60 minutes Interviews - Extractions & Orthodontics

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#1 Post by **neilar** » Fri Sep 05, 2008 7:13 pm

It seems that many of you have come down hard on both this woman and the 60 minutes report, and I don't agree with you. I think the 60 minutes doctors (both Dr. Mahoney, Dr. Mew and one other) are very credible, and it's hard to believe they would make these claims to "increase business". (Dr. Mew is an elderly man and has probably made his money.) I think they want to do a kind of expose in order to inform the public and prevent this kind of thing from continuing to happen. I believe the story because I have experienced this damage first hand. I was born quite a pretty girl, but after braces at age 14, my looks were greatly impaired. (I would say I went from about an 8/9 to a 6.) I was self concious about my looks thereafter, and I believe it was probably the main reason why I never married. I'm 45 now and ended up as a "single mother by choice", but this is not the life I was hoping to lead. I also now am experiencing facial strain, and I suspect that it has to do with drastically changing my natural bite. I wanted to stress that I don't think it's the removal of teeth, per se, that is the problem. It's the pushing the teeth back which causes bone loss and reshaping. If people have teeth removed because of crowding but the natural bite is somewhat retained, I suspect this doesn't impair one's looks. It's interesting that this is reported in Australia. My parents are from Ireland, and I've noticed on visits there that the overbite seems to be more prevalent in that part of the world. The Australians are descendants of the English, so they probably also have more people with overbites. (Just speculation, I know.) I think that all of this is very hard to prove because you rarely know what a person would have looked liked had they not had braces. Plus, when it comes to aesthetics, there's not always agreement.

When discussing this with an anonymous group, it's helpful to discuss celebrities because we can google them and know what we're talking about. For example, I think Drew Barrymore has that "sunken in mouth" look. I also suspect that Molly Ringwald had braces (perhaps hidden) sometime after making her successul movies. To me, her face changed for the worse after her teen years, and she now has that post braces look. (Note that her career also died after her teen years - I'm not sure if these things are related.) I know that Jodi Foster had braces, and I think she has some of the "small mouth" look. I read that Julia Roberts with her gorgeous smile did not have braces (her dentist told her it would ruin her look.) I wonder if she'd have the same career today if they pulled two top teeth and brought her teeth way back. When you think about it, this pulling of the teeth back and causing bone loss is the same thing as binding girls' feet in China.

I'm sure now someone will accuse me of being alarmist. I get annoyed with people who say "you're scaring people". Isn't it better to scare people in the short run than to leave them with self esteem issues long term? If damage is truly done to your looks, then the truth needs to come out. One person said that the health of your teeth matters most, but don't you think that consumers should decide this for themselves? (With the exploding plastic surgery business, some people have clearly said that they will risk their health - even their life - for a prettier package.) I I were told that my child's looks could be impaired, I don't think that I would proceed with the treatment. Also, orthodontists make the case that your teeth will be "functionally better". What does this mean? If I don't do the treatment, my teeth will all out by age 40? I don't know if they know that. Pre-brace (say 100 years ago), many people lost their teeth but they weren't brushing, flossing (didn't even have it) and going to the dentist. I strongly suspect that I would have kept all my teeth even if I didn't have braces.
I wanted to close with mention of Dr. Mew's comment about challenging conventional orthodoxy. He states that it's very difficult to "challenge conventional orthodoxy"... you will be resented. I find that that happens even among regular folks on this message board.
Ok, I'm done ranting. Feel free to fire away.

#2 Post by **jaswi** » Fri Sep 05, 2008 7:32 pm

*pops up some popcorn*

This ought to be good.

#3 Post by **neilar** » Sat Sep 06, 2008 7:13 am

I don't buy that people's faces naturally change that much after reaching maturity (ie in the mid to late teen years). In my case, I was at my adult hieght and fully developed by age 14. It's hard to believe that my face would have all of a sudden gone from pretty at 14 to sunken in at 16. I'm a nurse, and I know that bone structure doesn't change that much after you've reached maturity.
Why do people resist that this is a phenomenon that occurs? Given that pressure is put on the bones for two years, it would be surprising if the face didn't change. After all, the facial bones provide the framework for the face.
I agree that many people still look fine after orthondontic treatment - I mean it's not as if they're burn victims - but their looks are still altered, all the same. The bottom line is that orthontists should inform patients that bone loss will occur, the bone reshapes, and this whole process can result in impairing one's looks. Of course, most orthodontists won't want to do that for fear of losing business.

#4 Post by **beachmommy** » Sat Sep 06, 2008 8:27 am

How many teeth did you have extracted? Did you have quite a few? I can see where that would change your looks. My orthodontist showed me how my profile would look via digital image with 1) no extractions; 2) 2 extractions; 3) 4 extractions. In my case, the change was very slight with 2 extractions so that's what we went with. (No extractions would have meant a much more complicated set up in my mouth, with posts in the back.) Also, I could have had surgery to widen my jaw, but I just don't have a month that someone can take over my mom duties.

I really think they key is to have a orthodondist that has been referred by someone with perfect looking teeth - that's what I did!

#5 Post by **Her** » Sat Sep 06, 2008 9:00 am

I dont know why these posts freak me out so much. Is the op suggesting that just the nature of orthodontists pushing back teeth (with or without) extractions causes bone loss and a sunken face?? Or just with extractions?

I got my braces when i was 19 and i honestly dont see much of a change in my face.

#6 Post by **jennielee81** » Sat Sep 06, 2008 9:59 am

My kid's ortho did inform me that their looks would change even though extractions were not indicated. I had to sign a paper stating that.

Their faces did change, they are all even more gorgeous now!! Faces balanced, and teeth perfectly aligned. Point being, faces can change even without extractions.

I believe that it can be done wrong and for the wrong reason...Not sure that it is a pervasive problem.

We recently had a young man in our area who died because the dentist refused to pull a tooth. It was abscessed and the doc wanted to save the tooth so gave antibiotics...long story short, the abscess spread and killed him. Not that this is a similar situation, BUT shows that bad docs make bad choices. Shop around for a board certified, modern, frequently updated ortho and your chances of a good outcome are very high.

#7 Post by **jennielee81** » Sat Sep 06, 2008 10:22 am

Her wrote:I dont know why these posts freak me out so much. Is the op suggesting that just the nature of orthodontists pushing back teeth (with or without) extractions causes bone loss and a sunken face?? Or just with extractions?

I got my braces when i was 19 and i honestly dont see much of a change in my face.

I had my teeth moved back 4mm with elastics (no extractions) and NO SUNKEN FACE!!!!!!!!!!!!!!!!!!!!!!!!

#8 Post by **jennielee81** » Sat Sep 06, 2008 10:23 am

EEK double post

#9 Post by **Her** » Sat Sep 06, 2008 10:38 am

jennie...thanks so much. i never know what people mean when they say "sunken" i need a pic. lol. i have more cheekbones now and im like "o no!!!!!!! my cheeks are sunken!!!" Its so hard being mental. lol.

by the way, everytime im on this forum, i stop to look at the pic of the teeth at the bottom of your sig. I love your teeth!!!!!! They are nice straight and still you!!! I dont like the look when people have all the teeth shaved down to the same length.

#10 Post by **neilar** » Sat Sep 06, 2008 12:50 pm

I'm glad that jennielee81 posted a pic. (I assume that's a before/after photo of your teeth.) When you said you had "teeth pulled back", it looks like what happened is that you had two moved into alignment with your natural bite. They did not pull all of your teeth significantly back so that your bite was different. So no, I wouldn't expect this to change your face. The phenomenon occurs when you go from an overbite (that frankly I think can be quite attractive) to a pulled in, smaller bite. For those of you not starting out with an overbite, I wouldn't worry about this problem.

By the way, I had two teeth pulled on the top and two on the bottom. I had straight teeth on the top with an overbite. I would say I had a toothy, kind of sensual smile. The orthodontic treatment took that away from me. It changed how my mouth feels, my confidence, my personality, and the ultimate outcome of my life. I had braces on over 30 years ago, so hopefully they've improved on the treatment.

This topic has come up in my life again (I thought I had dealt with it) because I had another treatment that affected my face. That treatment plus the braces has made me feel very unattractive. I have to accept it for me, but it's a shame that this still continues to happen to others.

#11 Post by **neilar** » Sat Sep 06, 2008 7:00 pm

Meryaten
Note that I dismissed Jennelee's successul outcome because she does not fit the scenario in which the teeth are signicantly brought back. It doesn't look like she started out with an overbite. She appears to have hooked/crooked teeth. I think you can't count those cases when discussing this subject. (I have no problem with orthonture for crooked/hooked teeth.) I'm fully aware that some people have fabulous results from orthondontic treatment. I'm not making a blanket statement here about braces.

I agree wholeheartedly that I am responsible for the outcome of my life. If, for example, my face was severely burned, I could choose to kill myself or have the best life possible. My posting is some venting, but I'm also trying to advise people what the effects could be. I'm trying to help people not get burned in the first place. (Why make life so difficult?) And I think that's what the doctors on the 60 minute piece were trying to do too. Unfortunately, looks matter in this world. As one person joked, "I took my beautiful inner self out on the town and came home alone."

I know this all sounds very negative, but I do believe the truth should get out there. I was delighted to hear that an orthodontist required one family to sign a waiver about this issue. That's the kind of thing I think there should be more of.

#12 Post by **jaswi** » Sun Sep 07, 2008 12:00 am

*Refills his popcorn, and adds extra butter this time*

#13 Post by **markybwoy** » Sun Sep 07, 2008 8:18 am

Those 60 minutes, 20/20 special, etc etc. tabloid TV "news" shows are a joke. How TV producers can pass their hysterical nonsense puncuated by commercials every 6 minutes off as "journalism"? You rarely see evidence presented on those sensationalist shows.

You can have bone loss with or without braces. It can be genetic or the result of poor hygiene (and, practically, straight teeth can help you keep things clean easier)

Orthodontics is an empircal science. This means orthos know what they learn in school + what they observe in the population. It's not as simple as good treatment that functions well and looks great vs bad treatment that makes your face look wonky. Medicine is not that straightforward. Empirically, there are hundreds of thousands, even millions of cases that do not cause damage. Also a small number of cases that produce unintended side effects, just like with any medical procedure from ingrown toenails through nose jobs.

#14 Post by **jennielee81** » Sun Sep 07, 2008 8:41 am

Note that I dismissed Jennelee's successul outcome because she does not fit the scenario in which the teeth are signicantly brought back

DO NOT DISMISS ME!

NO, NO, NO, my outcome DOES fit your scenario!!!!!!!!!

I had my ENTIRE upper arch brought back 4mm, not just those two teeth. I wore elastics for a year from upper 3's to lower 6's.

Now some people on this board will believe that I am ignorant to my own treatment or a liar!

NICE WORK!

You really think I lied about my treatment just so I could post in your thread? Good Grief!

#15 Post by **neilar** » Sun Sep 07, 2008 11:20 am

Meryten,
One day, I think of writing a book on this topic. I've printed out your message to remind me that it is a challenging undertaking indeed to make my case. Regarding the 60 minute piece, I don't recall that they used the word "disfigured". I think that calling the effects "disfigurement" is an exaggeration. (When I referred to getting burned, I was taking a more extreme case to make a point. I did not mean to imply that I now appear as a burn victim.) The word used in the 60 minutes piece is "damaged" which I think is an appropriate term in SOME cases.

You imply that my proof or evidence falls short. I agree with that because it's a challenge to ever prove this. We can never see how a person would have looked had they not had treatment. (The closest to getting at this is looking at identical twins that have been treated differently.) Your side always has the advantage because you can make the claim that people's faces would have changed anyway over time. I guess the best I can do is to try and show that change and have people come to their own conclusions. Ultimately, it's a gut-level conclusion. With regards to aesthetics, I don't know if you can ever prove your case like you would with a scientific study.

I don't think that this is occurring because of "bad orthodontic treatment". I went to a well-respected orthodontist who became wealthy treating people for years. It has to do with a very specific way of treatment. As I've said at least once before, it's the extraction/pulling back effect that I object to.

You approve of asking the patient to "acknowledge that features may be altered as a result of changing the underlying dental structure", but I wonder how common this practice is. Everything I see on orthodonture implies that the treatment will enhance one's looks. (That seems to be the generally accepted notion among the public.)

I think I'm done with this subject. You know, it's understandable that people who feel that braces have affected their life in a negative way would feel the need to vent. But I don't quite get why people who are thrilled with their result would spend so much time defending the establishment.

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60 minutes Interviews - Extractions & Orthodontics

60 minutes Interviews - Extractions & Orthodontics

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