Lost faith in my daughter's ortho (Update)

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#1 Post by **jennielee81** » Mon Oct 22, 2007 1:57 pm

I just got back from my daughter's dentist appointment.

She has 2 cavities on front teeth that are caused (the dentist showed me and explained) by the BAD bonding job the ortho did. She said my daughter has been doing an excellent job brushing.

She (dentist) told me that I need to take her in to have those brackets pulled, back to the dentist to have the fillings done, and then back to the ortho for the brackets rebonded. Not a big issue though time consuming, I understand the need to do this, BUT get what she told me next!!

Dr. M (the dentist) told me that I need to go to the chair with my daughter and make sure they take off the right brackets and then go in with her when they rebond them to insist that they clean off the excess cement.

THEN, she told me to go to the store and buy a scaler and then go over her teeth and pick off any additional cement. Because she doesn't believe they'll do a good enough job.

I don't think my dentist trusts them and now I'm also ticked that I took her there for treatment!!! I think she's almost done, so we'll probably be done with them in the next few months.....

Because of their sloppy practices, I now have to pay for 2 fillings, my daughter will have 2 fillings in her front teeth for ever, and I'm really questioning what's been going on with her lower arch since July......she's got two teeth folding in on each other and they've not fixed it!

It is definately time for him to retire!! AND time for me to be more involved and proactive in her treatment. If I need to, I'll switch her to my ortho.

#2 Post by **Lala7603** » Mon Oct 22, 2007 2:24 pm

i would say first of all there it is a bummer that you have to pay for getting those cavities filled. i wouldnt want to pay for that....

if it were me....i would try to find another ortho. but i know there are challenges there. for instance the new ortho may not want to work with another ortho's type of brackets or whatever. i would say it couldnt hurt just taking her into your ortho's office and having he/she take a look at her teeth. if she is almost done that maybe it wouldnt be too expensive to switch her. And if you believe she is almost done with her treatment and teeth are still very visibly not corrected...maybe it would be better to get a second opinion???

im sorry this has happened....i would be SUPER upset if i had to go and get fillings on my front teeth. and you having to do all of that work.....are you getting a paycheck??? i dont think so...so why should you have to go out and buy stuff. maybe get the 2 brackets taken off and go to your ortho to get any excess off..i dunno...just a suggestion.

i guess i would agree...if you as a parent have to go and supervise the ortho's work...it may be time for retirement. OR jsut time for you to get a second opinion for your daughter. If you make sure she gets this braces thing done CORRECTLY the first time i am sure that would help her new smile last forever and lessen the chance for unhappy results.

sorry this was kind of all jumbled...i had a lot of thoughts going on.
SMiles
LALA

#3 Post by **Kat** » Mon Oct 22, 2007 4:32 pm

You say she is almost done with her treatment so my question would be why didn't your dentist see this before the teeth had the cavities? Didn't she have them cleaned while in braces or is this the first cleaning?

#4 Post by **rsprouse** » Mon Oct 22, 2007 4:33 pm

Jennie,

Can you explain to me or show me a picture of what you were told? I am guessing that the ortho left a ledge that collected plaque? I am not going to offer any advice since I don't know any details. But you should be aware that there is a good chance that any "bonding" that is done prior to bracketing is very likely to be messed up (technical term!) when she is debanded. I have a little bonding on the facial surface of one of my centrals that I am expecting to be obliterated when I get my braces off. Cavities really do not get any smaller, but this may be a case where a little patience on your end may save you a few dollars and save your daughter some extra time in the dental chair.

Lala7603,

Cavities don't develop overnight. One could argue that more frequent or a more aggressive hygiene routine could have prevented the decay. I am not saying that is the case, but it is a viable argument to your payment/responsibility comment.

Regards,
Rory

#5 Post by **platinum** » Mon Oct 22, 2007 4:45 pm

argh!!! What a bad luck!

I have fillings on my front teeth

. Even though they are made very well you can see them in certain light. It is very annoying to have fillings on front teeth... My two front teeth overlapped quite a lot, and it was difficult to keep my teeth clean. The cavities were caught when they were small, but the sloppy dentist did not do a proper work, and the cavities groved bigger.

I might take veneers after braces come off, if one can see the fillings.

#6 Post by **ohmyjaw** » Mon Oct 22, 2007 6:13 pm

So sorry to hear what happened to you and your daughter.

I had a similar experience but things didn't go quite so far. I was in braces for a year and a half before I had a dental check up. Not good, I know, but with the ortho payments I could never quite get the money together to go the dentist! Anyways, I went in for a check up and the dentist told me that one molar band was not fitting properly and was catching food. There was no decay yet but definitely potential for it to happen. The dentist then called my ortho and explained the situation. So the next time I went to see the ortho, he took the band off and replaced it with a bracket.

So, there was no cavity and no harm done, and I was not upset with my ortho. I didn't really think too much of it until I read your post, and now I am wondering, should my ortho have noticed that band? He is really good at what he does, so it is a bit surprising that he missed something.

I think, if I were you, I would discuss this problem with your ortho and see what he says. It always good to hear the other side of things. Also, it's too late for your daughter, but maybe once your ortho knows what happened, he might be more diligent with his other patients.

Finally, if your daughter is almost finished with treatment and things are not looking right, I would get a second opinion. A simple consultation may put your mind at ease. Or, if things really aren't going well, it's better to find out sooner rather than later.

#7 Post by **jennielee81** » Mon Oct 22, 2007 6:58 pm

WOW! YOu guys are great!

Rory, I will get a picture of her tooth in the morning when the light is natural and I will upload it tomorrow evening when I get home from work.

She's always been a good brusher and the dentist was fairly sure that it was the ledge or crease left from the cement that trapped gunk and caused this. This being said, I'm sure the ortho will have another story...most likely site my daughter's hygiene; though they've always told her she was doing a great job. But, she is a kid.

She hasn't been to the dentist in about 9 months (my fault, time flies!); I assume that's long enough for a small cavity to develop. As to why the dentist didn't say anything about the excess glue then, I can only speculate that she didn't see it causing any problem then.

What ever the cause, we are now dealing with the aftermath and the treatment. Which brings me to Rory's concern....Is it possible to slow the progress of this cavity so she doesn't have to go through the bonding process 2 times? How about using a fluoride rinse?

I come from strong-tooth people and my other two kids (18 & 21)have never had a cavity...I didn't have one until I was 35! Could it be that her teeth are more susceptible to decay (like her father's teeth) and this cement configuration encouraged that? Maybe on most people's teeth this wouldn't have been a problem?

I could go on for ever.....but I'll stop now.

#8 Post by **rsprouse** » Tue Oct 23, 2007 7:22 am

jennielee81 wrote:...
She hasn't been to the dentist in about 9 months (my fault, time flies!); I assume that's long enough for a small cavity to develop. As to why the dentist didn't say anything about the excess glue then, I can only speculate that she didn't see it causing any problem then.

The office should have been "up in your grille" about getting an appointment scheduled for the 6 month recall. The ultimate responsibility is on you of course because treatment is your decision. But I think they should give you a courtesy call to remind you it is time at a minimum.

jennielee81 wrote: What ever the cause, we are now dealing with the aftermath and the treatment. Which brings me to Rory's concern....Is it possible to slow the progress of this cavity so she doesn't have to go through the bonding process 2 times? How about using a fluoride rinse?

It doesn't work that way. If the decay is **only** in enamel (IE - hasn't reached the underlying dentin) then it is technically possible for the cavity to arrest and to not progress. The enamel can strengthen and life is good. It sounds like your Dentist was upset and that it is larger than that. My point was more that if she is a couple months from completion, it is likely a waste IMHO to restore, rebracket, and then likely have to restore again. I am a huge proponent of minimally invasive and preventative dentistry. And decay is a disease process that will not get better. But like anything else in life it is a judgment call and quality of life and treatment are factors that should be taken into account. I would ask your Dentist if she believes restoring the cavities can wait until after treatment.

jennielee81 wrote: I come from strong-tooth people and my other two kids (18 & 21)have never had a cavity...I didn't have one until I was 35! Could it be that her teeth are more susceptible to decay (like her father's teeth) and this cement configuration encouraged that? Maybe on most people's teeth this wouldn't have been a problem?

Just because you get a cavity doesn't mean that you are a bad person, have a deficiency, or don't take care of yourself. There are so many variables that come in to play. And as a data point, I would say based on experience that there is a marked increase in decay on young adults in the 18-24 range. What happens is they go off to college and no longer have Mom & Dad making sure they do things right and eat properly. 6 months later and poof! So make sure you stay that "evil" parent for a few more years

Best,
Rory

#9 Post by **jennielee81** » Tue Oct 23, 2007 1:20 pm

Thanks again!! The dentist sends reminder cards out and I just kept putting it off for no good reason. I realize that it is ultimately our responsibility to get her to the dentist every 6 months and to not accept the "stained cement" excuse when I ask the ortho what the brown stuff is on that tooth. When the dentist immediately put blame on the ortho's work, I was taken aback!!! Here I stand in the middle and it is really my fault.

The ortho didn't call me back yet about making an appointment to have the brackets removed and replaced. I left them a message without making any indication of my mood at the time, so they're not avoiding me. When they do call back, I will be sure to get a good # on how many more months she'll be braced and then ask the dentist if the filling can wait that long.

This daughter is 13 and I have told her NO MORE SODAS as of today!!! Once in a while, but not every day any more. She would have 1 diet soda a day but that will end.

Here's the pictures. In the first one, the canine is the tooth witht he cavity...I thought it was the lateral, thankfully, I find that the cavity is in a thicker tooth that's not as up front.

Here're the pictures:

This one is an example of the cement gobs that are left behind on almost all of her teeth. Quite clear on the laterals on both sides. BIG ridge on the left one (right side of pic)

THANKS again, for all the time and attention you are giving this little problem.

#10 Post by **jennielee81** » Tue Oct 23, 2007 2:05 pm

The ortho's office just called to make the appointment for all of this.

The assistant sounded VERY sheepish when I answered the phone.

I asked how much longer she'd be in the braces and the assistant said they were planning to do molds next month to assess that so she wasn't willing to even hazard a guess at this point. I did an uneducated assessment and see that her overjet is still about 2mm and she still has that annoying "dent" in her lower arch from the elastic thread he used WAY back in June and still hasn't corrected. So it's not looking like a month or two...more like 3 or 4.

Onward we go

#11 Post by **platinum** » Tue Oct 23, 2007 5:08 pm

The cement looks really weird! Not smooth, now wonder plaque can build up there.

It reminds me the fillings I had on my front teeth. They were not smooth.
The cavities grew back...

Website · #12 Post by **alexa** » Tue Oct 23, 2007 6:48 pm

Wow...that cement is really bulky! I had metals and I couldn't see any of the cement around the brackets.

Bummer for your daughter. I have a whole mouthful of fillings...and my parents didn't take me to the dentist as a kid very often (I can count the times on my fingers, to give you an idea). so I can understand why. But for your daughter, who does a great job cleaning, and although you're a little late, still gets to the dentist regularly, this just bites!

Good luck with getting all sorted out.

#13 Post by **ilovemacs** » Tue Oct 23, 2007 7:11 pm

I'm sorry to hear about all of this mess you and your daughter are going through. I hope you get things sorted out soon. Onto the cement issue, I agree with the others, that cement looks really sloppy, messy; to me it also looks like icing around a decoration, like the cakes that come with way too much icing! I just got my braces on 12 days ago; my cement isn't nearly that messy. I can see a little bit of cement on my front right tooth and another, but certianly not that much. I also have metals. One quick question: Is this the same ortho you had for your treatment? You sound pretty happy with your results. Hope this helps!! Good Luck!

#14 Post by **rsprouse** » Tue Oct 23, 2007 8:11 pm

jennielee81 wrote:The ortho's office just called to make the appointment for all of this.

The assistant sounded VERY sheepish when I answered the phone.

I asked how much longer she'd be in the braces and the assistant said they were planning to do molds next month to assess that so she wasn't willing to even hazard a guess at this point. I did an uneducated assessment and see that her overjet is still about 2mm and she still has that annoying "dent" in her lower arch from the elastic thread he used WAY back in June and still hasn't corrected. So it's not looking like a month or two...more like 3 or 4.

Onward we go

That is what we like to call a plaque trap. There is enough blame to go 'round, but the goal of any dental treatment is to keep things so that the patient can do their job in maintaining a plaque free environment. Although it is in an easy to access area, it is still a plaque trap.

That appears clinically to be a little more advanced to wait 3+ months. While you are at it, I would have them check 7 and 10 as well. Her gums look puffy to me (which is quite common in orthodontic patients), but due to the circumstances at hand I would ask the Dentist/Hygeniest or yourself to give her a brushing refresher. And remember, 2 minutes

Good Luck,
Rory

#15 Post by **rsprouse** » Wed Oct 24, 2007 7:38 am

KK wrote:The bonding is interesting Jenn. I'm sure there must be a reason to leave so much bonding resin exposed ...

No, probably not a good reason

Best,
Rory