3 very different consults (pics) - Edit: Now 6 consults

Message

#16 Post by **mikey** » Thu Apr 27, 2006 5:28 pm

dbagnell wrote:It's possible that the ortho who suggested no extractions was planning to hook you up with some damons, you rarely need extractions with damons from what I've heard. Good luck with your decision.

Thanks Denise.

The subject of damons is something I'm interested in. I also would've thought that perhaps that ortho was going to use damons, but I asked, and my choice is either normal metal or ceramics (both made by 3m). I saw the brackets. I didn't specifically ask about damons however, but it was clear that that ortho did not use them.

It turns out that all four orthos are using brackets with ligs. The only slightly weird case is the first (with the most extractions!), where the ortho is using "light force" techniques which are related to Begg techniques. I googled Begg, and it turns out that he was one of the people instrumental in the shift from nonextraction treatment to extraction treatment. Now the trend has shifted back it seems.

I am going to see an ortho who uses damons on Tuesday, and I'll report back on what I hear.

BTW, anybody have a recommendation for a damon ortho in the Pittsburgh area? So far I've found the AAO website (braces.org) to be the most useful source of information, since it allows you to search by distance and displays the universites attended. However, it doesn't have any information beyond that, such as the types of brackets used. I'm also hopeful that the damon website actually will have an ortho locator after May 1st, like they claim.

#17 Post by **missingu** » Thu Apr 27, 2006 6:39 pm

I have called Ormco (Damon's parent company) directly and found that people were more than willing to talk to me, and I clearly identified myself as a patient and not an ortho. Ormco's general phone number is 800-854-1741 and their hours are 6:00 am to 5:00 pm Pacific Time, US.

Their web site (www.ormco.com) has a lot of information on Damons, once you get past the main screen. It is very informative, but also exceedingly salesy. However, it is no secret that I was not happy with my Damons so I doubt any one is surprised that I am a bit cynical of their approach to marketing braces. However, the information is good for you to make your decision.

One caveat - if an ortho suggests Damons, ask very specific questions about the retention phase, I mean down to missing just a few nights. This is not my Damon-bashing, this came direct from an ortho who was discussing how Damons work but how the success can be "fragile." Just a head's up.

#18 Post by **Flora2006** » Thu Apr 27, 2006 6:43 pm

I won't really comment on which ortho sounds better and whatnot just because each has their own reason to do and say what they would do...

I just wanted to say that it's a good thing you are seeing a lot of orthos and get the feel of them and all. My biggest advice is that you chose someone that is nice and who you will feel comfy with.

You will be in braces for a long time thus seeing your ortho practically every month...so choose one that no only are you happy with the treatment plan, but happy with how he/she seems to be.

Good luck with the consultation on tuesday! Report back

#19 Post by **mikey** » Thu Apr 27, 2006 9:17 pm

missingu wrote: One caveat - if an ortho suggests Damons, ask very specific questions about the retention phase, I mean down to missing just a few nights. This is not my Damon-bashing, this came direct from an ortho who was discussing how Damons work but how the success can be "fragile." Just a head's up.

Interesting ... I'll be sure to do that. While the long term stability of nonextraction techniques in general is something I've seen questioned elsewhere (perhaps on this forum), I hadn't heard anything specifically about Damons, and I probably would have failed to ask about this on Tuesday if you hadn't mentioned it.

Thanks for all the feedback everyone. This is a great forum!

#20 Post by **missingu** » Thu Apr 27, 2006 9:40 pm

Let me explain the nature of my question about retention. One of fhe Damon's big "sell" is that patients don't need extractions. True. In fact, on their web site they extol the virtue of Damons in effectuating palate expansion: (quote from web site)

"This case was treated using the Damon System and Damon treatment protocols. The patient gained 14mm of posterior arch width â€“ without rapid palatal expansion or surgery."

OK, so the ortho said this is done by pushing the teeth "out", like expaning the shape of a horseshoe. It is all done together so the teeth don't stick out.

The problem comes in when the force keeping the horseshoe "pushed out" is removed. If the abovementioned patient gained 14mm of arch width in say, 18 months, which is Damon's average, that is a lot of movement very fast, but is it stable? The ortho I spoke to said his colleagues had patients losing retention if they missed literally a day or two of their retainers, and this was just in the short run. To date, I have not seen any long-term stability studies on retention from Damons as opposed to conventional braces and RPE expansion.

I wanted you to understand the nature of my comment. HOWEVER,

I know many people here are/have been happy with their Damons, and I am glad the Damons have worked out for them. But that does not mean I cannot share a concern that was passed on to me. If anyone wants to discuss the retention aspect of Damons (or other aspects of Damons), I'll be glad to. Personal attacks on me personally, and not my comments on the Damon bracket are not welcomed. I have had just about enough of those, thank you, just because my experiences have been different. Not better, not worse, just different.

#21 Post by **mikey** » Thu Apr 27, 2006 9:54 pm

missingu, thanks for explaining more fully. I took a few seconds to browse around and found that dr j. says raises similar concerns about damons and nonextraction in this thread.

for example:

dr.j wrote:I do not think the other ortho would do anything knowingly harmful. But "dental" expansion is not supported in the literature as being stable. If you are acceptant of indefinite/lifetime retention you may be ok. Asymmetric extractions are a compromise and do bring things out of balance in favor of a stable dentition.

Obviously, I think the purpose of having a forum like this is to be able to make an informed decision, so I appreciate your input. As for me, I'm excited about exploring the damon option, but I will definitely ask questions.

#22 Post by **photochick** » Thu Apr 27, 2006 11:30 pm

As a newbie, the one thing I can comment on is the bite. I've been seeing a dentist who practises neuromuscular dentistry. Anyone who has jaw problems, cronic headaches etc., should check into this.

#23 Post by **jennielee81** » Sat Apr 29, 2006 9:15 am

I did read something, in passing, about Damon's long term retention...I will see if I can locate it again...

I do remember I got it off of an ortho research site, not Ormco related, but what the heck was I there for????

This may take me a while....

#24 Post by **dena** » Sat Apr 29, 2006 8:31 pm

as everyone here has already indicated, there's no one way to treat your teeth and people have different concerns. I had three consultations, too, and had three very different price quotes and ortho plans presented to me. "Luckily" all three said some form of extraction was necessary or at least pretty likely (even if I had gone with Damons) so I knew that I'd be doing that. Since only one of your consults involved removing multiple teeth, I'd be inclined (personally) to go with one of the others and remove one or none...just because I've heard people tell stories of orthos who remove teeth unnecessarily.

Ultimately, I chose my ortho for a few reasons. His plan was 2-2.5 years and required the removal of 4 teeth, but he explained the balance issues in my mouth and I was confident with his explanation. Anyway, I admit, he was the cheapest. That did make a difference to me. But, that said, I am really happy with him and would tell you to go with the one that makes you most comfortable. The other thing I really liked about this guy was that he was quite candid. When I went to my consult and all the follow-ups, I really grilled him for a long time with tons of questions. He sat me down with the software models of my teeth and explained how 'not to treat' my situation and 'how to treat' my situation. He commented on what I told him other orthos had told me. And he discussed the reasons he didn't subscribe to their treatment styles. Ultimately, the fact that he dealt with all of my questions patiently and more thoroughly than the others made me pick him. I was still unsure at the time, but now I am very happy with him.

I hope all of these posts help you. Think about logistics like reputation, price, location...but also trust your gut instinct about this person.

Good luck!

#25 Post by **jennielee81** » Sun Apr 30, 2006 4:25 pm

Okay, this one is not the one I read, but the last few sentences do state that the type of braces had no effect on the reduction of arch size.

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

oh heck, I can't find the other one yet...I've been on here for an hour looking. I've read about 40 articles of interrest and all say basically the same thing as the link above...that "The degree of post-retention anterior crowding is both unpredictable and variable and no pretreatment variables . . . seem to be useful predictors." http://www.ncbi.nlm.nih.gov/entrez/quer ... med_DocSum

#26 Post by **mikey** » Tue May 02, 2006 10:39 pm

Had the fifth consulation today. Wasn't terribly impressed. This ortho uses only damons (even for children) and invisalign (premier provider). Ortho suggested 4 extractions (one of each bicuspid). However, said would be fine trying non-extraction first. When I mentioned the idea of a single extraction, he said could do that too. Basically, he seems to say he'll try anything ... I took that as a sign of wanting to get me started on treatment. Said invisalign is an option as well, even with extractions. Estimated treatment time is 18 months (up to 24 months because of extractions). Just over $5000 for damons ... about $6000 for invisalign.

Has been doing damons for 18 months, which means probably hasn't seen many outcomes from them (even though he has switched entirely).

Assistant warned (in a friendly way) about single extraction option. Said that is the reason that Tom Cruise's midline is/was so far off (which I never noticed before I heard people make a big deal about it).

#27 Post by **Chris** » Wed May 03, 2006 6:31 pm

Had the fifth consulation today. Ortho suggested 4 extractions (one of each bicuspid). However, said would be fine trying non-extraction first. When I mentioned the idea of a single extraction, he said could do that too. Basically, he seems to say he'll try anything ... ).

Thats not an uncommon answer he gave you. I had orthos tell me there are many different ways to approach the correction. Basically, its how much do you want to correct and what do you want your final outcome to look like?

#28 Post by **mikey** » Tue May 30, 2006 4:15 pm

Just an update:

I had a sixth consultation a few weeks ago. Before the consultation, I called ormco (thanks for the advice, missingu) and got the name of this ortho, because i wanted to get another opinion concerning damons.

This ortho's recommendation was 1 extraction (the first bicuspid behind the canine on the crowded side of the upper arch). So that makes the vote 3 out of 6 for extracting a single tooth (unilateral extraction). However, this ortho is willing to try nonextraction first if I want. So, that makes the vote 3 out of 6 for at least willing to try non-extraction.

This ortho uses damons on only some of his cases. He is not convinced that damons will help avoid extractions in this case because I already have some protrusion of my upper front teeth and my teeth are not tipped-in. But he is willing to try them (or use ceramics or standard metal). He does think that damons may make the process faster.

I really enjoyed talking to this ortho so I've scheduled a records appointment (2 weeks from now). I tentatively scheduled a brace-date for one week after that. I haven't decided between the single extraction and nonextraction. The ortho says that the casts of the teeth and x-rays will give him more information as well.

Thanks for the replies.