Getting braces again, need advice

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#1 Post by **BracesAgain** » Wed Jan 10, 2007 2:05 pm

Here is the back story. I had braces for 3 years when I was a teenager. The orthodontist at the time wanted to remove one front bottom tooth and I refused because I want symmetrical teeth. So, in order to get the teeth to fit, he positioned them so that they fan or flare out, instead of being straight up and down. The day I got my braces off, I thought I would be incredibly happy...and I was disappointed and wouldn't show my boyfriend my teeth for several days. I thought my teeth would be perfect and they weren't. To make a long story short, my bottom retainer got crunched up in a garbage disposal and the bottom teeth shifted in the 5 days it took me to get a replacement retainer. After a while, I just stopped wearing retainers at all...

Now, my one bottom tooth has shifted so much that people remark on it when they are talking to me (especially those people who knew me for those 3 years that I wore braces). I feel very self-conscious because my bottom teeth are very visible when I speak because of how my mouth is shaped.

The orthodontists I consulted with have given me 2 options:
1) Wear braces on only the lower teeth to align them, however my teeth will still fan out.

2) Remove 4 bicuspids to relieve the crowding on my bottom teeth and to make my teeth more straight up and down.

I am in my mid-20s and I am a single gal...I am unhappy with the situation that I am in. I don't know why I wasn't given option 2 when I was a teenager. I want perfect teeth and I am a perfectionist...but I don't want to appear to be so vain. Ugh

Does anyone have any advice for me? Here are some pictures of my teeth:

http://img405.imageshack.us/my.php?imag ... ethfa7.jpg

http://img265.imageshack.us/my.php?imag ... th2zq8.jpg

http://img443.imageshack.us/my.php?imag ... th1jt8.jpg

http://img408.imageshack.us/my.php?imag ... ut3wa2.jpg

http://img408.imageshack.us/my.php?imag ... ut2hl3.jpg

#2 Post by **ghostmyimag3** » Wed Jan 10, 2007 2:15 pm

When you say "fan out" exactly what do you mean. Your teeth look fine to me cept that one tooth. I had a 9mm overjet on my uppers, and I didn't want any teeth removed that won't absolutely neccessary. I had crowding but i told him to just round them out. So if you mean rounded then i completely understand.
Noone has perfect teeth. What is perfect teeth anyway, you have to deal with what you have right. I'm 30, and a perfectionist and I've lived with crowding since i was 8. But now I'm just to the point if they are straight and look right i'm fine with it.
I think you should get the braces on the bottom, that tooth may give you problems later, but as much as i have sat in a dentist chair i personally wouldn't remove any teeth. But thats just me.

#3 Post by **jennielee81** » Wed Jan 10, 2007 2:20 pm

Hi BracesAgain!

Remove 4 bicuspids to relieve the crowding on my bottom teeth and to make my teeth more straight up and down

Gee, that bugger sure did move!! Your uppers are very pretty!

Are you sure they said 4 lower bicuspids? That is a LOT of space. I'm not questioning your orthodontist's treatment plan, but I was just curious that it was really 4 lower bicuspids.

I recommend you have a second opinion (just the free consult) to see what another ortho says. If that one's treatment plan is similar, great! If the second one offers you another plan, it may help make your choice easier. There are so many ways to do this and every orthodontist goes about it differently.

I had one ortho say pull 2 upper bicuspids and use headgear. The other said no extractions and use elastics. I went with #2 since I'm a BIG FAT chicken when it comes to pulling teeth and there was no way I was going to wear headgear. My dentist commented last month on how nice my teeth were looking...that she was surprised they could look that good.

I would go with getting re-braced on the bottom and then get a permenant retainer bonded there and you're good to go for ever!

I wish you luck! Let us know what you do!!

#4 Post by **BracesAgain** » Wed Jan 10, 2007 2:21 pm

ghostmyimag3 wrote:When you say "fan out" exactly what do you mean. Your teeth look fine to me cept that one tooth. I had a 9mm overjet on my uppers, and I didn't want any teeth removed that won't absolutely neccessary. I had crowding but i told him to just round them out. So if you mean rounded then i completely understand.
Noone has perfect teeth. What is perfect teeth anyway, you have to deal with what you have right. I'm 30, and a perfectionist and I've lived with crowding since i was 8. But now I'm just to the point if they are straight and look right i'm fine with it.
I think you should get the braces on the bottom, that tooth may give you problems later, but as much as i have sat in a dentist chair i personally wouldn't remove any teeth. But thats just me.

I have an overjet. I'm not sure by exactly how much, but if you search for pictures of Emmy Rossum, you will notice that her teeth fan outwards in a similar way that mine to. I want "Hollywood teeth" and most people in Hollywood have teeth that to not lean out of the mouth. Here's another picture of how my teeth tilt. They don't look that bad in the picture, but they do bother me tremendously. The bottom teeth fan out worse, which makes me feel like they're literally falling out of my mouth. You shouldn't see the back of someone's bottom teeth when they're talking to you.

http://img408.imageshack.us/my.php?imag ... allmz1.jpg

#5 Post by **BracesAgain** » Wed Jan 10, 2007 2:23 pm

No, 2 bicuspids on the top and 2 on the bottom...so 4 total- which would give me space to correct both crowding and fanning.

PS- I'm pretty sure that tooth moved so far because it is very unnatural to lean the teeth so far out the way they were. So, it decided to move back and upright itself...and now it looks 3-4mm taller than all the teeth around it.

#6 Post by **jennielee81** » Wed Jan 10, 2007 2:28 pm

With an overjet, ya, you'd probably do upper and lower braces to use elastics and pull the top arch back. I get what you're saying about the lowers tilting out a bit to make space.

Hollywood teeth...keep in mind that most people in hollywood have Veneers or Caps. Is that a possibility for you? You may want to ask about that for your lowers. They will indeed be "perfect"!

#7 Post by **BracesAgain** » Wed Jan 10, 2007 2:31 pm

I've considered veneers, but I hate the idea of grinding my healthy teeth into nubs and getting something expensive that needs to be replaced every 10-15 yrs. I would need it on both the top and bottom since the fanning is on both and the idea just disturbs me :/

#8 Post by **jennielee81** » Wed Jan 10, 2007 2:33 pm

...disturbs me, too. I can almost feel it

.

#9 Post by **BracesAgain** » Wed Jan 10, 2007 3:41 pm

Hi, thanks for the input. First, I will say that I have already consulted with 2 orthos and I have a 3rd appointment scheduled for tomorrow. The first ortho told me that he was very glad that I elected to keep my bottom tooth because it would have created an even more severe overbite. Both orthos told me that they would be happy to treat me using interproximal reduction (the shaving of miniscule amounts of enamel from the teeth) in combination with lower teeth braces. However, both cautioned that they cannot change the rotation of the bottom teeth, so that this method would not allow the bottom teeth to be uprighted, only aligned...meaning they will still fan out. I have heard the argument against bicuspid removal and I have read several articles about "second premolar extraction studies" and how this is optimal if you do not wish to alter the profile. Here is an example:

http://www.blackwell-synergy.com/doi/ab ... alCode=pio

Since aesthetics are driving my concern about my teeth, I think that the best option for me are removing the 4 teeth. Both orthos told me that I would still maintain a good bite and that it likely wouldn't alter my profile- of course, only diagnostics, such as x-rays and impressions will determine that. I just wish that I had done this sooner...

#10 Post by **jennielee81** » Wed Jan 10, 2007 4:11 pm

It sounds like talking through this has made you more comfortable with the decision.

Most people can solve their own dilemas if given the opportunity to talk it through.

I think that your result will be what you want and that is most important. YOu have done your homework/research so you're very well informed!

I look forward to following your progress...no matter which path you take!

#11 Post by **mjbusch** » Wed Jan 10, 2007 5:07 pm

Your teeth do look beautiful. I hate the idea of teeth getting extracted. I didn't really even want my wisdom teeth to go, but they were in bad shape. Anyway, I think a expander might work in getting you the space you need without having any teeth extracted. But you will have to ask a trained orthodontist if this is the right treatment for you.
There are so many more appliances out there that might help for what you are trying to accomplish. I would search for more orthodontists, also if find a orthodontist that practices functional jaw orthopedics (FJO) they never like removing teeth and I have seen some beautiful smiles from there websites. By the way they are very hard to find. I live in a huge metropolis and there are only two that practice it. I have my own consultation tomorrow with the orthodontist and if he or she's says that I need a tooth extracted. Then of course, I will be moving on to the next one. I would much rather save my teeth wearing appliance then losing any tooth.

#12 Post by **ellebee** » Wed Jan 10, 2007 5:24 pm

Have you inquired about Invisalign? A woman I know had an arch something like yours. She had Invisalign braces for about 9 months and her smile looks great now. Worth asking about anyway.

Elle

#13 Post by **BracesAgain** » Wed Jan 10, 2007 5:51 pm

Invisalign would work only on the lower teeth. With 4 extractions, Invisalign cannot put the necessary forces on teeth to move them efficiently.

#14 Post by **BracesAgain** » Wed Jan 10, 2007 7:55 pm

Here's a new picture to illustrate the extent of the fanning effect.

http://img405.imageshack.us/my.php?imag ... ethfa7.jpg

#15 Post by **KatK** » Wed Jan 10, 2007 9:11 pm

I currently see one of the docs that mjbuesch (sorry if i butchered that username) was talking about. He doesn't believe in extractions, he actually laughed at me when i asked him (with a worried look on my face, i'm sure..) that if my pendulum device didn't work would i have to have teeth extractions. I have a 6mm overbite and he is using a pendulum to create space in the back of the mouth.... he'll then use braces (damon's) to pull my teeth back into those spaces. He's had tons of success with this device... google it if you want to know more info.. i usually do something like "ortho pendulum device".

Good luck!

Either way your teeth look really pretty on top, and very white!