Metal Mouth Message Board

Hey everyone, if you've read my other posts, you already know I've been struggling with my braces since I got them on. In my opinion, they are not put on correctly, and now, 2 months later, my worst fears are now visible. My top and bottom arch is getting more narrow by the day, I used to show a lot of teeth when smiling and now I dont. My teeth are like, curving upward, obviously, because my brackets and wires are curved, but ortho refuses to acknowledge that. My side profile has changed as well. My chin and jaw are receding and if I don't strain my chin I can't close my lips together. I seem to have an open bite now too, where my teeth touch in the back but not the front. I have bite blocks on my molars and the molars touch but they don't touch the bite blocks anymore...how is that possible?!

I have prominent lines when I smile now, which I didn't before, and I'm only 20 btw. My top lip is bigger and my bottom lip is smaller now, which doesn't make sense. My cheeks are sunken in, my right side more noticeably than my left side, and I have an overbite.( I didn't have any bite problems before I started, just minor crowding)


I didn't have any extractions, I refused to as I've read what happens to the face when you do, but my ortho did file between almost every tooth. Is this what's causing the sunken cheeks and receding chin? Seriously, in pictures now if I turn to the side my jaw is so far back now! I just got a power chain on my front four teeth and it makes it even more noticeable that my brackets and wire are curved, so now I know I'm not imagining it.

I had a sit down appointment with him a few weeks ago, telling him my concerns, he huffed and said, "I don't know what you want me to do, everything looks fine, im not going to reposition your brackets just because you want me to, I've been doing this for *7* years and I am very confident in my work, I'm happy to continue your case but if you want to switch that's fine too" WOW , I went to three other orodontists who know him and said he is reasonable and he will work with me if I tell him my concerns. Well I did, and he didn't do a Damn thing. The rude nurse who put my brackets on was there, rolling her eyes at me for questioning the drs. Work again. Another nurse, a kind one, talked me into staying, telling me to give him a chance. So I didn't switch. My second appointment was yesterday, changed ligs and got a power chain for front four teeth, and I was too tired of arguing to speak up about my facial changes. But after taking pictures today at home, I know I can't just accept my situation and bear it. Something has to be done. My face is changing for the worse and I need to stop it before it's too late, I don't want to have to get surgery. How do I bring my chin forward??? Do I need a palate expander to push my sunken teeth back out to where they used to be?

A lot of people have told me in the beginning, oh you just got them on, you're being paranoid. He knows what he's doing. I mean, it's common sense, teeth follow the position of the wire and bracket. Messed up wires/brackets = messed up teeth. The ortho I want to switch over to, I told him that my ortho said my brackets are put on low because my teeth are long, and he looked at me like I was crazy. Yeah, that's how I felt when my orthodontist told me that. I wish I could go back in time to my consultation with him and ask if he would put braces in the middle...so I would know that he would tell me NO and I wouldn't have picked him as my ortho. So, I'm stuck in a rut. I either have to wait it out for a year and see if it gets better, or switch orthodontists asap. I'm extremely upset and my orthodontist doesn't seem to care.

Should I just up and switch now, or call again and voice my frustration? What would you do??Also, Why am I experiencing side effects of extractions when I didn't have any done?

Im sorry for the long essay....Big thank you to anyone who can help!!

Hmmm your case is interesting! What do you mean when you say that your teeth are curved upwards?

Has anybody else confirmed the facial changes that you are experiencing? Your family or friends? Or before and after photos?

What did you get the braces for?

Filing can produce gaps just like extractions do. So maybe it can cause the profile changes by allowing the front teeth to be pushed back (loss of lip support etc) but it is also possible that your imagination is exaggerating some of the actual changes which might be quite subtle in reality.

Anyway if you go for a consultation with the new ortho, ask him/her for a detailed plan. If the plan seems to address all your issues and concerns satisfactorily, it could be a good idea to switch over to them. Like for example do they agree that the brackets are installed incorrectly and need to be reinstalled?

IPR will create space that needs to be closed, as do extractions. However, extractions create a lot more space than IPR. If you don't already I would recommend to take photos with the exact same angle and lighting on a regular basis and then you can compare objectively to judge the changes you perceive.

Your ortho is presumably treating your case the way he thinks is best based on his training and experience to know how teeth move and need to be positioned. However, that doesn't mean his plan is the only way or you have to agree with his plan - but you would need to find another ortho whose detailed plan you do agree with.

Your smile will certainly change as a result of braces (that is, indeed, the whole point.) I can say that whatever changes you are seeing, nothing dramatic is going to be caused by IPR; it just doesn't shave off that much... it's only good for minor tweaks.

The overall angles of your teeth is set by the "bracket prescription" and "dialled-in" using the square wires; if you aren't even at that stage yet, don't get too anxious about your smile while it's in the transition phase.

(Note: "Bracket prescription" sounds really fancy, like a prescription for glasses; it isn't... there are only a handful of choices. And there are also only a handful of archforms; I think each ortho supplier usually only has two.)

I sympathize, and please take my comments to be constructive, even if they may sound a bit harsh. I would have to recommend you go along with the ortho's placement of brackets; I think the force vectors in play are much more complicated than we as laypersons understand. While in general I agree that the bracket position does give a hint as to the ultimate result, I don't think you are in a position to offer a qualified opinion. I know that you understand that things invariably get worse with alignment and bite during a course of orthodontic treatment. I am at a loss to explain the changes to your face, but would wonder if stress and perhaps a change in diet due to braces might be contributing factors (i.e., eating softer foods requiring less chewing might cause the masseter and other muscles of mastication to atrophy and give the appearance of sunken cheeks.) For me, I noticed that my teeth were not as visible when smiling, but then I realized that it was mostly due to the fact that they were covered with brackets! I know that sounds stupid, but for me it was somewhat of an optical illusion, plus the fact that I probably spent too much time staring at a mirror ("Mirror, mirror, on the wall, why the heck did I make the orthodontics call?")
It definitely sounds like there is a great deal of tension in the relationship. He thinks you're questioning his ability, you think he's ruining your mouth. Think about some way you could ask something like "I know things have been difficult, and I don't understand orthodontics, but could you help me understand the big plan and the expected outcome?" And then listen -- really really listen. You chose this guy for a good reason -- and you both can get over this bump in the road -- but I think you may need to defuse the situation a bit. Best of luck to you!

That's interesting. You should take weekly photos of your face just to make sure you aren't creating problems in your head, not to say that you are. It's just good to have objective things to look at. Not being able to close your lips without straining sounds like a pretty definitive problem though. I would definitely seek a 2nd and 3rd opinion.

Trust the process.

Always amazes me how so many people on this forum think they have dept of knowledge with regards to how teeth should be moved. Your ortho is trained and has done many smile so before yours... what makes you think he's not doing it right this time?

I understand that you have noticed a few things and voiced concerns with your ortho but he "doesn't seem to care". So schedule an appointment with your ortho and inform the receptionist you need a chat with the ortho, nothing else. Suggest you come before/after clinic times etc.

If the ortho "doesn't seem to care" we'll suggest you want a second opinion, either at the clinic or elsewhere. Get the second opinion.

Is your ortho a qualified ortho? Just I meet a guy who had braces put on by a dentist too low down and he didn't get any movement. Not saying that's your issue, moreso make sure he is a qualified.

Hope it works out for you. I've read your ortho post and you were given sound advice. So upload a picture. You would be an absolute fool for changing so quickly.