My dream(!) treatment would include multiple build up steps.
First of all it starts with ceramic brackets on top and metal on bottom. I'm told that later in the progress I would need expanders, elastics and - if they won't do their job - headgear. To protect my bottom braces biteturbos are added on two of my upper teeth.
On the next appointment the Ortho finds out I bit off the biteturbos and didn't come in to get this fixed. I get them back on and I have to wear elastics from the upper front to the lower molars. One on each side for 24/7. Pretty simple but irritating.
Four weeks later two of my bottom brackets are loose since i bit them off, along with the bite turbos. Despite I tell the Ortho otherwise, I didn't wear my elastics for 24/7 - not even close. My Ortho gets slightly mad and tells me that this is my very last chance to cooperate otherwise my treatments gets a nasty twist regarding the necessary devices.
Of course I won't change any of my behaviour which results in an extented appointment the next time I come in: Since my lower brackets broke off so often I get fully bands on all my lower teeth. To further prevent me from biting them off, I get a fixed biteplate on top. Heavier elastics are added and I'm free to go.
On the next appaointment I receive the upper and lower expanders which are completly covered in plastic. They look like hawley retainers and in addition to the biteplate I have a significant lisp.
To make this worse on the following appointment my Ortho detects a tongue thrust caused by the biteplate. But instead of removing the plate the upper expander will be modified. While the lab works on the expander, my upper ceramic brackets are exchanged to full bands with huge brackets. The new upper expander consists of a thick acrylic plate with a screw and integrated biteplate. To prevent my tongue from pushing the inner side of the biteplate have spikes. Two more elastics are added and that's it.
This is my setup for the next 1,5 years before the combi headgear is added for 20 hours a day and a lipbumper on bottom. This is for another year - given that I wear my headgear and lipbumper as prescribed.
After 3 years the headgear and lipbumper are removed and I have to wear zigzag elastics which don't allow me to open my mouth any further than a few millimeters for half a year.
On removal day my Ortho gives me a permanent retainer on top and bottom and Hawleys for 1 year 24/7. Afterwards Hawleys for 8 hours and clear retainers for at least another 8. If I fail to wear them and my teeth shifts back, everything from before will come back on immediatly to stay there for a minimum of 1 year.
