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Author Topic: Looks like I’ll be getting braces again!  (Read 4835 times)

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Re: Looks like I’ll be getting braces again!
« Reply #15 on: 14. July 2022, 16:45:48 PM »
So, starting last night, it feels like my incisors are starting to tilt the wrong way. Can’t tell looking in the mirror or in photos (at least not yet).

Looking closely at my braces, it does look like they put the wrong torque brackets on my incisors (based on how the archwire slot is tilted and what the product webpage for those brackets shows).

I sent an email to the treatment coordinator this morning; don’t know when or how she’ll respond, if I’m just imagining this or if there is an issue. If there is, though, I didn’t want my teeth to move in the wrong direction for five more weeks before saying or doing anything about it.

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Re: Looks like I’ll be getting braces again!
« Reply #16 on: 20. July 2022, 22:07:27 PM »
As of yesterday morning, I had not heard back from my orthodontist's office regarding my email. Looking some at my teeth some the day before, I think my left central incisor isn't tilting back, but has shifted back a little, making the shape of my upper arch a little lop-sided (I can feel with my tongue that the right incisors are a little further out than the left incisors). My guess is this happened because my left lateral incisor was behind the other teeth, and so as it has moved forward some, it has pulled the teeth (mostly the central incisor) next to it back some.

Because of noticing this, yesterday I emailed my treatment coordinator again to say that I think I had incorrectly jumped to the conclusion that the tooth was tilting back. I mentioned that I still am not sure if the brackets on my incisors are the correct ones.

In that email, I also included that I have noticed that where the assistant bent back the archwire when I got my braces on, the ends of the wire are now touching my teeth, rubbing when the archwire is bumped or wiggled. (She bent the ends at basically a right angle, so the end points in between the last tooth with a bracket, the first bicuspid, and the tooth behind it, the second bicuspid; now that end is touching the tooth with the last bracket.)

Later yesterday, the treatment coordinator emailed me back to say that the wire will not damage the tooth but if it's poking gums or cheeks, I can come it for them to trim it. Otherwise, it'll get taken care of my appointment in a month.

A little later the same day, she emailed me again. She noticed that she had written a response to my email from last Thursday, but had forgot to actually send it, so she sent it to me. According to that, the ortho says the correct brackets are on my teeth. She said I will not notice tilting yet because the first wire is a round wire. That kind of change will happen once I've graduated through wires. She said they can talk about it in detail with me at my appointment.

I still think the wrong torque brackets are on my incisors, but I can ask the ortho for info about that at my appointment. And I suspected the first round wire couldn't really do the tilting, but given that my bite had changed, I wanted to bring it up (when I bite down right now, my lower incisors hit my left central incisor first, and I have to pull my lower jaw a little further back than normal to bite down on my back teeth).

I didn't bring this up in my emails, though may at my appointment if the torque of the brackets is actually correct, but I think the bracket on my left central incisor is actually twisted/bent just a little bit. The face of the bracket isn't quite square to the base that is glued to my tooth. Also, since I got my braces on, feeling around on them, I noticed that the under-tie-area of that bracket isn't as deep as any of the other brackets. Any other bracket I can fit my thumbnail in there with a little play, but on that bracket I can't quite fit my thumbnail.

Looking forward to moving up a wire size, one so that I get to see more movement, and two this first wire is so thin it almost feels sharp to my tongue, but also my lips basically don't feel it. It almost feels like just brackets with no wire. I'm guessing it'll be a little more comfortable on my lips and cheeks with a thicker wire.

Offline Embracer

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Re: Looks like I’ll be getting braces again!
« Reply #17 on: 21. July 2022, 09:07:09 AM »
I'm sure your orthodontist knows what they are doing. Don't over think it. Good luck with your treatment.

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Re: Looks like I’ll be getting braces again!
« Reply #18 on: 21. July 2022, 21:20:29 PM »
I'm sure your orthodontist knows what they are doing. Don't over think it. Good luck with your treatment.

He is a very good orthodontist. I am curious to hear him explain how those teeth will be tilted, because what I see when looking at the brackets looks like it will tilt them the wrong way.

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Re: Looks like I’ll be getting braces again!
« Reply #19 on: 22. August 2022, 16:47:58 PM »
Friday afternoon I had my first appointment since getting my braces.

I had been thinking about it for a while, and I decided to ask to get colored ligatures put on. I have Damon braces, but my ortho lets patients get colored ligatures put on their six front upper teeth. They get put around the bracket under the wire, so they don't interfere with or add friction to the wire. I went with the darkest blue they had that wasn't navy blue, since I know they look lighter once their stretched onto the bracket.

Here's a photo:
https://dereferer.me/?https://www.flickr.com/gp/[email protected]/6pA3LepevV

At this appointment, they stepped me up to a rectangular wire (I peeked at the computer monitor at the chair, and it said .014 x .027, some seaching online after the appointment shows that there is a Damon Ultima archwire that is .014 x .0275; my first wire was a round .016). This is supposed to start torquing my incisors forward. The wire size is almost odd; it's so thin from the front but so thick when viewed from the top or bottom. My understanding is that it fills the entire horizontal dimension of the bracket slot.

Here is a photo where you can sort of see the thickness of the archwire:
https://dereferer.me/?https://www.flickr.com/gp/[email protected]/S181B96918

I am concerned that the brackets I have will actually tip them further in. I asked the orthodontist about it, and he said I have the correct high torque brackets. I then showed him a photo I had taken with a macro lens of one of my brackets where you can see the angle of the slot, and it matches those that would tip the teeth in from an animation on the Damon Ultima webpage.

Here's the photo I showed him:
https://dereferer.me/?https://www.flickr.com/gp/[email protected]/1210kug198
And the animation (I didn't show him, since he should know this stuff) is about halfway down this page, where it talks about retrocline and procline brackets:
https://dereferer.me/?https://ormco.com/products/damon-ultima-system/

The photo kind of gave him a little pause, and then he looked at my brackets again and how the archwire was fitting into them (it was placed, but the doors weren't shut). He then still said I have the high-torque brackets, but admitted that my photo didn't look like it. I think he just thought the photo might be deceiving. He did say (and had the assistant note this) that at my next appointment, they can get out some extra-thick wire or something to see how it deflects when being inserted into the brackets to tell for sure.

When the assistant fully seated the wire and started closing the doors, it was a lot tighter! She even warned that it would feel tight. Starting a few hours after the appointment, my teeth started getting sore. About six hours after or so, I know teeth had moved some because my left first bicuspids were hitting first when biting down, and they didn't used to do that. This is annoying because one, I can't bite down all the way on my other teeth (or as much as I could, as my bite was already off on the right), and two, because that upper bicuspid has been one of the more sore teeth this time.

I hope the ortho is actually right about the bracket torque, because I'm excited to see those teeth start to tip forward some so I don't have to pull my lower jaw back to bite down.

My next appointment will be in mid-to-late October, and I think the ortho said I'd be getting a thicker wire again at that appointment (both at the appointment getting braces and at this one, the orthodontist has told the assistant what size wire I'll get at the next appointment; the way this played out is then at this appointment after I sat down in the chair, she got the wire and got it all ready and trimmed to size before he even came over and looked at me; at the orthodontist I had as a kid, the assistant would remove the ligatures and wires, then the ortho would come over, look at my teeth, and then tell the assistant what wire and elastics to put on for that appointment).

Offline bracessd

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Re: Looks like I’ll be getting braces again!
« Reply #20 on: 23. August 2022, 17:38:32 PM »
Thanks for the update and pics!

Online Cassandra

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Re: Looks like I’ll be getting braces again!
« Reply #21 on: 24. August 2022, 20:44:46 PM »
I’ve really been enjoying how detailed you’ve been with everything you’ve shared so far.  I’m curious why you went with blue? I think in one of your previous posts you said you only ever did blue before, so I think I’d be tired of blue from the get go :)

I also think if it were me in your place I’d be a little nervous asking such detailed questions from the orthodontist for fear I’d be “found out,” although I guess with so much information available online perhaps many many people would know enough to ask such specific questions and it’s nothing usual.

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Re: Looks like I’ll be getting braces again!
« Reply #22 on: 24. August 2022, 23:18:30 PM »
I’ve really been enjoying how detailed you’ve been with everything you’ve shared so far.

Yeah, I wanted to give detail so that others here could better understand and/or picture what’s going on. I also initially thought I’d go to more than two consults and it would be interesting to compare the proposed treatments, but I really liked the office I chose and started to get impatient to start the process.

I also find myself being really wordy in written communication like this.  ::)

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I’m curious why you went with blue? I think in one of your previous posts you said you only ever did blue before, so I think I’d be tired of blue from the get go :)

I went with blue for a couple reasons.

One, because I have had it before, it feels safe in a way, since I know I liked how blue looked on me as a kid. So I figured start with what I know before branching out.

Two, based on my past experience and photos I’ve seen online, blue tends to not have shades that look much better or much worse than others, the way some colors can (say, green or yellow), and I didn’t want to worry about choosing the wrong shade.

Three, it’s more subtle than some of the bright colors, and some people I know are still seeing my braces for the first time. I guess I don’t want too much attention on my braces, at least not yet.

I do want to make sure to try other colors this time around (almost thought of telling the assistant to make sure I don’t just ask for blue every time!). Right now, I’m thinking of getting red at my next appointment, as it’ll be the middle of college football season and I’m an Ohio State fan. The appointment after that should be mid-December, so maybe I’ll get a good green for Christmas, if they have one, but I’m not decided on that yet.

I know some people like the all-metal look of self-lighting brackets and think that getting colored ligatures on them ruins that. I actually very quickly have really liked how they look. This surprised me, because it usually takes me a while to get used to a change (it took a couple weeks with the braces for me to not think they made my front teeth look huge, and a few weeks after that to be pretty used to seeing them in the mirror). I do wonder it part of liking the look so quickly is due to almost all of the braces having the colored ligs. My ortho’s office only puts them on the top front six teeth, but I only have eight brackets so far. Once I get full braces in another 6-10 months, I may feel differently when it’s just a minority of teeth getting the color.

Something about having the ligs on them makes them look more “right” to my eye, and a little more complete somehow, while still leaving a lot of shiny metal and being subtle since they are entirely behind the wire.

Quote
I also think if it were me in your place I’d be a little nervous asking such detailed questions from the orthodontist for fear I’d be “found out,” although I guess with so much information available online perhaps many many people would know enough to ask such specific questions and it’s nothing usual.

Yeah, I have been a bit nervous of being either questioned (“How would you know that?”) or dismissed when bringing up my concern that the front brackets have the wrong torque (the ortho I had as a kid seemed confrontational the one time I asked a question that wasn’t 100% in agreement with him). However, that’s offset by me not wanting the teeth to tip inward even more, which would extend treatment and, more importantly, look terrible I think.

I have been running a voice recorder app on my phone at the consults and appointments (I live in a one-party consent state). For the consults, it was great because I didn’t have to immediately write down every answer to every question I had, and I have the recording as something I can go back to to refresh my understanding of the plan of my treatment. For the appointments, there’s a lot of background noise to it makes it harder to listen to the recording (suction sounds during getting the braces on, and the room with the exam chairs has a really high ceiling, so it echos a lot).

Listening back to what the ortho said about my new wire at my appointment, he explained that because it’s not filling the height of the bracket slot, the torquing of the front teeth that I should experience before my next appointment will be mostly just from the wire wanting to bend back to straight across; you can see in my photos that my incisors are lower than the canines/premolars/molars, so the wire dips down in the middle to go through those brackets. At my next appointment, the plan is to get a .018x.0275 wire that will fully fill the slot, and we can see how it fits to judge the torque. My ortho said if that doesn’t seem like enough torque, they’ll try a .019 “set” wire, that is pre-torqued, and that kind of wire would really move those teeth

 He also said that they can get out some low torque and high torque brackets for me to see the distance, and even take photos with my “macro lens” (I had told him the photo where the bracket slot was visible was taken with a macro lens, which is close enough to the truth; it was taken with a normal lens with an extension tube to allow it to focus closer; photography is a hobby of mine). I was pleasantly surprised by that offer. I suppose, though, that it shouldn’t be surprising that a (good) orthodontist would want to nerd out about some detail like that.

My ortho taking like that to me about those details and actually telling me the wire sizes in that part of the conversation is something I appreciate so much. The ortho I had as a kid didn’t interact with patients well. After the assistant had taken off your ligs and wire, he’d come over, look at your mouth for a second, maybe ask if you’d been wearing your elastics, tell the assistant something (wire size and elastic size/configuration) in a way that was indecipherable to a young teen, and then walk off.

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Re: Looks like I’ll be getting braces again!
« Reply #23 on: 07. September 2022, 23:26:05 PM »
Got a small update.

Last week, I emailed the treatment coordinator asking when should I expect to notice my incisors tilting out, since I haven’t yet, though I’ve noticed my first bicuspids tilt out some (those teeth were slightly tilted in, and I think tilting those teeth out some is how Damon braces achieve the “wider smile” that they brag about in marketing material). I also asked if it’s expected to be really tight between my incisors when flossing; flossing has been a little tight between all my teeth (probably since I got my braces off as a kid), but it’s been much tighter between the upper incisors ever since I got the rectangular wire. Basically, I was trying to ask about how to notice changes that might tell if the brackets on my incisors are the wrong torque or not, without saying that.

She said she didn’t know but would ask the ortho.

Yesterday morning, she emailed back that the ortho wanted to see me next week for a check. I called the office and got an appointment scheduled for next Thursday.j

I could be wrong, but I’m guessing he asked to have me come in because my questions indicated that things aren’t moving correctly. He knows that I was wondering if the brackets had the wrong torque since we spoke about it at my last appointment, so he probably wants to check that again. Looking today and comparing to photos from a month or two ago and to the photos they took at my consult, I think my incisors have tilted in a little, which is the opposite of the direction we want them to be going in.

If I’m right about that, I suppose they’d remove those brackets and place new, correct brackets on those teeth. I’m guessing that would be a separate appointment, if it happens.

Seeing what looks to be those teeth tilting in, it feels good to know that I was right about what I was seeing with the brackets earlier. However, it’s a bit annoying that I might have been set back several weeks, and my teeth are moving to where they shouldn’t go.

I’ll be sure to update after that appointment next week.

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Re: Looks like I’ll be getting braces again!
« Reply #24 on: 19. September 2022, 22:22:15 PM »
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.

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Re: Looks like I’ll be getting braces again!
« Reply #25 on: 11. October 2022, 21:58:15 PM »
There is less than a week until my next appointment now, and the SET wire has barely moved my incisors, as far as I can tell. I can feel that the left lateral incisor has tilted out a small amount, but the others I can’t even tell if they have moved.

Based on those results and the close-up pictures I’ve taken, I’m still convinced I have the wrong brackets on my incisors. I will try to do a good job explaining this to the orthodontist at my appointment. I think the only real way to fix it and get things moving how they should would be to remove and replace those brackets. If they do agree to do that, I don’t know how quickly that would happen.

My intention right now is to ask for red ligatures (for Ohio State football).

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Re: Looks like I’ll be getting braces again!
« Reply #26 on: 20. October 2022, 22:19:59 PM »
I had an orthodontist appointment this past Monday.

I hadn't seen as much progress as I bet the orthodontist expected from the SET wire (even though it had only been four weeks), so I brought up again to the assistant that I thought I had the wrong brackets on. I showed here photos of my braces, the example brackets they showed me last time, and when I first got my braces on so you could see the colored dots that indicate which tooth they go on. I explained that I think they are lower incisor brackets.

When the orthodontist came over, I explained that to him and showed him the photo, and he decided to remove the brackets and replace them with the correct (high-torque upper incisor) brackets right then and there. I had hoped this would be the conclusion reached, but expected to have to schedule another appointment for it to happen, so I was pleasantly surprised.

Barely noticed the brackets being popped off, but having the cement ground off was much more uncomfortable than I remember from getting my braces off as a kid.

They got the new brackets on, put on the red ligatures I chose this time, and then put in a new wire. This time I got an .018 x .0275 Damon Ultima wire (so same shape as the wire I got in August, but thicker).

It didn't take long for me to feel the new brackets and thicker wire (the assistant even recommended taking ibuprofen once I left). That evening and the follow day, my teeth were pretty sore, even when not touching those teeth. My incisors are still fairly tender.

I'm glad to have finally been believed, and to have the correct brackets on now. I'm slightly surprised my 2-year-old and 4-year-old haven't said anything about now having red (less surprised that my wife hasn't said anything; she doesn't notice details), but they never commented on me having blue for the past two months, either. I guess having the colored ligatures be entirely behind the wire makes them a lot more subtle. That might encourage me to be even more adventurous in the future.

I'll try to get a picture uploaded that I can link to some time in the next several days.

My next appointment is mid December. I'm hoping there is enough progress by then to start the Carriere (that would put me at the long end of the 4-6 months they forecasted of braces before the Carriere). I hope there wasn't too much time wasted by having the wrong brackets and my teeth moving in the wrong direction for a few weeks.

Offline bracessd

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Re: Looks like I’ll be getting braces again!
« Reply #27 on: 21. October 2022, 18:02:06 PM »
Looking forward to seeing the progress

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Re: Looks like I’ll be getting braces again!
« Reply #28 on: 23. October 2022, 21:25:25 PM »
Here's a photo from just the other day with the red ligatures:

https://dereferer.me/?https://www.flickr.com/gp/[email protected]/81XWE947c5

They are more hidden/subtle in person than they are in that photo. You can also kind of see the shape of the rectangular wire.

Online Cassandra

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Re: Looks like I’ll be getting braces again!
« Reply #29 on: 29. October 2022, 00:50:26 AM »
I am feeling kind of annoyed on your behalf about the delay due to the wrong brackets, especially since you knew you were right all along. I would get so antsy waiting 8 whole weeks between appointments too, that seems so long but I guess that is normal these days!!! I guess the newer braces are more efficient like that, but also unfortunately if anything isn’t right it doesn’t get resolved for eight whole weeks, which is long. I’m glad they decided to just replace the brackets either way. It’s funny your teeth look so straight in your pics but you’ve got a pretty great list of different things you will get to experience, whereas someone with crooked teeth could very well go through a whole treatment with just brackets and maybe elastics.