Metal Mouth Message Board

Hey guys,
long time since I last posted... I'm now 6 months or so into my second round of braces and things have been cool with my new ortho (well, after we had a small fight right after I got the braces on, because she was also going to level my front teeth by their tips, giving me an old man's smile. But she came around and changed some brackets to give me MY smile back. This time I would not take the sesame "we'll do it later", meaning never). She is listening and is taking things cautiously. If only the other one were like this I would surelly be a happy camper the first time around, while keeping all my teeth... So just to recap, she agreed on top braces only to realign teeth after serious relapse (cause I did not want to finish anything with the first ortho, nor retainers to lock her stupid job in place) and close extraction gap as best as possible, which is the stage I'm in right now. She said TADs might be needed but she's first trying to push my molars forward, one by one, to minimize having the front teeth pulled back. The problem is that my front teeth hurt "normally" as when they are being pulled to move, but the second premolar doesn't... All front teeth were ligated together to stabilize and move together, and a strong powerchain used to pull from the canine to the premolar across the gap. That did nothing to the premolar and I could not even push a fingernail between it and the first molar after a full month (during which the power chain was swapped once). On my last appointment she decided to both swap the powerchain and add an open coil spring between the first molar and second premolar. However, I still feel no pain on this premolar, altough I can now push a fingernail in between it and the molar, BUT my first molar does hurt a bit. So I'm wondering if this tooth is really moving through the bone painlessly or just being pushed so hard that it became a little mobile or if it was actually the first molar that is being pushed back... All this is being done way too long after the extraction took place, so maybe the new bone is too dense to allow movement?

I'd really like to hear from people that have moved molars forward to help fill extraction gaps. Was it painfull like when every other tooth moves? And how long did it take?

BTW, my bite is a complete mess because my upper arch has now been widened again to it's former self, but not the lower, forcing me to bite down on one side or the other for good molar contact... so I may have to get bottom braces too, which I'm really not keen on doing when facing the possibility of losing the dead tooth courtesy of my former ortho. Maybe the ortho can agree on not bracing this tooth (since the bottom teeth don't need to be moved a lot, just torqued and the front intruded) and not puting me on bite turbos, either is a big no-no for me...

Cheers!

Your situation with your bite sounds very similar to mine, I had second consultation today, and this orthodontist mentioned that my lower arch is a fair bit narrower than my upper. The plan is to get my old records if I can (the orthodontist who did the work is dead and someone else has taken over the practice) and see what went wrong the first time so as to avoid the mistakes that were made last time. The other option is surgery and I'm really not keen to go under the knife, I don't need perfect, I just want better.

For me, it took about 7 to 8 months to move the molars forwards and close my extraction gaps. It hurts just like every tooth did I guess, nothing remarkable. It was loose for abit and I was definitely unable to chew on it for about a week or so after each monthly adjustment.

Thanks for your replies! Assertives, was this done using TADs? Maybe the forces being used on me are insufficient? If there are no signs of this one tooth moving then either something is wrong or a different strategy is needed... But I will definitely talk to her about lower braces, although I really would like not to...

No tads, my ortho just used powerchains. But mine was for the lower arch though, which are supposedly harder to move than the upper ones because of the bone density in the mandible (I think I read about it somewhere but I'm not sure I remembered correctly). I did get my 2nd premolars extracted on the bottom, so my ortho only had to move the 1st and 2nd molars right away and didn't have to deal with moving the premolar first.

It certainly didn't happen immediately for me though, it took some time, perhaps yours are also just being stubborn.

Thanks a lot for the update. In my case I have to move the back 3 teeth to partly fill in for the missing 1st pré-molar, the rest will be filled from retraction of the front teeth... Not ideal as it will cause asymmetry, but don't care. The ortho's idea is to try to pull the premolar first so that the front teeth have better anchorage and don't shift as much, otherwise the back teeth would win and I would have mostly retraction of anterior teeth. Actually, looking at it closely, the space has for sure closed a little already. I just don't want to have too high forces applied to avoid losing more teeth to orthodontics, cause that totally sucked with the previous ortho and I still hate her for that. It could have been totally avoided...

I can't really speak from experience in regards from having completed the process but this thread is certainly enlightening. My ortho was trying to close my extraction gaps and my front teeth started tipping down and in, rather than the molars, and now I'm at risk of losing one of my teeth.

Interestingly, it's been much easier closing the bottom gaps than the top. My top molars have moved a wee bit but not a lot. For me, I do find they're tender when you know they're moving, and you get that feeling of them being kind of loose/uncomfortable, as if you have kernels stuck in your gums. The biggest giveaway is that you start constantly getting food stuck in between them.

(well, after we had a small fight right after I got the braces on, because she was also going to level my front teeth by their tips, giving me an old man's smile. But she came around and changed some brackets to give me MY smile back.

Do you have pictures of both smiles?

I have had the same thing done - given a flat old man's smile and I'm female and used to look alot younger for my age before this was done.

In what way did they change the brackets?

Sorry, haven't been around.
@melere, k known how teeth feel she they move, but I felt nothing on this one. It turns out the force was not enough. She then added an open coil spring to the archwire between premolar and first molar, in addition to the elastic between canine and premolar. Now, in about 1 month, the premolar has moved forward almost 1 mm!!! Still it does not hurt much while the molar does. Yeah, food gets stuck in there a lot...

@Vive18, I don't have pics of they looked before, sorry... But basically the brackets on the front top teeth were all placed at the same distance from their tips, which would cause them to look like old people's dentures... I immediately demanded for the brackets to be changed so that the natural difference in crown size would be apparent as difference in tooth length. So she (reluctantly) moved the brackets on the lateral incisors 1 mm toward the tip, and now I have a more normal smile, with larger canines and central incisors and smaller lateral incisors, proportionally to their crown sizes. It's still not 100% as it should be, but then it would probably impact on my deep bite. I'm ok with it now.

New update: in less than 2 months the extraction gap has closed about halfway or more! Of course this has created a second gap behind the 2nd premolar, but that was expected since the ortho is pulling the teeth forward one at a time, to minimize retraction of front teeth. If no roots are being lost (will ask for x-ray on my next appointment) this is going rather well and I'm pretty optimistic. I was so depressed with the other ortho and her incompetence that I was rather cautious with this one. Now I'm actually thinking of also getting lower braces, since its becoming obvious that my bite will be way off due to inward tipping of the lower teeth, also courtesy of my former ortho. That is, only if it can be done without bite turbos as I'm sure I cannot stand having my teeth not touching. And I still have my dead lower premolar to worry about. What a nightmare that was...

New update: the molars began to be pulled forward and it was pretty fast to substantially narrow the gap left by pulling the premolar foward. I always read that molars are hard to move but that's luckily not what I've been experiencing.

So... long term follow up, as I haven't been around for very long... Braces came off (for the second time) last week. I'm pretty happy with the result. I have a slight midline shift, but that was expected when trying to close the unilateral gap of a needless premolar extraction. The second ortho did a good job overall and my smile is again more natural, as it had always been, but with straight teeth. I do wish she had used a TAD to anchor the front teeth and avoid some arch collapse, but it's really not bad at all. Unfortunately I still have a small pickle to solve with her regarding retention... She made the casting immediately after removal of the braces, but the problem is that I only had top braces this time and my bite was off. So now I find myself settling the bite during the whole day without the retainer and it feels fine by night time, when I have to (painfully) put the retainer back and set the bite off again... and repeat that the next day when my bite if off once more. I already tried to explain to her that I need a new retainer, made by the end of a day without it, but she doesn't seem to get it. I know it's standard procedure to retain right away WHEN you've had full top-bottom braces and your bite should be as good as it gets by the end of it. But that wasn't my case and the bite was off when the braces came out, especially due to the small asymmetry on the top arch caused y unilateral gap closure. If I can't reason with her I may just have to break my retainer badly and show up for a new cast at the end of the day. Although I'm pretty sure that this thing is made of a thermoplastic material, and could probably be shaped to a new, almost identical dental cast within a tenth of a mm or so...
Anyway, to sum up, I'm happy with how things turned out, although I do wish I didn't have to go through it because of an unethical ortho that put me in a bad place for a long while.

Hi, I am interested in revision/opening up of premolar extraction. I had two upper premolars extracted as a child, resulting in breathing difficulties, recessed chin and not enough space for my tongue. I am now 63, and have a crossbite due to molar extraction. I need to get these teeth sorted, for my overall health and for esthetics. Does anyone know of an orthodontics in London/surrey who does this procedure. Mike Mew is very close to where I live but I don't think they treat adults my age and with my complexities. Hoping someone can help. Thanks Pixi

ToothPixi wrote:


p.s. in the UK, I have dialogued with the Shadow Minister of Health regarding extraction consequences, All extraction cases who have health issues are advised to write a formal letter of complaint about their orthodontic work, to their MP.

For those who had extractions, you might want to see this article that reviews the consequences--

https://karinbadt.medium.com/premolar-e ... aa115481bf

and the survey mentioned in the article:

https://forms.gle/F5LEdN9ujjiMu4Mt6