First consultation (Ortho A)
Had my first consultation last Friday. This was the orthodontist whom I sent photos to through their website.
They took photos and a panoramic x-ray there, and then had the orthodontist come in to look at my teeth and bite and measure and evaluate it. During this, he said "class 2 div 2", class 2 division 2, which I hadn't heard of divisions of class 2 before, but looking it up after the fact it means upper teeth are too far forward, but my upper incisors are tilted back (retroclined), which hides the amount of overbite. He explained this about my teeth without specifically telling me the classification terminology (though the letter that they said they will send my might, I don't know). So, what I was noticing that didn't feel right was the class 2 on the right side (left side is really close to class 1). I also have a significant deep bite, and a moderate curve of Spee. There are also a few small things that have mildly annoyed me for years, but none of which are bite issues that are causing issues.
With how my bite is, the teeth on the right side could wear down each other's cusps, and the deep bite with retroclined incisors will eventually cause my lower incisors to be worn down, too, against the backs of my upper incisors. I have to slightly pull my lower jaw back to bite down on my back teeth, because of the deep bite and retroclined incisors.
Here is what this orthodontist recommended:
First, brackets across the top front 8 teeth, first bicuspid to first bicuspid, for 4-6 months. This would be to correct the tilt of the upper incisors. Overbite would seem to get worse during this.
Then, they would remove the brackets from the bicuspids and canines (leaving the brackets on the incisors), and give me a Carriere distalizer appliance on both the upper right and upper left, canine to first molar. I would get bands on my lower first molars to hook the elastics to, with a lower lingual holding arch connecting the bands. This would be for 4-6 months, to correct how the teeth in the back match up when I bite down.
After that, the Carriere and lower lingual holding arch would be removed and I would get full braces, with box elastics to close up my bite in the back. If necessary, they would give me bite turbos on the back of my upper incisors to keep me from biting on the lower front brackets.
For retainers, they would give me an upper essix and lower permanent retainer, like I had before. However, they would also give me a lower essix for wearing at night. I appreciate this idea, since my lower bicuspids and molars moved after braces the first time and they had no retention. Also, and I found this very interesting, they would give me a clear upper retainer with acrylic behind the front teeth that my lower incisors would bite down on, like a biteplate, for wearing at night. This would be to prevent the deep bite from coming back and to provide transverse support (I think that's what the treatment coordinator said; I guess it provides stiffer support to the arch width that a normal essix).
Total treatment would be about 18 months, for $7,175. About the top end of what I was expecting to hear for the price. Clear brackets would be an extra $350.
There are other treatment options they could suggest if I just wanted to fix the alignment of one or two teeth or something (my left lateral upper incisor is a little further back than the other incisors, for example), but it wouldn't fix my bite, and that's what's bothering me and causing issues ("wreaking havoc" in the words of the treatment coordinator).
This office uses only Damon braces on all patients, except young kids who have expanders; they said they use the traditional twin brackets on those patients' front teeth (I don't know why). The treatment coordinator did mention that teenagers at their practice do still enjoy getting colored ligatures, but based on the models they showed me, it looks like they just put them entirely behind the archwire.
I really liked the treatment coordinator, who explained a lot of the details and answered a bunch of questions for me, though I wouldn't really interact with her as an active patient (though she said I can always email her during treatment if I have a question of what something is or why we're doing something). The office isn't too close to my home or work, but it isn't super far, either (15-20 minute drive, depending on traffic). I think it would be interesting to have the Carriere and the lower lingual holding arch (I've always wondered what one of those or a TPA would feel like to wear), but having brackets on just the front four teeth during this makes me wonder a little if it'll make me look like a little kid (I'd be even more worried about this if I had shorter hair and no facial hair). The downsides of essix and permanent retainers have annoyed me, but it does seem like, with diligent wear, they can do a better job of holding teeth in place than hawleys. The extra retainers for night is appealing to me, since it eliminates some of the concerns I've had with the retainers I have/had after having braces the first time. Kinda glad the clear brackets cost more, since I'd prefer metal and wouldn't want my wife trying to talk me into clear (I have no idea if she'd even have a preference).
Don't know if I'd ever try to ask for colors on the Damon braces; one of my regrets of my first time with braces was not trying out other colors and color combos. I just had blue ligatures and powerchains the whole time because I was afraid of any attention I'd get if someone pointed out or commented on the color on my braces changing. Looking back, this was a ridiculous worry, since literally like a quarter to a third of the kids in my grade had braces at the same time.
Overall, walked away from this consultation with a positive feeling about the office and the treatment they recommended.