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Author Topic: My Journey to Removable Braces  (Read 17269 times)

Offline foobar

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My Journey to Removable Braces
« on: 01. February 2021, 23:35:32 PM »
I've just started my second try to get braces. First time (3 years ago) I went to an ortho my dentist recommended, but they would only have used brackets or invisalign, neither of which I'm interested in, so I chickened out. For a real treatment I'd rather like to have removable plates of some sort.

Now, 3 years later, my bruxism night guard starts to crack after 6 years of usage. I had the decision to get a new one or just try to go for braces again (as I don't want to pay hundreds for a new guard and then get braces, making my new guard not fit anymore anyway).

This time I searched online for orthos near me that treat adults using removable braces and found 7 whose websites stated that they do so. Those websites mention both invisalign and removable appliances separately. Judging from their website and location I called my top 3 a week ago. In that call I directly asked them if they used removable appliances which are not aligners like invisalign. That's when one of the practices said that they only use brackets or invisalign, leading to me ending the call quickly. The other two orthos do also use removable braces for adults and gave me initial consultation appointments for today and tomorrow respectively.

Since I got the appointments, I am super nervous and my whole body is just screaming "stress" all over the place. I think the last time my body reacted this strongly to stress was during the last weeks of my thesis. To those people having gone through the same thing, how do you handle your nerves building up before the appointment?!

Offline foobar

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Re: My Journey to Removable Braces
« Reply #1 on: 02. February 2021, 00:18:22 AM »
I had my first consultation with ortho1 today morning. Before leaving the house I checked my blood pressure and pulse and they were completely through the roof! So much for wanting to stay calm…

The practice has an open treatment area with 3 chairs. I was led into a semi-private room with an open doorway to the open treatment area. Upon entering the room I instantly spotted 6 sets of appliance presentation model. Gladly, none of them was for invisalign :) Two had fixed brackets (one with metal ones and one with clear ones). Two more had removable plates and another one even a Bionator. The last one was for showing fixed retainers.

I stated from the very beginning that I'd like to have some smaller problems fixed with removable appliances which I only did at the end of the appointment 3 years ago. I'd like to think that this helped, but judging by the models I guess there really were only two options to begin with.
The orthodontist took a look at my teeth and pretty much found the same things I had collected over the years and want to get fixed. According to her, most things can be fixed with removable braces, albeit with a bit of difficulty. However, aligning my midline (2mm off) and fixing my wisdom teeth (which have enough space but are biting edge-to-edge not affecting my bite) can only be done with fixed braces and elastics (which I don't want).

The removable appliances she showed me are somewhat similar to Schwarz appliances. She said that my plates will probably with a few springs, screws and maybe other goodies. For my bruxism, she wants to apply a posterior bite plane to the lower appliance. She'll make the plane pretty thick, thicker than my night guard which has 2-3mm to relax my joint muscles. All in all she expects 1 year of treatment depending on how much I wear the braces (12h/d minimum).
For retention she showed me bonded retainers and stated that she always uses them on both jaws, usually on the front 4 or 6 teeth, sometimes even on 8. For my bruxism I'd additionally have a night guard for my lower jaw. I asked whether it'd be possible to use removable retainers instead. She wasn't really positive, stating that I'd need to wear them for the rest of my life as teeth will always shift to a certain degree and that fixed retainers are lower maintenance. I replied that I'll probably already wear the bruxism guard for the rest of my life, so it wouldn't really matter if I'd have one or two appliance in my mouth during the night. She didn't seem to positive, but also not fully negative about it.

If I go ahead with this ortho, there'll be a second appointment for record taking where they'll take two sets of molds (one for the record and one for appliance creation) and radiographs. In a third appointment she'll present the treatment plan. If I agree to still go forward with her, the braces will be fitted in a fourth appointment.


In the end, I'm already super stoked. This was a huge success as I got an offer containing just what I wanted and which I'll gladly accept. I still have a consultation tomorrow morning with a different ortho, so I'll se what they propose. But I can go into that more relaxed as I don't really "need" it anymore, already having a very good option.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #2 on: 04. February 2021, 01:10:03 AM »
Yesterday I had my consultation appointment with ortho2. I was slightly less nervous as expected. This appointment went more like what I expected most of them to go and be like. Their website stated that they use brackets, invisalign and removable braces for adults, which was confirmed when I called beforehand. The doctor himself is rather old, which should be a good indication for removable appliances.

The practice is located in a more expensive area and was pretty large. It felt more impersonal than the practice of ortho1, which was smaller and in general felt more individual. Upon being seated in a patient room, a female orthodontist explained to me that the older ortho will retire soon and thus won't take any more new patients. Instead, she'll be taking over the practice and handle all new patients.

When I was asked why I was there and answered that I'd like to have a few minor things fixed with removable non-invisalign braces, she already started to become quite dismissive. After taking a look into my mouth, she explained what was wrong with my teeth. Only some of the things I already knew about. Other things she noticed I still don't really agree with, but then again I'm not an orthodontist. After I added the things I'd like to get fixed, she stated that only brackets or invisalign will give me a satisfactory result. Removable plates won't be able to fix most things and she doesn't like using them. She only rarely uses them, for example when a single tooth relapses during / after retention. For me the only options would be fixed braces for 9-12 months or invisalign for 3-6 months.

Honestly, this was pretty much what I was expecting to happen during all of the consultation appoints, them looking at my teeth and stating that they only offer brackets or invisalign. Luckily, as I already had my offer from ortho1 with what I wanted, I quickly ended the appointment with ortho2.

Upon leaving the building, I instantly called ortho1 to accept their offer and start treatment with them. Tomorrow (Thursday) will be the record-taking appointment. After that 2 more appointments until I get removable braces, just as I wanted (hopefully)! So now there is no way back for me (or at least that's what I tell myself not to chicken out in the end ;) )

An interesting thing is that I've been at 3 different orthos total so far (including the one 3 years ago) and all of them found and focused on pretty different problems of my teeth. I guess asking 3 people for their input will get you 4 different answers :)

Offline foobar

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Re: My Journey to Removable Braces
« Reply #3 on: 06. February 2021, 00:03:53 AM »
Yesterday was my record-taking appointment. It didn't involve the orthodontist at all. Instead, the assistant prepared and handled everything. First, both a panoramic and a side-view radiograph were taken. Afterwards she photographed my side profile in addition my teeth from the front. The last thing to do where the impressions of both jaws. Luckily I didn't have any problems with that. The impression material went back into my mouth quite a lot, so far that I couldn't have my tongue not touch it. However, I didn't really need to gag. It wasn't necessarily comfortable, but it also didn't bother me significantly compared to what I've read pretty much everywhere else. While my impressions were taken, another patient next to me was lucky (or unfortunate?) enough to get a lower lip bumper installed. After my impressions, I was already finished, in fact quite a lot quicker than I expected. I have another appointment in 3 weeks to get presented and discuss the treatment plan. If (or rather once) I accept, another set of impressions will be taken to create the braces from (the ones taken yesterday are for record-keeping and treatment evaluation only). I guess 3 weeks isn't anything unusual, but that time will probably feel like ages for me. I wonder how much time they'll need to create the appliances afterwards. How long did it take for you accepting the treatment plan to getting removable braces? So what time frame can I probably expect?

Offline bdave

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Re: My Journey to Removable Braces
« Reply #4 on: 06. February 2021, 18:51:07 PM »
That's pretty cool, good luck with your braces!
Where are you from?
Write in English, please! :)

Offline foobar

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Re: My Journey to Removable Braces
« Reply #5 on: 06. February 2021, 21:46:48 PM »
Thanks. I'm from Germany. Guess I can call myself lucky in my quest for removable braces being from a country where at least children are still somewhat regularly treated with them.

Offline prahm

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Re: My Journey to Removable Braces
« Reply #6 on: 10. February 2021, 23:10:55 PM »
That sounds pretty cool

Offline PlainJane

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Re: My Journey to Removable Braces
« Reply #7 on: 12. February 2021, 11:53:29 AM »
When I got my removables as a kid they made them in house so it was all really fast - probably all farmed out to labs now though.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #8 on: 23. February 2021, 16:20:26 PM »
When I got my removables as a kid they made them in house so it was all really fast - probably all farmed out to labs now though.

I'm interested in how long it'll take after I accept the treatment plan in two days until I get my braces. If it's made in-house I'd expect it to happen quite fast similar to your experience. But unfortunately I'm expecting it to be several more dreading weeks :S

I just realized that I haven't picked a color for my braces yet, even though I'll need to decide within the next days. Of course it'll depend on what's available. I'm thinking transparent dark blue, but that may be a bit boring?

Offline foobar

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Re: My Journey to Removable Braces
« Reply #9 on: 27. February 2021, 17:43:42 PM »
Two days ago I had another appointment where the ortho presented me with an overview of my treatment. She acknowledged all of the small things I'd like to get corrected, but also mentioned some other things that she found. There are the known slight crowding, rotation and tilting, mainly in the front. But she also explained that my front teeth are close to an edge-to-edge bite, only having a slight overbite and overjet, less than the normal expected ones. Regarding my edge-to-edge wisdom teeth, the impressions unfortunately had an air bubble where my wisdom teeth are. They took new impressions, making sure that my wisdom teeth were included this time, to see if she might be able to partially correct them.

As treatment she plans removable plates with posterior bite planes for bruxism. Maybe, depending on the new impressions, she can use buttons on the wisdom teeth to correct them. Primarily, she wants to pull back my lower and upper front teeth to increase my too small overbite and overjet while also fixing the crowding, rotations and tilting. In the upper jaw I have enough space for all of those corrections, but the lower jaw will require IPR. For retention I'll get fixed retainers as well as hawley-style retainers, each for both jaws. All in all, the treatment will take roughly 1 - 1½ years.

I should get the detailed treatment plan today, which I'll sign and hand to them on Tuesday. At that appointment yet another set of impressions will be taken for the lab to construct the appliances from. The lab is part of their practice, so the braces will be done by Thursday already, where I'll finally get them!!!

Offline Retainer101

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Re: My Journey to Removable Braces
« Reply #10 on: 27. February 2021, 19:34:59 PM »
I never knew they made them onsite. 2 days to make them is crazy quick! Although waiting 3 weeks for my retainers was too long for the anxiety levels so quicker is probably better! Had too much time to get worried about it. By the time I got to the practice I was so nervous!

Offline foobar

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Re: My Journey to Removable Braces
« Reply #11 on: 28. February 2021, 14:16:41 PM »
Them having the lab on-site makes me glad I chose their practice instead of others. The removable braces production step itself is just 2 days. However, with all the appointments beforehand, I'm nervous since pretty much the beginning and didn't have a good night's sleep since close to 4 weeks now. So I already had plenty of time to get and be nervous and still have several days left.

Offline bracessd

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Re: My Journey to Removable Braces
« Reply #12 on: 01. March 2021, 17:07:02 PM »
@foobar That's exciting! Looking forward to seeing pictures of your appliance and progress

Offline foobar

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Re: My Journey to Removable Braces
« Reply #13 on: 01. March 2021, 23:59:38 PM »
The detailed treatment plan mainly contains what was already discussed beforehand. The diagnosis sounds like my whole mouth is a construction site ;) Treatment plan is as expected, except that it doesn't mention anything regarding my wisdom teeth. Guess that'll be a question for tomorrow.

When I get my appliances on Thursday I'll absolutely post pictures of them!

Offline foobar

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Re: My Journey to Removable Braces
« Reply #14 on: 02. March 2021, 21:25:08 PM »
Today I had my final non-braces appointment, where yet again, another set of impressions were taken. I asked her about fixing my wisdom teeth, which was left out in the detailed treatment plan. She said, that it might be fixable with buttons but is not related to the removable plates. She'll take another look at that when I receive my appliances in two days. I was also able to convince her to make the upper plate fill my whole palate instead of being horseshoe-like. So if everything goes according to plan, I may get beyond the treatment of my dreams (removable plates filling a lot of space), possibly having buttons and elastics as well (what else would you need buttons for)! :D

Offline bdave

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Re: My Journey to Removable Braces
« Reply #15 on: 03. March 2021, 18:52:24 PM »
That's crazy man, you're so lucky! How much will the treatment cost (approx.)?
Write in English, please! :)

Offline foobar

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Re: My Journey to Removable Braces
« Reply #16 on: 03. March 2021, 19:17:42 PM »
The estimate is around 4000€. I guess that'll increase with all my special requests which hadn't been part of the treatment plan (like the buttons).

I'm really starting to dread the appointment tomorrow. On one hand side, it could be even better than what I am dreaming of for over a decade, on the other hand side I could be overhyped and get disappointed because the appliances are different from what I expected, or I could even realize that reality isn't as amazing as fiction. But hey, at least I'll know which one of the three it'll be in less than 24 hours :)

Offline foobar

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Re: My Journey to Removable Braces
« Reply #17 on: 05. March 2021, 00:08:25 AM »
I got half of my braces today. Unfortunately, the model for the upper plate seems to have warped slightly. The appliance fit the model perfectly, but doesn't fit my jaw, which the ortho wasn't able to fix. Another set of impressions for the upper jaw was taken and the appliance will be remade. Thus I only got the lower appliance for now and will get the one for the upper jaw in one week.

Here are some pictures:
https://dereferer.me/?https://cdn.discordapp.com/attachments/530075173014077451/817415470420197386/1.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/530075173014077451/817415467693637712/2.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/530075173014077451/817415476749402132/3.jpg

The lower brace feels absolutely massive. Talking is pretty hard already and the tongue feels very restricted. And I only have 50% of the appliances so far :) Even if I learned to speak with the lower appliance alone, I'll need to relearn how to speak anyway once I get the plate for the upper jaw.
I didn't get a close look at the non-fitting upper appliance, but from what I could make out, it looked like it had a Y-screw and several springs, some of which were going back to the wisdom teeth. So maybe no buttons and elastics for me…

For now I'm just supposed to get used to them as nothing has been activated yet. Still, everything feels like a weird surreal dream, but I hope the dream will never end ;)

Offline retained

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Re: My Journey to Removable Braces
« Reply #18 on: 05. March 2021, 00:16:37 AM »
Great so far.
It does look quite bulky.
Its strange that the top surface is not very polished. Looks like it was shaped with grinder but not polished. Is there mor to do on it.?

I always think that my bottom retainer has more effect on my speech than the top one.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #19 on: 05. March 2021, 09:54:32 AM »
The top surface was polished originally, but I couldn't bite on it properly. Only a single tooth connected. Thus the ortho ground away material until it fit better.
I always think that my bottom retainer has more effect on my speech than the top one.
The top one looked quite bulky as well and was pretty thick in the front. It'll be interesting to see which one will affect my speech more. It won't be a fair comparison though, as I'll already have worn and practiced with the lower one for a week.

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #20 on: 05. March 2021, 11:28:08 AM »
I am surprised your ortho did not make your brace with clear or clear pink acrylic rather than blue. Or did you ask for it to be blue? Blue will be quite visible, which for me would be fine if it was just for night time retainer wear or just to wear for fun. However,  for proper orthodontic use you will have to wear your braces 24/7 and blue will be pretty obvious in everyday use. Perhaps you are more outgoing and self-confident than me. Is your top brace also blue or is it a different colour?

I agree the brace does look quite bulky and can understand that it might affect your speech. However, I am sure your speech will adapt quickly and it is perhaps a blessing in disguise that you will have to wait a week to get your top brace so as to have some time to adapt your speech to the bottom brace before having to adapt to the top brace as well.

Good luck with your treatment. Perhaps you will be able to post some pictures wearing your braces?

Offline foobar

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Re: My Journey to Removable Braces
« Reply #21 on: 05. March 2021, 16:46:08 PM »
I don't need to wear them 24/7. I should have them in for a minimum of 12 hours a day, but should strive for 14-16 hours if possible. I'm definitely not self-confident enough to leave my house with my braces (yet?). As the top plate has a labial bow, which will be visible instantly, a discrete color doesn't really matter. So even though they did have a transparent option, I just went with blue for both jaws. And I definitely like how the color turned out!

Regarding speech I'm currently just taking them out whenever I have meetings, which doesn't really help with learning to talk in them. Home office and digital meetings are definitely a blessing and curse in that regard :) I'm not sure how long it'll take for me to get used to them enough that I'll just leave them in (at least when talking to friends).

Offline bracessd

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Re: My Journey to Removable Braces
« Reply #22 on: 05. March 2021, 17:04:40 PM »
Your bottom appliance looks nice!

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #23 on: 05. March 2021, 17:25:41 PM »
Hi Foobar,

 I initially wanted a removable brace ( like I had in my youth) when I started out with my adult  orthodontic treatment, but it did not seem to be an option these days with any ortho. I eventually went with a fixed brace with clear Damon brackets and came to realise that it was probably a good option for me to have a fixed brace because I would have been constantly taking a removable one out and would not have had the willpower to wear it enough. Having a fixed brace meant I had to acknowledge it both with friends and in my work, and after I had broken the ice with it, it became less of a deal.

It will probably be best to try to wear your braces 24/7, in terms of both speed of speech improvement and efficiency of treatment. It would be ideal if you could have a couple of weeks holiday spent doing a lot of talking with someone you trust. Then you could present yourself to the world with your braces and make yourself understood and after first meeting with people, it will become no big deal for them.

FYI I wear a hawley retainer at night which I really like . I would be happy to have a blue one like your braces.

Offline bdave

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Re: My Journey to Removable Braces
« Reply #24 on: 05. March 2021, 18:40:38 PM »
Your appliance looks cool! Why are there so many springs in the front?
Also, could you please post a pic while wearing it? Thank you
Write in English, please! :)

Offline foobar

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Re: My Journey to Removable Braces
« Reply #25 on: 07. March 2021, 01:53:16 AM »
Why are there so many springs in the front?
Those springs will probably be used to align my front teeth, which are slightly crowded and rotated. I'm wondering why they won't need a labial bow for that, but I guess they know what they are doing.

I initially wanted a removable brace [...], but it did not seem to be an option these days with any ortho.
I also needed to look around for quite a while. It helps tremendously to live in a large metropolis where I had lots of orthos to choose from. But even here, from among hundreds of orthos, I didn't find many that had removable braces on their website, and even less that actually use them for treament.

It will probably be best to try to wear your braces 24/7, in terms of both speed of speech improvement and efficiency of treatment.
It's always easy to say that, especially after you've already done something similar ;) At this point I'd also recommend everyone that's thinking about getting braces to just go for it. However, it took me over a decade and 3 attempts to actually go through with it, having chickened out of 2 earlier attempts.

I've thought about this, and you're probably right. For now I think it makes sense to wear them around my friends (mostly in voice chat anyway). They likely couldn't care less about it, and it increases my wear time and makes it easier for me (no need to take them out and put them back in repeatedly). During work meetings I'll still take them out though.

Regarding speaking, with just the lower plate I can create most sounds perfectly fine (when I talk a bit slower than normal). The only problems are (post-)alveolar fricatives (e.g. "sh", "s", "z"). After a day of trying to relearn how to talk, I think I've somewhat managed "sh". But my "s" sounds very unnatural. The way I create that sound also won't work once I get the top plate. It's crazy to realize how many words actually have an "s"-like sound somewhere in them, it feels close to every second one. It'll be interesting to see which sounds the top plate will restrict, as I'm surprised how little different sounds the bottom one actually hinders (even though just the "s" is already a pita).

Also, could you please post a pic while wearing it?
No, sorry.

Offline Retainer101

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Re: My Journey to Removable Braces
« Reply #26 on: 07. March 2021, 20:56:32 PM »
That is some appliance! When I finished my treatment I thought I had the perfect smile but 6 months into retainers I’ve looked closer and while they are straight they aren’t as aligned as I would like. Having a Hawley retainer I guess I have looked closer at my teeth and I just noticed my top Centre and bottom Centre are not meeting in the middle and the left side is more flush than the right side. I’m not sure I share your confidence to try sorting it out, even with working from home. I deff couldn’t do fixed braces again, maybe Invisalign might work but I’d be scared they gave me a functional appliance and I can’t say I’d have your confidence. Fair play to you for having the balls to go for the treatment.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #27 on: 10. March 2021, 18:51:17 PM »
(I know that my images of the lower brace have been removed. I don't know why they were flagged as virus as virustotal finds nothing wrong with them. I've written to Marty and am waiting for a response on how I can restore the links / reupload the images.)

Quick update after close to a week of wearing the bottom brace, and one day before getting the upper one. I've told most of my friends that I have braces by now, and they really don't care in the slightest. It's just an "ok" and that's it. No more mention about it. Talking hasn't improved much. I can talk faster again, but "s" sounds are still impacted. Probably even more so tomorrow when I get the top plate. Some friends say that they hear quite a difference when I'm talking, others didn't notice anything (at least in voicechat). With having my braces in around friends I've been able to consistently wear them 16-20 hours each day, which is way more than I expected to be able to do. Maybe it's just the honeymoon period :)

I've already noticed that my teeth don't meet perfectly anymore, even though nothing has been activated yet. I guess that's due to biting into the bite-plane all the time when wearing the brace. That'll be something I'll (need to) get used to during the next year. I also have slight headaches every now and again, probably because my jaws are further apart than I'm used to.

I'm really intrigued by the appointment tomorrow, not only because I'll finally get to embrace (pun intended) the upper plate, but also because I'm interested in when / how the braces will be activated and whether buttons will still be part of my treatment or not (which didn't get mentioned last week).

I just noticed my top Centre and bottom Centre are not meeting in the middle

That sounds like your midline is shifted. All 3 orthos I've been to said that correcting the midline can only be done with fixed brackets unforunately. My slightly off-center midline is my only concern that won't be corrected during this treatment as I went with removable braces.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #28 on: 11. March 2021, 23:54:54 PM »
(The images for the lower appliance are available again.)

With one week delay, I got my top appliance today!

Images:
https://dereferer.me/?https://dereferer.me/?http://dereferer.org/?https://dereferer.me/?https://cdn.discordapp.com/attachments/530075173014077451/819671435995512883/1.jpg
https://dereferer.me/?https://dereferer.me/?http://dereferer.org/?https://dereferer.me/?https://cdn.discordapp.com/attachments/530075173014077451/819671461886296094/2.jpg
https://dereferer.me/?https://dereferer.me/?http://dereferer.org/?https://dereferer.me/?https://cdn.discordapp.com/attachments/530075173014077451/819671454198923284/3.jpg
https://dereferer.me/?https://dereferer.me/?http://dereferer.org/?https://dereferer.me/?https://cdn.discordapp.com/attachments/530075173014077451/819671456492552222/4.jpg

Isn't it a beauty with all of those springs? :)

The brace doesn't cover as much of the palate as I expected. They said that my brace already goes back further than they usually make them. They had bad experiences with plates that fill large parts of the palate in the past, so they went with this design for me.
There is quite some wax residue on the finger springs in the front, which you can also see in some places in the images. I've tried to remove it with a toothbrush without much success. I guess it'll flake off over time and usage.

Talking just became really hard! It's nothing compared to just the lower brace. This upper plate makes talking extra complicated, because it doesn't sit flush against the palate. Instead, there is a small gap of a millimeter or so between the brace and my palate where air can flow through and saliva build up. The former means that any fricative is pretty much impossible now, while the latter results in me spitting all over the place while talking… Let's see how this improves over the next few weeks.

The ortho started activating some springs on the lower appliance. I can really feel the pressure immediately.

All in all I must say that the appliances are very very close to my (real, non-fictional) dream treatment! I'm super happy that I finally took the plunge!

Offline besinger

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Re: My Journey to Removable Braces
« Reply #29 on: 12. March 2021, 00:25:36 AM »
that all sounds very interesting, thank you for sharing your experiences! Would be great to see how the applainces look in your mouth! Can you share some shots? Cheers from Berlin, Jan

Offline retained

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Re: My Journey to Removable Braces
« Reply #30 on: 12. March 2021, 01:38:07 AM »
Sounds like a challenge and really great.
I wonder if the top one will fit up to your palate more as it starts to move things around.?

It was always my ultimate dream to have retainers and I could believe the feeling when I finally got them. After a time I took the plunge and had another top one made to cover almost my entire palate.
I have to say that I do prefer that feeling.

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #31 on: 12. March 2021, 11:51:03 AM »
Gosh that is a really complex appliance. I think I can count 14 metal components in addition to the expansion screw and complicated labial bow -  which I assume is designed that way to give flexibility for opposing forces to the springs behind your front teeth.

Do the springs at the back of your upper appliance actually touch your wisdom teeth or are they designed for attaching elastics?

Are your expansion screws being activated yet? What does your ortho say about the viability of expansion in adults?

What is the purpose of the bite plane on your lower appliance? It does seem odd that the lower appliance does not have a labial bow. Perhaps your ortho is just opening up space with this one and will follow it with a second lower appliance to actually straighten your lower teeth. Rotation must be a challenge with a removable appliance.

Are you managing much wear time with both appliances?

Sorry to ask so many questions but your treatment is really interesting. Kudos to you for pressing for your choice of removable braces when it would have been easier to go with fixed braces.

Good luck!


Offline bracessd

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Re: My Journey to Removable Braces
« Reply #32 on: 12. March 2021, 17:10:36 PM »
Very nice!

Offline Retainer101

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Re: My Journey to Removable Braces
« Reply #33 on: 12. March 2021, 17:58:01 PM »
How are you getting on with them? How long do you have to wear them for? I was so nervous going to get my retainers I can’t imagine how you felt getting those

Offline foobar

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Re: My Journey to Removable Braces
« Reply #34 on: 13. March 2021, 01:18:11 AM »
Can you share some shots?
No, sorry.

I wonder if the top one will fit up to your palate more as it starts to move things around.?
I don't think so. I always create a slight vacuum in my mouth, which resulted in my bruxism night guard leaving indentations in my gums, which I used as reason asking them to have the plate cover my full palate. Instead, they designed the plate to not touch the gums to prevent me sucking that negative pressure. Guess that's partially my own fault in the end, trying to use somewhat bogus reasons trying to make the appliances more extreme.

I took the plunge and had another top one made to cover almost my entire palate. I have to say that I do prefer that feeling.
Now you're just trying to make me envious! ;) I guess I still have a chance for them to create a new top plate, if I have some sensible reasons on why I don't like the current top plate. The ortho said that I should try getting used to the current plate for now and see if it works for me, and if not we'll see what we can do. Any ideas / suggestions for arguments? Another idea would be to ask for the full-palate plate for my retainers, so I get to enjoy both types in the end.

labial bow -  which I assume is designed that way to give flexibility for opposing forces to the springs behind your front teeth.
The two straight springs between the finger springs of my outer incisors and canines are to move the canines back. I think the labial bow is formed that way to control the movement of the canines better as the two loops are (or will be when adjusted) touching my canines. For counteracting the opposing forces of the finger springs a normal labial bow would probably be just fine.

Do the springs at the back of your upper appliance actually touch your wisdom teeth or are they designed for attaching elastics?
I think they are intended to touch the molars and move them inwards once activated. Currently one sits in the middle of the wisdom tooth while the other is sitting close to the gum line (which will most likely be fixed when they are activated). For elastics the wires are probably too long and at a weird angle where elastics would create too much torque.

Are your expansion screws being activated yet? What does your ortho say about the viability of expansion in adults?
The expansion screws aren't activated yet. I don't know if the plan is to activate them at some point at all. The ortho hasn't mentioned anything about expansion or the screws so far. They could be there for a reason (which I'd definitely enjoy :) ), but they could also just be there because they are incorporated into every appliance they build? I don't know. But their mere existence would suggest that they'll be activated in due time, which I really hope for. In the top jaw I have enough space for all my teeth and the planned movements. Only in my lower jaw my incisors are a little crowded. Maybe they'll try to tip my teeth slightly to make room, but then again the ortho plans IPR for the lower incisors.

What is the purpose of the bite plane on your lower appliance?
I grind and grit my teeth a lot, resulting in strong abrasions. The bite plane is used similarly to a bruxism guard.

It does seem odd that the lower appliance does not have a labial bow. Perhaps your ortho is just opening up space with this one and will follow it with a second lower appliance to actually straighten your lower teeth. Rotation must be a challenge with a removable appliance.
I don't think that a second appliance is planned. At least from the treatment plan there is one appliance per jaw during treatment, and one set each of bonded and removable retainers. Rotations and other movements are done with all of the finger springs, of which there are plenty! How the fine-tuned alignment will be done I'm wondering myself. I'd have expected a labial bow as well.

Are you managing much wear time with both appliances?
I've only gotten the top plate yesterday, so I can't really comment on that yet. Considering that all of my friends know about my braces by now, and can understand me (I sound different, but perfectly intelligible), I only take them out during business meetings and when eating. So far, with just the lower plate, I've managed to have them in 16-20 hours each day, which I expect (read: hope) to make with both appliances as well.

Sorry to ask so many questions but your treatment is really interesting.
Ask away! I'm having a blast answering all the questions! Can't really get a conversation about braces started with my friends, as they just don't care, so this forum is the next best thing :) (Also, it helps getting me to 30 posts :D )

Kudos to you for pressing for your choice of removable braces when it would have been easier to go with fixed braces.
Fixed braces were never an option for me personally. I wouldn't have my teeth fixed if I hadn't found an ortho willing to treat me with removable plates. Even though it may not seem like it given the crazy appliances, I only have very slight imperfections, nothing that would require treatment if I didn't want it.

How are you getting on with them?
So far pretty good. They feel as nice as I hoped for. Some teeth started to move, which hurt like hell, just as expected. The only two problems are the expansion screw with its gap between the two halfs of the top plate, which irritate my tongue quite a lot, and the two springs between the top right molars, which are angled in a way that they pinch my tongue whenever I move it over them. So all in all my tongue isn't too happy right now, but I somehow anticipated these kinds of problems. Hopefully my tongue gets used to that so I won't wake up with my tongue hurting in the future.

How long do you have to wear them for?
I need to wear them a minimum of 12 hours a day, but should try to keep them in for 14-16 hours. The longer I wear them, the sooner I'll be done (though I'm not sure if that's a good thing ;) ). So far I make 16-20 hours each day, let's see if it stays that way.

I was so nervous going to get my retainers I can’t imagine how you felt getting those
Before getting the bottom plate (and expecting to get the top one), I was extremely nervous. I can't remember ever having been that nervous before in my whole life, not even before defending my thesis. My blood pressure and pulse were completely through the roof, even higher than when I'm doing sports. Adrenaline was pumping like hell. As it turns out, theorizing about an event for over a decade and playing it through in my head a million times didn't help me in the slightest for this one.
When getting the top appliance a week later, for some reason I was much more relaxed. Still pretty nervous, but not nearly as much as before the previous appointment.

Offline retained

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Re: My Journey to Removable Braces
« Reply #35 on: 13. March 2021, 18:09:50 PM »
Am enjoying reading all the answers.
I understand exactly what you mean about the nervousness / blood pressure!
When I eventually went ahead and made my appointment to go and get my (completely unnecessary) retainers and I went for the impressions, I think I was almost passing out with the anticipation. Then I had to go away and wait a week or more for the call to go back for fitting. That was the longest week of my life!
The feeling when the technician put them in was unbelievable. He asked me how they felt. I could hardly answer.

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #36 on: 14. March 2021, 15:18:50 PM »
Presumably if your ortho has not discussed expansion with you, they will not have given you a key to turn the expansion screws?

I had IPR as part of my orthodontic treatment. I think my ortho was looking to find about 3mm of extra space. It seemed to do the trick with the help of a short powerchain. It is not at all painful, but perhaps a little disconcerting the first time. My ortho did it all by hand rather than using any powered equipment and i was a lot happier with that approach.

Have you had any part of your upper brace activated yet? Or are you due another visit to your ortho.

How is your speech progressing? I  expect you will reach a stage where your speech improves to the extent that you will be able to have a go at wearing your braces for work meetings too. I think it would be desirable to aim for that. For treatment with other types of removable braces like invisalign and inman aligners, orthodontists seem to require 22 hours plus per day. I can't imagine it can be very good for your teeth to have persistent periods of tooth movement whilst wearing your braces followed by persistent relapse when you are not wearing them.

I guess it is different when treatment is completed and you gradually move  from 24/7 retainer wear to just overnight or even just a couple of nights per week.

I presume you are mostly working remotely because of covid? Has the remoteness from other people caused by covid made it easier for you to proceed with your treatment?

All the best

Offline foobar

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Re: My Journey to Removable Braces
« Reply #37 on: 18. March 2021, 02:03:07 AM »
Update after nearly one week with both braces:

The bottom brace is perfectly fine. It fits well and doesn't produce any sore spots. When it was activated during the last appointment, the next few days the activated teeth hurt quite a lot, which I expected but was somehow still surprised by. However, it wasn't too bad, as I was still able to eat all of my normal food. Due to the top plate moving things around slightly even though it's not yet activated, and the new occlusion surface of the lower grinding planes resulting in pretty strong clenching, all of my teeth are a bit sensitive in general.
The top appliance on the other hand is a pita. It had a sharp edge in the tongue region, one wisdom teeth spring was digging into the gums, the labial bow exerted force on one tooth which shouldn't be the case yet, two springs are formed in a way that they pinch my tongue when I move it to that spot, and two small pieces of plastic already broke off. A few of the finger-springs also poke my tongue when I touch them. Due to all of those reasons I went to the ortho on Monday, who fixed most of them (apart from the pinching and poking springs where "just don't move your tongue there" is a valid solution I guess ;) ). The last few days were better, and at least my tongue isn't hurting all the time anymore.

The activated bottom teeth moved quite quickly to their new position. Already two days after the spring activation, they were in their new position and stay there since (I can't feel any further movement with my tongue since then, and the ache reduced significantly after 2 days). But already that small adjustment resulted in none of my chewing surfaces matching up like before anymore. That happened way earlier than I expected. I feel like I'm not able to chew properly anymore but instead just mush up food. It's a weird feeling.

Regarding the wax and how to remove it, an ultrasound cleaner apparently works wonders! All of the wax is gone.

I think I was almost passing out with the anticipation.
That describes it pretty much perfectly. Way better description than I tried to achieve in several sentences :)

He asked me how they felt. I could hardly answer.
My ortho also asked me if I felt any pressure. I was so overwhelmed with everything that I couldn't say anything. I just sat there in awe of everything that was happening. Even if I wanted to answer, I just didn't feel anything at all in that moment. It was incredible. Unfortunately, already in the second appointment a week later when I got the top plate, the anticipation and feeling of awe wasn't quite as strong anymore. I hope that it'll be back strong for my first adjustment in 5 weeks time. One week maybe wasn't enough time to calm down enough to get hyped up again before the next appointment.

Presumably if your ortho has not discussed expansion with you, they will not have given you a key to turn the expansion screws? [...] Have you had any part of your upper brace activated yet? Or are you due another visit to your ortho.
No key whatsoever. So far only a few finger springs on the lower appliance have been activated to start rotating my lower front teeth, and that was also only done because I needed the second appointment for my upper brace. My first proper adjustment will be at my next appointment in 5 weeks. At that time I'll hopefully be introduced to all the active parts of my appliances, including the expansion screws. When asking about how my teeth will be moved the ortho referred to that appointment. Until then I should just get used to the braces.

I had IPR as part of my orthodontic treatment. I think my ortho was looking to find about 3mm of extra space. [...] It is not at all painful, but perhaps a little disconcerting the first time. My ortho did it all by hand rather than using any powered equipment and i was a lot happier with that approach.
3mm sounds quite a lot! For me I suspect it'll only be around 1-1.5 mm of space that'll be needed (though my ortho hasn't mentioned any specific number). I still hope that it's not needed and instead can be achieved with a little bit of expansion / tipping. At least your positive experience takes away a bit of my fear for that part of the treatment.

How is your speech progressing? I expect you will reach a stage where your speech improves to the extent that you will be able to have a go at wearing your braces for work meetings too. [...] I presume you are mostly working remotely because of covid? Has the remoteness from other people caused by covid made it easier for you to proceed with your treatment?
Talking is improving little by little. I've managed most sounds somewhat well, and I'm starting to find ways to make my alveolar and postalveolar fricatives sound not as bad, but also still not good. Probably around the time I'll lose the braces again, I'll finally have mastered talking :D Currently I don't expect pronunciation to improve enough for me to wear the braces during work meetings. Maybe in one-on-one meetings with one of my coworkers with which I have probably around 50% of my meeting time at work. However, due to SARS-CoV-2 and home-office I usually have no more than 2-3 hours of meetings per day anyway. Staying home most of the time definitely helps with wear-time a lot!
I'm not sure if covid was a major deciding factor for me to get braces now. Al least I haven't consciously used it for any decision, but it probably had a subliminal effect.

For treatment with other types of removable braces like invisalign and inman aligners, orthodontists seem to require 22 hours plus per day. I can't imagine it can be very good for your teeth to have persistent periods of tooth movement whilst wearing your braces followed by persistent relapse when you are not wearing them.
My ortho recommends 12-16 hours each day for adults. Even for children she recommends only 14-16 hours with removable braces. I guess she's able to achieve all the movement in that time-frame. Treatment will maybe take longer than when wearing them full-time. Currently I'm easily able to get 16-20 hours per day, which should be more than enough. I'll see how it turns out in the appointment after the next appointment, when we'll see the first results of spring activations. I can start adapting from there if movements are too slow or unstable.
Once home office is over, I don't know if I'll wear the braces during working hours, so that may reduce my wear time down to 12-14 hours. I'm allowed 2-3 days of home office per week (even before SARS-CoV-2 hit), so I can make up time during those days. But I'll tackle that once we get there (which may still take some time as for my company there's no rush to get us back on-site).

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #38 on: 19. March 2021, 11:13:36 AM »
Sounds like you are doing well!

Offline AlexwithBraces

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Re: My Journey to Removable Braces
« Reply #39 on: 26. March 2021, 09:37:38 AM »
How is the bottom expander? I would love to get one, but never really clear on effectiveness in young adults

Offline cancelledDSD

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Re: My Journey to Removable Braces
« Reply #40 on: 06. April 2021, 19:03:16 PM »
Wow that sounds like such a great treatment so far! I’m quite envious! I’m looking forwards to more updates to see how it is going.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #41 on: 09. April 2021, 18:43:25 PM »
Quick update after 4 weeks of having both appliances with 11 days to go until my first adjustment.

Already two days after the spring activation, they were in their new position and stay there since
Yeah that was a wrong statement. That tooth is still wandering forward bit by bit. In fact, even though nothing else has been activated, several of my teeth are moving around. For example the spring for an upper lateral incisor is touching my central incisor, inducing some forward tipping. I guess that's what the getting-used-to-the-braces-phase is for, to let the removable appliance settle, allowing incremental changes afterwards. For fun I tried inserting my old bruxism night guard. Two weeks ago it still fit with a little pressure, now I can barely insert it. There's definitely more movement happening without any activations yet than I expected.

At this point I'm pretty used to the braces and have them in most of the time (~20+ hours on most days). There are still some rough edges, and my subconscious suction while sleeping makes parts of my cheek and tongue get pinched between the plates and teeth, resulting in several sore spots (and a bruise in my cheek). Nothing that requires an urgent appointment, but I'll ask my ortho about that at the next appointment how that can be improved.
There are times when I completely forget that I have the plates in and it just feels natural, and then there are the times where I'm hyper-aware of the braces, feeling them fill large parts of my mouth, prodding and poking my tongue, cheeks and lips. I still wish I'd have gotten an upper plate filling the whole palate. But what I have is very very close to my dreams, so I can't complain.
My grinding and clenching has already left quite some marks in the bite plane. My TMJ isn't used to the more open position due the bite plane yet and aches and cracks every now and again.

Talking is improving week by week. It still sounds different than without the braces in, and I don't expect that to change, but at least I can make distinct "s", "z" and "sh" sounds now :) I'll most likely always sound different while wearing the braces. Previously, with my ~1mm thick night guard, I was able to talk without a noticeable difference after some time, but that one is way less intrusive and I've had it for 6 years instead of the expected 1-1.5 years I'll have these braces.
On some days when I wear the braces all the time except for eating, I start to have trouble speaking without them when taking them out before meals. I takes some minutes for my mouth to adapt back to not having the braces in anymore. Unfortunately the reverse is also true and after putting the appliance back in it sometimes takes 30min until I get used to having them back in. It's intriguing to see how quickly the body can adapt to these things.

I've also received the first invoice from the ortho. For the appliances I've found some weird discrepancies. The numbers that are correct in the invoice are 16 active springs (6 each for upper and lower frontal 6 teeth, 2 in the upper appliance for moving back my canines, and 2 in the upper appliance for my wisdom teeth = 16) and 2 two-arm clasps (the two adam's clasps in the upper plate). However, additionally it lists a labial bow and a modified labial bow. The latter probably means the one on upper brace, but my lower brace doesn't have a labial bow, so I don't know why there are two in the invoice. There are also 10 triangular clasps in the invoice, but I count only 8 (6 bottom, 2 top). I'm not sure if I'm missing something or if the invoice might be wrong.
Either way, my private health insurance covers all of the cost (and already payed for the invoice), but I'll still ask my ortho about it out of personal interest.

All in all I'm not regretting my decision to get these braces in the slightest so for and am very satisfied with them. It's just such a joy to have and wear them, such a fulfilling feeling after all these years dreaming about such a treatment!

How is the bottom expander? I would love to get one, but never really clear on effectiveness in young adults

I can't comment on expansion yet, as my ortho hasn't talked about that topic with me so far. I expect my appointment in two weeks for my first adjustments to touch upon that topic. My guess is that it'll mainly be used for tipping the teeth a bit, but I don't know. I hope I can tell you more in two weeks.

Offline retained

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Re: My Journey to Removable Braces
« Reply #42 on: 10. April 2021, 00:08:06 AM »
Thanks for the detailed update. All sounds good and its interesting that there have been quite a few noticeable changes even before activation.
Interesting to hear that speech is slightly difficult for a time when you take them out.
I certainly found that after wearing my simple retainer / bite plate absolutely full time for a few years (purely by choice). A couple of times I had to quickly disappear from a situation and put it back in because it was embarrassingly difficult to speak without it. I did like that though !

Will be good to get the next instalment..

Offline foobar

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Re: My Journey to Removable Braces
« Reply #43 on: 23. April 2021, 17:10:51 PM »
I had my first adjustment a few days ago. Already before the adjustment, one of my canines moved back quite a lot, pretty much already eliminating the space between it and the premolars (which is the main issue I wanted to get fixed with the braces, or rather, which is the main thing I used as reason of why I wanted braces to the ortho :) ).

During the appointment, the ortho tightened the holding clasps of both appliances quite a lot, to provide better anchorage for the active elements to do their work. She adjusted the springs of my lower incisors and activated my upper lateral incisors to start pushing them out. The springs moving in my wisdom teeth were activated a lot (which really hurt!). When inserting the plate, those springs now get caught on the surfaces of my wisdom teeth, so I need to push them out with my fingers. She also activated the move-canines-back springs, but I think one of them is blocked by another wire and doesn't actually touch my canine.
I asked her about the expansion screws and when / how / if they'll be activated. She said she doesn't need to gain much space. If and when needed she'll just turn them during my normal adjustment appointments.
Given this, I don't think I can answer your question regarding the effectiveness of expanders in young adults as I won't really need much expansion / it'll only be so slight that it doesn't matter.
I mentioned the sores in my lips and cheeks I talked about in my previous post to the ortho and she adjusted a few things here and there to hopefully reduce them. Three days later I can say that it didn't really help and with the new activations other parts of my tongue now also get pinched and start to hurt. I also mentioned the impressions of the upper plate in my hard palate tissue due to my subconscious sucking in the night (which don't really bother me). She smoothed the edges a little bit (although I know that won't help as my dentist also tried everything over the five years of me wearing the bruxism guard without any success). I used that as argument for why I wanted my top brace to cover my full palate which unfortunately they didn't do. I'll continue mentioning it, in the hopes that I'll get that wish fulfilled at least for my retainer :) (which user retained made me even more envious about)

With the tightened clasps, my upper plate hangs now even lower in my palate, reducing the space for my tongue even more. The plastic now goes below my lateral incisors and is even visible from the outside (which I guess doesn't really make much difference as the plastic from the lower bite plane is already very visible). It also strongly affects my speech again. I was finally at a point where I could talk pretty well, and now, again, I sound like I have just gotten the braces…

The pain was about as I expected. When I got the upper plate six weeks ago and my lower plate was adjusted slightly, I already realized that the strongest pain occurs roughly in the timespan 4-12 hours after putting in the braces after the adjustment. An advantage of removable appliances is that this time I was able to time wearing them in such a way that the strong-pain-time was while I slept. With fixed braces I imagine you can't time your adjustments that well and might have meals with that strong ache, which explains quite a lot of tips surrounding soft food after adjustments. In my case, I was able to continue eating normally, though some things like crunchy fries weren't too much of a joy to eat ;) I guess another difference is that only some of teeth were activated, while after a wire change with brackets all teeth are activated in some way or another.
Three days later, I still feel constant pressure and some slight ache, both of which I really enjoy though!

Regarding the missing labial bow and the two missing clasps from the invoice, I asked the ortho. Those elements are really missing. The bottom appliance was supposed to have a labial bow and it's also missing two clasps. She said that she'll definitely need the labial bow to properly align the incisors, which we all were already wondering about and expecting. The technician forgot to / didn't work them into the appliance. I need to bring the bottom brace to the ortho next Tuesday evening. On Wednesday the technician will be there and add the missing elements. Thursday morning I have another appointment where I'll be fitted the lower plate again, and possibly have a few more adjustments.
Additionally, on the bottom brace one spring broke. I think that happened during the adjustment when the ortho was bending it with the pliers, as it was already broken when I was back home and looking at the braces the first time since the adjustment. Either way I'll mention it when handing over the bottom plate next week to make sure that it can be repaired if needed.

Interesting to hear that speech is slightly difficult for a time when you take them out. I certainly found that after wearing my simple retainer / bite plate absolutely full time for a few year.

Your anecdotes about that were exactly what I was immediately thinking about when I realized that phenomenon. It's crazy how quickly the body can get used to or even dependent on something like that.

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #44 on: 01. May 2021, 11:46:30 AM »
How did you get on last week?

Offline foobar

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Re: My Journey to Removable Braces
« Reply #45 on: 13. May 2021, 19:51:21 PM »
Two weeks ago on Tuesday evening I went to the ortho to give them my lower plate for the missing elements to be added. It felt weird only having the upper plate. I was used to having only the lower plate in during the first week, and both plates since then. But this was the first time I had the upper plate in alone. As expected, talking is very different in all three cases. Only having the upper one in is the easiest talking-wise. That's probably due to the bite plane on the lower one blocking me from making proper "s" sounds and instead requiring me to approximate them somehow without being able to bring my incisors close to each other.

I went back Thursday morning to get back the lower plate. The labial bow and two wires, each resting on the occlusal surface of a molar (does someone know the name of those?), were added. Here are new pictures of the modified lower appliance.

https://dereferer.me/?https://cdn.discordapp.com/attachments/530075173014077451/842400994846703616/1.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/530075173014077451/842401023275958331/2.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/530075173014077451/842401044880556052/3.jpg

The modifications changed the bite planes, so they needed to be ground down in some places again to allow for good occlusion. This is always an ordeal as the ortho only has blue foil for detecting bite marks to be ground away, which is near invisible on the blue plastic. I asked her if there aren't foils with other colours to which she responded that she'll probably end up ordering another colour. I wonder why she hasn't already done so in the past. Maybe there aren't many people with bite planes who choose blue acrylic?

During the appointment pretty much all active springs of both plates were activated in one way or another. At least it felt that way later on when the pain set in.
I guess another difference is that only some of teeth were activated
Regarding the pain that statement is probably the root cause for my lower pain the week before. While I was confident last time that my teeth won't ache too much and that I can work around it by having most of the pain during the night, this time I woke up several times during the night due to the pain. Interestingly, mostly my molars hurt, which don't have any active elements. That was probably due to the addition of the occlusal wires and modifications of the bite plane. At least now I know that next time I won't leave the strongest pain for the night :) Instead, when the pain comes during the day, I can see if it is bearable or if I should take painkillers.

Before beginning treatment, I expected speech to be affected but become better over time. What I didn't expect was that after each adjustment I'd need to relearn how to talk anew. The activations of the upper plate during that appointment resulted in the appliance sitting different and yet even lower in my mouth. Therefore, the way I was finally able to pronounce some letters were now void again. It took nearly a week for me to pronounce "s" sounds properly again…

My jaw joints started aching a few weeks ago, which I asked the ortho about during the appointment. She said that as long as it's only a slight ache and they aren't cracking it should be fine. However, if it stays or becomes worse, we can try to make the bite plane a few mm thicker to try to relax the jaw muscles more.
Since then, the jaw pain mostly subsided, but the right joint started cracking sometimes when I take out the braces to eat. Either way, I'll ask her about it again during the next appointment in four weeks. Because to be honest, I'll probably enjoy the thicker bite plane anyway ;)


Initially I feared that I reality with braces will hit me quickly after getting the braces and I'll start to see them like more of an annoyance than enjoyment. I'm glad to say that that hasn't happened so far. I'm still enjoying them every single day with their smooth acrylic, the lisp they give me, and the way they restrict my mouth and my tongue movement. I'm so happy I convinced myself to get them after years of missing courage and chickening out several times!

Offline mattt

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Re: My Journey to Removable Braces
« Reply #46 on: 13. May 2021, 22:35:55 PM »
Thank you for your updates, your journey definitely sounds very exciting and fun! Is making photos of the plates in your mouth or any kind of before pictures and absolute no-go for you? :D

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #47 on: 17. May 2021, 19:16:38 PM »
I agree it would be very interesting to see close up photos of your braces on your teeth. Obviously with no more than your mouth in picture so you are not identifiable.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #48 on: 05. June 2021, 12:28:13 PM »
"Small" status update less than two weeks before my next appointment.

I've reached the stage where stuff gets worse before it can get better. The good changes are that the gaps behind my canines are pretty much completely gone. Food didn't get stuck in there since over a month compared to pretty much every meal before starting the treatment. My wisdom teeth are also noticeably moving inwards.

However, my lower central incisors are being intruded by the labial bow sitting on an inclined plane from grinding. They are already about 1mm lower than my lateral ones. With the top incisors being pushed forward by the springs without the labial bow being activated yet, it feels like I'm having a slight anterior open bite. Biting off pieces of bread or pizza is neigh impossible. It's more like tearing than properly biting. Due to the posterior bite plane and because my canines are being pushed forward, when chewing only my canines are touching. Eating feels very weird and foreign. I hope that it'll improve soon.

Another thing I'm noticing is that gaps are starting to open up between teeth wherever holding clasps are. Before starting treatment, I always had trouble getting floss between my teeth, usually ripping it several times in the process. Now, I can get between my teeth way more easily with only little resistance. I guess that could somehow be counted as an improvement?! There is one gap, however, between my two lower right premolars, which is becoming larger than I'd like. It's where the ortho tightened the holding clasp significantly more than the other ones, which is applying pressure between those two teeth. I hope that once I tell her about it, she'll reduce the tightness and the gap will close on its own again.

My jaw joints have stopped hurting except sometimes when I wake up. The right one is still popping every now and again while eating though. On the one hand, the cracking is not really that pleasant, on the other hand, it might mean that the bite plane will be modified to be thicker, which I'll thoroughly enjoy :)

I realized that my lateral jaw movement is slightly restricted by the wisdom teeth springs. With my braces in I can't move my jaws sideways as far as without them. It's improved since the wisdom teeth started moving inwards, but still somewhat reduced.

Currently, I'm wearing the braces pretty much full-time. I'm only taking them out to eat and during work meetings (still working from home). I leave them in when going shopping (where I'm wearing a mask anyway), but also when meeting with friends or going to the park. I'm getting in 20+ hours wear time per day. Whenever I'm in public, I'm actively and subconsciously trying to hide the braces. It's weird how such a small thing like braces can affect personality and self-esteem that much. I notice a significant difference between my personality with braces and without having the braces in.

Speaking is at a point where it most likely won't improve much anymore. A friend of mine commented that it's become really good and isn't too noticeable anymore. Myself, I still hear and notice a strong difference. With the next appointment I'm expecting speaking to become different again, requiring me to practice for a week or so before being used to the new changes. Especially if the bite plane will be made thicker.

it would be very interesting to see close up photos of your braces on your teeth.
No, sorry.
Maybe in a year or so once I've reached the "fuck it I'll just wear them full-time" moment (even though that moment may never come).

Offline mattt

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Re: My Journey to Removable Braces
« Reply #49 on: 06. June 2021, 21:35:52 PM »
If you are uncomfortable making pictures of you wearing the appliance, do you perhaps have the moulds of your teeth? showing both plates on those would make it much easier to understand as well!

Offline foobar

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Re: My Journey to Removable Braces
« Reply #50 on: 06. July 2021, 20:02:51 PM »
Tonight was the first night without any plastic in my mouth since well over 6 years. And it felt weird. But let's start with the appointment 3 weeks ago.

To be honest, not much happened there. A few adjustments here, a little grinding away of material there, and I was on my way again. We were finally able to grind away all parts that pinched my tongue or resulted in sore spots. She removed some plastic on the inside of my wisdom teeth such that they can move inwards further. She also reduced the pressure on the clasp between my lower left premolars where the unwanted gaps started opening in the hopes that the teeth will move back. The lower labial bow was moved down as well to not intrude the front teeth further and hope that they'll come back up by themselves. As I'm wearing my plates more than the suggested 12-16 hours, the ortho said that we can have less time between appointments. We set the next one to be three weeks later.

Since that adjustment, the lower front teeth have started to come back up, but only a little. The unwanted gap between my premolars is unfortunately steadily increasing, with me getting food stuck there every single meal at this point. But the front teeth in general are mostly derotated and starting to align properly.

Fast forward to yesterday, where I had my next appointment. After a quick overview, the ortho said that my wisdom teeth are close to reaching their final place. She started by adjusting the lower holding clasps again to try and close the opening gap, but one of the triangle clasps broke. When trying to adjust the top plate, she also noticed that one of the springs is close to popping out of its socket. She kept the braces and will have the technician fix them. I used that chance to ask if it would be possible to increase the thickness of the bite plane on the lower plate and make the upper fill the whole palate. I got the feeling that she wasn't too keen on those suggestions, but I was able to convince her by saying that in the worst case if the modifications result in problems, she can just grind all of that away again. Taking plastic away is easier than adding some. For the thickness of the bite plane, she put a piece of wax roughly 1cm thick between my jaws and had me bite into it. She told me that the bite plane will be as thick as the space between my jaws when I bite into the wax. Of course that resulted in me biting into the wax as little as possible to get the plastic as thick as possible while still having my jaw in a comfortable position. Afterwards, another set of impressions was taken, this time with a tray for the upper jaw reaching further back into my palate.

This brings us back to last night, the first night since over 6 years without me having some smooth acrylic in my mouth. The braces are in the lab, and my old night guard obviously doesn't fit anymore. Instead, my mouth felt empty. As if there's something missing. Which there is. In fact, I slept rather bad and woke up several times. My body seems pretty used to the feeling of the plastic in my mouth during the night.

During the day there were moments where I felt like I forgot something. Which would be the case if my mouth was empty and my braces were laying next to me. My tongue doesn't have anything to play with anymore. I also noticed that speaking sometimes feels weird. During work meetings where I always remove the braces, there wasn't any problem. But when talking to my friends in voice chat, where I usually have my braces in, I noticed my mouth trying to talk around the braces. Which failed, as there are no braces.

But all of that is a small price to pay for finally getting the complete set of braces of my dreams with the whole palate covered with plastic and a bite plane as thick as a twin block!

I'll get the braces back on Thursday, and I'm already as excited as I was when I initially got them!

Offline retained

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Re: My Journey to Removable Braces
« Reply #51 on: 07. July 2021, 00:32:00 AM »
Hope you get them the way you want them.
It will be interesting to see how you find the thick bite plate as I find mine makes speaking easier than the one with less plastic behind the front teeth.
Although I asked for the most coverage possible with mine and the plate went a long way back, I would still like a bit more.
Maybe I will get around to asking for that when I order a new hawley with a tooth on it from the Braces Shop to fill the gap where I had a tooth extracted a few years ago.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #52 on: 31. July 2021, 12:11:19 PM »
Three weeks ago I got back the modified braces. Half of my wishes were incorporated. The anterior bite planes are now substantially thicker, but the top plate doesn't go back any further unfortunately. But let's start at the beginning.

Going to the appointment my excitement was immense. After having had the braces for several months now and having gotten used to them, my general excitement for them had started to level off a little. The same could not be said for this appointment. I felt very similar to the first appointment where I initially got my braces. But while I was also quite anxious during that appointment, this time I was able to fully enjoy every last second of it. Already upon entering the treatment room and seeing my models with the thick lower plate I was elated. When I noticed that the upper plate doesn't go back any further and thus won't cover more of my palate, a little disappointment set in. This was due to a misunderstanding between me and the ortho, where the ortho thought I meant that I want the plate to sit closer to my gums as there was a small gap between the plate and my palate. The lab added some plastic to the palate-side of the plate. While not what I originally wanted (and still would like to experience), the significantly thicker upper brace was definitely not an unwelcome surprise. The lab also replaced every spring at the front of both braces. They also added two more springs between my upper canines and premolars. I don't know what those will be for though.
When the ortho inserted the braces into my mouth, the feeling was overwhelming. The way the thick bite planes hold my teeth apart, the noticeably increased thickness of the upper plate, and the now completely different lisp all hitting me at the same time was just incredible. But I needed to concentrate as the thick bite plane needed to be ground to fit my teeth again. At least this time the ortho had ordered red marking tape which she used instead of the blue one which didn't work too well in the past. Accordingly, that part was finished much quicker than during previous appointments.

do you perhaps have the moulds of your teeth?
I don't have the moulds of my teeth, but I have some six year old moulds from when I got the bruxism night guard made. While the braces don't fit perfectly, I think it's good enough to get the gist of it. Here are new images of the modified plates with and without the moulds:

https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/863502240076660746/1.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/863502250570809374/2.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/863502255184805908/3.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/863502265091227702/4.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/863502274654502912/5.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/863502284104269829/6.jpg

Lisp-wise I started fully anew. While s sounds are surprisingly easier now, everything else has regressed significantly. It took me over two weeks until I was somewhat satisfied with my pronunciation again. I still sound muffled and like I'm mumbling with still quite a lisp. It sounds like I'm talking with a full mouth. Which I guess is exactly the case. Talking fast I still trip over a lot of sounds. When concentrating and talking slowly it's okay-ish, but I don't think it'll get much better. But even then there are some hard sound combinations like s followed by sh between which I need to make a pause.

The new tick bite plane seems to relieve all the problems I had with my joints. They don't ache anymore and I don't have any clicking or similar. That really worried me as I didn't have these kinds of problems before getting the braces. But while this means that I'm getting to keep the thick planes, it also means that I'll need to keep the thick planes. Something something double-edged sword.

Treatment progress wise, my upper wisdom teeth are located well now and will only be held / retained from now on. The bottom incisors are de-rotated but still crowded. The ortho said that during my next appointment next week she'll start to perform IPR to get the required space. I'm still not too keen on that to be honest…

The last few weeks I was together with my family which I was a little apprehensive about. They didn't know about my braces yet. When I arrived and mentioned the braces, we talked about them for a few minutes, but that was it. No further question, comment or anything. It's crazy how such a big thing for me results in so little reaction from everyone else. I didn't really trust all the comments on this forum stating the same thing. But it's surprisingly true. Noone else cares. It's only a big deal for yourself.

Offline retained

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Re: My Journey to Removable Braces
« Reply #53 on: 31. July 2021, 17:13:52 PM »
That really is a mouthful now. Yes you are right, it is a shame they didnt make the plate cover the palate fully. It is that feeling that I particularly like, although mine could still go back further.
There are certainly enough springs to move things around a bit!
Looks like they keep your mouth much further open than my activator does.
Interesting, isnt it, that you find s sounds a little easier with the thicker plate.
I also found that the bite plate made that easier and a little more 'forward' than the thiner retainer, although I have to be a little more careful to avoid excess saliva.

Offline Parisbraces

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Re: My Journey to Removable Braces
« Reply #54 on: 08. August 2021, 01:55:14 AM »
Thank you for your interesting story. What does IPR mean?

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #55 on: 13. August 2021, 11:56:04 AM »
If they had increased the acrylic coverage of your palate, they could probably have squeezed in a second expansion screw as well'- which again would have required fairly thick acrylic. It still seems odd to me that they have installed expansion screws top and bottom but are not using them.

From an orthodontic perspective, your case would be managed much more easily with fixed braces, so kudos to your ortho for accepting your demand for removables. I can't imagine there has ever been a more complex set of removable braces. very impressive.

Don't worry about the IPR. It is not at all painful and the amount of enamel removed is minimal and should not impact on the health of your teeth. My orthodontist told me her invisalign practice was reliant on IPR; should could not have done most of her invisalign cases without it. 

Offline Sparky

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Re: My Journey to Removable Braces
« Reply #56 on: 30. August 2021, 23:42:07 PM »
....What does IPR mean?

Inter proximal reduction: https://dereferer.me/?https://www.bos.org.uk/News-and-Events/BOS-Statements/BOS-Statement-Interproximal-reduction ....

"Interproximal reduction (IPR) is a technique used during orthodontic treatment to create space for tooth alignment. It involves removing up to 0.5mm of enamel from the sides of teeth to enable the orthodontist to straighten them accurately. The technique can also be used to improve the shape of teeth."

Offline foobar

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Re: My Journey to Removable Braces
« Reply #57 on: 21. September 2021, 01:25:12 AM »
I just realized that I never updated you on my last appointment 7 weeks ago. As I'll have the next appointment tomorrow, I thought I'd give a quick update beforehand.

Last appointment the planned IPR was performed between my lower incisors. Due to that I wasn't in a separate room as was the case for all previous appointments. Instead, I was in the open treatment area with three chairs next to each other. Next to me was a teenager with fixed braces getting a wire change.
The ortho explained to me the stripping procedure. She said that it can be done either with a machine or by hand. For me she prefers by hand. She had two different strips of sort-of sand paper. She started with a coarse one and finished with a more finer one. It really felt weird. Even though it was exactly as I imagined having sandpaper between your teeth feels like, it still felt somewhat unexpected. I definitely didn't enjoy the feeling one bit. Luckily, it was over pretty quickly after only a few minutes. Afterwards, she applied some fluoride. She said that she took away very little and that the gaps should be barely visible. Looking in the mirror and pressing my tongue against the incisors, however, I was easily able to see tongue through the gaps. Though noone apart from me would be able to notice it.

The top plate wasn't adjusted, as she wanted to wait with that until the lower teeth have gone backwards. She did trim away some acrylic that was digging into my gums at the left wisdom tooth. Unfortunately, as a result that wisdom tooth moved inwards quite a bit in the last seven weeks, probably because there isn't anything holding it back anymore (as the plastic there was ground away). On the other side the wisdom tooth is where it was left as inward movement is prevented by the plate going back there. I'll mention it tomorrow and am interested in how that will be undone.
I asked her about the two additional springs that I noticed last time when all the springs were replaced. She said that those are maybe because the lab tech couldn't remember between which teeth the springs were exactly once they removed all the springs. They most likely decided to add them in both places where they thought they were. They won't be needed or used.
One thing that annoys me quite a lot, is that the spring between my left canine and incisor is pressing against the incisor. That resulted in both incisors on that site tilting quite a lot. The central incisor is trying to push in front of the right central incisor but is blocked by the labial bow. Thus, the right central incisor is pushed back, leaving me not able to bite properly at all. It's also extremely visible. In fact, I was asked by a colleague if the corner of my tooth broke off because it looks just like that. Additionally, that central incisor was already tilted slightly to begin with. During the initial consultation the ortho said that this kind of untilting can't be done with removable braces. I really hope that it can be fixed somehow.

On the bottom plate the ortho ground away a bit of the plastic behind my incisors, allowing them to move back and adjusted the labial bow to apply quite some pressure. Since the adjustment, those four incisors have moved back amazingly and I'm really starting to love how straight they are. There are still some very slight gaps between some of them, but they are barely noticeable even for me. I'm sure they'll be gone very quickly after the next adjustment. However, all four incisors are still pretty sensitive to pressure. When flossing, the gaps where IPR was performed feel pretty rough compared to how smooth it fells between all other teeth.
Finally, the ortho fastened the holding clasps, as the lower plate was sitting rather loosely. Unfortunately, that resulted in the space opening up between my right premolars yet again.

Once finished, she inserted my plates back in my mouth and said that she usually expects the braces to be worn at least 3-4 hours after IPR. Having had the adjustment in the morning hours, I'm pretty glad I didn't have any work meetings afterwards. Otherwise that wouldn't really have been possible.

I have to be a little more careful to avoid excess saliva.
I definitely noticed myself spitting quite a bit more when talking since I've gotten the thick bite planes when I'm not careful with my saliva management. In general speech hasn't improved much since the last time. While my family says that they don't hear much of a difference, especially when wearing a mask, I still notice quite a difference. I can pronounce most words without much trouble intelligibly. Except for my last name. Already without braces I usually need to repeat it several times. But with braces it just feels like the worst combination of sounds ever. Spelling it out doesn't help either. And when I try to speak super clearly and think about every word (e.g. when asked to repeat something), talking becomes much harder. So being asked to repeat my last name results in even less understandable gibberish.

If they had increased the acrylic coverage of your palate, they could probably have squeezed in a second expansion screw as well
Yeah, I still feel a bit bummed about that. But I'll try again for more acrylic coverage when it's time for retainers. Even if they did increase the acrylic, I wouldn't have expected a second expansion screw, since I don't expect them to ever be used. But one can always dream :)


From an orthodontic perspective, your case would be managed much more easily with fixed braces, so kudos to your ortho for accepting your demand for removables. I can't imagine there has ever been a more complex set of removable braces. very impressive.
I'm also really glad that in the end I finally found an ortho willing to treat my case with removable plates. Otherwise I wouldn't have gone for any treatment at all. The plates are definitely quite complicated compared to most "normal" ones. Since years I've been thinking about what removable braces would look like for me. Most of the things I expected are actually there exactly as I thought (the modified upper labial bow, the springs to move the canines back, …). But then there are so many more springs all over the place that I would never have thought about. Definitely quite some metal in there!

the amount of enamel removed is minimal and should not impact on the health of your teeth.
That's what my ortho told me and what I'm telling myself as well. But as an avid teeth grinder, I've already lost so much enamel that it just feels bad to have even more removed.

All in all some stuff is getting better while other stuff is getting worse. I really like the changes of the lower incisors and I'm sure that the upper teeth will be fixed in due time.

PS: "quick update" apparently equals over 1200 words…

Offline retained

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Re: My Journey to Removable Braces
« Reply #58 on: 21. September 2021, 23:54:34 PM »
Thanks. Am finding the detailed updates very interesting. That really is a mouthful of thick plastic.
Its always surprising how we can learn to deal with something so intrusive.
It will be interesting to know how it is to speak without the plates when you eventually finish with them.

(One small thing, and please excuse me for saying....but it is 'ground' not 'grinded')

Offline foobar

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Re: My Journey to Removable Braces
« Reply #59 on: 26. October 2021, 02:18:56 AM »
A lot happened since the last update. In fact, I had two adjustments and will have the next one tomorrow.

In the last update before the first of those adjustments, I wrote that my teeth had shifted quite a lot in the seven weeks since the adjustment before. When the ortho asked me how it went since the last adjustment, I answered that a lot of stuff moved in ways they probably shouldn't. She looked at my teeth and acknowledged the very same things I noticed.
My 11 (I'm going to use FDI from now on if that's fine with you) moving back and blocking my bite was promptly moved forwards. Regarding my rotated 21 and 22, the ortho said that it's mainly due to intrusion. She explained that some intrusion is to be expected when using removable braces, but she has never seen a patient where teeth intrude as quickly and strongly as mine do. She also mentioned that my teeth seem to move very fast in general. She relieved the pressure on 21 in the hope that the tooth will extrude back out.
After mentioning that my 28 had moved inwards quite a bit as the acrylic counterpart was missing, she reduced the pressure of that spring.

In the bottom she increased the pressure of the labial bow a bit to close the minimal gaps I was still noticing. I mentioned that those incisors still feel sensitive even after 7 weeks, probably due to the bottom plate being pushed forward when I'm clenching subconsciously. She spent quite a lot of time removing any pressure I felt from all the springs behind those teeth, adjusting them little by little for each individual tooth. She also pushed out the holding clasp between my 44 and 45, ground away a little from the acrylic on the inside and increased the tension of the triangular clasp behind 45 such that the 44 can move back and the 45 is pushed slightly to the front, reducing that gap. That definitely helped as that gap is gone again.
I also asked when my 38 will be derotated which I initially requested before getting the braces. She wants to have my bottom from teeth finished before starting on that tooth, as there are currently already enough things to work on. It'll require another modification to the bottom plate. The acrylic on the inside will need to go back even further to fully cover that tooth. A spring will also need to be added similar to the ones I had for my top wisdom teeth. From that description I guess the original idea during the first consultations of using a button won't be happening...

Due to my teeth moving quite fast, the ortho wants to see me more often with less time between appointments. I agreed on another appointment three weeks later.

As my teeth and bite were shifting all over the place again, already the evening after the adjustment I bit of a bit from the corner of my 12 as I hit that tooth once 11 was moved out of the way. Luckily it's only a small piece without any further problems. Apart from that, not much happened. The bottom incisors improved rotation- and alignment-wise. The top got slightly better but I still can't bite properly. I can't bite off things like pizza and can't chew properly due to a posterior open bite resulting from everything being in flux.

Three weeks later, two weeks ago, I had the next adjustment. All gaps between the bottom incisors had closed. My 42 was still out of line a bit. The ortho said that she'd like to strip the space between the 42 and 43 a bit more to move 42 back a bit more. I think I'll never get used to the feeling of IPR. It just feels so ... weird. I can't describe it. On one side it's exactly as expected, sandpaper between teeth, on the other side it makes me feel like when I hear fingernails on a chalkboard. Anyway, she added more pressure to that tooth from the labial bow, which now makes a curve inwards in front of that tooth. She said that from now on she wants to only apply very slight pressure as my teeth again moved quite a lot in the three weeks. When I asked her in how far that was unusual, she said that usually with adults movements aren't that fast and teeth don't react that strongly. I told her I wear the braces about 18-20 hours each day, which she meant could explain part of it. Anyway, she'll try to move ahead with using only slight pressure and adjustments every 2 weeks now.

On the top plate, the spring for the 28 dug into my gum since the last appointment. The ortho said that my 18 and 28 are in their final position and have been retained there for some time already. The springs shouldn't be needed anymore and are causing more harm than good. Thusly, she removed them. She clipped them off and smoothed the places where they met the acrylic. She also adjusted the spring behind my 12 to move it forward and out of harms way. And then the unexpected happened: She turned the expansion screw of the upper plate. Only half of a turn, so 1/8 of a full rotation, but she turned it! She said that she needs a bit more space in the front.

As I've always been highly intrigued by expanders, I was on cloud nine. It was just such a slight expansion, but I was able to fully enjoy the feeling of the sideways pressure. Though unfortunately it was very slight and only lasted for about a day. Still an amazing experience I had only dreamed of before.

In the weeks since, my top teeth didn't change much, but the top plate also wasn't modified much. The alignment of the bottom incisors improves ever so slightly bit by bit. However, they are at completely different heights now, probably due to different pressure and rates of intrusion.
Last week I had a painful sore spot in my lower gums, which the lower brace pressed against. I wasn't able to wear the plate for three days, letting the spot heal and disappear on its own. Interestingly, the differing heights of my lower incisors started to equalize a little during that time, as if some of the teeth were extruding again. Also the posterior open bite started to close a little. However, all of that was undone within a day of starting to wear the lower plate again.

I'm at a point where first doubts start to set in. Some things improve a bit here and there, while other parts go haywire. I still absolutely enjoy the whole experience with lots of elated moments. However, I'm thinking about if I'll ever be able to bite as well again as I did before starting with all of this. I guess I'm currently just frustrated that stuff is moving around in ways it shouldn't. But then again I've read a lot that it always gets worse before it gets better.


In my region, some places start to open up a bit more with mask mandates being partially lifted. This means that in some places I'm now wearing the braces around without a mask to hide them behind. I have to say that it's a very different feeling. Beforehand, noone could see the braces and given my speech having become quite good (with only a bit of the "braces-accent" left), I think hardly anyone would even notice that I have braces. But now everyone can see them when I'm talking or laughing. There are some times where I completely forget about them and act just normal, and then there are times where I become extremely self-aware about them and try to hide them. The switch between those happens instantly, sometimes while I'm talking. I guess I'm not used to that "exposed" feeling yet. On the other side, not wearing a mask in public places doesn't prevent me from wearing the braces anymore as was the case when I initially got the braces. Still, I don't wear them during work meetings or in the office. Luckily, it's still mostly home office for the foreseeable future.

It will be interesting to know how it is to speak without the plates when you eventually finish with them.
I'm not sure I understand what you mean. I still speak quite a lot without the braces in as I don't wear them during work meetings or when eating. It takes a few seconds to adapt to not having them in when I take them out where my mouth still tries to swallow and speak as if I had them in and fails miserably. But after those few seconds everything's back to normal.

(One small thing, and please excuse me for saying....but it is 'ground' not 'grinded')
(On the contrary, thanks a lot. I thought "ground" might be correct, but it just sounded wrong to me for some reason.)

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #60 on: 30. October 2021, 22:29:14 PM »
How did your recent adjustment go?

Offline foobar

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Re: My Journey to Removable Braces
« Reply #61 on: 16. November 2021, 00:48:00 AM »
Last adjustment was rather quick and simple. I told the ortho about the painful spot I had, which made her grind away a little material from the inside of the bottom plate there just to be careful. I also explained that during the few days I couldn't wear the braces, the bottom teeth's height started to equalize partially. She changed the labial bow to only apply pressure to the one tooth she's currently moving (42) and created space between the labial bow and the other three incisors. Since then, the slightly intruded lower incisors did actually extrude. They aren't all perfectly equal in height, but that also wasn't the case before I started treatment, so it's probably as good as it'll get with removable braces. They're also just at barely different heights.
In the top the ortho activated springs to move out the incisors and canines that were "blocking my bite" (i.e. the only teeth touching when I tried to bite together). Even with those changes, I still can't really bite down. Only one molar and one canine are touching when I bite down. At this point I'm not sure if it's really the incisors that are messing up my bite, or if it's rather my molars having intruded due to the bite planes and clenching.
I mentioned my 21 still being tilted to the ortho. She explained that that kind of rotation can't be done with removable braces. I said that I compared it to 6 year old molds for my night guard back then and while that tooth has always been a bit tilted, it wasn't nearly as much as it's now since I started treatment. She answered that she can try applying force to the inside left of that tooth to maybe change it a little. Unfortunately, since then I haven't seen much improvement in that regard. However, when I was little, I broke of the right hand corner of that tooth which has been fixed with some glued plastic composite several times (since the plastic breaks off every few years). Maybe after treatment is finished, I'll have the corner reconstructed to give the tooth a more straight look, and not have such a noticeable step to the 11.

I observed that when the ortho activates springs to push out my upper teeth, she doesn't stretch out the springs as much as she bends them upwards. That explains why the plate always sits lower after adjustments and why I need several days to adjust to speaking again. I just have less space in my mouth after each adjustment.
Since the last adjustment, the plate is pretty low. You can even see a gap between my upper incisors and the plate hanging below them. When I'm concentrating on work and subconsciously suck a vacuum, my upper lip now gets caught in that gap, leaving marks which hurt sometimes. Interestingly, I noticed that those marks are happening mainly during the day when I'm concentrating and not during the night.
I'm used to years and years of marks in my cheeks and tongue, and I don't even notice those anymore. In one of the earlier appointments the ortho said that she was a little concerned about those. But I don't even notice those anymore. It's unfortunate that my body seems to have adapted to relieve stress through grinding, clenching, sucking, lip biting and similar means.

Since the adjustment, my upper teeth have been pushed so far forward, that there are noticeable gaps between them. In fact, even my upper labial frenulum now fits between my central incisors. I guess that's also a side-effect of my 21 having force applied only to the left side. Either way, that diastema is getting larger and larger every day and rather visible. I'm glad that I have the next appointment tomorrow in the hopes that those gaps will be closed. I still feel like while my bottom incisors are becoming better and better, my upper jaw becomes a construction site more and more. At least the upper wisdom teeth are staying in their positions even with their springs removed and seem to be done. To be honest, I kind of miss those springs and notice my tongue trying to play with them, but they aren't there anymore...

Offline foobar

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Re: My Journey to Removable Braces
« Reply #62 on: 17. November 2021, 17:34:39 PM »
Well, the appointment yesterday was very interesting!

It started very normal. The ortho asked me if my bite had improved since the last adjustment and if more teeth are touching now. I responded that nothing really changed and I still only have contact between my left canines and my left 7s. She reacted surprised and took quite a deep look at my upper teeth and bite. After also studying the notes in my file, she asked, what I think about completely leaving out the upper plate for now and only wearing the lower one, coming back for another appointment one week later. Now it was my turn to be surprised. She explained that she moved my incisors and canines outwards so much that they are starting to flare, yet my bite still isn't improving at all. She wants to let the upper teeth settle for a while to see if that helps.
After taking another look at the upper teeth, she shook her head and adjusted the springs for my 22 and 23 on the upper brace, saying that we can first try pushing out the teeth a little more.

Next was her examining my lower teeth. She noticed that the step from my left first premolar to the canine had become quite large. She explained to me, that the posterior bite-plane together with me clenching quite strongly and wearing the plates religiously way more than most of her patients, could maybe have resulted in my molars intruding. Which interestingly is exactly what I suspected in my last post. I wanted to ask her about this later during the appointment, but she came to the same conclusion beforehand. She fetched my impression model from before I started treatment for comparison. It confirmed not only that my molars intruded, but also that in addition my left lower canine extruded as it was not covered by the bite plane's acrylic. She said that she had never seen such a thing as all of what is happening with my teeth in her career.
She explained that she wants to extend the occlusal coverage to go over all lower teeth including the incisors to prevent any in- or extrusion. However, that will only be possible once my lower teeth are completely finished with the treatment as the acrylic is going to enclose all those teeth, locking them in place.

She went back to my models, the braces and her notes and thought for several minutes. When she came back, she suggested the complete opposite of her first plan: She asked me to only wear the upper plate and completely leave out the lower brace. As the lower left canine is the only tooth touching the upper plate's acrylic, that might result in the tooth intruding again and giving my molars space to come back up. Testing out how my canine interacts with the upper plate without the lower one, we realized that the canine slips to the side. The acrylic where my canine hits is also relatively thin, such that the ortho has concerns about it breaking off.

This was when the ortho decided upon a complete redesign of the plates. My braces will go back to the lab technician. The posterior coverage will be completely removed from my lower plate. The upper plate will gain an anterior bite plate to intrude that canine and give my molars space to erupt again.I took the chance to try and push my luck further. I again asked if it was possible to make the acrylic cover my full palate. This time I also showed her what I mean directly on the braces. I also explained the reason more, that I'd like to try to distribute the pressure of the acrylic more, as the plates had always left marks in the gum of my palate. I don't think that we talked cross points as we did last time, as she asked "The whole palate?", which I confirmed.

After writing down everything, she wanted to perform yet another slight IPR on my bottom incisors. They are getting better, but still have a bit too little space. So we went to the other area with three chairs next to each other, where she stripped away a bit more between all incisors up to the canines. I still can't get used to that feeling and still hate it as much as during the first time.
Then came another set of impressions. Every single time so far, the upper jaw required at least two impressions as my wisdom teeth wouldn't fit properly even on their largest (XL) impression spoon. This time, after three failed attempts by the assistant, the ortho used a bit of wax to increase the length of the spoon. Only then, with the fourth attempt, the impression was finally usable. The ortho checked that the impression of my palate was good as well, a further indication that maybe this time I might finally get full palatal coverage.
After getting fluoride applied for the IPR and making an appointment for Thursday, I was finally done with the appointment. The whole appointment took well over an hour. When I left, there ware at least 5 children with their parents in the waiting room.

All in all quite a rollercoaster of an appointment. I'm super excited for tomorrow and really hoping to finally get full acrylic palatal coverage. I also expect that I'll struggle with lisping for several weeks again.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #63 on: 30. November 2021, 02:47:28 AM »
The appointment two weeks ago where I got back the modified braces went exactly as I had hoped!

When I was called back into the treatment room, my models with the plates were already laying on the table. Taking a quick glance I was able to see that the upper plate does go back quite a bit and that the front is pretty thick. The ortho said that she can't imagine anyone liking a plate that fills the palate that much. I mentioned that I'll probably be fine with it if that stops the acrylic from digging into my gums. She mentioned that those marks are clearly visible in the impressions, so we can at least give it a try.

Before getting into more details, here are images of my new-ish plates:

https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/914871058593624124/1.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/914871059168235592/2.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/914871059923206154/3.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/914871060460089374/4.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/914871061080838154/5.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/914871061659648060/6.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/914871062297215036/7.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/914871062804705290/8.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/914871063509364758/9.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/914871064138502154/10.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/863502137362743399/914871150117535764/11.jpg

When I sat down, the ortho first showed me the lower plate. The thick posterior bite plane has been removed, making the brace look quite delicate compared to before. The acrylic on the inside goes back further than before, stopping after my wisdom teeth. She explained that she had the tech incorporate a spring to derotate my 38. She also noticed that my 48 is rotated slightly, so another spring for that one was added as well. She inserted the lower brace into my mouth and it fit surprisingly well on the first try. There were a few rough corners and edges, which were fixed, and that was it for the lower plate.
Then came the upper brace. Upon inserting it, it hung quite low and didn't feel right. There was at least half a centimeter between it and the roof of my mouth (that's 0.000003 miles for the non-metric speakers). I tried to tell that to the ortho, but whichever sounds came out of my mouth were very far away from what I wanted to express. I just couldn't talk. I've never had such a strong lisp. Not even when I initially got the braces. Somehow the ortho was able to understand whatever I tried to say. After some grinding and me saying where the acrylic was poking into my gums, the plate fit better. It wasn't perfect and there was still a little gap between my palate and the acrylic, but it was good enough. The next step was to investigate the bite plate. She had me bite down several times and used marking foil to see where my teeth and the bottom plate were hitting the top plate. She removed some acrylic from the bottom plate and the right side of the bite plate to ensure that only my left canine touches, to intrude it.
After everything fitted and was done, I asked her if she could polish the plates to remove the roughness from the drill bit, which she did. No springs were activated as I should get used to the new braces first.
She stressed repeatedly, that if there is any problem or anything that bothers me, especially with the palatal coverage, I should call immediately and make an early appointment even though my next scheduled appointment will only be two weeks after.

Since then, I fully enjoyed the new braces. The upper plate almost entirely covers my hard palate except in the back middle, where it could go back slightly more for my liking. It is quite thick in some places, especially where it becomes the bite plate. The bite plate itself feels crazy huge in my mouth even though it doesn't look that large to me just looking at the brace. My tongue has very little room and needs to sit quite far back.
I expected the lower brace going back pretty far not to be much of a problem. Surprisingly, it does interfere with my tongue's normal resting position. My tongue now rests on top of the acrylic of the lower plate and in the vertical gap between my teeth created by the bite plate, making the space feel even more restrictive. The springs for my lower wisdom teeth poked my tongue in the first few days, but I got used to it.
Speaking is a whole different beast. It's similar to when I first got the braces, but even more severe. I've actively practiced talking and reading aloud. It's gotten better and I'm understandable, but I notice a strong lisp and quite some mumbling. In retrospect, while previously my mouth was very full, the "talking" areas weren't that inhibited and only few sounds were affected. The bite plate and full palatal coverage do interfere strongly with most sounds.

Due to my negative-pressure-sucking the upper brace seems to have deformed a bit and now fits snugly in the roof of my mouth. I can't feel or see any marks created by the acrylic in my gums, so that part seems to be working as I hoped it would. Unfortunately with my tongue not having much space, it presses into the expansion-screw slots, which hurts at times. I did think about these rough edges during the last appointment and wondered if I should have the ortho smoothen them. But I thought that maybe they won't be a problem this time. Welp, guess I'll ask her to smoothen the edges during my appointment tomorrow.

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #64 on: 30. November 2021, 14:55:35 PM »
Wow that upper brace is now enormous with a very thick bite plate!  It is amazing that you can speak at all. I would say that the acrylic goes about twice as far back as that of my recent hawley ( I have no first premolars ) and it is at least double the thickness. And I thought my hawley was fairly bulky. Does the bite plate show beneath your incisors? Is there a danger of this bite plate allowing your molars to erupt further, leaving you with an anterior open bite? Presumably your ortho will be keeping an eye on this.

Fixed braces are very much the normal approach in Europe these days, but quite complex orthodontic work was done with removable braces maybe 40+ years ago so it is interesting to see your ortho having a go at it. 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. But kudos to you both for using removables.

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #65 on: 30. November 2021, 15:26:16 PM »
PS  You probably now have space for two additional expansion screws.... :)

Offline bracessd

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Re: My Journey to Removable Braces
« Reply #66 on: 30. November 2021, 16:54:27 PM »
Those look great!

Offline retained

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Re: My Journey to Removable Braces
« Reply #67 on: 30. November 2021, 22:14:04 PM »
Looks great. I fully agree with you about wanting full coverage.
Yes, it looks very thick, and that certainly will add to the experience. I am sure you will get fully used to wearing them quite quickly.
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.

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #68 on: 02. December 2021, 11:01:20 AM »
PPS Why do you have an adams clasp at one side of your upper brace but arrowhead clasps at the other side?

How did your adjustment appointment go?

Offline foobar

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Re: My Journey to Removable Braces
« Reply #69 on: 09. January 2022, 18:20:29 PM »
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.

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.

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.

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.

PS  You probably now have space for two additional expansion screws.... :)
But also still no need even for the first one :D

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.

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.

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.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #70 on: 11. January 2022, 18:27:11 PM »
Remember when I wrote that I find it harder to wear the braces for 12 hours each day than full-time? That will become way easier now.

At my appointment today when I entered the room, the ortho immediately asked if I am able to bite properly again and if all my teeth are touching again. After I answered in the negative, she asked if the bite plate is still opening my bite while I wear it, which I confirmed, stating that it closes during the day again while not wearing the braces. She had a quick glance in my mouth with and without the braces, then with just the top brace in followed by just with the lower plate in. She concluded that the situation with my teeth is geeting too precarious (is this the best translation for the German word "heikel" in this context?). I should stop wearing my braces completely for the next three weeks at which point she wants to see me again. She checked if wearing only either the upper or the lower plate might make sense but decided against it. As I do notice my bite getting better while not wearking the plates, she hopes that my teeth will settle by themselves in that time.
And with that I was on my way again. All in all the whole appointment didn't even take 10 minutes (compared to 20-30 min usually). Definitely my fastest appointment yet.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #71 on: 01. February 2022, 17:46:11 PM »
Today I had my next appointment after 3 weeks of not wearing the braces at all. Well, technically I did try in the braces two days ago for a few minutes to see how they fit after this time. Well, they don't fit well anymore. I can push in the bottom one with a bit of force, but feel pressure everywhere. The top one doesn't touch my palate at all and basically just hangs in my mouth. I find it interesting how much my teeth moved in this small amount of time with no external force.

The first few nights without the braces were very weird as I've been wearing my braces close to a year and had a bruxism night guard for six years before the braces. Already when my plates were modified the last time and I had a few nights without any plastic in my mouth it felt like something's missing. This effect was enhanced with the increased duration. During the first week I woke up several times in the middle of tfhe night because I had the feeling that I forgot to put in my braces / guard. It's become better since. Still, whenever I'm going to bed, I have a quick moment of "you forgot something - nevermind, you didn't".

During the last three weeks, my bite improved quiet a bit. All right teeth are touching again. Not as perfectly as before starting treatment, but somewhat good enough. On the left side the premolars and molars extruded as well, but I still only have contact between my last molars and my wisdom teeth. I told the ortho as much today. She checked my teeth and bite several times. She concluded that the posterior bite plane might have tilted my molars on the left side. Also pushing in my wisdom teeth might have resulted in them blocking my bite. She couldn't really tell just by looking into my mouth. She wanted new impressions to analyse and plan further treatment options. For now it doesn't make sense to activate my plates until the bite is settled.
She checked if the intended teeth movement has stayed so far or reversed itself while not wearing the braces. She was pleasantly surprised that pretty much everything we achieved so far is still looking good. She was fully expecting the gaps behind my canines to reopen which at least visually didn't happen. I did mention that I noticed floss entering behind the left upper canine becoming a bit easier, so the space might be opening up very slightly.

A new set of impressions was made. This time the upper impressions already worked second try, which is a new record :) The ortho had me bite on a piece of wax as hard as possible, biting through it where possible (instead of leaving a few millimeters of space indicative of the bite plate thickness).

The ortho will study the impressions and basically develop a new treatment plan. I have an appointment next Tuesday where she'll discuss the next steps with me. Considering that the lab tech is there every Wednesday, I'd expect to be back in braces next Thursday. Although seeing how everything went so far, I also wouldn't be surprised with the contrary.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #72 on: 14. February 2022, 01:07:32 AM »
Welp, I've got fixed braces since Tuesday. Ish.

During my last and this appointment, the ortho studied my models and bite. In the appointment on Tuesday she explained to me that my bite on the right side looks good and has good contact. The left side however is blocked by my second molar. When I had the thick posterior bite plane, my strong clenching resulted in that tooth tilting forward while intruding. Now the forward part is stuck below the cusps of my first molar. This results in the back of the second molar to be raised, blocking my bite. The ortho explained that reversing this is the type of movement that can't be done with removable braces. While I didn't want anything fixed, this can only be fixed with brackets. She needs three brackets, one on the wisdom tooth and one on each molar in my bottom left jaw to upright the second molar. As a consolidation she said that it shouldn't take too long, maybe three or four weeks. Knowing my luck, it'll probably be at least double that.

She continued that my bottom incisors are looking good. With the performed IPR they moved back and straightened just as she wanted. She recommended placing a fixed retainer to finish and stabilize them as soon as possible. However, I'm not fully satisfied with those teeth yet as they started to shift within the last four weeks of not wearing the braces. My left central incisor moved forwards while the right one is rotating inwards. She looked at the models again and confirmed that she can see the rotation and understand that I want that fixed first. It could be corrected with fixed braces in 1-2 weeks and we'd be done with it. But I'm not too keen on that. Three small little brackets (boy was I in for a surprise) on the last three teeth are somewhat acceptable to me as they are required at this point and at least won't be too visible. But if possible I'd still like to avoid brackets on my front teeth. While I think she wasn't happy with that response, she said that my lower removable brace could be used after my molars and bite are fixed. Depending on how well I get along with the brackets, she may or may not keep them on some more time for stabilization. In that case the lower removable brace can be modified to work with the brackets still in place.

Either way, she wants to only tackle one movement at a time now. First the lower molar must be fixed. Only then we're going to correct the lower incisors. Once the permanent retainer is in and my lower jaw finished, we'll get back to the top jaw. Upon the end of the treatment, she suggested a top retainer with full posterior and anterior acrylic coverage as bruxism night guard. That way I likely won't need a permanent retainer for my top jaw. (I was slightly surprised by that statement as she previously vehemently insisted on permanent retainers for both jaws, always citing that removable retainers may not be worn regularly enough. I guess she can see that weartime won't be a problem with me :) )

After she told me all this, I was somewhat overwhelmed. It wasn't that I didn't expect something like this already. On the contrary. During the week before the appointment I thought about possible treatment continuations myself. The posterior bite plate didn't work as it intruded my molars. The anterior one intruded my incisors too much. Thus, no bite plate it is, accepting some tooth wear until I'm finished with treatment. If my bite problems were due to movements possible with removable plates, they'd self correct or at least get better while not wearing my braces. However, the left side didn't change during the last two weeks. Therefore, the only logical conclusion is that movement is needed which requires fixed brackets. Still, I didn't want that to be the truth and tried to suppress those thoughts. Now with this actually being the reality I was startled.
As I didn't really respond, the ortho asked if she should repeat the treatment steps again. I answered no and summarized: First three molar brackets, then a removable lower plate for the incisors, afterwards a permanent retainer, and finally the upper jaw. She asked if I agree to the proposed treatment or if I want to sleep over it. I concurred that I ultimately kind of expected something like what she explained already. She asked when I'd have time to get the brackets bonded. She usually would have lunch break soon. However, knowing that I need an hour to the practice, she offered to do it right then and there anyway if I have time. I thought about sleeping over it, but decided there was too much of a risk of be chickening out of brackets. So right then and there it was.

I was led to the open treatment area chairs and asked to sit down. While the ortho prepared the brackets, the assistant cleaned, etched and dried the three to-be-bracketed molars. Once done, the ortho placed the brackets one by one, moved them around on each tooth a little and removed excess glue before the assistant cured them. I don't think she got all excess glue away, as I can feel some rough residue in some places. Next, she got a wire and cut off a piece. She said that she won't start me on a rectangular wire. A thin round wire should be plenty of force for the required movement. She started to thread it through my brackets, which surprised me. I'd expect her to lay it into the brackets and fasten it with ligatures, not thread it through them. I also realized that she never asked me about any ligature colour. While I had all of these thoughts floating around, the ortho was close to being done with the archwire, bent its edges in the front and back and clipped off a bit more in the back. During all of that I was incredibly tense and my heart beat very strongly and fast.
Not even ten minutes after sitting down everything was finished. My mouth was as drier than I thought it could get. My tongue, lips and cheeks were incredibly sticky until I wet them again. The chair was raised and I was handed a mirror to look at what had just been done to my teeth. What I saw was way more metal than I expected. It wasn't three small little brackets. It was more like three times a quarter of a molar band with a long tube instead of a small bracket glued to it, which were glued to my teeth. In fact there is less white visible than grey. Three large buccal tubes with hooks instead of three small brackets.
The ortho asked me how it feels apart from something I never wanted to feel. I was frozen from the realization of the large buccal tubes and couldn't formulate anything. She continued and explained that the brackets will feel very rough in the beginning, but the cheeks will eventually get used to it. As I had quite some problems with my cheeks with the removable braces, she gave me two boxes of wax and suggested to use it preemptively to prevent sores in the beginning. She further said that I can pull forward the archwire a bit if it moves back too far. And with that, it was done. I now had fixed brackets.

Parting, the ortho said that she wants to see me again in three weeks at the very latest. If nothing happens, or too much happens, or something weird happens, I should call her immediately for her to decide if I should make an emergency appointment.
The assistant gave me a date and time for my next scheduled appointment and I left.

Once home, I immediately went into the bathroom to look at my mouth in the mirror. The brackets were still just as large as when I left the ortho. Who would have guessed. The bracket on my first molar is straight on the tooth. The one on my second molar is low in the front and goes up towards the back, making the wire apply pressure the opposite way. The bracket on the wisdom tooth is moved towards the front to finish the derotation started with the lower removable brace. The way the brackets are placed and the way the wire is weaving through the tubes makes the teeth look way more out of place than they actually are.
Luckily I realized that even with the large size of the braces, they aren't visible when talking or smiling. Only when I smile wide or laugh, a trained eye can make out a little bit of grey. Also my webcam is low-res enough that even when I pull away my cheek and try to actively expose the brackets nothing can be seen in the pixely mess in meetings. So in that regard, I'm good.

In the beginning my cheeks took everything without any problem. I didn't use any wax during the rest of the day and also decided against using it in the night as I didn't feel anything. What an error that was. While my cheeks didn't hurt during the night itself, they immediately started to hurt in the morning. I've been wearing wax pretty much full-time until yesterday. It's nearly as if the ortho has experience with all that stuff recommending me to use wax immediately...
Honestly using wax doesn't feel much different to a removable brace. Instead of taking out the braces before eating, I need to remove the wax. After eating, I brush my teeth before applying wax instead of putting in the removable plates. Except when everything hurts, I can't just take the brackets out.

Eating didn't really change, except that the brackets are food magnets. As my right teeth are fitting better than the left ones currently, I've primarily been chewing on that side anyway. But even doing that, so much food gets stuck below the brackets and under the wire between the brackets. I'm not even chewing there. How does food even end up there?! Only having three brackets, it's quite easy to clean them though. After eating, I can get out most of the stuck food with my tongue and the rest with a rinse of water.
Brushing is similarly more complicated, but only a little. I can still brush over 90% of my mouth regularly. Only those three teeth require a bit more attention with additional cleaning using an interdental brush.
I can only imagine how much harder all of that is with brackets on every single tooth.

The first night was bad. Not because of pain, but because of the omnipresence of the brackets. Although I expected that fixed brackets might be among the possible outcomes, and agreeing to them, I'm still not fully accepting them. Neither am I really enthusiastic about them, nor am I completely satisfied with the status quo. With that in mind at all times I slept extremely bad and couldn't fall into a deep sleep, always needing to think about what happened that day and what I've gotten myself into.

Regarding pain, apart from my cheeks there wasn't any movement-related pain. My teeth are very sensitive to acids in general (e.g. when I eat lots of fruit or sour gummy bears, my teeth often hurt for some days). With the etching, I had the exact same problem. Although the ortho did apply a layer of fluoride after curing the brackets, even now there is one spot left that's extremely sensitive when I brush my teeth.
While I didn't feel any movement-pain, I did feel some pressure the first few days. Putting some ice cream on the brackets felt like a relieve. It wasn't that I actively felt pressure. It was rather that with cooling the NiTi archwire something I didn't feel beforehand was gone. Like with noise outdoors which suddenly stops. Even if the lawnmower outside doesn't really register, it still feels good when it is finally turned off.

When I wanted to add the appointment to my calender on Thursday, I realized that the appointment wasn't in three weeks time but in four. This was weird as the ortho specifically said she wants to see me the very latest in three weeks. I called the practice, only to find out that they are on vacation in that week, so the appointment in four weeks is correct. I slept over it but it didn't feel right. Even though the practice is closed on Fridays, the ortho said previously that she always answers emails. Thusly, I wrote a mail to ask if I should come back in two weeks time or if the appointment in four weeks is good enough. The ortho answered, asking how much pressure I felt and how much my bite improved already. As she was expecting very quick results, the brackets should have made a significant difference already.
I tried to provide a detailed description, stating that my bite didn't change much. The vertical gap between my first premolars seems to have closed a little, the wisdom tooth is derotating quite nicely and now has contact with the upper one, but I don't see or notice any difference with my molars. The step from my second molar to the first one (where the second one slid below the first) is still higher than on the other side. She responded that in that case I should come in after two weeks time and bring along my removable braces. I'm glad this was her response, as currently I'm in favour of more appointments rather than less. After all it was the long time of seven weeks between two appointments which started all of this mess.

In conclusion, I'm still somewhat dissatisfied with the whole fixed bracket situation. I need them, I agreed to them, I have them, they are there, but that's it. They are exactly how I expected them to be, a bit achy, rough, cheek-penetrating, and one heck of a chore to clean. While I think I can get along with them, and maybe even accept them, I don't think I'll learn to enjoy them. Definitely not in the way that I enjoy removable braces, which I do start to miss the feeling of.
At least I am now able to also experience some of the joys and challenges of fixed brackets. And they will allow me to experience having fixed brackets and removable braces at the same time, which I am very intrigued and excited about.

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #73 on: 15. February 2022, 11:50:04 AM »
Hi Foobar,

Your treatment continues to be very interesting. There now seems to be an element of trial and error to it. Kudos to you and your ortho for persisting.

As you say, a mixture of fixed and removable braces, especially on the same jaw,  will be interesting. Many years ago, a girlfriend of mine had both, but it was all fixed bands on the lower teeth and a series of removable braces on top. I happened to meet her again fairly recently. Her bottom teeth were  still beautifully straight, but her top ones were quite wonky again. I'm not sure retainers were even offered after braces in those days. I doubt that the difference in relapse in the two jaws arose from the different types of brace being used, but would be interested to know if there has been any research on this.

I was given a fixed retainer after my adult treatment, but it hasn't stopped my teeth relapsing and I would strongly recommend conscientious and long term use of removable retainers.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #74 on: 08. March 2022, 02:25:26 AM »
On Tuesday two weeks ago I had my first adjustment with the three fixed brackets.

Up until that appointment, the brackets still hurt my cheek significantly. Especially the bracket on my wisdom tooth is digging into the cheek. I didn't have a single day where brushing didn't result in some amount blood. I tried using wax, not using wax, different ways of putting on the wax and in the end found a way that it didn't hurt too much and only was slightly unpleasant.
The wire also rotated a few times, especially in the days before the appointment. The ortho showed me how I should rotate it back during the previous appointment as she expected as much.

During the appointment this time, I wasn't invited into the more private room with a single chair. Instead, I was asked to take a seat in one of the three chairs in the open treatment area. This was something I previously feared but luckily was mostly in the private room. However, at this point I've somewhat come to terms that I'm just another patient no other patient cares about. Therefore, while I still like the privacy of the other room a bit more, I was ok with it.
The first action was that the ortho had me bite on a marking foil to check if my bite improved. She said that I still only have the single contact on my left side between my second molars when biting down. When chewing, there is a bit more contact, but only little so far. She asked if anything changed since I wrote the email. I said that not much changed since then, but I feel like the bracket moves the molar lingually a bit, making it have earlier contact with the upper molar.

The ortho clipped off the end of my wire and pulled it out. She asked if what I wrote about the pain I experienced was really true, that I feel more pain when the removable braces are adjusted compared to what I felt with the fixed brackets, a bit in disbelief about that statement. I confirmed that I felt some pressure, but no pain at all.
She decided to skip two wire sizes and tried to insert the wire three sizes up, but she couldn't get it through all tubes yet. Moving one wire down, she was able to fit the wire through all brackets.  The feeling of the wire being inserted and pushed through the tubes was definitely weirdly interesting. She asked me how much pressure I felt. I answered that currently I only feel a little numb pressure and that I'll only be able to tell in a few hours. For comparison she pulled out that wire again and inserted the wire one further size down, the next wire up the line compared to the one I had. She asked me how that felt. My response was that even if she held me at gunpoint I wouldn't be able to tell any difference.
She left in the lower-size wire in as I'll be back in two weeks time anyways so there's no need to possibly torment me with a bigger wire. As I had problems with my cheek, she shortened the wire in the back such that it would end inside the buccal tube on my wisdom tooth, not being able to poke my cheek. This definitely helped. At least I don't need wax anymore. There's still some dull pain every now and again, but scar tissue forming where my wisdom tooth bracket is, definitely helps reduce the constant pain and sensitivity.

The ortho put a bend into the wire between my two molars. She showed me how to derotate the wire if it rotated again like the first wire did.
While the first wire only rotated during the last few days before the next appointment, the bend this time resulted in the wire wanting to rotate at all times. When eating, the wire rotated. When brushing my teeth, the wire rotated. When just sitting around and talking, the wire rotated. I needed to derotate the wire at least five times each day...

Since the ortho is now only focusing on one problem at a time, I noticed some of my other teeth moving back. For example there is a visible gap forming behind my lower left canine. It wasn't there before I started treatment, but I assume it moves forward into the space IPR provided while my incisors are moving forward back to where they came from. This interferes with my upper left canine and lateral incisor, being one of my strongest contact points when biting together strongly. As this makes makes it harder to see improvements in my molar region, the ortho wants to use the removable upper brace to push out the upper two teeth for now.
She inserted the top plate into my mouth and asked where I felt pressure. While the plate fit somewhat, I felt pressure everywhere. The ortho ground away some plastic inside my molars and reduced the pressure exerted by clasps until I didn't feel any immediate pressure anymore. She significantly reduced the anterior bite plate thickness, saying that I need to bite somewhere. If she completely got rid of the bite plate, she worries that me biting on the metal wire of the clasps directly might damage them or my teeth. Additionally, she wants to prevent my lower left canine to extrude too much again. To not intrude my other incisors, she reduced the acrylic as much as possible while still keeping the bite open a little.
After activating the springs in the top, she said that I should wear the plate 12 - 13 hours daily, either throughout the day or also during the night, whatever I wanted. With that, the appointment was done and I was on my way.

I was glad to finally have plastic back in my mouth. I was also happy that I was asked to wear the braces at least half of the day and not only a few hours. I decided that I'll wear them during the evening and night.
Unfortunately, already after the first night when I took out the brace, I noticed that my bite changed for the worse again. It took nearly three hours until my bite was back to the current "normal". I noticed that all of my upper premolars and first molars were a bit sore.
Thus, I scheduled another appointment Thursday.

After I told the ortho about where I felt pressure, she ground away even more of the plastic inside of the premolars and molars. When she was sure that there was no contact between the plastic and those teeth anymore, I still felt a bit of pressure. She said that the only reason left are the wires. After modifying a few holding clasp wires, everything felt good.
She activated the incisor spring a bit more and said that I should wear the upper brace only for 4-6 hours and only during the day. Just as much as is needed to move the two upper front teeth out of the way.

Since then, I tested around a little with how my bite changes while wearing the upper brace. In general it's better than before, but my bite still changes when I wear the plate. After taking out the braces it still takes some time for my bite to go back. However, instantly after taking them out the bite is only a bit off, way less than before Thursday. Wearing the brace during the night (I did one test), it took about two hours for my bite to recover, but the canine doesn't interfere for the rest of the day. Wearing it from lunch until supper it takes about one hour for the bite to settle again, but already in the morning I can feel my canine touching the incisor again. Same thing happens when I wear it from dinner until I go to bed. I'm not sure, but it feels like the molars intrude a little while wearing the plate. I'll discuss during my next appointment tomorrow (well, taking a look at the clock actually today).
I think this, again, may be due to me sucking negative pressure (which I still do subconsciously during the night and when concentrating during the day). As my teeth shifted quite a bit since I last wore the plates, with the modifications the ortho did, the brace doesn't fit snugly against my palate. Instead, there is a millimeter or so of space between the plate and the roof of my mouth. With the negative pressure, I force the plate to be against my palate. The whole brace sits differently and the plastic and wire push differently.

The fixed brackets seem to do their job. The step from my second molar to the first one is gone, which should also mean that the second molar isn't stuck below the cusp of my first molar anymore. I can also chew a bit better on that side. Nevertheless, I don't feel like the tooth contact itself improved much.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #75 on: 28. March 2022, 18:54:17 PM »
After just 4 weeks of brackets, I'm already on a rectangular wire.

During my last appointment three weeks ago my round wire was replaced with a rectangular one. The ortho said that it's way easier to insert than two weeks earlier where she struggled a bit. She was satisfied with how my molars are moving even though I still don't have better contact as the bite seems to be closing little by little.

When checking the rest of my mouth, she said that she wants to strip away a bit more from my bottom incisors. I said that a space has started to open up behind my lower left canine as my lower incisors are starting to crowd again. She looked at it and I had the feeling that she isn't fully convinced if that's enough space, but decided not to perform IPR at that time. Since then, a small space also started to open up behind my lower right canine. I guess with the plan of first fixing the bite, then the bottom incisors, then the top incisors, we can pretty much start back at square one with my bottom incisors.

We had a discussion about my top left lateral incisor which is blocking the bite for which I'd been wearing the upper brace partially again. I had been wearing it 6 hours per day before going to bed. While sleeping my bite settled again. However, my incisor also went back rather quickly touching the bottom canine again. Wearing it through the night moves the incisor to be out of the way for most of the day but it takes my bite three hours to settle. She explained that this is all due to my suction which might be a variation on a tongue sucking habit. She's never seen it that strongly in any other patient. She presented several options:
First, she suggested that I could wear the plate during the night and come back the day after at which time she can place a permanent retainer in the top jaw. The teeth are sitting well and could be finished up that way. But I'm not satisfied yet. The spaces between the canines have started to open back up very slightly. I'm also a bit worried that when my bottom incisors are moved back again the contact in the front could be a bit off. Additionally, if possible I'd like the upper left canine to be moved lingually a bit more. This also sparked another discussion surrounding permanent retainers which I'm not too keen on.
The second option is that she could cut away the back part of the upper brace starting from the second premolar. That way the holding clasps wouldn't affect the molars anymore with my suction, only the premolars.
I asked if there was a third option of somehow breaking the tongue sucking habit. She said that usually when she notices such behaviour it's in way younger patients. In these cases she usually suggests trying to become aware of and trying to avoid it in addition to doing some muscle relaxation exercises. But she doesn't have much faith in me succeeding as the habit is very pronounced in my case. I still wanted to try this option. She said that I should try to wear it more during the day, closer to 12 hours or as much as I need for the incisor not to block my canine.

I've tried being more aware of it for two weeks but ultimately failed. Whenever I take out the upper plate after wearing it, my bite feels off. Even after just one hour. I wasn't able to bite properly during any meal as I wore the brace a lot during the day. In the end I decided to wear it during the night again. That way the incisor is under control and my bite settles until lunch such that I can at least properly bite during the rest of the meals.
If the habit results in problems later on (which I wasn't aware of before starting treatment; heck I wasn't even aware that I was doing anything unusual), I'd really like to get rid of it, but I'm not sure how.

The wire turning during every meal solved itself as that's just not possible anymore with the square wire. Funnily enough the wire now started to move forwards a few millimeters while I'm eating. At least that's easily fixed by just pushing it back with a finger instead of requiring tweezers and a mirror.

Tomorrow is my next adjustment and I have no idea what to expect. I'll definitely bring up the retainer topic again to finally reach a solution. I'll state my case that I don't see a need for permanent retainers as I'll wear my removable retainers diligently every single night due to needing a bite-plate anyway. But if she still insists on permanent retainers, I'll give in and at least try them for half a year or so.

Offline bdave

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Re: My Journey to Removable Braces
« Reply #76 on: 29. March 2022, 16:32:52 PM »


Just so you know, I have top and bottom permanent retainers and they're really cool!!!
Write in English, please! :)

Offline Person

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Re: My Journey to Removable Braces
« Reply #77 on: 01. April 2022, 04:05:44 AM »
Just so you know, I have top and bottom permanent retainers and they're really cool!!!

Not to derail foobar's thread, but out of curiosity why do you think that permanent retainers are cool? I've never been really thrilled about mine, though part of that might be that I was told I'd get it removed and replaced with a removable retainer after a handful of years but that never happened.

One one hand, I'm glad the six teeth it's attached to haven't moved, but on the other hand it did nothing to stop the teeth behind those (bicuspids and molars) from shifting some. If I were to ever get braces again, I'm not sure if I'd want permanent retainers or not.

Offline Sparky

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Re: My Journey to Removable Braces
« Reply #78 on: 02. April 2022, 20:49:08 PM »
The problem with having your teeth "straightened" is that for many people, that "straight" position isn't a stable position for the teeth (by which I mean that your teeth don't properly 'interlock').... so, without a retainer to regularly / constantly push the teeth back into their non-stable position, then the teeth will try and move into a more stable position (ie where the teeth interlock better).

Some people are lucky in that their new teeth positions ARE 'stable', so their teeth won't move (or won't move as much). (and I'm thinking that this will include people whose teeth get moved a long way, eg fixing a massive under / over-bite, where the jaws are moved such that the teeth 'take a step' forwards or backwards)

Offline foobar

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Re: My Journey to Removable Braces
« Reply #79 on: 23. April 2022, 12:49:58 PM »
Last appointment quite a lot happened. Initially the ortho said that she wants to remove the wire from the brackets, letting the molars settle by themselves. She doesn't want to remove the brackets just yet in case they'll be needed again later on.
I said that I feel like my bite is still quite a bit off on the left site. She got marking foil and inspected my bite and contact points. While the second molar uprighted well, the opposite force tilted my first molar a bit. Usually such force is distributed among all other teeth when all teeth have brackets. Due to the tilting, instead of removing the wire, she took it out, added a bend and reinserted it.
She asked how I got along with my top plate. I explained to her that I tried different wear times and finally settled on wearing it through the night for the reasons laid out in my last update. She seemed to be fine with it as an interim solution.

Next came the expected discussion about retainers. After stating my point of view I got the feeling that she hopes that I won't need removable retainers with the fixed retainers considering all the complications I had with my removable braces. When I mentioned that I'll need a bruxism guard anyway, she mentioned a possible compromise of having a fixed retainer in the bottom where people have less problems with it and the bruxism guard in the top jaw. However, so far in my bottom jar during treatment spaces developed between my canines and first premolars, and the first premolars and second premolars. Even if the permanent retainer would include all four premolars (which would be pretty extreme), there's no guarantee that no space between my premolars and molars would open up. I don't think the retainer discussion is finished yet…

Then came the lower plate. As discussed during the previous appointment, we are sticking to the plan of finishing up the bite, then the lower teeth and finally the upper ones. While the bite isn't fully fixed yet, we're getting close enough to start with the lower incisors and canines again. The ortho inserted the lower plate and checked how it fit. Surprisingly the triangle holding clasps didn't interfere with the brackets and wire at all. They fit perfectly in between. But I felt pressure everywhere. She decided to cut away everything going back further than the first molars on both sides. The wisdom teeth derotation springs aren't needed anymore and she feared that the holding clasps between my molars might wreck more havoc than they're worth at this point. After spending quite some time bending the holding clasps, letting me check, and bending again, the lower plate fit well enough. We tried minimizing the pressure from the holding clasps.
To move the canines distally, she applied inwards pressure with the labial bow. She explained that usually it also moves them distally if there's space. If that doesn't work in my case, the plate will need to be modified to add springs similar to the ones in my top plate to move the canines backwards.
I asked how long I should wear the lower plate. Her response was to wear them as long as possible without my bite becoming worse again. Similar to what I did with my top plate I need to figure out how long I can wear it and when I should keep it out to let my bite go back to normal. But 12 hours are needed at minimum to properly move the other teeth. In addition I should continue wearing the top plate as long as needed to keep the lower canine and top lateral incisor from interfering with each other.

And with that, I now have top and bottom removable braces and bottom brackets (albeit "only" 3) all at the same time. Probably a dream treatment for many here.

Already on the day after my appointment the gap between my lower canines and premolars was closed. With the lower left canine back, it stopped interfering with my upper incisor. While having all the braces and plates at the same time is quite an experience, I quickly stopped wearing the upper plate. It isn't necessary for its current purpose anymore but still changes my bite quite a bit.
The lower plate isn't perfect and has similar problems, but not nearly as strongly as the upper brace. When I take out the lower brace, it takes about an hour for my top and bottom premolars to fit together again. I'm wearing it for about 16 hours each day. The 8 hours off seem to be enough to keep the bite stable.
Interestingly, the small gap that reopened behind my upper left canine has closed completely.
Not having an anterior bite plate or posterior bite plane, my joints are aching a bit in the morning as I'm primarily biting down on the holding clasp wires when clenching / grinding. Also every morning I have pretty deep imprints in my cheeks from the brackets.

It's interesting how the mouth adapts to talking with braces. Some months ago when I had the long bottom plate and the thick upper bite plate, after a few weeks I was able to talk with them without too much of a noticeable lisp (although I feel like there'll always be a rest-lisp with a bite-plate). Not having any plate in my mouth for a few weeks completely reset everything that I'd learned about talking with them in. After getting back the top plate two appointments ago I was struggling to pronounce everything correctly again, even though the bite plate was shaved down significantly which should have helped significantly. But again, after a week or so I was able to talk with them in okayly. Now with just the bottom brace I've adapted to speak pretty much perfectly, so much so that even some family doesn't notice. But putting it the top plate again, I can barely be understood. Apparently it only takes few weeks to learn and unlearn everything.

My next appointment will be on Tuesday.

Just so you know, I have top and bottom permanent retainers and they're really cool!!!
That's interesting. What do you like about them? Don't they just interfere with everything? For example doesn't flossing take ages?

Offline JB_Brace_Lover

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Re: My Journey to Removable Braces
« Reply #80 on: 24. April 2022, 06:57:29 AM »
I am confused. Have you gone away from those removable braces to fixed ones?
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Offline foobar

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Re: My Journey to Removable Braces
« Reply #81 on: 25. April 2022, 10:07:22 AM »
I haven't moved away from removable braces. However, for one tooth to be fixed, my lower left wisdom tooth and molars needed brackets as that kind of movement isn't possible with removable braces. I'm still using removable upper and lower braces.

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #82 on: 03. May 2022, 13:00:35 PM »
How did your appointment go?

Offline foobar

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Re: My Journey to Removable Braces
« Reply #83 on: 23. May 2022, 17:25:33 PM »
The last appointment wasn't too exciting. The wire was removed from the three brackets to see if the bite improves by itself again. The ortho wants to keep the brackets on for now. To prevent them digging into my cheeks during the night, she suggested to put elastic ligatures on them. They probably won't stay for long, but hopefully my cheeks will get used to the brackets until the. First she tried thick ligatures, but they didn't fit firmly. I was able to push them from the buccal tubes with my tongue. Then she tried thinner ones which did fit and made the brackets less sharp-edged helping quite a bit. Two of the ligatures fell off after 5 days. One is still in place but feels roughened compared to its smoothness directly after the appointment.
She stripped my lower teeth again and adjusted the labial bow and springs of the lower plate to derotate my 32 and 41 and push my 31 inwards.
And that was the whole adjustment.

During the first week I tried wearing the lower plate 12 hours per day as before. I didn't notice any improvements to my bite on the left. I went down to 8h/d for another week with the same results. Then I tried out 16 hours. The bite didn't improve but also didn't get worse. But the longer wear time helped the incisors significantly. Thus I wore the braces for 14-16 hours for the last two weeks.
My left second molars make good contact, but the premolars and first molar don't. For example in that area my teeth don't cut through pizza. On the right side everything is good enough.
I went to the office one day (usually I do home-office) and didn't wear the braces for about 14 continuous hours. I noticed that I clench quite strongly at work. In the evening all of my teeth felt pretty sore, but I did feel like my bite improved a bit. Unfortunately it didn't last when I wore the braces again.
The incisors got better, but don't feel stable. If I don't have the braces in for 8 hours, they are moving back to where they were quite a bit.

Regarding my bite, I'm interesting in what the ortho will recommend during my next appointment tomorrow. Personally I see two options. Add brackets to my lower and upper left molars and premolars and somehow try to close the bite with elastics (which will most likely result in yet some other complications considering how my treatment went so far). Or, fix the lower incisors, then the upper incisors, put in fixed retainers and then tackle the bite again. However, if the upper fixed retainer includes the first premolars to keep the gap between them and the canines from opening up again, this won't work. But as it is, I'm definitely not satisfied with the situation. I'll wait and see what the ortho suggests, but I may need to make up my mind about the possibility of something like that happening.

The situation with my TMJ without the bite plane / bite plate is worsening. I had two times where the joint clicked and hurt for a few minutes. I tried wearing the upper bite plate again during the night, but it doesn't fit well and affects my bite negatively. I'm going to ask the ortho to make it fit for the night again.

All in all I still enjoy the treatment, but am a bit torn. After over a year I had expected to be in the finishing touches phase and not have new problems to tackle every appointment.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #84 on: 24. May 2022, 18:40:21 PM »
Not even one hour after the last post, where I wrote that two out of the three ligatures fell off, the third one also parted with its buccal tube onto exploring my intestines.

The appointment today started with me explaining everything that happened during the last weeks. For the strong clenching resulting in soreness the ortho ordered a gel splint as temporary solution which I should wear in situations where I find myself clenching. She is going to fit it in a week. Regarding the TMJ clicking and pain I experienced, the ortho is starting to get a bit worried. With me already having mentioned grinding and clenching related problems during the last few appointments the situation seems to be deteriorating.

I asked her if she could modify the upper plate to fit again to alleviate those problems. She said that with my habit of pulling so much negative pressure, there would be too much risk of it negatively affecting my bite even further.
I explained that I looked online through different resources regarding tongue sucking and found that something like a tongue crib helped in some cases. I thought about mentioning this during the last few appointments already, not only because a tongue crib would probably be quite an interesting feeling, but also because it might actually help. But until today I've always chickened out. She said that there are tongue cribs, spikes and the similar, but those are usually used for treating tongue thrusting. In my case they will most likely just cause extreme discomfort and pain.

The ortho looked at my occlusion and didn't notice any major improvements. She looked at the lower incisors and stated that they look pretty much done. If I'm satisfied with how they are aligned, she can put in the fixed retainer and we're done with the lower plate. I stated that I still feel bumps lingually, as if the lower left central incisor still leans a bit to the front. She explained that labially it's aligned, and that's what's most important. Even when all incisors are aligned perfectly, they may not align on the inside, which is normal. If it bothers me, she can move it back further, but then it won't be aligned in the front anymore. However, the left outer incisor can still be rotated a bit inwards toward the canine and outwards toward the central incisor.
She adjusted the springs and labial bow accordingly. As I noticed a small gap forming between the left premolars and molars, she losened that holding clasp a little as well. In four weeks I have another appointment, at which we're going to retire the lower plate and I'll be getting a fixed bottom retainer. She discussed that she would not like to make an essix retainer for the bottom teeth until my occlusion is fixed, as that will lock all teeth in place. But if my joint pain increases even with the lower plate gone, we could consider it as a temporary option.

She noticed that my lower left wisdom tooth rotated back outwards a bit since she removed the bracket wire last appointment. She put in a new wire. Once the wisdom tooth is back in place, she could add a fixed retainer to the outside to retain it, but it's likely to brake off. Or I could keep the brackets for now until everything is finished and I can get an essix retainer or a bruxism guard which will retain the teeth. I don't like either option, as already after a few hours since the wire has been put back, my second molars don't fit well anymore. And those were the only teeth that improved occlusion-wise during the last weeks.

Before we parted, I asked her what the plan regarding the occlusion is. She said that initially the plan was to first fix the bite, then the lower incisors, and finally the upper incisors. She hoped that just the three bracktes would be enough for the bite to fix itself, which doesn't seem to be the case. Therefore, the plan has changed slightly. Now, first the lower incisors will be finished. Once the fixed retainer is placed, she wants to give my teeth another few weeks without removable braces to see if the bite fixes itself. If it doesn't, there is the option of adding transparent buttons to the "problem teeth" and pulling them together with triangle elastics. Which would be exactly what I predicted.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #85 on: 28. June 2022, 01:56:20 AM »
A week after the last appointment I went back to the ortho for the gel splint fitting. She ordered an AquaSplint, which doesn't really need much fitting. As such, it took only a few minutes. It had a sharp edge in one place which the ortho smoothened. She explained that I should wear it if I feel the need, but try to use it as little as possible to prevent further premolar intrusion as that's where the gel pads are located.
Afterwards, she checked the lower removable plate and adjusted the labial bow and springs a little. And with that I was on my way for 4 further weeks until my next appointment tomorrow.

I've worn the gel splint three times, each for 1-2 hours either when I woke up with jaw pain, or when I noticed that I clenched while doing stressful work. It helped in both occasions by relaxing my muscles.

Regarding tooth movement, the lower left outer incisor improved a bit, but isn't moved back quite enough yet. At the same time the lower left central incisor moved a bit outwards and the right central incisor moved inwards a bit. I think another round with slight adjustments will be needed. I feel like the lower left wisdom tooth moved back with the wire through the brackets again.

As it would be boring if that was it and there were no further complications, my lower left first molar intruded quite significantly, I'd guess about 1mm. I only noticed a few days ago because food was getting stuck between the elastic hook and my gum as the bracket is now lower, which didn't happen before. Before, it was always stuck between the hook and my tooth with a little more space for me to get it out with my tongue. I remember the ortho already saying that the wires resting on top of both lower first molars may result in some intrusion, but she hoped that won't happen. It also didn't happen when I didn't have the wire through the brackets (though I don't know if that's related).
When I ate some sticky stuff which sticks to the teeth, I noticed that quite a lot was stuck on the occlusal surfaces of my molars and premolars on both sides. As such I think the bite will need some fixing on both sides. Even though the right side feels okay, I think it could be improved quite a bit still. If we're tackling the bite, possibly on both sides, I want to ask the ortho if my wisdom teeth could also be moved into better occlusion. Currently they are on top of each other but with a gap between them, not touching properly. That was even worse before treatment, before the wisdom teeth were derotated and moved inwards more, but if it could be fixed easily, why not do it as well.

With all the side effects for my case I wonder when the ortho will be at wits end and just suggest full metal brackets on all teeth for a few months to finish everything. I hope that won't happen as I really don't want brackets on my social 12 (don't try to convince me otherwise, I have tried to convince myself and failed, that reluctance comes from way further down somewhere).
If I'd guess, I'd say that the ortho may carry out the option of putting buttons on my upper molars / premolars and pull the teeth together with triangle elastics starting from tomorrow already? Maybe she may also put brackets on the lower left premolars and try to pull it back up with a wire that way.

At this point I'm a bit torn. On one hand side, after 15 months of treatment I would have expected to be either finished already or at least in the finishing stages. Instead, every time we think we have a working plan, there is some complication pushing the treatment back a few weeks. On the other hand side, these complications let me experience lots of stuff I wouldn't have otherwise. First the anterior bite plate, then the three brackets, and now buttons and elastics (which I'm pretty sure I'll get at some point or another). Without the complications, I wouldn't have any of those. I'd also most likely already be done…

Let's see what tomorrow holds.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #86 on: 17. July 2022, 13:00:53 PM »
During my appointment two weeks ago nothing of what I predicted happened. I told the ortho that my lower left first molar has intruded. She looked at it and said with a bit of disbelief that the tooth tilted forward mesially in the exact same way my second molar did previously. She thinks that the wire of the triangular holding clasp was pushing the molar down together with my clenching, grinding and suction. She bent the wire to not touch the tooth occlusally in the hopes that it'll upright by itself.
She made some finishing touches to the labial wire and springs to finish my lower incisors. With a new appointment three weeks later I was on my way.

During the next week I didn't see any positive changes, in fact my lower right central incisor was pushed further back instead of forward. I also noticed that my lower left lateral incisor was interfering with my upper left central incisor. Therefore, I scheduled an earlier appointment for Monday.
On Monday, the ortho checked my intruded molar and saw that nothing changed. She put a bend into the wire of my brackets, trying to upright the molar that way. Next, she modified the labial bow and springs of my lower brace until I felt equal pressure everywhere. She did some very slight IPR, less than 1/10th of a mm, to make space for the 32 to move back and away from the 21. She had me wait for 10 minutes with the brace in to make sure that I have the feeling that the contact between my lower and upper incisors improves. I didn't notice anything regarding that, so she made some more modifications. After waiting another ten minutes I felt slight improvements. We decided to keep it that way for now but keep the already scheduled appointment one week later. If there are still some imperfections she can adjust further. Otherwise, she might put in the fixed retainer.

The last modifications seem to have been it, as I'm fully satisfied with my lower incisors now when I remove my lower brace. The result isn't really stable yet as it only takes an hour or so until the teeth shift back a little once I remove the braces.
The good news is that this finally means progress. The bad news is that I'll probably be rid of the lower removable brace in 2 days.

The ortho seems to use lip bumpers a lot. During all of my last three appointments there was someone in the chair next to me getting braces and all of them got lower lip bumpers as well.

Offline Embracer

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Re: My Journey to Removable Braces
« Reply #87 on: 18. July 2022, 09:55:17 AM »
Exciting news that your bottom teeth are now corrected.  I understand that bottom incisors are particularly prone to relapse, so a bonded retainer will be essential.  But a bonded retainer is only likely to be on your front 6 teeth. Perhaps you could ask for a bottom hawley as well in order to keep the whole bottom arch aligned?

If your bite permits, you might also get a bonded retainer on your top 6 front teeth. Again, a hawley in addition would help maintain the whole upper arch and the hawleys in combination should maintain your bite.

This way, whilst you will have lost both your removable braces, you will have something similar in the hawleys on an indefinite basis. And perhaps you might have some input into the design and colour of the hawleys to make them interesting.

 Good luck at your next appointment.

Offline foobar

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Re: My Journey to Removable Braces
« Reply #88 on: 31. July 2022, 13:15:47 PM »
The last appointment went exactly as expected. The bottom incisors were pretty much perfect. The right central incisor is slightly tipped inwards, but less than 1/10th of a mm. The ortho said that she'll be able to push that teeth forward while the retainer is bonded to fix this (which didn't work that well, but I'm satisfied with the result and honestly think that these slight imperfections make it look more natural).
The bend that was added to the wire through the brackets didn't upright the 36 as hoped, at least not during one week. As the holding clasps of the removable brace had created a little space between my 35 and 36, the ortho removed the wire from the three brackets and wants to let my bite settle on its own again. Until the next appointment two weeks later I shall not wear my removable braces (well, the lower one won't fit anyway with the permanent retainer).

I had impressions made and the ortho started bending the retainer wire. About 20 minutes later they started bonding the permanent retainer from canine to canine. After instructions on how to brush and floss I was on my way.

I have to admit that the permanent retainer isn't nearly as bad as I expected. While on the first day my tongue chafed the wire, already on day three I started to forget it was there. I expected it to be way more present and even interfere with speech a little. I didn't observe any of that. I can definitely see how so many people prefer it over a removable retainer which you need to always remember to wear.
However, lots of food seems to get stuck between the wire and teeth. On several occasions something got stuck in a way that I was only able to remove it once I was home with floss. Considering that the primary goal of the treatment was to close the two gaps behind my upper canines where food got stuck every meal, instead, now I have five new places where food cat get stuck.
For now I'll be able to tolerate the bonded retainer for a year or so until the end of the treatment as it will make fixing my bite easier than trying to work around removable plates which are responsible for my molars' intrusion in the first place. When active treatment is over I still think I'd prefer to have the fixed retainer removed and rather use a removable appliance.

When the retainer was bonded, there was about a millimeter of horizontal space between the upper and lower incisors. When I asked the ortho about it she said that the incisors don't necessarily need to touch when I bite together. If it's something that bothers me we can tackle it later.
Luckily, only a few days later the problem fixed itself as my upper incisors have moved inwards on their own and are now perfectly touching the lower ones again.

Without wearing any removable plates, the first three days all of my molars were quite sensitive as the bite started settling. The gap between 35 and 36 is closed again and the 36 was able to extrude a bit. But there's still a vertical gap of ~1mm. The vertical space between the left premolars didn't change and is still about half a millimeter. Let's see what the next appointment brings.

If your bite permits, you might also get a bonded retainer on your top 6 front teeth.
The initial plan of the ortho was to do retention with both a lower and upper fixed retainer. The top one might even include the first premolars to keep the gap behind my canines closed.

Perhaps you could ask for a bottom hawley as well in order to keep the whole bottom arch aligned? [...] Again, a hawley in addition would help maintain the whole upper arch and the hawleys in combination should maintain your bite.
I'll need some form of bruxism guard anyway again after the active treatment phase. Already after half a year without grinding protection (since the bite planes were removed from my removable braces) my dentist noticed that the bruxism marks on my teeth got worse. This was also how I plan(ned) on convincing the ortho to just use removable retainers. If I need to wear a bruxism guard diligently every night for the foreseeable future anyway, why not use it as retainer and add a second plate for the other jaw as well.