Nervous Wreck over a Spacer Lapse

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#1 Post by **LadyGoddess** » Mon Apr 10, 2006 2:11 pm

I feel like a nervous wreck here. A little over three weeks ago I had my brackets put on top while the bottom got brackets, wires, springs, and of course, spacers. Now I have nearly three weeks to go before my next appointment. However I'm feeling very anxious that one of my spacers has came out. I think I swallowed it sometime on Friday...

It was between my two front bottom teeth and had been loose since the day I got my braces on. On the long drive home, I had toyed with it with my tongue, pulling at it mindlessly as I drove. Last Thursday I attempted to push it back down for I noticed it was nearly out. Friday evening at work, I realized it was not there at all and that all 6 teeth making up the front bottom teeth were sore.

I called the orthodontist and the receptionist told me that sometimes spacers are only meant to stay in for 10 minutes. It's been three weeks and the others are all still tightly packed down, but the miniscule space where the front spacer used to be is hardly shifted at all. They are trying to make room to pull a tooth forward that had came in quite a distance back when it came in when I was around 7. There wasn't room for it then.

Online I've read that spacers are only suppose to stay in for up to 10 days on the dental websites ran by dentist offices. Others say that if the spacer falls out before two days before your next appointment, call them and they'll send you a new one to insert. I have three weeks to go. I'm afraid that all the severe pain I went through the first week will be for nothing.

I feel sick with anxiety. Is it okay for the spacer to be gone? I don't want the teeth to move back together and then be needed to be wrenched apart again...

#2 Post by **LadyGoddess** » Mon Apr 10, 2006 4:15 pm

Thanks. I live 2 hours away from the orthodontist so I don't really have an option of just dropping in, unfortunately.

The receptionist on the phone made light of my concerns as did my friend whom I've been going to about my concerns.

I turn 21 the day after my adjustment, but this office keeps insisting that I'm 14 years old. So besides having this annoyance with them, I had a really bad first week. I doped up on everything I could get my hands on and went through several Orajel and other soreness treatments. Anything dealing with my braces scares me currently.

#3 Post by **missingu** » Mon Apr 10, 2006 4:48 pm

Now I'm confused. Did you have a spacer between two teeth with brackets on? Maybe that is a standard I have never heard of, but it's new to me.

The other thing I don't understand is why a spacer is being used to move a tooth? Isn't that what the braces are for?

Now I'd better make sure I am thinking of the right kind of spacer. Either they are little coils or blue tubes, right? They are used to make space between teeth for banding usually?

If the goal is to move the tooth (or make room for it), and you are braced on the bottom, can you help me understand why the ortho would use a temporary piece like a spacer as opposed to a permanent attachment? If the spacers are between molars in the back to be banded, then if they got the spacer in, can't they get the band in, too? They had to do that with me.

I'm sure it is very frustrating to be treated like a child by the ortho's office. Would you be able, the next time someone treats you poorly, to say, "you know, maybe we got off to a rough start [or whatever]. How about we start all over again, as adults, now that I am 21." That is just something I thought of to say, what will be critical is to calm, even-toned, and open to listening. Sometimes just a change in tone of voice can help and a calm demeanor. Since I don't know why the office staff treats you that way it is a little hard to help out.

As I have gotten into "bad start" situations, I have learned that sometimes I've had to say "you know, maybe I got a little angry [or whatever] at my first appointment. Can we just let that go and start again" - as long as I own my behavior and not blame them, and acknowledge that I want to make things better, I've never had a problem.

Another tool I find helpful is to ask myself, in a bad situation, "what is the worst case scenario and can I live with it." Granted spacer placement isn't fun, but if the worst case scenario is placement again (or placement of bands without spacers), if you lived through it once, can you do it again? I imagine it is yes, though begrudgingly. In which case, maybe you can relax just a little and enjoy your "spacer-freedom" for the next few weeks.

#4 Post by **Joual** » Mon Apr 10, 2006 6:05 pm

LadyGoddess, do they have the incorrect birth year in your file? Is there a computer glitch in their office that says you were born in '91 or '92? Even if you look 14 they should know from your paperwork that you are 21. Next time you go in you may want to ask what birth date they have for you in case somebody made a mistake.

As far as the spacer, the receptionist shouldn't tell you or any other patients how long your spacers should stay in. She should have had an assistant or the ortho speak to you.

#5 Post by **LadyGoddess** » Mon Apr 10, 2006 6:27 pm

Well, its the fact of the matter that I do look young and the braces sure aren't helping that impression. Honestly, this is something I've been dealing with for the last 5 years at least of regardless how people know my true age, they treat me many years younger. Cool beans when I'm 40, not so much when I'm trying to take care of medical stuff.

At my three different medical offices (reg. doctor, dentist, ortho), the receptionists pretty much refuse to let you talk to a doctor or get a message to a nurse. Intensely annoying, but there doesn't seem to be much I, as a patient, can do about it seeing that Medicaid gives you few if any other options of where to go.

Thank you though.

#6 Post by **LadyGoddess** » Mon Apr 10, 2006 6:36 pm

missingu wrote:Now I'm confused. Did you have a spacer between two teeth with brackets on? Maybe that is a standard I have never heard of, but it's new to me.

Yes, I have brackets on all my teeth and spacers between all the bottom teeth minus where the very front one fell out. Wires and springs are also attached. I do not have elastics as of yet.

The other thing I don't understand is why a spacer is being used to move a tooth? Isn't that what the braces are for?

The spacer is being used to help make a space so that the pushed-back tooth can be brought forward. I personally don't understand the mechanics of it, so I can't explain what they're doing besides what I can see they've applied to my teeth.

Now I'd better make sure I am thinking of the right kind of spacer. Either they are little coils or blue tubes, right? They are used to make space between teeth for banding usually?

My spacers are bright blue rubber bands (as they appear to me) squashed down between my teeth. By the time the other spacers are taken out, I'll have a distance of at least 2 mm between each tooth on the bottom.

If the goal is to move the tooth (or make room for it), and you are braced on the bottom, can you help me understand why the ortho would use a temporary piece like a spacer as opposed to a permanent attachment?

I have no idea. My orthodontist office told me nothing but just sent me home. Most of the people at his office don't speak English or the like the guy who put my braces on, spoke with a very heavy accent. Then again, the doctor himself is crazy as hell. He goes out into the waiting room and randomly starts spewing speeches about how he was an awesome missionary in Africa and how easy it is to break our appliances. I've found in the last 3 weeks that you'd have to be really trying to break the wires.

#7 Post by **missingu** » Tue Apr 11, 2006 10:16 am

Granted there are a bunch of conditionals in this post, but bear with me.

I did not think Medicaid would pay for ortho work othen than those under age 21. If you are a patient and payment is by Medicaid, I can almost guarantee they will treat you like a child because it is almost unheard of for someone 21 to use Medicaid for dental. Dental is solely a child option from the perspective of Medicaid policy (sorry, but with a Masters in public policy and a Masters in social work, I'm familiar with strict health care policy. your situation may be different and the office will work with you when you 'age out' ).

Bottom line, from the legalistic health care policy at least in my state and in most states, but maybe not yours, Medicaid only covers dental under 21. No way would an adult be covered, so if you look young and have Medicaid, they are most likely going to assume you to be a child, especially if you look young.

I wish there were no such thing as Medicaid-discrimination, but it is alive and well. It sounds like they have made decisions about you and your care based on the coverage, which is illegal and unethical, but is done all the time. You deserve respect and to be treated with dignity because you are a person, regardless of how you pay. That you are not saddens me immensly.

Your posts have been very enlightening to me. I hope to hear from you again soon.

#8 Post by **LadyGoddess** » Tue Apr 11, 2006 10:23 am

missingu wrote:I did not think Medicaid would pay for ortho work othen than those under age 21. If you are a patient and payment is by Medicaid, I can almost guarantee they will treat you like a child because it is almost unheard of for someone 21 to use Medicaid for dental. Dental is solely a child option from the perspective of Medicaid policy.

No problem whatsoever. The apparent loophole my orthodontist is exploting is that as long as the braces are applied before I turn 21, Medicaid will be forced to pay for the two years of treatment. Thus, I was rushed on the list to get them applied and at least one adjustment before my birthday so that they can go, "See? She has her braces and is part of the program now."

These babies cost $6,000 I'm told and I must say, the ....humbleness of knowing that much money is going into my mouth to straighten my teeth is numbing sometimes.