Midline shift, prior braces, want less than perfect outcome.

Message

#1 Post by **teezo** » Sat Feb 23, 2008 1:59 pm

Hi all, I'm new to the forums.

A bit of history. I had braces when I was 13. My maxillary lateral incisor never grew in. My other lateral incisor was a peg tooth. The orthodonist at the time was to correct everything, but he did not. He told me I would be left with at most a 1 mm midline shift.

Now at 33 I am left with a 2 mm midline shift that I am so unhappy about. I went to two orthodontists to get consultations and of course they both said "jaw surgery, tooth extraction, braces for 2.5 years, etc.".

I am looking at my teeth and I just want to know why they can't do a less than perfect job in order to make me happy. When I look at my teeth, I see 1 mm of space between my central incisor and lateral on each side. My midline shift is 2 mm difference. Why can't they just use braces to shift over my midline to where it is supposed to be, shave teeth and fill in gaps with bonding, etc.

do I HAVE to get my whole jaw and bite and everything fixed? I have another consultation next month, but just want to know your thoughts. I posted a link to pics.

Thanks!
~Teezo~

http://i266.photobucket.com/albums/ii26 ... G_0216.jpg
http://i266.photobucket.com/albums/ii26 ... G_0214.jpg
http://i266.photobucket.com/albums/ii26 ... G_0213.jpg

#2 Post by **jennielee81** » Sat Feb 23, 2008 5:27 pm

Your teeth look great!

I suggest you go to a cosmetic dentist and talk to him/her about what you want.

#3 Post by **ohmyjaw** » Sat Feb 23, 2008 7:39 pm

I don't know why you would need an extraction since you don't have any crowding. I am guessing they said surgery because your front teeth are hitting end-to-end? That's what it looks like in the photo but I don't know if that is your natural bite. I would say go for the cosmetic fix UNLESS your bite is causing you problems - joint pain, excessive wear on your teeth, etc. If that is the case, it might be worth diving in and getting the whole thing fixed.

#4 Post by **teezo** » Sat Feb 23, 2008 9:27 pm

jennielee81 wrote:Your teeth look great!

I suggest you go to a cosmetic dentist and talk to him/her about what you want.

wha??? but they don't! can't you see how awful the midline shift is? I look....deformed or something.

They said jaw surgery because as of now, my bite is correct. If they start moving teeth around, they will have to completely correct my bite again which means jaw surgery. But my question to the orthodontist will be, what if I JUST want those four front teeth moved? Why would my jaw have to come into the picture?

One orthodontist suggested removing that darker lateral incisor (in the picture the tooth to the right of my front tooth) and bringing all the teeth forward.

How could cosmetic dentistry shift my midline though? Can it somehow?

Thanks so much!

PS - no, my bite has never caused my any pain or problems.

#5 Post by **lionfish** » Sat Feb 23, 2008 10:37 pm

You hardly look deformed.

I'd suggest getting another consult.

#6 Post by **ohmyjaw** » Sat Feb 23, 2008 11:16 pm

If you wanted to get veneers, I would think they might be able to fix your midline. Or rather, they might be able to camoflage it. Basically they shave down some teeth and build up other ones, I think. (But I am not a dentist!)

But I agree with lionfish on both counts - get another consult (or two), and you do not look deformed! You have very nice teeth. When I first got braces my teeth were pretty crazy - sticking out every which way. If they look as good as yours when I am done, I will be happy.

#7 Post by **teezo** » Sun Feb 24, 2008 12:05 pm

Well, okay maybe not deformed, but the midline shift is just so noticeable to me.

The second orthodontist (the one I liked) said that veneers could camouflage it to about 1 mm discrepancy. I just really didn't want veneers because I think I have good teeth -- just not symmetrical.

I guess I just don't understand why they can't move my front teeth 2 mm over with braces, without touching or moving the back teeth or my bite.

~Teezo~

PS - does anyone know of a good cosmetic dentistry forum/message board?

#8 Post by **SinOnYourLips** » Sun Feb 24, 2008 2:44 pm

teezo wrote:
I guess I just don't understand why they can't move my front teeth 2 mm over with braces, without touching or moving the back teeth or my bite.

You really can't see why? If you had big gaps between your teeth, especially on the side to which you want to shift your teeth, than maybe they would be able to do that. But from the pictures above it seems to me your teeth are pretty tight and close to each other, so now physically picturing this, how can they shift your midline without shifting your WHOLE top jaw, over and therefore changing your bite as well.

Realistically speaking, I don't see how they could just move your front teeth without the back ones involved, seems impossible.

#9 Post by **teezo** » Sun Feb 24, 2008 7:32 pm

SinOnYourLips wrote:
teezo wrote:
I guess I just don't understand why they can't move my front teeth 2 mm over with braces, without touching or moving the back teeth or my bite.
You really can't see why? If you had big gaps between your teeth, especially on the side to which you want to shift your teeth, than maybe they would be able to do that. But from the pictures above it seems to me your teeth are pretty tight and close to each other, so now physically picturing this, how can they shift your midline without shifting your WHOLE top jaw, over and therefore changing your bite as well.

Realistically speaking, I don't see how they could just move your front teeth without the back ones involved, seems impossible.

Because there is 1 mm space already on the side I want to shift them, and why can't they just shave 1 mm off another tooth? That will leave me with a 3 mm gap on the opposite side (because there is already 1 mm space there as well) which I thought could be veneered or bonded.

#10 Post by **jennielee81** » Mon Feb 25, 2008 11:01 am

Because there is 1 mm space already on the side I want to shift them, and why can't they just shave 1 mm off another tooth? That will leave me with a 3 mm gap on the opposite side (because there is already 1 mm space there as well) which I thought could be veneered or bonded.

I see what you are saying here. I agree that they might be able to shave a bit off a few teeth to make room then slide the front teeth around leaving the 3mm on the other side. I'm then realizing that you would end up with one HUGE tooth on the opposite if they added 3mm to one on the other side. This would fix the midline problem, but create another that may be far more noticable to others than the midline.

...I'm wondering why they couldn't shave some off of the teeth on the left and then just send ALL the teeth in that direction.

I would NEVER have that lateral pulled, if they pulled it then moved the back teeth forward, you'd have one lateral on your right and then a pointy, canine on the left. That might look very odd.

Since both orthos suggested surgery, perhaps you have a skelletal problem that is only noticeable to dental experts?

Let us know if you find a reatment that you like!

#11 Post by **teezo** » Mon Feb 25, 2008 11:38 am

jennielee81 wrote:
I see what you are saying here. I agree that they might be able to shave a bit off a few teeth to make room then slide the front teeth around leaving the 3mm on the other side. I'm then realizing that you would end up with one HUGE tooth on the opposite if they added 3mm to one on the other side. This would fix the midline problem, but create another that may be far more noticable to others than the midline.

...I'm wondering why they couldn't shave some off of the teeth on the left and then just send ALL the teeth in that direction.

I would NEVER have that lateral pulled, if they pulled it then moved the back teeth forward, you'd have one lateral on your right and then a pointy, canine on the left. That might look very odd.

Since both orthos suggested surgery, perhaps you have a skelletal problem that is only noticeable to dental experts?

Let us know if you find a reatment that you like!

Yeah, I thought having one huge tooth would be better than having a shifted midline.

Actually, only one ortho suggested the jaw surgery (after telling me I should just leave things alone). The other ortho suggested what you said above -- pull the lateral and move all the teeth forward. I just have a bad feeling about that route, and I didn't like the ortho.

Anyway, I might have a skeletal problem and may not be able to do anything, but I really appreciate everyone's input. I got the answers I was looking for on this board.

Everyone says the midline is not noticeable, but I notice it!!!

#12 Post by **teezo** » Tue Mar 18, 2008 4:27 pm

Well, it's a sad, sad day.

I went to the orthodontist today and basically, only one thing can be done, and it will take 12-18 months (6-8 months of carrier distalizer, and then 6-8 months of braces) and then a dental implant.

He also said my midline shift is not 2 mm, it's more like 3.5 mm.

I am devastated. I would never consider a dental implant

I was totally into doing the distalizer and the braces, no problem. But no to the implant.

#13 Post by **teezo** » Tue Mar 18, 2008 7:02 pm

Meryaten wrote:Is cost the issue with the implant route, or just a gut reaction to that suggestion?

Btw, I know that you see the midline shift - it's like a massive, glaring flaw to you. But truly, at a casual glance most people wouldn't notice - you do have pretty teeth, and they are beautifully straight - that's what most people would notice. And certainly having a midline at least as off-centre as yours has not held back Tom Cruise Still, I can understand where you're coming from and why you'd so keenly want to sort this out.

Not the cost issue. just that...well, it's an implant! I've heard such bad things about them, and isn't it true that maybe the ortho would make the space and then it's possible maybe my bone wouldn't even hold an implant? Then what would I do!

I don't know. Not the cost issue for sure. Just the whole implant issue.

I am going to get crown lengthening surgery and a new crown (on that tiny yellowish tooth) and laser my other gum so at least they are all even and symmetrical, and then get everything whitened. maybe then it will bother me less. I don't know....

Am I silly to overreact about the implant? Are they not as bad as they seem?

#14 Post by **Dutch** » Tue Mar 18, 2008 10:15 pm

Teezo I have the same type problem as you and it has always bothered me.
because of a broken tooth things have shifted and now I am braced to bring things back to make room for an implant. I asked the ortho if we could do something about the midline? I am only braced on the bottom and it will not be perfect but a lot closer than it is now.
People have never noticed my midline, I have never worn braces before but I alway receive complements on my teeth. The midline is just something you (and I notice).
I have figured out how to put pictures on photo bucket... if you tell me how I will send you a link

#15 Post by **teezo** » Wed Mar 19, 2008 11:24 am

Dutch wrote:Teezo I have the same type problem as you and it has always bothered me.
because of a broken tooth things have shifted and now I am braced to bring things back to make room for an implant. I asked the ortho if we could do something about the midline? I am only braced on the bottom and it will not be perfect but a lot closer than it is now.
People have never noticed my midline, I have never worn braces before but I alway receive complements on my teeth. The midline is just something you (and I notice).
I have figured out how to put pictures on photo bucket... if you tell me how I will send you a link

((HUGS)) thanks!

Do you want these links to show up for everyone? Or just for me?
On photobucket, you will notice underneath one of your pictures four boxes -- choose the one that says "direct link", copy it, and then either post it on here or PM me with it.

Thanks so much!!

So what did your ortho say about your midline, and how many mm is it shifted over?