Looks like I’ll be getting braces again!

Yesterday I got spacers for the lower lingual holding arch. Four in total, around my lower first molars.

So far, not as much soreness as the first day or two of the braces, and I think not quite as much soreness as I remember having as a kid when I had spacers. Kind of surprising me is that I’ve been feeling tightness or pressure across my lower front teeth.

Next week, I have the impression taken for the lower lingual holding arch (and maybe the bands are test-fit, or maybe even placed? They said the appointment would be 50 minutes, and I know an impression doesn’t take that long), and the week after I have the appointment to place the lower lingual holding arch and the Carriere.
 
Here's a picture of my spacers:
https://www.flickr.com/gp/189082961@N04/71Z99GFC9i

They weren’t as bad as I remember having as a kid as far as soreness goes, but maybe that’s just because I was good about taking Tylenol for the first two days after this time?



At the beginning of this week, I had the ortho appointment to get the impression for the lower lingual holding arch (LLHA).

First thing they did, actually, is remove the brackets from my upper canines and first premolars. My guess as to why they did it at that appointment and not the appointment where the Carriere is placed is just to not take up that time at that appointment. Brackets popped off easily, but the grinding off the glue was even worse than when they replaced my front four brackets, despite the teeth not being as sore this time. They then just trimmed the existing archwire to fit just the front four teeth. I chose teal for the ligatures behind the wire.

After that, the assistant test-fit some bands on my lower first molars. Once a band was seated on each of those molars, she took an impression of my lower teeth. This will be used for a lab to make the LLHA that I'll be getting next week (it will be anchorage for the Carriere). They use digital iTero scans for records and creating retainers, but use impressions for these kinds of lab-made appliances because they are more accurate, I guess. My ortho's office has a whole list of flavors for this, where it seems like the assistant adds some drops of flavoring to the impression material as it's being mixed. I chose chocolate, but it was so slight I could barely notice it, and it was that fake chocolate flavor/smell that Tootsie Rolls have. The assistant let be rinse out my mouth really quick after the impression, to rinse out any bits of impression material left behind. I got to see the bands on my molars (but didn't think at the time to take a quick picture), and and it was a little weird seeing bands on my molars again (I had molar bands on all of my first molars when I had braces the first time). I could also tell that the part on the cheek-side of the bands that has the hook will irritate my cheeks, and I'll probably need to use wax for a while once I actually have the bands on.

The assistant then removed the bands and put spacers back in, and I was on my way.

The archwire didn’t get quite centered in the same place as before, so my front teeth were fairly sore for the first couple days after this appointment. Those teeth also don’t have the canines and premolars anchoring them, so pretty quickly I noticed them starting to tilt back inward (even though my ortho said the wire would keep the torque on them). We’ll see goes much that really matters next week or after.

It has looked weird to me to see just the front four teeth in braces. I’m glad it’ll just be for a week, because it’s a little awkward explaining to someone that I have fewer brackets on now because we’re getting ready for the next step of my treatment (I admit, it’s not intuitive to me).

Here’s a picture of what they look like this week, with the teal ligatures:
https://www.flickr.com/gp/189082961@N04/C7s3H1zp73



My appointment to get the Carriere and LLHA is next week; I will be sure to post about it and post some photos.
 
TrainTrack said:
they could monitor my teeth with a ScanBox Pro which is essentially a lip spreader that connects to your phone which gives you instructions through an app.

This is almost a perfect first paragraph for a braces story :)

Also, thanks a lot for the detailed insights into your treatment, Person!
 
I have the Carriere and lower lingual holding arch (LLHA)! I had the appointment to have it placed this past week.

At the appointment, they first started with placing the LLHA. The assistant had a hard time getting the bands to fit on my molars, despite having test-fit them the week before. She said the issue was that the lab used a lot of solder attaching the arch, and that made them not fit easily (maybe the bands needed to flex a little to fit, and the solder was preventing that?). Eventually she got it seated enough, though I don't think quite as far down on the teeth as when they were test-fit. The assistant ground down some of the metal a little because my upper molars were hitting it. I could tell that the hooks on the molar bands would irritate my cheeks easily, so the assistant bent them inwards a little bit, but I don't know if it made a difference.

The assistant then prepped my upper canines and first molars, and then the orthodontist came over to bond the bars of the Carriere to those teeth.. This was pretty simple and straightforward (they had already measured what size they needed the week before). Then the assistant had me watch her place an elastic on one side and place the other myself (hooked from the lower first molar (hook on molar band) to the upper canine (hook on front of Carriere bar) on each side. I am to wear Ormco "Zebra" (5/16' 4.5oz) elastics for the first two weeks, and then Carriere Force 1 (1/4" 6oz) elastics after that (at least until my next appointment; there are also Force 2 elastics, which are 3/16" 8oz, and I suspect I'll have to wear those on the right side at some point, as the other ortho I got a consult from even said that as part of his treatment plan).

They left the brackets on my upper incisors and the wire that runs through them alone.

After the appointment, it felt like there was so much in my mouth compared to right before. I had one of those "What did I get myself into?" moments.

The LLHA is higher up and further away from my teeth than I expected, so my tongue is constantly hitting it while talking. Luckily, it doesn't seem to give me a lisp in spite of this. Food gets stuck between it and my teeth fairly easily. When the elastics are on, the hooks don't bother me, but when I take them off the molar band hooks poke my cheeks while eating. Unfortunately, wax on them doesn't work great while eating since those are the teeth I'm chewing with, so the wax gets knocked off almost immediately. I'm just doing without using any wax on them. I don't think it's visible when I talk.

The bars of the Carriere have been really comfortable. They are very smoothed, and the hook on the front is very low-profile. Food does get stuck between them and my teeth. They kind of help make it look like I have braces across all my upper teeth.

The elastics aren't too difficult to put on, but it takes a little practice to do easily without a mirror. I was told by the assistant at the appointment to change them twice a day (morning and bedtime), but the info sheet said four times a day (after each meal and bedtime), which is also what I was told at my consultation. I emailed them after a couple days to check which is correct, and it's four times a day. When I take the elastics off, it almost feels like there is a slight force on my teeth in the opposite direction that the elastic pulls. After just a couple days, I can tell when flossing between my canines and lateral incisors that there's already been a very small amount of movement.

I didn't have any soreness for the first several hours after the appointment. Even with taking Tylenol, though, my teeth were pretty sore the next day and somewhat into the day after that. There's been more soreness on the left side than the right (I find this a little interesting, because the left side doesn't have to move as much to reach class 1).

It's nice having something going on that is going to produce more significant results. And, in a way, it's nice having a more in my mouth and stuff both on top and bottom. Makes the braces feel more complete and full.

Here's a photo from the front where you can see the Carriere and the elastics:
https://www.flickr.com/gp/189082961@N04/ip936a1r56

And here's a photo of the LLHA (and elastics):
https://www.flickr.com/gp/189082961@N04/0329ZFk0u0

Feel free to ask me any questions about the appliances! I may have left something out, and I know the Carriere is not as common as some appliances. I'll probably take a photo where one of the bars of the Carriere is more fully visible later.

I suspect my next appointment in several weeks will just be the ortho checking my progress and potentially changing what size/strength elastics I'm wearing.
 
A few notes after a week of the Carriere:

The upper bars of the Carriere are really comfortable themselves. They are really smooth, and cause no irritation at all.

The LLHA doesn't cause any lisp, and it didn't take too long to get pretty used to. Sometimes I can kinda forget it's there and not notice it. However, food gets stuck between it and my teeth really easily, and it's really hard to get it out sometimes.

I can already see small gaps that have opened up in front of my upper canines. They are only about the width of a sheet of paper, but it makes me curious to see how big it gets by my next appointment, and by the time I get the Carriere removed (if my upper incisors don't move at all, which I would guess they will some, the gap on the right will have to get to be as wide as half a tooth in order for that side to get to a class 1 bite).


Also, this is from a few weeks back but forgot to mention it and it's kind of funny. This is about when I got the brackets removed from my canines and first premolars (the week before I got the Carriere), and so I just had the four brackets on my upper incisors and nothing else. Later that night, my wife said that when I got home she could tell something looked different but wasn't sure what. She did recall that I was supposed to get more stuff added at some point, so she just figured the top braces were added. Yeah, she tends not to notice small details. And, I suppose, it's verification that she doesn't secretly have any sort of interest in braces (though I was basically already 99.99% sure of that.)
 
One question about the Carriere. How is it different from regular elastics connected to brackets? It seems the same to me, and as you said, it isn’t the most widespread used appliance.
 
TrainTrack said:
One question about the Carriere. How is it different from regular elastics connected to brackets? It seems the same to me, and as you said, it isn’t the most widespread used appliance.

At my consultation, they said it was the “most efficient” way to get the movement we want, and didn’t really go into detail beyond that.

From what I’ve looked up online, the results the Carriere gets isn’t really much different different than elastics with braces. There are some small differences, but I didn’t fully understand what I read of those differences. I did find something that said that the Carriere tends to correct class 2 to class 1 more quickly than elastics with braces, but then the time in braces after the Carriere makes total treatment take a little bit longer (less time just in braces after having the Carriere, but Carriere + braces is longer than treatment that is braces and elastics).

From what I’ve seen online, it seems like the protocol for the Carriere uses higher-force elastics than normally used for class 2 elastics with braces. I don’t know know if that’s because the Carriere is marketed around taking less time than braces and they want to back that up and so they use stronger elastics than ideal, or if it’s because the archwire for full braces isn’t stiff enough when using those strength elastics but they’re still safe/healthy/etc to use. I’ve seen comments from an ortho on the braces subreddit whose against the Carriere because he says the forces of the elastics are too high. That’s just one opinion, though, and I’m reassured by the fact that the best orthodontist in my city uses the Carriere on some patients. (I haven’t worked up to those strongest elastics yet; I’m curious how they’ll feel.)

From my personal experience with braces and the Carriere, hygiene is easier with the Carriere than with braces, so the shorter time in full braces should be advantageous for the health of the patient’s teeth. The marketing for the Carriere doesn’t touch on that, but fewer things glued to fewer teeth will be good for preventing cavities and such. The marketing more plays up the angle that you can correct the bite “before braces”. Which I feel like is a half-truth. People will be able to see it and the elastics (if it’s bonded to the canines), but it will be a lot more discreet than brackets across all your front teeth.

So sorta faster than just braces, but not depending on how you measure. More discreet than full braces. And from what I can tell more hygienic than full braces.
 
Did your ortho offer you headgear to achieve your molar distalization? Would you have gone with it if they had?
 
Hi I’m new to this site and this is my first post. In 48 hours I will be getting my upper and lower fixed metal braces fitted again. It’s a long story but I recently got my money back for my first treatment. Looking forward to wearing braces again but I’m also very anxious about what other people will say. I think I will enjoy it more 2nd time round and I have already ordered some other items to have some fun with. I wanted to get molar bands in the hope that they had headgear tubes but the Ortho didn’t want to put bands. I will try face masks and j hooks and might need some advice or suggestions to try some other things. I will go for silver ligatures on the first fitting but might get a bit more adventurous at the first adjustment.
 
Embracer said:
Did your ortho offer you headgear to achieve your molar distalization? Would you have gone with it if they had?

They did not; no other method of distalization was mentioned or offered. I'm guessing that's because it's not a huge amount of movement needed, but I don't know (my bite on the right side is off about half a tooth, not a whole tooth like you sometime see).

While I am curious what headgear would feel like to wear, I don't think I'd actually want it as part of my treatment. If it had been offered, I would have probably turned it down, or if the ortho insisted on it I probably would have gone to a different ortho.
 
I meant to post last week, but better late than never.

I recently had another appointment, to check my progress with the Carriere. Ortho said I was making good progress with the Force 1 elastics, and to stick with those. I had been kind of expecting that he would switch me to Force 2 (smaller and stronger) on the right side. Next time he will evaluate if I should stop wearing the elastic on the left and just wear the one on the right.

Archwire across my upper incisors stayed the same. I got the teal ligatures changed out for green. I kinda wanted something for the spring, but didn't want to go with pink. With them being entirely behind the archwire and brackets, I'm finding I like brighter/bolder colors, I think. I took a photo of their little ring of the colors I have so I can better think about what I want for next time.

The elastics have pulled my canines down some, relative to my other teeth. It's not enough that someone would notice unless they were studying my teeth, but it's enough that they are the only teeth that hit when I bite down now. I haven't measured, but I'd guess that the gaps between my canines and lateral incisors is up to about 2mm now.
 
Sniffer9 said:
Hi I’m new to this site and this is my first post. In 48 hours I will be getting my upper and lower fixed metal braces fitted again. It’s a long story but I recently got my money back for my first treatment. Looking forward to wearing braces again but I’m also very anxious about what other people will say. I think I will enjoy it more 2nd time round and I have already ordered some other items to have some fun with. I wanted to get molar bands in the hope that they had headgear tubes but the Ortho didn’t want to put bands. I will try face masks and j hooks and might need some advice or suggestions to try some other things. I will go for silver ligatures on the first fitting but might get a bit more adventurous at the first adjustment.

how did it go? update?
 
I had another appointment last week, and now have a date to get my bottom braces on!

It was again a very simple appointment. The orthodontist looked at my teeth and my bite and said things are moving well. In spite of what he said last time, he's having me continue to wear elastics on both sides (still the same strength elastics, since he said they're working well).

The ortho then said that at my next appointment, they’ll remove the Carriere, lower lingual holding arch, and permanent retainer (that I still have from having braces as a kid), and put on lower braces (and brackets on the upper teeth that don’t have them because of the Carriere). He didn’t mention bite turbos, but at my consultation I was told I would probably get bite turbos on the back of my upper front teeth. He did say that I'd probably continue to wear an elastic on my right side to finish fixing the bite on that side (the left side will be corrected or overcorrected). At my consult, I was told I'd wear posterior box elastics once I got full braces (to close my bite in the back to help fix my deep bite), so I'm not sure which it'll be now.

At the end of my appointment, I asked the assistant if I can keep anything once it's removed, and she said sure if I want to (otherwise they just throw it out in a sharps container), and that she'd put a note in my chart and I should just tell whoever when the appliances get removed. I want to keep all the appliances, as well as my old permanent retainer (I'll have had it for 24 years).

At this appointment, I got ligatures that are a pale blue, kind of like a sky blue. The assistant said it's one of their most popular colors, but I'm not wild about it. From a short distance away, it's basically unnoticeable (what with being behind the brackets and the archwire). It makes it a decent neutral option while still having some color, I guess, but I've liked the bolder colors I've had so far. I haven't wanted to repeat anything and get stuck just having the same color every time, though. Right now I'm thinking I might try their dark blue next time.

My next appointment will be at the end of June, so full braces a little over a year after starting treatment. I have a dentist appointment two weeks before that. I'm curious how difficult it will be for the hygienist to clean around/behind the LLHA (especially since it is very nearly touching my permanent retainer). I was supposed to have that dentist appointment a week before this most recent ortho appointment, but I rescheduled it because I had a cold. I was wondering if I'd get the bottom braces before or after the rescheduled dentist appointment.

A couple days after this past appointment, the elastics hook on my right-side molar band hooked my cheek a little one morning, and caused a fair amount of irritation for several days. I was using wax on that hook every day until just a couple days ago.
 
Small update here.

A week and a half ago I had a dental cleaning, and the hygienist seemed to do a good job cleaning around everything. The assistant who took bitewing x-rays saw my lower lingual holding arch and thought it was a retainer and asked me to remove it.

This past week, I hit one year of having my braces. it's weird, because my bite is worse now than it was then, and I have visible gaps that I didn't have them, but that's just due to the process and the way my ortho decided to treat me.

This week, I get the Carriere and LLHA (and my 24-year-old permanent retainer) removed and get full braces. Like I mentioned last time, I intend to ask to keep everything that's removed. I haven't decided what color ligatures I want to try, maybe a darker blue but I'm not sure yet.
 
I've got full braces!

The other day I had the appointment to remove the Carriere, LLHA, and my permanent retainer and got brackets on the rest of my teeth (first molar to first molar, top and bottom).

At the beginning of the appointment, I informed the assistant that I wanted to keep everything that was removed. The tone of voice she responded with indicated that she thought that was a strange request, but she did let me (the assistant I had at my previous appointment was much more cheery and positive in her response when I asked her if I could keep everything).

First thing she did was remove the LLHA. She popped the bands of each molar, and it came right out. It felt nice having a little more space for my tongue.

Then the Carriere bars were removed. The right side popped off relatively easily, but the left side took a little more work (though still nowhere as bad as I’ve seen online some people say). Then their hygienist ground off the leftover cement from the Carriere, and it was just as unpleasant as when back in the fall when I had the front four brackets replaced. I swear that when I got my braces off as a kid, getting the excess cement off was much more gentle, and quieter, too.

The molar bands didn’t leave any cement to grind/polish off because they apparently use a kind that just flakes apart when the bond is broken (according to the assistant).

The assistant put the Carriere bars and the LLHA in a ziploc bag for me and handed it to me.

I think they were supposed to remove the permanent retainer at this point, but the assistant hasn’t noticed it, so I was taken to a different room for updated photos to be taken.

I then went back and waited for the ortho for a bit. I mention the permanent retainer to the assistant, and also picked out my ligature color in this time, too. I went with green, even though I had it somewhat recently. I may have been up for trying something that stuff out a little more, but my high school 20th reunion is in a couple weeks, and am thinking of going to some of it. It’s one thing that I’ll have braces for it (when I had braces the first time was in middle school, but high school was basically all the same kids), but I didn’t want to have like people or orange or something on top of that. The assistant put the green ligatures on the four brackets of my upper incisors (since those would be staying put).

A few minutes before the ortho was ready to come over to me, the assistant polished and etched my teeth and put on the primer (I think; they paint something on the teeth and cure it with UV light, and the the brackets are bonded onto that).

After a bit of a wait, the ortho came over and they placed the brackets, from first molar to first molar top and bottom, other that the top incisors which already had brackets. They put bonded buccal tubes with hooks on my first molar. The upper canines and premolars got Damon Q brackets, while it seems that all of my lower premolars, canines, and incisors got Damon Ultima brackets (which is what my upper incisors have; the upper canines and first premolars had Damon Q before the Carriere was placed, but I didn’t know if that was because they know those brackets would get removed and replaced before doing much).

The way my ortho puts on braces, the assistant hands him one bracket at a time, “loaded” so to speak on a tool (don’t know the name, but pliers or tweezers or something). The orthodontist would place and align the bracket, scrape off the excess cement, and then cures it himself before moving on to the next bracket.

After he was done, he told the assistant the wire size that I'd be getting and said something about 12 hours. He left, and the assistant did another round of UV light on all the brackets, I think to make sure the cement was all fully cured. Then she flossed between my lower incisors, to make sure no cement got in between my teeth, I think.

Having brackets on all of these teeth again felt kind of weird, but not as "mouth-filling" as the Carriere and LLHA did at first.

I then got .014 round wires on both top and bottom (I bet CuNiTi). I was curious what size the orthodontist would go with, since on one hand the upper and lower incisors were each already lined up with respect to themselves, but on the other hand I now have gaps in my upper teeth and my upper canines are too low compared to the other teeth and my lower premolars need rotated (and the lower right first premolar got pushed out of line and kind of became a snaggletooth from the force of the elastics while I had the ). As the wires were put in and the doors were closed on the brackets, I could feel a bit of tension across my teeth.

After that, the hygienist came over and removed my permanent retainer from my lower incisors. It took a while to grind away all of the cement, especially since there was a lot used on my canines, because the wire had been popped free of them at dentist appointments back when I was a teen, and the ortho's office put it back on with way more cement than they used the first time. Again, both the sensation and the sound of the tool is terrible. It sounds awfully destructive, and so you're almost surprised that your teeth aren't damaged afterwards. I was pleased to see that the wire of the retainer came out in one piece (they didn't cut it or anything before removing it. After the hygienist left but before the assistant came back, I grabbed the wire off the tray and put in my my bag.

When the assistant came back, she added hooks to the brackets on my upper canines. The Damon brackets don't come with hooks built in to the posterior brackets, but instead have little vertical holes in the base where a hook can be added. I am to continue wearing class 2 elastics, but just 12 hours at night, and they are much weaker than what I wore with the Carriere. The assistant put them on briefly to show me how and she said I'd barely feel them, which was true. They are 5/16" (7.94mm) in diameter and 2oz (60gm) in force. They are so thin that they look like there was a manufacturing mistake, and if I try to grab just one or two from the bag I easily get five or more. They stretch so easily that it doesn't feel right.

After that, the assistant put the green ligatures on the upper canine brackets, gave me some bags of elastics, and I was on my way.

Seeing myself in the mirror with full braces wasn't as big of a shock or adjustment as seeing myself with the partial braces was last June. Definitely much more of a "silver" smile, though, partially because the colored ligatures are only on the top front six teeth, and because the premolar brackets have larger pads where they're glued onto the teeth, so those teeth are a little more shiny.

So far, there's been soreness basically in all the teeth from first premolar to first premolar; the second premolars and first molars haven't felt much yet. The tooth that has been the most sore in my upper left lateral incisor, which is the tooth that was slightly behind the other before getting my braces on last year.

My next adjustment in in eight weeks, though I haven an appointment here in a couple days because the night after I got the full braces on I noticed sensitivity along the gumline of one of the molars that were banded for the LLHA. It's still sensitive, so they're having me come in for the ortho to take a look at it. Hopefully it's not serious and resolves on its own soon.

Here's a picture of the full braces. You can see the premolar that got pushed out of line and the larger premolar bracket pads. The hooks on the upper canine brackets are sorta visible, but they're out of focus:

https://www.flickr.com/gp/189082961@N04/Zp62SWA7f6

I intend to take pictures of the removed appliances soon to show, and am more than willing to answer questions.
 
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