you're very rich), molar bands, upper and lower metal expanders, herbst appliance and sometimes, for the unluckiest ones, tongue cribs and or highpull headgear to be worn at least 16 hours a day for the half part of the treatment (and would be fixed 24/7 for those who do not respect the wearing time). Due to the low force, the treatment would last from 4 to 8-10 years on average and could be endless, even for life, for the worst case (lifetime for 1 % of treated patients).

These persons would be added to adults who voluntarely wear braces like nowadays, so you would not know if an adult wear braces because he wants or he has to.


Offline panda777

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Re: New Normal
« Reply #10 on: 11. November 2022, 09:41:03 AM »
My new normal would have the government provide comprehensive dental care to all citizens free of charge. This is done in large "dental hospitals" located in every city. Dentistry is traditionally an almost entirely female profession, and staff are renowned for being gentle and caring, and tend to wear colorful banded braces as part of their uniforms. Restraints on the chair are common, but usually not mandatory. Orthodontics is usually done similar to how they are now, but with high-quality invisible braces.

The only catch is that all treatment is mandatory, with citizens needing to get cleanings and check-ups at least twice a year. If a patient is late for appointments or appears to be neglecting their oral hygiene, they will often be subjected to unnecessary orthodontic treatment as humiliation. This can be anything from metal full bands to bulky wired-in headgear.

The nature and duration of the treatment is fully at the dentist's discretion. This is done with no warning, and could potentially happen at any appointment. When asked, dental staff will deny it being done as a disciplinary measure, softly saying the braces are an unfortunate necessity.

Patient non-compliance is so vaguely defined, dentists are allowed to do this to virtually any patient. This has lead to some odd instances of bias and discrimination, with transgender women in particular being several times more likely to receive these treatments than the average patient.

Offline nyar

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Re: New Normal
« Reply #11 on: 11. November 2022, 12:34:08 PM »
The treatment would begin during the junior year in high school at the earliest, preferably either the senior year or the freshman year in college.
At least four molar bands are mandatory, preferably eight. Only metal brackets are used.
Extractions are not allowed: expanders will have to be used, and will stay in place for the entire duration of the treatment.
Underbites are strictly treated with reverse pull headgear; overbites can be treated with headgear, forsus or herbst appliances depending on the case (sometimes more than one appliance is used in one treatment, if the other didn't work well enough).
Minimum treatment length is 36 months.