Top fixed braces

[markyc]

Hi. I was just hoping to get peoples ideas/opinions :).

I went to see the orthodentist a few weeks ago. I have a top incisor that sits a bit back, a 2mm open bite and a 5mm overjet.

He said he can sort the slight crowding and recommended braces for my top teeth. He said he can't do anything about the open bite and unlikely to be able to change the overjet. My questions (and i will be asking him this friday too!) are:

I have 1 wisdom tooth on my top jaw, how will this affect the brace in terms of balancing it out?

If only having braces on the top teeth, how is it kept so the top and bottom keep are still aligned?

Is 5mm overjet considered bad or?

and

If the braces won't necessarily make the overjet any better, could it not make it worse? to fit the tooth back in line i'd imagine that involves moving the other teeth apart and out slightly...which would surely make the overjet increase? :\

thank you

[catgyrl]

My very unprofessional opinion would be that you first have a consultation with a different orthodontist. This one doesn't sound very motivated to fix anything. Granted, I don't know what your teeth look like and, well, I don't have a degree in dentistry. But the issues you've outlined sound very fix-able.

To say he would be unlikely to change the overjet sounds strange. There are others here who started with overjets much bigger than yours, and they're experiencing great progress. I started out with a 6mm overjet, and 19 months later, it's down to about 2mm now. Here's a pic I took last month comparing Day 1 with now. It's a drastic difference. In fact, it's gotten even smaller since then:

viewtopic.php?f=9&t=34883&start=420

"Can't do anything with the open bite"? Then why on earth would he put braces on you, if all he's going to fix is one set-back tooth? And most orthodontists will brace both upper and lower teeth because you're right, if he only braces the upper ones, you probably won't end up with a proper bite afterward. I didn't think my lowers needed braces, either... boy was I WRONG!!

Go ahead and keep your appointment with this guy, but I would highly suggest getting a second, or even a third opinion. You want to have the best result possible because this is an expensive, long process.

Good luck to you!!

[ArchWired28]

I agree with catgyrl, 2mm open bite does sound fixable to me, and 5mm overjet is by no means huge. I am not an ortho, but seems to me that by pushing your teeth back and down a little it might be possible to both reduce an overjet and close an open bite.
Seek 2nd opinion. You don't want to pay a lot of money and spend 2 years in braces for nothing.

[catgyrl]

I wanted to add that you shouldn't feel pressured to make your final decision this Friday when you see him. I felt enormous pressure from the first ortho I consulted with, and ended up signing a contract, taking my pics and molds, all in the same day. That didn't sit well with me, and I ended up getting a second consult, which I was MUCH more comfortable with. If he tries to pressure you, that just shows he doesn't have your best interests at heart, and you should go elsewhere.

[markyc]

Thanks for advice :).

He said the open bite is hard to fix as for some people is more down to your jaw than teeth. Which does make some sense as my teeth would need to either be longer or pointing down more (which I think they do mostly anyway). He said surgery would be an option but that's not really a route I want to go down.

The overjet he said he may be able to help but that it all depends on if he can widen the arch to accommodate it basically. Which he said depends on whether my jaw bones have that width to give.

A second opinion does sound like a good decision before diving into a commitment. I've got this appointment friday and I'll ask him these questions. It's mainly the one tooth that bothers me. That may sound odd but I'm conscious of how being further backs casts a darker shadow on it which to me makes it standout. No ones ever said anything to me.

I keep obsessing over my teeth so it's at least nice to know I have some options to at least improve them, even if a 'perfect' smile isn't attainable.

[catgyrl]

markyc
You have a good attitude, in that you're not expecting "perfection" (whatever that means), and will accept any help that they can give you re: your teeth. I know for a fact there are things they can't fix with mine, and I'm just happy if they can get my teeth to stick out less, and fix my bite so I can bite with my front teeth without dropping food all over the place.

The most important thing is that you're comfortable with your orthodontist and the treatment he's giving you, cuz you'll be stuck with each other for 1-2 years (probably). Mine irritates the crap out of me sometimes, and other times he's a cool guy. I have to keep remembering that he's the expert and I'm the patient.

[markyc]

Thank you. Definitely agree with you. The thing is I only notice other people's teeth because I think of my own so much. I think in reality, most people don't notice the things we see in ourselves. I told my mate about my plan for treatment ( expecting ridicule as I'm 23) and his response was that he'd never noticed anything wrong and that there's nothing wrong with getting it done if I want. So I'm happier about it.

My big concern is whether straightening the teeth will increase the overjet. I'd hate that as an outcome!

We'll see what he says! Annoyingly the Ortho I had as a teenager wants £120 just for a consultation which amazed me!

Haha as long you're happy yours knows what he's doing then you can forgive him the occasional annoying moment :). I'm on my phone atm but I'll check out your threads tomo :).

Thanks for the help, it's nice to talk such things out!

[ArchWired28]

markyc

there is no way the treatment will increase your overjet. If anything, it should decrease it, not increase. In any case, ask about it straight from the bat, don't leave anything out.

People can only notice appearance of your front teeth. Sadly, nobody - including my parents - ever noticed my crossbite that is on the back molars. But the truth is, it did cause the TMJ pain (granted, the pain started after the dental work, but I am sure crossbite has to do with it). Back teeth do all the chewing and support, and when I am being asked "why did I get braces", I find it very-very annoying. Sure my front teeth are straight, but a healthy balanced bite is so much more than that...
Just wanted to point that out. The rationale behind getting braced may not be immediately visible to others.

[markyc]

thanks arched.

I spoke to the OD yesterday. He was happy to answer my questions and did so well enough.

He said

1. 1 wisdom tooth wont make a difference to treatment as they dont fix the brace to the wisdom tooth. if a wisdom was to be trouble it would most likely get removed rather than try to change it etc.

2. He said moving just the top teeth only CAN affect the bottom teeth slightly. However he said from the space I need creating to move the further back tooth into line, not much will need to change. He added that if something was affected it would most likely be the bottom front teeth but as I have a slight open bite, these teeth dont touch and thus they wont get affected. Basically there shouldnt be any chance of having off centre alignment.

3. the overjet cant be made better with just a brace. i'd need extractions to make room, else there isnt any room to move the teeth back. He said he wouldnt suggest getting teeth pulled out. I asked him if it could make the overjet worse when making room for the tooth that needs moving back inline. He had another look at said tooth and said he only needs to make <2mm of space to get the tooth inline. Spread that aprx 1mm space out over the entire arch and nothing else is going to change much. Basically the overjet isnt going to get any better and at the very worse it would get a tiny tiny tiny amount worse but very unlikely. that was his opinion.


so the open bite cant be fixed without surgery it seems.

the overjet cant be fixed without extractions.

but the tooth I hate can be put nicely in a decent place.


Now I just need more time to think things through. I dont think a 5mm is too major (even though it does bother me yes). But when the average seems to be 3mm (i think?), 5mm isnt much off right?

The pushed back too IS the main thing I dislike and notice so. Damn decisions

[markyc]

i should also add that the crowding of my top teeth is only slight. other than the one tooth pushed back, the rest are basically fine. So treatment would only take 8-12 months..

[peaches]

Get a second opinion, it's worth it even if you have to pay for it. It seems strange to me as well that he can't fix/improve a 5mm overjet. Open bites are trickier, though I've heard the problem is typically more in retention than in closing it initially.

[markyc]

probably a good idea I guess.

For most cases though, like catgyrl, they removed one or more teeth to make room for the overjet to be reduced though right? He wasn't keen on that and I neither am i really. to make it even they'd presumably have to take a tooth out from each side which would create far more room than is needed. take only one out and you wouldnt get the teeth being central...

[catgyrl]

probably a good idea I guess.

For most cases though, like catgyrl, they removed one or more teeth to make room for the overjet to be reduced though right? He wasn't keen on that and I neither am i really. to make it even they'd presumably have to take a tooth out from each side which would create far more room than is needed. take only one out and you wouldnt get the teeth being central...

Not true. I only had one extraction, and my midline is lined up centrally. Because my teeth were pushed off to the right, he HAD to remove that left tooth to make enough room to move everything back over to the left. And my teeth weren't just moved off to the left; my back teeth were moved forward, too, so everything is all lined up.

[markyc]

[quote="catgyrl"][quote="markyc"]probably a good idea I guess.

For most cases though, like catgyrl, they removed one or more teeth to make room for the overjet to be reduced though right? He wasn't keen on that and I neither am i really. to make it even they'd presumably have to take a tooth out from each side which would create far more room than is needed. take only one out and you wouldnt get the teeth being central...[/quote]

Not true. I only had one extraction, and my midline is lined up centrally. Because my teeth were pushed off to the right, he HAD to remove that left tooth to make enough room to move everything back over to the left. And my teeth weren't just moved off to the left; my back teeth were moved forward, too, so everything is all lined up.[/quote]

That's understandable, and your teeth are looking great by the way :). But my teeth are lined up centrally atm so that wouldn't necessarily apply to me? And when I had braces as a kid I had 4 teeth (2 top, 2 bottom) extracted. I'd only have 2 molars left each side if they took another two. I'd start running out of teeth :)

[catgyrl]

That's understandable, and your teeth are looking great by the way . But my teeth are lined up centrally atm so that wouldn't necessarily apply to me? And when I had braces as a kid I had 4 teeth (2 top, 2 bottom) extracted. I'd only have 2 molars left each side if they took another two. I'd start running out of teeth

You are absolutely right; I stand corrected. Of course, if you're already lined up centrally, removing an odd number of teeth would make it look... well... odd. We definitely would not want you to run out of teeth.