Anterior open bite, retreating 20 yrs later, intro and ?

[mmkay]

Maybe it's just the pictures...but I have to say that what you have in your mouth looks pretty chunky/obtrusive compared to what I have - 4x screws outside of the mouth with plates poking inside, and simple composite bonded TPA-ish wires on both upper and lower arches.

[jfriend33]

Can we see what you have so that I can show my ortho later today? Thanks!

[jfriend33]

No more TPA for good. Hopefully these are the last bands on these molars. I cannot endure another band change. Too traumatic and makes me paranoid I will cause my crown to fail beneath or fracture the tooth.

As you can see there are green ligatures they are just there for comfort. First week of April they are placing two TADs on my palate and attaching one to each band where the green ligature is.

I had my elastics changed on my lower tads as well.

Now they are saying that maybe a few degrees of flaring outward would be beneficial to my molars (not possible with a tpa). And I was promptly reminded that straightening my front teeth is the easy part and will be the last thing completed.

Goal, close bite more. Then realign front teeth.

Tads may be removed and repositioned as needed.

Dear God please let's see more progress. I have only been in braces since December 15th.

[mmkay]

Can we see what you have so that I can show my ortho later today? Thanks!

Not one for posting pics, but identical to this:
http://4.bp.blogspot.com/-Si6ss9a_5Iw/T ... 20/new.JPG

With a piece of thread attached between the bracket and the little hole. One for each quadrant.

Plus upper arch wire:
http://www.ericcampbellortho.com/Portals/0/TPA.jpg

And lower arch wire:
http://www.mainepedo.com/gallery/115676.jpg

Except in both cases attached to the inside of first molars using composite, not those awful wraparound mental things.

I'm not sure I could stand all that chunky stuff being on the roof of the mouth etc.

[jfriend33]

Can we see what you have so that I can show my ortho later today? Thanks!

Not one for posting pics, but identical to this:
http://4.bp.blogspot.com/-Si6ss9a_5Iw/T ... 20/new.JPG

With a piece of thread attached between the bracket and the little hole. One for each quadrant.

Plus upper arch wire:
http://www.ericcampbellortho.com/Portals/0/TPA.jpg

And lower arch wire:
http://www.mainepedo.com/gallery/115676.jpg

Except in both cases attached to the inside of first molars using composite, not those awful wraparound mental things.

I'm not sure I could stand all that chunky stuff being on the roof of the mouth etc.

Lol. Thank you for your reply. I am going to agree that it has previously felt quite obtrusive/intrusive/space taking! I mean for me the whole cause to my malocclusion and open bite was not just the poor tongue posture, but essentially a size 12 tongue in a size 10 mouth. Why make the available space even less (with a deliberate distance from palate TPA), especially so soon after successful elimination of poor resting position/tongue thrust.

The composite attachment sounds so nice. But I think it's because of my pesky molar crown that made banding a prerequisite.

I know for me, even wearing spacers before band placement, moved my molars enough to open my bite up a little (noticeably). For every action there is an equal an opposite reaction...

I guess most peoples teeth have enough ability to compensate when bands come off to still be aligned well. I won't worry about that.

I am going to keep up the oral hygiene, be happy I don't have anything that is too fragile. Really enjoy eating again. Remember that I'm only paying a fraction of what most people pay. Acknowledge surgery may happen. But there's still more probability that I won't need it and that's my goal. Really more than anything, have healthy teeth for a lifetime.

Thanks for reading everyone.

[rebecca121760]

From what I have been reading (10 hours a day for the past week, lol) tongue thrusting is a huge problem and does cause open bite. We have been told since my son was pretty much a baby that he would eventually have to have jaw surgery. Then we saw a surgeon recently and found out what they have to do to him to accomplish this. Anyway, the research commenced. I am so wishing that I would have researched this years ago. I would have known that he has a tongue thrusting problem combined with mouth breathing. He now has a 12mm gap. I wish I could see your pictures. For some reason it says that I don't have permission to see them? Do you guys know why this would be by chance? Anyway, Over the years, our son has been in braces, has seen three orthodontists and a oral surgeon. Not a soul ever mentioned Tads with braces. I did put pictures of his teeth on another site and a Denver orthodontist came on and said that it could likely be fixed using this method if we can get a handle on the underlying causes. I hope so.... I have known people who had bad results with the surgery and am a pretty terrified mom right now. Thank you for telling your story and I really wish I could see the pictures.

[jfriend33]

From what I have been reading (10 hours a day for the past week, lol) tongue thrusting is a huge problem and does cause open bite. We have been told since my son was pretty much a baby that he would eventually have to have jaw surgery. Then we saw a surgeon recently and found out what they have to do to him to accomplish this. Anyway, the research commenced. I am so wishing that I would have researched this years ago. I would have known that he has a tongue thrusting problem combined with mouth breathing. He now has a 12mm gap. I wish I could see your pictures. For some reason it says that I don't have permission to see them? Do you guys know why this would be by chance? Anyway, Over the years, our son has been in braces, has seen three orthodontists and a oral surgeon. Not a soul ever mentioned Tads with braces. I did put pictures of his teeth on another site and a Denver orthodontist came on and said that it could likely be fixed using this method if we can get a handle on the underlying causes. I hope so.... I have known people who had bad results with the surgery and am a pretty terrified mom right now. Thank you for telling your story and I really wish I could see the pictures.

Thanks for the reply Rebecca! You won't be able to see or post photos here until you have made a certain number of posts. I'm not sure how many it is exactly.

I am so happy that you have at least been enlightened on surgery alternatives. 12mm is certainly open. My heart goes out to you. If anything he could at least improve the open bite, may not be perfect but still. It may take a long time too. But would be worth it!

My latest semi obsession had been reading about and watching videos about Orthotropics. It's basically along the lines of having good posture, using non traditional appliances, and incorporating myofunctional therapy. Look it up. I admire the gentleman for saying that this day and age, doctors need to understand many patients come in, often times with a folder of info they brought in. And that it's truly possible the patients could be more knowledgeable than the doctor is with certain areas or treatments. But most specifically that no one's ideas should be dismissed!!!

I would say at the bare minimum, it is in his best interest to find myofunctional therapy. Would depend on his motivation level for sure. If he is highly motivated, he could complete this tongue posture therapy and see improvement in his open bite (without braces!). AND even if he needed surgery, this crucial phase will help guarantee his retention. Too many times people have jaw surgery, the tongue thrusting and resting posture aren't corrected, so the teeth relapse. This doctor that commented on your photos, he may be of help. But my ortho told me, there's always going to be a Dr that will take your money. In and out and on to the next. U should try to find a teaching University near you. They have the cutting edge technology. Payment plans. And their goal is to educate and try everything. Not just conventional practices.

He may need to see a ear nose and throat specialist. If he's mouth breathing maybe it's because he has enlarged tonsils/adenoids? I was luckily able to avoid surgery (to improve my breathing) just by having my mouth closed. My tonsils have shrank and I can breathe so much more easily. Something is obviously wrong. Maybe small nostrils? But it's like this, which came first, the chicken or the egg?

Also, open bites can be genetic. There isn't too much talk about that at least not that I've read. But my mother, uncle, and great grandparents all had the similar issue.

Once thing I really need to work on is my posture. I was obese as a child and have slightly rolled shoulders. I firmly believe if my posture was slightly better my bite would improve just a bit more.

I also want you to know I have several friends in the medical profession and also speech language pathology. I have stressed to them all the importance of catching this early. There are warning signs. It's just baffling to think that most dentists base their normal range of measurements on x-rays taken over 60 years ago. Humans are beginning to consume high caloric softer food and it's taking a huge toll on our teeth. The best exam an ortho can do on an open bite is observe them in the waiting room. See how they sit, walk, talk, drink, etc. You go in for an exam, you're nervous, and act differently than you normally do!

And I have to say this. Surgery isn't so bad. Some people require it. It would help preserve his teeth too (if he kicks the tongue habit). But why not try one more time, but with tads, and if they don't work, he'll already be in braces, and more prepped for surgery. Heck, I may need it, although it's less likely.
__________-_-
Anyway just a little update,
I am fully adjusted to my 4 tads. Should be getting 2 more on my palate the beginning of April. I really am beginning to notice my molars on the right side intruding and not touching like they used to(hooray pesky crown! Thank you for finally moving!). This phase kinda sucks because things are getting a bit worse before better. But eventually my farthest back molars will intrude/align and the rewards will be amazing.

It's something like for every unit of measure that's been intruded in the posterior, it's like 3-5x that amount as a closing effect.

[rebecca121760]

How is it going now? I hope you are doing well. I am beating up the internet looking for ways to help my son. I want to post pictures to see if anyones bite has been as bad as his and been repaired just orthodontically without surgery. The surgeon we saw is actually wanting to replace his joints. :( It looks horrible!!

[rebecca121760]

Wow. Thank you for all of the information. Noah has a slightly rolled shoulder posture too. I am not sure how that effects it all. I will look myofunctional therapy later this afternoon. He has had his tonsils and adenoids removed because of his mouth breathing/snoring. It didn't help much to my opinion. The oral surgeon said that his left nostril is pretty much clogged. Not sure exactly what with. I am going to try to get a copy of his dictated note. I am kind of of the opinion that the orthos who don't do this procedure recommend surgery because if they don't, and you discover a different, less traumatic procedure, you go to the doctor who does the other procedure and they miss out on treating the patient. I don't blame them, but I think they all need to get on board with this if it works. Somebody told me earlier that they have been doing this for 10 years. I am a little frustrated because my boy has been suffering with this forever waiting until he got to the right age for surgery. Blah. Thanks again!! I am looking forward to when I have enough posts to add and see photos.

[jfriend33]

Got two more TADs placed. Have a total of 6. One got loose and a half turn tightened it right up.

They also cut my bands tubes open to allow for each connection to last molar to be "stepped". So now they use wire to attach it. (the only difference I see is a bend in the wire which couldn't fit thru the hole hence them having to cut it open and tie it). They also changed from elastomeric to that same wire to my upper buccal tads.

Have to get excess skin build up around the exterior tads removed with a laser next month. Should be exciting.

Been prescribed chlorhexatine for the inflammation. Will dc that after laser. Side effect of rinse is grey teeth so have to be careful.

They are also going to join a wire over each upper molar and use composite to secure it. This will also help intrude as I bite down.

Also stumbled upon more interesting videos on YouTube. Called orthotropics. Makes total sense. I really need to work on my back posture.

Hope life finds you all well!

[rebecca121760]

Has it caused you much pain or affected your speech? I am wondering because my son will be a junior in high school next year in a new school. He is pretty tough, but has been taught to talk basically using his tongue to close the gap in his bite.

[jfriend33]

Has it caused you much pain or affected your speech? I am wondering because my son will be a junior in high school next year in a new school. He is pretty tough, but has been taught to talk basically using his tongue to close the gap in his bite.

Heck no! This is way better than my TPA with acrylic. Very streamlined. I don't have any speech problems whatsoever.

Your son and myself both probably have minor speech idiosyncrasies due to our open bites. They are probably at minima they aren't noticeable. To make a proper s sound your teeth should be closed up front. This will improve with treatment.

[rebecca121760]

Thank you so much!! Keep us updated!

[30andbraced]

Curious on your progress? Do you feel as though things are progressing the way you want them to? I've been reading a lot about TADs but my ortho never suggested it to help with my open bite.

[jfriend33]

Curious on your progress? Do you feel as though things are progressing the way you want them to? I've been reading a lot about TADs but my ortho never suggested it to help with my open bite.

I definitely think there's some progress. It's not very much though. It can take a while to get things moving but once they start it can happen quickly. I've only been in braces 4 months and the tads are a newer addition. They say for every 1 millimeter of posterior intrusion you gain 5-6x that in closing effects up front.

I will say for me that my spaces between my teeth are tight. And getting spacers for molar bands moved my molars out of place enough to even worsen my bite (not that noticeably but I felt it). Now that's getting corrected with the steps on my archwires and TADs.

So I had an idea and mentioned it to my ortho. The type of material we use to connect from TADs to braces wears out. The elastomeric ties I have can lose their effectiveness after just 2 or 3 weeks. So my suggestion was adding buttons to my palatal tads (so they have a flat head), and using patient changeable elastics. Like a penguin or smaller size rubber band. I could change those daily.

After reading a few threads here I also requested more information on a official Rapid Molar Intruder device (RMI) that has special springs encased in plastic tubes. Hopefully will leave that as a last resort.

I had to visit my ortho unexpectedly yesterday. One of my Palatal tads became pretty sensitive Saturday. Then Sunday I knew something wasn't right and it just fell right out. I think when he put that one in he went in so far that it went all the way through my bone causing it to come loose. The replacement wasn't painful at all going in. They changed my other elastomers and kept the upper exterior tad wires the same. They aren't pulling, just stabilizing. Every time I get anxious to get things moving I am reminded that in orthodontics for every action there is an equal and opposite reaction....

Also, I've been smoke free for 4 months! I am hoping that my teeth will move even better! And who knew coffee was the culprit for staining teeth!