Long time no update, but here it is. The appointment nearly six weeks ago was rather quick. As planned, I told the ortho that the expansion slit irritates my tongue. She drilled a V-shape into the slit around the expansion screw up to the bite plate as those were the areas that hurt.
She was satisfied with my open bite starting to close a little. She said that it'll need some time to undo what has been done in half a year of wearing the posterior bite planes close to full-time. She wasn't really sure if what she's doing with my case was the right choice, so she was really glad seeing my bite starting to close. Intrusion of the canine also worked as expected and it's already at the correct height after only two weeks of wearing the anterior bite plate.
The only other modification she did was to activate the springs of my lower wisdom teeth to start their derotation. She activated them very slightly as my teeth reacted very strongly in the past. In fact it was so slight that I didn't even feel any discomfort during the next days.
She ended the appointment by polishing the upper plate. I made an appointment for 6 weeks later (the coming Tuesday). The ortho told me to come in before Christmas if I anything changes for the bad, or even if I don't notice any changes until then.
And as it would be too boring if everything went according to plan, of course I needed another appointment before Christmas... Without the braces, only my second molars and front teeth were touching. About a week after the appointment, I noticed that now only the second molars were touching and an anterior open bite started developing. So I made an emergency-ish appointment two weeks after the previous one.
During those two weeks my speech improved slightly, but I was nevertheless lisping quite strongly and sounded like I had a potato in my mouth. Still definitely way worse than with my previous braces. I noticed that the expansion slit throughout the bite plate makes talking especially hard as a lot of air escapes through there. It also results in me spitting quite often while talking when the saliva collected in the slit escapes.
Then came the time for the emergency-ish appointment. After I had explained my concerns to the ortho, she asked me how much I was still wearing the braces. I said that I wear them 18-20 hours on average, just as before. This resulted in what I had feared during the last few appointments already: She told me to stop wearing the braces for that much time. I should instead aim for a maximum of 12 hours per day.
Additionally, she ground away about 1mm of thickness from the bite-plane to reduce the force with which I bite into it, reducing the chance of unwanted incisor intrusion. During that, she adjusted it to intrude my 32 incisor, which stands a bit higher than the rest. Once I was back home I noticed that that tooth didn't touch the bite plate anymore, probably due to abrasions while the ortho polished the plate.
She also activated the bottom wisdom teeth springs slightly (barely noticeable for me) again. She explained that my bottom incisors moved due to the modifications to the lower brace. To align them again, she first needed to push out my upper incisors, making space for the bottom incisors to move.
After these adjustments, I felt that the spring behind my left upper canine was pushing it out pretty strongly, which it shouldn't. It took several minutes of the ortho modifying that spring until I didn't feel that pressure anymore.
While most people would be delighted to be told by their orthodontist to wear their braces less, I find it harder to get to 12 hours than it was to get to 18 or 20 to be honest. While before I just had the braces in whenever possible, now I need to actively keep track of when I need to take them out and when to put them back in to get to around 12 hours. Also my fingernails are suffering greatly again. While my pronunciation improved until that appointment, only wearing the braces 4 hours during the day (+8 hours each night) has resulted in it getting worse again. My mouth can't really get used to talking with them in anymore in that short amount of time.
On the other hand side my open bite seems to be closing and other things are also improving. Whenever I take out my braces after having them in for 10-12 hours, I have a slight anterior open bite again, which goes back to normal after a few hours. My tilted 21 has "untilted" itself a bit. My molars are beginning to have some contact in some places every once in a while. I can chew way better again, but it's still nowhere near to before the treatment. It'll probably take some more time to fully close my bite again.
Whenever I take out my braces to eat breakfast, all of my molars hurt a little. I'm not sure where that is coming from and if that's a good thing or not. I'll definitely ask the ortho about that during the next appointment.
Embracer said:
Does the bite plate show beneath your incisors?
It did before it was ground down, and it still does now. If I smile with my teeth closed (as much as that's possible with a bite-plate), the blue acrylic it's very visible.
Embracer said:
Is there a danger of this bite plate allowing your molars to erupt further, leaving you with an anterior open bite?
That might have been a problem if I would have worn the braces full-time. Only wearing them 12 hours per day I don't think overeruption will become a problem. Also the bi-weekly appointments will hopefully catch such a case early on. I do worry about the second molars, which are already touching, to erupt as much as the rest of the teeth, which would mean that my other molars won't ever touch. But then again I can see in the mirror that the vertical gaps between my teeth is getting smaller.
Embracer said:
If I were in your shoes, I would ask the ortho to finish off with fixed braces anything the removable ones can't achieve so your teeth are as good as they possibly can be after all this effort.
I'm still not keen on anything fixed. In fact, I don't even want a fixed retainer if I can convince my ortho about that. If everything goes well with the removable braces, I don't think I'll go for fixed braces. What I could imagine is the ortho suggesting brackets in case my bite doesn't close properly or some other complications occur. She already told me that she isn't sure anymore if the current treatment path is the correct / best one for my case. I'm exited and curious, but also a bit anxious how everything will continue.
Embracer said:
PS You probably now have space for two additional expansion screws....
But also still no need even for the first one
retained said:
I am sure you will get fully used to wearing them quite quickly.
I thought so as well and was on a good path. But with the new regimen of only wearing them 12 hours it is regressing strongly. Especially after putting them in it takes at least 15 minutes, usually around half an hour until I'm able to talk with them in again to some extent.
retained said:
Its very strange that my thickest, fullest coverage plate with bite plate area is the one I can speak with best. Not sure why. It also makes 'S' sounds easier and more forward.
I do find that my bottom retainer makes speech more difficult although its quite small and fits perfectly and tightly.
With the new quite thin lower plate I find that I don't have much difficulty talking. Yes, it's different, but with some practice I don't think it would be very noticeable.
The top plate is a whole different beast. The bite plate really restricts my s-sounds. Due to the expansion slit through the whole bite plate I can't really make an alveolar fricative for my s (though I'm trying it out and with some training it might work). Instead, I'm making more of a labiodental fricative. Maybe once I've gotten used to the alveolar one it might sound better.
My speech might also be better if the plates fitted perfectly. Due to being in active treatment they don't fit perfectly and snugly all of the time. Every spring activation changes how the braces sit in my mouth and how they affect my pronunciation.
Embracer said:
PPS Why do you have an adams clasp at one side of your upper brace but arrowhead clasps at the other side?
On the side with the adams clasp you can still see the remnants of the wisdom teeth spring that was cut off in the fourth image. I also noticed that during the appointment when I wanted to take the plate out but couldn't find the wire to pull down on on the right side. I asked the ortho about it and she said that it wasn't needed anymore without the wisdom springs. It doesn't really make much sense to me and I'm going to ask her again. I think that during the changes of the upper plate the right side needed to be reconstructed fully with all springs removed while the left side was left intact mostly. Why it now has 3 triangular clasps instead of one triangular and one adams clasp I don't know.
