My 17 months progress feeling worried.

[snowblaze]

Hi,

I have been wearing braces since September 2014 and I found some old pictures of the first day I got my top braces on. I'm quite happy about the progress so far but I feel like there's lots of work still needed in there and I'm very anxious as to make sure we don't exceed the deadlines. I'm financially unstable since I broke with my girlfriend and I can't afford a few extra 300$ visits. I paid all 24 months but I was warned that the 25th appointment won't be free. And let's be honest, I can't wait to get these things out of my mouth!!!

If you look closely at my top teeth, you can see that the wire kinda slopes downwards on the right side. I hope they will fix this since it is very obvious and it looks weird. Then I hate how my two front teeth sticks out and are big. I feel it's still quite noticeable, even after the 17th month mark. Then there's my bottom teeth, they are all uneven. It seems like my four front teeth are at one height and the others are lower, on each side.

Here are the pictures before :





Then 17 months later :







Sorry about the sheer size of those picture, I'm not really tech savvy. Again I find it very odd to take picture of my own mouth but I was amazed to see how clean my teeth looks like. I have zero cavities too so I'm a bit proud there.

So what do you think, should I be worried?

[ItsFreyja]

Hi Snowblaze, sorry you haven't gotten any replies yet. I'm a little confused about your ortho's plan to start charging you for visits after the 24th month, as it sounds fairly unusual. Many cases overshoot the ortho's original estimated treatment time, and it sounds like it could be quite a racket for the ortho to systematically underestimate them and then bill for the extra! I think you should (1) look over your contract carefully and (2) have a pointed conversation about the timing issue with your ortho so you know what to expect in these (possibly) final months.

That said, I think your teeth are looking great! But let me address the three concerns you raise.

As to the wire sloping downward, this is NOT a quick fix and if correcting a cant wasn't specifically in your treatment plan, it's not going to happen at this point. The usual treatment involves surgery or the insertion of TADs to impact or intrude the side of the arch that is lower. Frankly, I don't think the amount of cant you have is that big of a deal cosmetically. If your bite is not well seated as a result, though, that's something you need to discuss with your ortho.

As to the upper central incisors protruding, this is the kind of minor adjustment that is usually accomplished via wire bends in the final months of treatment. Discuss it with your ortho.

As to the varying heights of the lower incisors, the fact that the wire looks pretty straight suggests that your ortho may be planning to do a bit of shaving to even out the teeth. Discuss this with him.

[NeilH]

Hi, I agree with Freya, you should be treated to a standard, not a timeframe and any suggestion that you should pay additional fees for what is an inexact science does sound a little unusual. Check your treatment plan and make sure this wasn't specified at the time and if it was, query why it wasn't drawn to your attention. Many people overshoot their estimates for a variety of reasons, all orthodontists know that, but to penalise you to accept completion earlier than would be ideal does not sound morally defensible.

At 17 months, you still have some time to go so don't be too worried that all won't be fixed in that time. The images you want to look at are the ones where you are biting together, do you teeth meet in a class 1 occlusion, are there gaps where one side meets before the other (in which case there are options including elastics that many others have had prescribed). I should mention, however, that sometimes photos show an odd shape to the arch (I have binned hundreds of images that show this) and its sometimes down to the camera, the angle the photo was taken and the position of your teeth relative to the lens. The only way to really tell is to bite together and see how it all fits.

Refinements to your lower teeth can yield results really quickly so make sure you outline your concerns to your ortho and seek their clarification on what can be achieved and what they would consider to be an ideal outcome. Hopefully you can get this resolved quickly for your own peace of mind. Good luck.

[Felina Grimm]

I'm on the same boat as you. My mouth refuses to close despite strict elastic wear and I'm afraid I'll go past my estimated time. In the office where I go to, you get a 6 month grace period if you go past the estimate and once you exhaust that, you start paying for every visit. I thought other orthos were similar with such matters.

[maralv]

i think you should be fine. the ortho i went to is a set price for duration of treatment not based on "sentenced time".