Considering Braces

[BraceComfort]

I suffer from moderate to severe periodontal disease. I'm in my mid-40s. My periodontist recommended braces because my gums are stable at the moment. She said getting braces would improve the health of my gum and teeth which I'm not doubting. I saw an ortho last week for an evaluation and am seeing another tomorrow. The first ortho assured me that I could have braces without tooth loss as long as the treatment is slow and managed carefully. Unsure if I should move forward with braces given that my front teeth has receded and I fear tooth loss. Have expressed my concerns to both the periodontis and orthodontist but they suggested I move forward (wonder if that's because they're friends)... I've been reading the internet about this topic and the net (pardon the pun) results are 50/50 for/against. Please share your experiences and/or feeback. Thank you!

[shekhinak]

I was sent to a periodontist because the oral surgeon had to be "aggressive" when taking out my wisdom teeth, and there isn't much support for the back teeth. Oh, and I was told I had gingivitis too.

I had some teeth that were crooked, and were very difficult to clean, even for the dental hygienists. So at age 48, I decided I'd better get my teeth straightened so I could at least clean the crooked ones.

My periodontist said my gums were healthy enough for braces. So after much procrastinating, I made an appointment with my daughter's orthodontist.

I had decided that I would only get my teeth straightened if they would use Invisalign, as I decided that I'm just too old for "tinsel teeth." To make a long story short, they said they couldn't recommend the Invisalign, but they did offer the ceramic braces or the lingual braces (the ones that go behind the teeth). I had so much emotionally invested in it all, that I opted for the ceramic braces.

Apparently, most adults who opt to get braces reach a stage where they think, "What did I do???" I'm one of them, and I had a meltdown over the weekend (8 days since being braced). So to speak, the orthontics staff "talked me off the ledge." I'm actually impressed with just how helpful the orthodontics staff has been. I've been told that after a month, you'll find yourself talking other adults into getting braces.

So my opinion: Go for it. You'll love the results afterwards, and you'll find that although there are a few "bumps in the road," the trip isn't all that bad.

[BraceComfort]

Hi, Shekhinak - Thank you so very for your reply. The first ortho said I was not a good candidate for invisalign either. Bummer! I was supposed to get ceramic braces tomorrow, October 20, but I opted out because I'm very scared and nervous. My perio and ortho have assured me that they will closely monitor the treatment to avoid any potential teeth loss. And after reading your post, I feel a whole lot better about forging ahead with braces. (THANK YOU AGAIN!!)

Separately, I will need one tooth extracted but the ortho said that can be done after the braces are put on. Is that even possible?

I plan to get a second opinion tomorrow and will circle back with the results. If all goes well, I will reschedule my appointment with the [first] Ortho for mid-October.

At any rate, I look forward to having a better smile and heathy gums/teeth - I've waited almost 45 years!

[shekhinak]

I was sitting in the chair with the lobster bib on waiting to have the braces put in, and that's when they told me that I might have to have a few teeth extracted. I think you reach a point where you just want to make sure the job is done right, and if they have to extract teeth, then you'll be perfectly willing to go along with it. And hey, if it gives the rest of my teeth more room on the gums so that they don't fall off the back, that's a good thing

I believe they could extract the teeth after they put the braces on, as all they would have to do is remove the arch wire.

From what I understand, they typically just put the top braces on first, to get those teeth in line. They'll decide if I need to have the extractions in about a month or two. I've read on this site that the extractions are much less traumatic than getting your wisdom teeth out.

Being nervous is perfectly normal. I just felt like I was in a regular dentist appointment, and having the braces put in didn't hurt at all. It took just a little under an hour to have the top braces put on.

I'll be honest in that I spent months procrastinating about calling for the evaluation appointment with the orthodontist. I was disappointed that I couldn't get the Invisalign, but I decided to get the conventional braces right then and there. I was originally scheduled to get them put on tomorrow, but an unexpected job commitment came up, so I asked if they had any cancellations at the orthodontist's office. They did, and I was braced on September 9th. It doesn't hurt to ask if they have a cancellation list

Keep me posted on how things are going!

[BraceComfort]

Hi again! Just returned from my second consult. In my opinion, it went fairly well. For starters, he confirmed that I am a good candidate for braces. Woo-hoo! He also said that I can have invisalign for the first 12 months (to allow more time for my gums to get better/adjusted), then for the remainder 8+ months, I will be in braces. Have you heard of this approach before? While we didn't get a chance to discuss $$, I suspect the two in combination could be quite costly. My other concerns are:

He said 2 teeth (1 upper / 1 lower) will need to be extracted. The (first) ortho said we only need one tooth (lower) pulled. Here is my dumb question - by extracting more teeth, would the end result yield more gaps between teeth? I do have gaps between my lower/upper front teeth and will continue to have them even after treatment. I can live with that but I don't want the gaps to get wider from having 2 instead of one tooth extracted. Any thoughts on this issue?

I personally like both orthos. Besides my pocket book, I like the idea of having both invisalign/braces. I'm such an easy target - the second ortho scheduled a follow-up for next Thursday for fitting! Yikes! And I made an appointment (yesterday) with the first ortho. Oh boy ...

Would appreciate hearing from you. ;-). Take care

[shekhinak]

I was told that if I pushed for Invisalign, that they'd have to finish up with braces - so to just do the braces in the first place. But think about it... they told you the SAME thing, but they put a positive spin on it. If the expense isn't a big deal, then why not go with that option?

That pretty much underscores what I've heard about Invisalign, that they don't provide the orthodontist enough control for the final movements. My spouse went with Invisalign given by our general dentist, and that's exactly the problem she had (which is why I went to an orthodontist).

My opinion, both options sound good to me. Pick which ever one that you and your bank account feel the most comfortable with. Either way, it's money well spent!

Not to worry about the extractions. The problem is that you don't have enough room on your gums for all the teeth. Believe me, they wouldn't recommend the extractions if they couldn't fill the gaps. If you were left with gaps, you'd be a walking anti-advertisement for that office!

So cool... you're going to become one of us!

[BraceComfort]

Thanks for your repiy! I am inclined to go with the combo - and will make the final call once I have an estimate - calling the office tomorrow.

I am so excited about the prospect of having braces. Having straight teeth even at my age! Nice.

You've been very supportive and i am most grateful. Can't wait to be a part of the "braced" family. I will keep you posted.

[BraceComfort]

Btw, would please share your "1st week" experience of getting braced? Did you experience any discomfort/pain? Are you able to go back to a normal diet?

I know I will be going down this path soon but thought I'd ask. -:) Thanks.

[ArchWired28]

BraceComfort

Invisalign + reg braces will for sure cost more, compared to just reg braces to achieve the same result. I have a few friends who wanted Invisalign and not quite being suitable for it (too complicated). One of them finally found an ortho who was willing to do invisalign following with the reg braces for 6-12 months, and the cost was approx 50% higher, compared to braces alone. Frankly, I am not sure why anyone would go that route since it is costly, time consuming, bothersome and combines the adjustment period for invisalign as well as reg braces.

About the gaps, I would imagine, they will close all the gaps with braces. Isn't it the main purpose of braces, to close the gaps? Anyway, if they suggest you must have teeth pulled, I am sure they plan on closing the gaps, because otherwise, what's the point?

As of the adjustment period, it was (and still is) quite a hassle for me. You know, pain/soreness, uncomfortable bite etc - all the nice stuff But for me, it is well worth it.

[shekhinak]

Hmm... Archwired28 brings up some good points. I didn't give too much thought about the cost, but Archwired28's estimate does sound reasonable. The going rate for braces is about $5000, so if the estimate is a 50% higher cost, you're looking at $7500. The going rate for the lingual braces (they are attached to the back of the teeth) is around $6500. If that's the case, it might make more sense to save $1000 and get the lingual braces. Perhaps a third opinion might be in order?

OK, my first week. I was expecting to have a throbbing pain, 24 hours a day, but that didn't happen. Instead, it just felt really sore every time I tried to bite down on something. So for the first few days I survived on yogurt and applesauce. It took me a while to figure out how to floss (like a few hours), but looking back on it, I can't understand why I was so thick-headed about it. They give you a plastic needle device that you can thread the floss under the wire, and it isn't that hard to do. It just takes a little longer than it did before braces.

The one thing that threw me was that after about a week, my front teeth started colliding. It would happen while I was eating or talking, and at first it really startled me. My teeth were sore to begin with, so even though the impacts were pretty minor, they felt like major blows. So at first when it happened, I couldn't help but let out a stream of profanity each time. I kind of had a meltdown because I had to give a BIG customer presentation at work, with LOTS of corporate vice presidents from BOTH sides. I had to speak as a technical expert, and going off into a stream of profanity in the middle of it would have been pretty lethal to my career. Long story short, I made it through just fine. The teeth collisions may well happen no matter what approach you take, so don't worry about it. Looking back on it, I feel pretty foolish for having freaked out about it. My embarrassment on that count is perhaps exacerbated by the fact that my teenage daughter thinks I made a complete fool of myself.

I only have the top braces on for the moment, and Archwired28 tells me that the bottom ones hurt much worse. Given that my bottom teeth are the most messed up, yeah, I have to believe that. I'm not sure when I'm supposed to get the bottom braces, but I'm glad Archwired28 gave me fair warning about that. If you get Invisalign first, you'll start off with both the top and bottom trays at the same time, so you have that much more of an adjustment to contend with.

So it sounds like you've made the decision to become a full-fledged member of the bracket club, and you're only wrestling with what approach to take

[BraceComfort]

Thank you both for responding. A lot of useful information here and some scrary stuff, too! I am definitely moving forward with braces - the question is which approach. I have not yet heard back from the ortho regarding costs - will let you know when I do. If too expensive, I will forego the combo.

Backdrop: The reason invisalign is more appealing to me is that my firm will conduct a worldwide partners meeting and I've been asked to help host the event. This undoubtedly means I will be greeting VIPs from all over the map. At the risk of sounding vain, Conventional braces (tinsel teeth) would add to that anxiety. Then there are luncheon engagements and meetings at this event.... Hopefully by November (1 month into being braced) the process will be easier. And regardless of which approach I chose, both my upper and lower will be braced. :-(

I've not thought of lingual braces but perhaps I should ask my ortho. Thanks for bringing that up. At this juncture, i am planning to go with the first ortho. (Upon further reflection, they can be quite pushy, hence, I wound up having an appointment scheduled with both offices - but I will save that story for another day!)

Mentally, I am prepared to go thru what most of you have gone thru. Dreading it but I will remind myself that this is all worthwhile at the end.

[TwistedShelby]

Hi there I feel your pain, I really didn't want braces and looked at Invisalign and lingual. I wasn't suitable for Invisalign and the lingual ones were sooo expensive. I have ceramics and love them, I almost wished I'd gone for retro metal. I smile loads more to show them off, I feel more confident if you can believe that. you really do become a convert, gonna miss them when I have them off in 2 years.
Good luck in whatever you choose

[ArchWired28]

BraceComfort

my supervisor have chosen to go with Invisalign because of the exact same reasons you listed. Plus, she's giving talks a lot, so she wanted it off for the talk. She's an easy case, just some crowding and rotations, so she's a candidate.
She only has it for a week, but so far she has been very happy. And I can attest, it is really invisible, meaning - you cannot see it even if you know it is there. She does not have any speech changes as well, so she does not even have to take it off for a talk.
She will have to wear it for almost 2 years (already has 44 or 48 tray sets programmed), but so far, she's happy with her choice. Her only concern so far is that she has to brush and floss after every single bite of food, but I am sure she will be more comfortable with it very soon.
As of the cost, her relatively easy case costs her the same amount $$$ as does my case (moderately complicated, but not an Invisalign candidate).
So I guess, it is really up to you. If an added cost is not a barrier - go for it. In my opinion, the most important is that you are happy with your choice, as you will be stuck with it for a long time of your life

[BraceComfort]

Thanks for the replies. I'd like to take this opportunity to apologize in advance for being long-winded...

Oddly, my first ortho didn't suggest invisalign at all. In fact, I asked about it and she said I was not a candidate. Needless to say, when the second ortho suggested that I go with invisalign, followed by the conventional braces for the remaining duration - I was estastic. He reminded me that I will, in fact, need braces during the last 8-10 months of treatment. I realized the cost for both will/can be expensive but I am hoping to get an idea from his office today as to exactly how much I would be in debt. I did read from another post that all orthos are not in a position to offer both (invisalign/braces) as one course of treatment. The ortho must be experienced. (Btw, did I mention that this ortho has achieved the Invisalign Premier Provider Elite status, which recognizes the top 1% of Invisalign doctors?)

Since returning from the second consult, I emailed the first ortho to determine if having invisalign/braces would be a good path of treatment for me. I have not heard back from her but hope to soon. My other fear is that she is a bit young and inexperienced. She opened her office earlier this year. A good by-product is that I did get a great discount (because she's new) for the conventional braces (just under $4k - not too bad!). But given my age and the condition of my gums (moderate to severe perio disease), I want someone with more experience in this field. Know what I mean? Then there's this problem where my periodontist is good friends with the younger ortho; hence, my perio has been encouraging me to see her. Argh!

Separately, does anyone know the difference between a "DDS" vs. "DMD, MS?" I ask because the more experienced ortho (been practicing for years - graduated at the top of his class at one of the best dental school in the US; he's now a faculty at the same dental school) is a DDS. The younger ortho is a "DMD, MS" graduated from Columbaa/Harvard and attended residencey at the same dental school. In fact, when talking to the more experienced ortho, he said the younger ortho was his student!! Hmmmm...

So...these are dilemmas. I probaby should be thankful that I don't have anything more serious to worry about!! Life is a blessing.

[shekhinak]

I went with the ceramic braces, and the few people I've disclosed my secret to have all said, "I never would have guessed." I also give quite a few talks at scientific conferences around the globe, so being able to talk is pretty essential skill. No matter what kind of braces you get, you'll likely be brushing your teeth every time you eat something. That's not a bad thing. It's harder to be tempted by an unhealthy snack when you know how much effort it will take to clean your teeth afterwards. I've had no trouble losing weight (I've been meaning to drop 5 lbs for quite a while now).

There's no difference between a DMD vs. a DDS. It's about as different as a PhD vs. a ScD (Doctor of Philosophy versus Doctor of Science) - they're equivalent degrees. If an orthodontist has M.S. after DDS or DMD, it likely means that they went through a 3 year residency program instead of a 2 year one. In a 3 year program, it's a bit more research oriented. (I was a "professional student," so I tend to key in on degrees and where everyone went to school). My understanding is that both types of residency programs require the same number of clinical hours, but in the 3 year program they'll see more patients from start to finish of treatment.