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Last Thursday I had an appointment to check my progress, since I had emailed the office with some questions about the progress I should be seeing. The rectangular wire I had should have been tipping my teeth out a little, but it felt like they were tipping in, I think because the torque of the brackets is incorrect.

To orthodontist had the assistant take out my archwire and then he looked at my teeth and brackets, and even looked at loose high torque and low torque brackets to try to compare them. He didn't comment on my progress, and said he still thinks I have the correct high torque brackets on .

Even with that, he decided to have the assistant place a "SET" wire, which is a rectangular wire that has a twist in it to put torque on the incisors separate/in addition to what the bracket slot will do by itself. The assistant had to use some force to get the wire into the brackets and close the doors.

I mentioned that my left first bicuspid was hitting early when I bite down. The ortho put a bend in the wire just before that tooth to raise it up a little to help with that. I think it was hitting because the bicuspid had tipped out a little. That bend hasn't stopped that tooth from hitting early yet, but it did make it extra sore for a couple days, which in a way was even worse, since I've still been occasionally hitting it unexpectedly! The extra soreness is gone now, but that tooth still hits early, so I've been trying to be careful when chewing.

The assistant didn't ask me anything about changing the colored ligatures (that are around the base of the brackets, behind the wire) and she didn't remove the blue I already had. This is fine with me, since they kept my already scheduled appointment in four weeks (normally eight weeks apart), and I had already been thinking about getting colors at my next couple appointments that coordinate with what would be happening between those appointments, and changing the timing of appointments would mean I'd have to rethink that.

After the orthodontist had left and the assistant had placed the wire and closed all the bracket doors, the assistant and I looked at the loose high- and low-torque brackets and, because I had brought my camera with a lens and extension tube so I can take close-up photos, I took photos of the loose brackets for the sake of comparison. I remained convinced I have the wrong brackets on. The assistant said something about the angle that the doors are at when open, but she also said wasn't crazy for thinking I was seeing what I am seeing. She said she thinks I have the correct brackets, too, but it sounded like she was looking at how the wire sat in the bracket slot, rather than the shape of the bracket itself. She also said that she thinks the SET wire will take care of it. I tried to explain what I was looking at, but I'm not sure how well I did.

The assistant did say she would talk to the ortho about and put in my notes the idea of replacing the four incisor brackets when they remove the other brackets to place the Carriere appliance, as something to help me feel reassured and not worry about it during the rest of my treatment.

A later day, looking at the photos I took of the loose brackets and photos of my braces, I think I know what happened. I had been confused because the slots looked like low-torque brackets, but the day I got them on they had the red dots on them that looking online (and the assistant said at my most recent appointment) means they are high-torque. I noticed the loose brackets also had a blue dot off to one side on the upper part of the face of the bracket. Looking up the manufacturer's catalog for Damon braces, that indicates that the bracket is for an upper central incisor. In the first photo of my braces, there is only the red high-torque dot on my central incisor brackets, and the red dot and an orange dot on the lower part of the face of the brackets on my lateral incisors. I'm confident this orange dot means lower lateral incisor. The brackets on my incisors are for lower incisors, not upper. They are high-torque, but on the wrong arch they then roughly match low-torque upper brackets. An assistant or someone must have grabbed lower brackets instead of upper brackets when I got my braces on. (The brackets on my canines and bicuspids appear to have had the correct, upper arch dots, so those are fine.)

I think the SET wire will roughly just cancel out the incorrect torque of the brackets, so I'm not expecting as much tipping as my ortho is probably expecting. I'm not sure if or how to bring up the issue for a third time, but I did put a few photos on my phone so I can clearly show what I'm talking about if/when I do try to explain it again. It feels weird that the ortho has looked at it a couple times and not seen what I'm seeing, though he's only looked with naked eye and the differences between the brackets are really small, physically.


Other things to note:

I've seen at least one or two other adult patients at each appointment I've had so far. At this one, there was a woman a few chairs down who, from what I overheard, was getting invisalign/aligner attachments removed and would be getting retainers soon (didn't want to look over and stare). Sounded like she was asking if she could keep wearing her last trays until she got her retainers, even though the attachments would be gone.

A few days out from the appointment now, and my teeth have not been too sore. Definitely a lot less than the first week or so with the first rectangular wire.

Speaking of, the new wire catches the light more and is more shiny than the previous one. The previous wire (one of the "Damon Ultima" wires) was "rectangular", but it was flat on the top and bottom and rounded on the front and back. In addition, it seemed to have a finish that was less shiny (or maybe they are different materials?). This new one is plain rectangular in shape, so the front is flat, and it's noticeably shinier. The wire feels sharper to my tongue, probably because of the more square edges. I like how this wire is shinier, so I'm wondering how much I'll have those Damon Ultima wires and how much I'll have normal rectangular wire.


Next appointment is in about four weeks, and they'll check my progress from getting this new wire.
 
Everyone? No; I think you want it to line up well with the mandible, and for a lot of people that will already be the case. And for adults, unless you have surgery to reopen the suture, an expander isn’t going to do anything to improve nasal airflow or anything like that. It‘ll tip the teeth out, or push them out further in the bone, maybe.

If you can find someone who will do it if you pay them, more power to you. But it might not be the best option for you. I think if you talk to enough orthodontists, you’ll get an accurate picture of the state of your teeth/jaws and what would be best to do. Maybe some do recommend an expander. Maybe some recommend jaw surgery. Maybe some recommend extractions; you can ask those orthos what other options there are that would avoid extractions.
 
But don't you feel everyone could benefit from some expansion? There's no way my maxilla is at genetic potential. I have tongue scalloping, buccal corridor, and my tongue doesn't fit in my mouth. I'm also in Mexico where you can usually pay someone to do your request lol
 
Actually not as good as I thought it would be. It was way worse than I expected when I first got them but I did think I’d get used to speaking with them better than I have. I have got used to having them in my mouth but Still have a big lisp. I’m getting braver wearing them out in public so hopefully with more practice my speech will get better. I have to go back on Tuesday as the occlusal isn’t moulded very well to my bottom teeth so only my back left tooth touches which keeps my jaw open more than it should which might be why it’s still hard to speak, will see if they can fix it
 
I think it’s awesome that you’re excited about getting braces!

As for your plan, getting consults from multiple orthodontists is a great idea. However, you might not find any who will give you an expander. Stiff, thick archwires are able to do a little bit of widening, and that might be more than enough for your crossbite. And I don’t know why elastics for a crossbite would cause “retraction”.

For molar bands, it does seem like a lot of orthos don’t use them unless you’re getting some sort of appliance. I will be getting some on the bottom for a lower lingual holding arch when I get a Carriere appliance, but I won’t have them when I get full braces after that. They will use them, however, if the bracket on the molar keeps falling off, or if there’s a filling or crown or something that causes an issue with it staying attached.

I don’t want to come across as a downer, but want you to be realistic instead of getting your hopes up too high. I would get consults from a several orthos, and choose one based on how comfortable you feel at that office and how much the treatment makes sense (without your interest in braces coloring this too much).

If there’s some appliance you really want to see what it feels like to wear after that, buy some fakes after your treatment is done.
 
Update: I know what I'm going to do. I'm going to go to another orthodontist, and keep going to different ones until someone is willing to put an RPE and fixed metal braces on me. I don't want any retraction. I've seen some good evidence that it will work on adults. So I'm willing to try it on myself.

I'm also going to say I need expansion to create room for my tongue as my tongue hurts all the time which is true.

Other benefits include increased nasal volume.. Better sleep and therefore less anxiety and better athletic performance! These are big and important and life changing. I don't know why people where are often worried about the ortho "finding out". Most of us don't have developed jaws anyway. Any kind of crossbite and you're not at your genetic potential. Almost all of us could benefit from some kind of expansion and it can be done without surgery. There are studies. I'm gonna get an RPE. You can tell your ortho you know about this and how it's related to health and this is the procedure you want for you health. If an ortho won't do it, move on..someone will take your money for it. You just need to hold correct tongue posture to retain it.

Great idea lol thanks to the weed cookies
 

tommorowdies

Gold Member
Hey there!

I getting braces for the first time at 37. So excited.

I have had the initial consultation. I need a posterior crossbite corrected on one side. They said it would be braces on at the next appointment, but they didn't give me any spacers so I assume they won't use molar bands. I did want an expander put in but they said they can fix it with just braces. Although I don't want anything retracted or pulled in, and I know that happens with crossbite elastics a little bit.

The main reason I want molar bands (or ideally an expander) is just because I love them.

Do you think there's any way of encouraging my ortho to give me molar bands without confusing her or sounding crazy?

Or maybe I could say I absolutely don't want any teeth retracted inwards, and just by the laws of physics they'll have to give me an expander?

Thanks everyone!
 
Sooo, heute hatte ich meinen Termin beim KFO. Eine neue Gummikette wurde eingesetzt und ein Bracket ausgetauscht. Die Schiene soll ich beim nächsten Termin erhalten.
 

andys

Silver Member
Has anyone customized the modified twin-block with telescope appliance to add a tongue crib? I really want to add one to it, but I'm not sure how it would work.
 
Embracer said:
Just looked at pictures of your braces again. They really are epic. How are you getting on with them?

The removable braces I had were all absolutely amazing and I enjoyed every last single bit with them. Unfortunately, I can't wear them anymore. Since I have the lower fixed retainer the bottom plate doesn't fit anymore. And I now have a button on my upper left first molar where the adams clasp of the upper removable plate is located, due to which it doesn't fit…


The ortho said that I could skip the last appointment if I still notice my bite actively settling. However, during the last week before the appointment I didn't notice any further major changes, so I went in.
After a short inspection and wax foil to check the bite, she decided that we should try out the next idea for fixing my bite: elastics. She placed a plastic button on my upper left first molar for elastics to my lower left first molar to close the vertical gap between those teeth of >1mm.
Standard procedure with cleaning, etching, cementing and curing. Etching hurt like hell as my teeth are very acid-sensitive. In fact that tooth is still sensitive to warmth and cold and I'll ask for fluoride varnish during my next appointment.
I was given a pack of 100 light elastics 3/16" (4.8mm) 2 OZ (60 g / cN) and told to wear them 18 hours per day between 26 and 36, switching them out daily.

All of which is to say: I'm now wearing elastics (well, technically just one elastic).

It feels weird. Whenever I put it back on, it feels weird all over again. First, it's as if my teeth are being forced together. After a few minutes, I feel my muscles starting to work against that force. A few more minutes later, I stop noticing the elastic as my muscles are fully compensating the additional force.

The first few days the elastic pinched my cheek and a blood blister developed. I started hanging the elastic twisting it 180°, making it cross in the middle. That helped and soon my check got used to it at which point I was able to put in the elastic normally again.
I didn't have much of a problem with the button. Its edges are a bit rough, but I only notice that when not wearing the elastic.
Especially during the first two weeks, I had an elastic snap pretty much daily on me. It's gotten better now, probably because my tongue plays less with them.
Due to the different force between my left and right muscles, and a slightly shifted lower jaw position, my TMJs are acting up again and are clicking every now and again.

The button and elastic are practically invisible, being so far back, even when I laugh. Though if the plan is to move forward with more elastics to close the gaps between all my premolars as well, the buttons on those will be quite visible even when just talking.

I've been wearing the elastic diligently. The ortho said that if I notice the gap being closed I can stop wearing the elastics. I took that as a good sign that things should be moving quickly. Of course, why would I be that lucky? In the last 5 weeks, the gap only got a little smaller, now being at around 0.9mm. However, I can't feel the teeth actually being extruded. Instead, I think they just tipped lingually which improved contact between them a little. I don't know if that was the plan or if it's just my luck again. Guess I'll find out during the next appointment in two days.
I also notice that my lower jaw is pulled a bit to the left, which affects my bite on the right slightly. Either that, or it's the way my left molars are lining up differently now. My left canines push into each other a bit now, which makes the upper one move out, opening up the gap between my upper canine and first premolar again. There's also more contact between my lower incisors and my upper left lateral incisor.

I can definitely say that the brackets, button and elastic don't have as much an effect on me as the removable braces. Here, it's more of a love-hate-relationship. It's still fun to experience quite a lot of different orthodontic appliances and measures, which most people won't all experience during a single treatment.

Last week was the 1.5 year mark since getting braces, which initially was the predicted latest point at which I should have finished treatment. Instead, we're still dabbling around trying to fix something which wasn't even a problem before beginning treatment. One friend suggested that the treatment might be considered malpractice. Although I don't think that's the case as the complications weren't due to anything the ortho directly or indirectly influenced, that statement started creating some small doubts for me. On the other hand it's not like I'm suffering. Quite contrary, I'm still enjoying every minute of the treatment and don't even want to think about the time where I'll be braces-free.
 
I wasn’t actually given a choice of color. She said they only provide these types of appliances in clear color. I’m ok with that as it’s bit more discrete.

I have to wear them 24/7 except when playing contact sports, eating and swimming. I mentioned a few meetings I would find it hard to wear them and she was ok with that. She said drinking was fine but I didn’t ask about tea and coffee, thank for the heads up on that.

She said it was likely I would need a turn on the screws but would need to be gradual and probably only one or two and then the labial bows will be used to straighten everything.

Your retainer sounds very similar to what I have but I think you are right that having the screws definitely makes it thicker. 



 
Just looked at pictures of your braces again. They really are epic. How are you getting on with them? You have not posted for a while.
 
Excellent new braces! I guess they have to be fairly bulky to accommodate the expansion screws. Will the screws be activated as part of your treatment?

Do you have to wear the braces 24/7? if you do, I imagine your speech will adapt pretty quickly.

Did you have a choice of acrylic colour? My first hawley retainer after fixed braces in 2012/3 was clear and it got stained with coffee drinking.  When I got a replacement after losing it on holiday, I asked for transparent pink. By that point I was on nighttime wear only so I suppose staining was not really an issue anyway.

I went for a new retainer late last year and was told I had had some relapse and some loosening of two teeth through intermittent wearing of my retainer . So I have had to wear  a new retainer 24/7 for 6 months to correct the relapse then for retention and now I am gradually reducing my daily hours of wearing it down to 12 by the end of 12 months. The acrylic is pink again. There was no discussion of choice of colour but I am happy with pink and would not want a more obvious colour.  I guess if I had a bite plane or occlusal coverage, I might have asked for clear as being a little more discreet. i have not drunk tea or coffee with this retainer in, but have worn it whist drinking beer at the pub.

I remove the retainer for eating and presume you do the same?
 
Luckily the pub was quiet but still got asked by the bar staff twice about my braces. It’s so weird. Has anyone else had braces like these as an adult? Feels so weird being so old with removable braces. I know it gets easier but such a strange thing to go through
 
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