Metal Mouth Message Board

I've been at this over 2 1/2 years now - first with 30+ trays of Invisalign, then followed with partial retainers while trying to get my rear teeth to grow out to correct a deep bite. One molar has been especially difficult since it was growing at an angle. We tried interarch elastics without having any real effect. The tooth is making slow but seemingly sure progress. I'm getting concerned at the length of time its taking to get my rear teeth to settle in.

When I started out, I was told that my deep bite would be difficult to correct and nearly impossible to hold correction long term due to the shape of my lower jaw. Initially I decided I wasn't going to do anything, but my lower front teeth were hitting my upper gums causing a fair amount of pain. After I decided to start treatment, my doc found other pre-existing conditions - tooth root damage - that further complicated things.

I would like to know if anyone else has had problems with a difficult treatment plan and if there are things that could speed things up.

I'm also concerned that when I finish, I may wind up with my rear teeth getting pushed back in again like what happened with my last treatment. Most retainers appear to hold horizontal movement, but won't stop vertical changes. What is the best way to keep this from happening?

Tipped molars are extremely difficult to upright with aligners. It may be a good idea to put on a section of braces in that area to correct the problem.

With respect to the deep bite, allowing the anterior teeth to contact more in the retainer than in the posterior will generally prevent the back teeth from intruding again.

Good luck!

Dr. Tam,

Thanks for your comments and suggestions. I presently have partial retainers that cover all but my molars and second pre-molar. These create a gap where my rear teeth don't touch (after Invisalign, there was a gap of about 2 mm between my rear teeth). It appears the rear teeth are growing in, although very slowly. The tipped molar seems to be coming up and may be ok on its own. My next doc visit is in August, so I want to have any ideas to discuss when I go in that may speed things up. I do take pictures of the rear molars every couple of months to check progress and can see a difference.

My big goal is to get passed wearing retainers 22 hrs / day while not risking pushing back in any progress that my rear teeth had made. This is what caused my relapse from my last treatment.

Its also easy to forget how bad the initial problem was after a while. My deep bite was serious enough I had difficulty sleeping as my lowers would make contact with sore upper gums and wake me up. This hasn't happened since I started Invisalign, which in part covered the injured spot like a Band-Aid.

My entire treatment has been Invisalign followed by partial retainers with the only exception being metal buttons on some of my rear teeth for elastics. My doc wanted to use Invisalign due to damaged tooth roots - until this was found, I was supposed to have regular braces and there was some question at first if Invisalign would even take the case. Overall, a complex case is coming out successful and I still have all of my teeth. I do wish I could speed things up a bit!!