Orthodontist here to help

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#16 Post by **strugglebuggy** » Wed Sep 26, 2007 11:31 am

Hi Dr. Jones.

Just a quick question. What the heck does that metal thing in the middle of my acrylic plate do? Thanks.

Strugglebuggy

#17 Post by **discomom** » Wed Sep 26, 2007 6:15 pm

WELCOME!!! Coming from a person who is just beginning the journey, I will appreciate having some advice! Thanks for posting!!! Lori

#18 Post by **jonesortho** » Wed Sep 26, 2007 8:54 pm

Root resorption is best judged with xrays. There is not a link between gingival health and root resorption--only gingival heath and periodontal or bone loss. I'm sure that your dentist or orthodontist could take a panoramic xray or periapical xrays to assure you that your roots are ok. Resorption is related to time in braces and the distance teeth are moved, but most of all genetics. I don't want to undermine your orthodontist, I'm sure she's on top of your oral health. An xray every 6-12 months wouldn't be a bad idea.

Snugglebuggy- It looks to me that the metal thing on the top of your retainer is intended to attract your tongue to the roof of your mouth. Have you been accused of being a tongue thruster or did you have an open bite or spaces before treatment? If so, the wires on top are there to encourage your tongue to position itself on the roof of your mouth when you swallow rather than for it to push forward against your front teeth. There is some evidence that open bites or spacing in the front may be due to tongue position. If this is true for you, try to use the retainer as a tool to train your tongue to go up, not forward. If you didn't have a tongue thrust, open bite, or anterior spacing, then you had a retainer maker who wanted to show off a bit. Any way you look it's not a bad thing!

I am trying to scroll through the various threads, but it is easiest if people who would like to ask me a question place it in this thread or put something in the topic like "question for ortho" or "question for Dr. Jones" That lets me cut right to the chase.
Everyone on this board is so informed and smart, I'm blown away. I'm proud to be a help wherever I can.

#19 Post by **strugglebuggy** » Thu Sep 27, 2007 4:51 am

Hi Dr. Jones.

Thanks. I don't have a tongue thrust issue. I do have a bite plane built into my retainer to open my bite more though. I was thinking the metal things was more of a shock absorber for my bite...lol. Funny what the imagination can do. My bottom retainer is really loose.... I am told its because my bottom teeth are already straight. It's kinda annoying, though. Why is it that some people have clear acrylic on the wire and some don't? He is moving a couple of teeth with my retainers, does that have something to do with it?

Welcome, by the way! It's always great to have a professional opinion!

#20 Post by **DavidT** » Thu Sep 27, 2007 12:22 pm

What specific strategies for widening my arch width can I suggest? My ortho is actually a dentist who's new to orthodontics and does not know what to do.

#21 Post by **jonesortho** » Thu Sep 27, 2007 1:06 pm

Hi DavidT,
That's a hard question for me to answer, especially without full records. The width of the arch of your teeth is limited to the width of the arch of your jaw bone. You can only get your teeth as wide as your jaw bone is. If you try to widen the teeth too much, you can push the roots of the teeth too close to the outer edges of the bone and create periodontal problems. If you still have room in your jaw on the outside of your teeth, you can affect the appearance of your dental arch by altering the arch form of the wire. The teeth end up (basically) where the wire is, so by expanding the wire a bit, you can sometimes change the width of the dental arch. Arch form has a lot to do with the appearance of the smile, but again, it is limited by the width of your jaw. That is one of the reasons that we do expanders in younger patients who's jaws are not yet fused. The expander can widen the upper jaw at the middle suture. In adults, the suture is closed, so the only option for really widening the upper jaw involves surgery.
I hope this helps. I can't discuss your case specifically without photos and models.

#22 Post by **HeyTeach** » Thu Sep 27, 2007 1:20 pm

Good to see you here Doc! Looks like I'm a pretty easy case, and am finding the ride smooth so far. However, to any out there wondering if it is worth the hassle, soreness, whatever, I dare say 95% of us here would say YES. Nothing to fear and nothing to loose except one's problematic alignment and or bite. As a teacher in high school I expected some razzing from some of my more rowdy charges, but got absolutely none. Yes they notice and yes they know what you're going through and they know why as well and it's normal to them; not a novelty at all.

#23 Post by **jonesortho** » Thu Sep 27, 2007 1:25 pm

I ask all the adults that I meet who have had orthodontic treatment or are almost finished with it if they would do it over again (if they feel it was worth it). The overwhelming majority say yes. It's very rare that someone says no, which I find very encouraging.

#24 Post by **jonesortho** » Thu Sep 27, 2007 3:10 pm

strugglebuggy wrote: Why is it that some people have clear acrylic on the wire and some don't? He is moving a couple of teeth with my retainers, does that have something to do with it?

That is exactly why they have the clear acrylic in there, to prevent the incisors from rotating at all as they are moved. Sometimes the teeth are "re-set" on a model into the ideal spot and the retainer is made on the ideal model. The acrylic helps capture the facial side of the teeth to encourage them to move that direction. A lot of times, I'll put the acrylic on the wire on the lower retainer just to prevent those pesky incisors from slipping at all and to provide more surface area to push the teeth back into place when people leave the retainer out for a few days.
Please, everyone, remember to wear your retainers forever. It's for your own good. We make money when people opt to not wear them and get re-treated, but it pains me to see that hard work and expense that go into straightening them the first time go down the tubes!

#25 Post by **JoviFan** » Thu Sep 27, 2007 3:26 pm

Dr. Jones, I have a question, if you don't mind. Quick background, I'm 40, have Class 11 Div 11 , upper ceramics on 1/29/07, trying to straighten front teeth....worked well, but in fixing them and my upper arch, it made my overbite worse...so after 7+ months had to get 2 upper premolars done 2 weeks ago.... just got my metal lowers on this Tues. when I left the office one of my upper molars was/is hitting the lower molar bracket... they said to give it some time and it should get corrected.... but how long do I put up with this discomfort, several days or weeks???
They also repositioned one of my upper front brackets, tooth is a little crooked, however, I'm not sure it's really 're-positioned', can/should this wait til my next visit...??? THANKS!
Here are a few pics to give you and idea:

#26 Post by **SandraJones** » Thu Sep 27, 2007 3:49 pm

I don't want to hide Jovifan's question directly above, but I also have a question ...

Dr. Jones, do you have any suggestions for where my tongue should be positioned at rest ? I'm a thruster and I suspect this has contributed to my current alignment and occlusion problems. I have quite a fat tongue and small jaws, and my tongue tends to stick out wherever it can. Also, I was a chronic thumbsucker for many years and I'm afraid I trained my tongue to push so well that it continues to do so decades after I stopped sucking.

Now that I have my braces on I am much more aware of my tongue on my teeth, in part because my teeth are sensitive to pressure so I feel it when my tongue is against them, and also because I want to ensure that my teeth remain as nice as possible after the braces come off. I really want to try to train it to rest in a better position, but I honestly have no idea where it's supposed to go. During my 3 visits to my orthodontist I have forgotten to ask her, and I won't see her again for another couple of weeks.

I'm acquiring a good dental/orthodontics vocabulary and can look up any words I don't yet know, so you can use your technical lingo ! Thank you so much in advance ...

#27 Post by **jonesortho** » Thu Sep 27, 2007 3:50 pm

Hi JoviFan,
Sounds like what you are going through is very standard. When we bond the lower arch up, it is so hard to get things to meet properly and brackets invariably get in the way. There are a couple of tricks that we have up our sleeves that we use in some cases. Build-ups can be put on the molars or incisors to keep your teeth from hitting the brackets, but that still means that only the teeth that hit the build-ups will be touching anything. You have too much space between the upper and lower teeth in front to do build-ups there, so you'd have them in the back. Those teeth will be the only ones that you can chew on and will take th brunt of the force, so they will be sore. If you aren't breaking off brackets, then I see little difference between having your teeth hitting on a bracket and having them hit on a molar build-up. Commonly, we leave it hitting only on a bracket, like in your case. Unfortunately, we can't predict how long it will be like this, but it's going to be more like weeks/months than it will be days. Sorry, that's one of the worst parts about braces and when I figure out a good solution for it, I'll let everyone know--and then retire on the proceeds.
As far as the repostion....this is another tricky one. You often can't tell if the tooth is getting straighter until the wire has had a chance to fully express itself---takes at least a few weeks. Even so, they may not have gotten it in the ideal spot. I've repositioned one of my wife's brackets twice now, and it's as far off as ever. The anatomy of the tooth and the bracket can be a tricky thing to get to mesh right. I'm sure they will get it straight before it's done, so I wouldn't call them about it, just mention it kindly to them at some point.

Sorry, I wish I could give you more advice than "this sucks, but it's common" but that's about it. Keep "livin' on a prayer"...and some pain killers!

#28 Post by **jonesortho** » Thu Sep 27, 2007 3:52 pm

Hi JoviFan,
Sounds like what you are going through is very standard. When we bond the lower arch up, it is so hard to get things to meet properly and brackets invariably get in the way. There are a couple of tricks that we have up our sleeves that we use in some cases. Build-ups can be put on the molars or incisors to keep your teeth from hitting the brackets, but that still means that only the teeth that hit the build-ups will be touching anything. You have too much space between the upper and lower teeth in front to do build-ups there, so you'd have them in the back. Those teeth will be the only ones that you can chew on and will take th brunt of the force, so they will be sore. If you aren't breaking off brackets, then I see little difference between having your teeth hitting on a bracket and having them hit on a molar build-up. Commonly, we leave it hitting only on a bracket, like in your case. Unfortunately, we can't predict how long it will be like this, but it's going to be more like weeks/months than it will be days. Sorry, that's one of the worst parts about braces and when I figure out a good solution for it, I'll let everyone know--and then retire on the proceeds.
As far as the repostion....this is another tricky one. You often can't tell if the tooth is getting straighter until the wire has had a chance to fully express itself---takes at least a few weeks. Even so, they may not have gotten it in the ideal spot. I've repositioned one of my wife's brackets twice now, and it's as far off as ever. The anatomy of the tooth and the bracket can be a tricky thing to get to mesh right. I'm sure they will get it straight before it's done, so I wouldn't call them about it, just mention it kindly to them at some point.

Sorry, I wish I could give you more advice than "this sucks, but it's common" but that's about it. Keep "livin' on a prayer"...and soft food!

#29 Post by **JoviFan** » Thu Sep 27, 2007 3:56 pm

jonesortho wrote:Hi JoviFan,
Sounds like what you are going through is very standard. When we bond the lower arch up, it is so hard to get things to meet properly and brackets invariably get in the way. There are a couple of tricks that we have up our sleeves that we use in some cases. Build-ups can be put on the molars or incisors to keep your teeth from hitting the brackets, but that still means that only the teeth that hit the build-ups will be touching anything. You have too much space between the upper and lower teeth in front to do build-ups there, so you'd have them in the back. Those teeth will be the only ones that you can chew on and will take th brunt of the force, so they will be sore. If you aren't breaking off brackets, then I see little difference between having your teeth hitting on a bracket and having them hit on a molar build-up. Commonly, we leave it hitting only on a bracket, like in your case. Unfortunately, we can't predict how long it will be like this, but it's going to be more like weeks/months than it will be days. Sorry, that's one of the worst parts about braces and when I figure out a good solution for it, I'll let everyone know--and then retire on the proceeds.
As far as the repostion....this is another tricky one. You often can't tell if the tooth is getting straighter until the wire has had a chance to fully express itself---takes at least a few weeks. Even so, they may not have gotten it in the ideal spot. I've repositioned one of my wife's brackets twice now, and it's as far off as ever. The anatomy of the tooth and the bracket can be a tricky thing to get to mesh right. I'm sure they will get it straight before it's done, so I wouldn't call them about it, just mention it kindly to them at some point.

Sorry, I wish I could give you more advice than "this sucks, but it's common" but that's about it. Keep "livin' on a prayer"...and some pain killers!

Thanks for the quick reply!!!! btw - loved the 'livin' on a prayer' Bon Jovi reference!!!! I'm impressed

#30 Post by **SandraJones** » Thu Sep 27, 2007 4:04 pm

(whoops, posted question twice and couldn't delete, could only edit)

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