Question about treatment.

Message

#1 Post by **Chris1960** » Sat Dec 22, 2007 6:12 pm

I'm going to go out on a limb here and post my teeth.

Because I have this question:
As you can see my incisors are crowded between my canines. And my 2nd bicuspids were removed to make room.
Wouldn't it make more sense to FIRST move the canines/bicuspids into the gap, THEN straighten the incisors?

My ortho seems to be doing the opposite. He's straighting the front incisors which is going to give me an underbite. Then I guess he's going to pull everything back to fill the gap. It just seems that it would make more sense to do it my way. Anybody know why he's doing it the other way?

#2 Post by **lionfish** » Sat Dec 22, 2007 6:23 pm

I suggest you ask your ortho before jumping to any conclusions.

#3 Post by **Chris1960** » Sat Dec 22, 2007 6:59 pm

lionfish wrote:I suggest you ask your ortho before jumping to any conclusions.

My ortho's not real talkative. Usually he looks at me while the tech has her fingers in my mouth so I can't get a question out anyway.

#4 Post by **joney** » Sat Dec 22, 2007 7:04 pm

Hi Chris

I always thought the same thing, that it would make more sense to close gaps first but from what I've learnt on the board gap closure is done much later in treatment. My teeth were straightened first and now, one year down the line, my ortho is working on gap closure. The good news is that my top extraction gap closed pretty quickly but the bottom one is taking it's time. I definitely noticed that as a result of the straightening process the gaps closed quite a bit anyway, poking wires were usually the first sign.

Regards
Joney

#5 Post by **Chris1960** » Sat Dec 22, 2007 7:15 pm

I guess it's the engineer in me. I want to know WHY things are done a certain way. And like most engineers I always thing I can design something better. It doesn't make sense to me to wait to close the gaps. While he's unraveling the incisors there's no reason we can't be moving the incisor/bicuspids back. Or is there?

#6 Post by **Skates** » Sat Dec 22, 2007 7:30 pm

Ask your questions on a piece of paper. Hand it to him when the tech has his or her hands in your mouth. It worked with mine....

Good luck.

#7 Post by **ilovemacs** » Sat Dec 22, 2007 7:35 pm

Great answer Skates! That's what I do, it works perfectly. They actually see the paper which tells them you've got questions!

#8 Post by **HIMgurl** » Sat Dec 22, 2007 7:51 pm

Or you could just start talking as soon the tech gets in there and let them know you have questions to ask. Or trying getting them after your adjustment is done but before in has time to slip out of he door.

#9 Post by **Chris1960** » Sat Dec 22, 2007 8:16 pm

Meryaten wrote:Some good ideas on how to ask questions. Some (comparitively few) orthos get a bit defensive, as they get the idea you are doubting or criticising, but most seem only too happy to explain things to their patients who are interested.

I have gleaned the same as joney about the order in which things are done. Take a look at the UNC web site that is oft-cited here, and which explains the general stages you might expect to go through in treatment: http://www.unc.edu/depts/appl_sci/ortho ... t/one.html In fact, since you'e an engineer, you might enjoy it if you backtrack to the start of the site (http://www.unc.edu/depts/appl_sci/ortho ... index.html), and read all the way through.

Remember that the initial alignment work tends to be done with extremely flexible archwires. My sense is that these types of wires would not work well for gap closure.

Thanks M. That's what I need. I've been looking all over the web for a little more detailed info. I think that I am going to go ahead and buy a Intro to Ortho textbook.

#10 Post by **berries** » Sun Dec 23, 2007 8:29 pm

I had two teeth extracted on top, and my ortho opted to start closing the gaps first, with just a few braces plus power chains. After a few months, the gaps were about half closed. Then he let me choose whether I'd like to continue with closing the gaps or switch to straightening out the crowded front teeth, then go back to dealing with the gaps. (So we're currently straightening--things were starting to look a little bizarre because of the new spaces opening up.)

In my case, I don't think there was enough room to untangle the front teeth until the gaps closed somewhat. Straightening would've produced more overjet. It's producing more overjet now, too, but not nearly as much, and the teeth will be moved back later.

My ortho did seem to understand that getting the front teeth aligned has a lot of psychological significance for me compared to gap closing. Even if the overall treatment time is the same, it looks like progress. And the teeth are still moving into the gaps somewhat, so it's not like things are a total loss on that front.

So, I suppose others are correct when they imply that it's one or the other: gaps or straightening. But is this really just because of wire gauges? I had assumed the power chains, not the wires, were doing most of the work in closing the gaps.

#11 Post by **berries** » Sun Dec 23, 2007 9:07 pm

Thanks for the information, Meryaten. I must admit that I'm slow to understand the technical aspects of orthodontia. Guess I don't have an engineer's outlook on things. But I do like to understand the whys and wherefores, and like other posters have mentioned, when one's mouth is full of wires, fingers, etc., it's hard to ask questions. I'll keep that written-note advice in mind.