Metal Mouth Message Board

I hope I spelled torqued correctly. It means "turned".

I have an upper eye tooth that has a big bump above it high up on the gum. The ortho said it's part of the root and he said he could torque the tooth during my last adjustment to make that bump go down. The torquing would be done by a bend in the archwire at a particular point. That adjustment was just a few days ago.

Now, I expected it to hurt a little on that tooth as a result. However, it's not that tooth that hurts, but the one next to it. I'm afraid what has happened is that he put the bend in the wrong place and now it going to torque the wrong tooth! My upper wire is only changed every 4 months, and that will mess up that tooth for 4 months, and of course take 4 more months to make it right again, plus the original tooth has to be torqued. My treatment time was going to end later this year (after he originally said the end of April). But this could add 8 or more months to my treatment time, and I really don't want that!!!

Now, I could mention my theory to the ortho, but in order to know for sure, he would have to undo the adjustment and put in a different wire. Probably not a reasonable request, I know.

Ok. Here's my question: If a tooth is being torqued, is it normal for the tooth next to it to be the one that hurts, or is this abnormal and indicative of a problem? Part of the reason I believe he may have done it wrong is because he was constantly distracted by people coming up and talking to him while he was working on me.
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I had a tooth rotated 90 degrees in the last few months & often it was the tooth next to it that was really painful. But if you are unsure, get in touch with your ortho. They will answer you & stop you worrying.

My premolars were all very rotated because they'd moved into extraction gaps. At times I had discomfort from the teeth next to them because they had to move out of the way to make space. It might be worth waiting a few days to see if the pain settles down. If the wrong tooth is being worked on then you would soon see evidence (it would start to go out of line). If in a few days you are still concerned then give your ortho a call. Hopefully he'll be able to put your mind at rest, and if it did turn out he'd made a mistake with the bend, it wouldn't take him long to put you a new wire in.

(Just for the record, orthos change archwires at different times depending on patient need. In a year I've probably had about 6 different wires on my lowers, am on the 3rd wire on my uppers. Getting more or fewer wire changes isn't a good/bad thing per se. It depends on what needs to be done for the individual's treatment)

Héhé, hi !

I think I answered several of your posts about this bump. I wondered several
times what happened after that. So, great to hear from you again. So I guess
I was right then. The tooth needs to be torqued. Now, after having that done to
my first upper premolar, I can say this : torquing is very difficult. It asks a lot
of skills of your ortho. Bwah, my second ortho said, I hate torquing. And indeed
he couldn't do it also. Some orthos are able to do this very well, others just can't.
Now, this doesn't help you at all, does it ? If they torque one tooth, they use a
square, even better a rectangular archwire. They bend the wire just before the tooth
in some direction and just after that tooth again. The part of the wire that is in the
bracket of your eyetooth is laying canted in the bracket. By firmly connecting
this wire to the bracket, a torque effect can be achieved, the root going inwards,
the crown outwards. But like Meryaten said about Mr. Newton and his third law,
a similar but inverse effect is to be expected on the teeth next to your eyetooth.
That may explain the pain. If you look very carefully, you should be able to see
if the bends are on the right place, just before and after your eyetooth. If your
ortho did not place the archwire just right, or if it did shift a bit, then the bends
may be on the woring place. So, that is a possibility too. You can do this experiment.
If you push a little bit on the point of your eyetooth (front side, push inwards),
then if after some seconds you stop this, you should be able to feel that the wire
indeed wants to torque that tooth. Not sure if everyone can feel this. My second
ortho was kinda surprised I could, but I could clearly feel he made an error.
When he looked, he indeed had to admit I was right. He ruined several archwires
to get it right, so don't worry about this.

Torquing is not easy. Especially an eyetooth with its long root. And it will ask some
time too. But is you have doubts, then do not hesitate to see your ortho. Talking and
being distracted and torquing do not go hand in hand. It is possible he made an error.
But I have to admit I wonder if it is even the right way to torque an eyetooth in
the first place. Because of the long root of an eyetooth and shorter ones of the
teeth next to it, I think it is very likely the eyetooth will not budge and the other
teeth will torque in the wrong direction. But maybe that is just me being skeptical
again.

Torquing forces are pretty complex and it's not always easy to predict the exact outcome. There's a rather scholarly article here if anyone is interested.

http://www.angle.org/anglonline/?reques ... &page=0214

A tooth can be rotated in a side to side direction using bracket placement and round archwires, but actual torquing of a tooth (imagine that the root is one end of a see-saw and the crown is the other end) needs a rectangular wire which can be put into the bracket slightly twisted to produce a fulcrum around which the tooth will torque. A round wire would just spin freely inside the bracket slot.

Ye canna gae aginst the laws o' physics, Capt'n Kirk!

Thank you for all the replies and information! The pain has eased quite a bit. The idea of the tooth next to the one being turned isn't something I had considered.

My ortho has been changing an archwire every adjustment appointment. On one visit, he does the top, then the bottom the next time. I'm surprised to hear that some people have it done much less often. This is my first and only time in braces, so I don't know what's normal.

I will be keeping an eye on my eye tooth (pun intended ) and see if that bump on my gum goes down.