Metal Mouth Message Board

Hi all,

I'm about to take the dive in! I posted a hello note here and got some great encouragement which finally pushed me over the edge - I am doing this!!! I've had two consults and the message is about the same from each. Apparently my combination of crossbite and overbite makes things not as trivial as I would have hoped. I'm not sure what to do. I was hoping for invisalign, and both said I could be a candidate but that my crossbite would make the treatment challenging. Both said fixing my crossbite requires palate expansion. One ortho said this will require surgery (unwanted!) but the other it could be done using slow maxillary expansion and that they have had great success with adults. Here are the two treatment plans I was proposed

From the first orth: surgery followed by braces or invisalign

From the second:
Option 1) First step would be palate expansion using a remove appliance
Second step - bite plate + braces (bite plate necessary to prevent teeth from hitting brackets)
Third step - braces + quad helix(to finish expansion)

This all sounds scary and a bit crazy?! Anyone here have similar issues and can help decode?

Consider finding an orthodontist who works with Damon braces. I had an overbite and a cross bite and didn't get into all those situations you have been told. 20 months total time.

Great advice! I will look into this. I have a couple more consults coming this week. My crossbite is quite bad which I think is the real problem but if I can avoid surgery AND nasty appliances that would be ideal!

mindinggaps wrote:Great advice! I will look into this. I have a couple more consults coming this week. My crossbite is quite bad which I think is the real problem but if I can avoid surgery AND nasty appliances that would be ideal!

Surgery really should be a last resort and only if multiple orthodontists agree that it would be best. That's a major trauma to your body compared to an unpleasant appliance or extractions.

With your issues you're probably going to have to end up with one less than fun appliance for some period of time - the question is will it be one you can tolerate?

For example I don't think I could tolerate a fixed bite plate - I'm pretty sure I'd feel like I was choking all the time since I have a tendency to gag easily as it is. Although I do know removable bite plates exist and had I had to go the traditional route I would've insisted on one. (As in you are not installing a fixed bite plate in my mouth and if you try I'll physically resist you)

But not everyone has the gagging/claustrophobia kind of stuff I do so your experience may be different

lilyflower wrote: Surgery really should be a last resort and only if multiple orthodontists agree that it would be best. That's a major trauma to your body compared to an unpleasant appliance or extractions.

With your issues you're probably going to have to end up with one less than fun appliance for some period of time - the question is will it be one you can tolerate?

For example I don't think I could tolerate a fixed bite plate - I'm pretty sure I'd feel like I was choking all the time since I have a tendency to gag easily as it is. Although I do know removable bite plates exist and had I had to go the traditional route I would've insisted on one. (As in you are not installing a fixed bite plate in my mouth and if you try I'll physically resist you)

But not everyone has the gagging/claustrophobia kind of stuff I do so your experience may be different

Yes, surgery is really a last resort for me. I would much rather deal with some annoying appliances. Someone mentioned here that I should investigate Damon braces and I consulted a third ortho today who is experienced with this. The ortho still said that with my problems (I need to have my palate expanded) I would definitely have some appliances.

The first ortho who mentioned the bite plate said it would be removable so I don't think that would be a huge deal for me. I am leaning toward this treatment plan. Yes, it is a nasty stream of appliances but that ortho is the most experience and showed me pictures from similar treatments with very successful outcomes. This made me feel more comfortable.

Lily, you have invisalign with bite ramps - will you need any other appliances or will your treatment be entirely completed with invisalign?

mindinggaps wrote:

lilyflower wrote: Surgery really should be a last resort and only if multiple orthodontists agree that it would be best. That's a major trauma to your body compared to an unpleasant appliance or extractions.

With your issues you're probably going to have to end up with one less than fun appliance for some period of time - the question is will it be one you can tolerate?

For example I don't think I could tolerate a fixed bite plate - I'm pretty sure I'd feel like I was choking all the time since I have a tendency to gag easily as it is. Although I do know removable bite plates exist and had I had to go the traditional route I would've insisted on one. (As in you are not installing a fixed bite plate in my mouth and if you try I'll physically resist you)

But not everyone has the gagging/claustrophobia kind of stuff I do so your experience may be different

Yes, surgery is really a last resort for me. I would much rather deal with some annoying appliances. Someone mentioned here that I should investigate Damon braces and I consulted a third ortho today who is experienced with this. The ortho still said that with my problems (I need to have my palate expanded) I would definitely have some appliances.

The first ortho who mentioned the bite plate said it would be removable so I don't think that would be a huge deal for me. I am leaning toward this treatment plan. Yes, it is a nasty stream of appliances but that ortho is the most experience and showed me pictures from similar treatments with very successful outcomes. This made me feel more comfortable.

Lily, you have invisalign with bite ramps - will you need any other appliances or will your treatment be entirely completed with invisalign?

Entirely Invisalign unless for some reason it doesn't work and I have to go conventional braces after. The bite ramps really aren't bad at all - they force my jaw forward so with the aligners in I can see what I'd look like without an overbite - meanwhile things are moving (slowly) in the back. Once all the crowding is taken care of on the bottom it'll be bite refinements for the last 10 or so trays.

lilyflower wrote: Entirely Invisalign unless for some reason it doesn't work and I have to go conventional braces after.

I was really, really hoping for invisalign, but because my palate needs to be expanded most orthos are saying it is just not the best route. I'll be sure to follow along with your progress!

mindinggaps wrote:

lilyflower wrote: Entirely Invisalign unless for some reason it doesn't work and I have to go conventional braces after.

I was really, really hoping for invisalign, but because my palate needs to be expanded most orthos are saying it is just not the best route. I'll be sure to follow along with your progress!

Yeah, my palate really isn't an issue - my top is pretty straight with just some minor things that are cosmetic (like a slightly rotated canine). My problem is mostly the lower arch which is crowded and what probably caused at least a good portion of my deep bite as my wisdom teeth fully erupted (they were removed 10 years ago.)

I know I "lucked out" so to speak. I mean, sure, lucky would be to not need any orthodontic work at all but straight Invisalign even with 21 attachments is pretty easy to handle. I'm a week in and aside from a sharp edge on my first tray and the normal pain/soreness the first few days I've had no problems. I was eating raw carrots on day 3. The only "hassle" (and I far from considering it a hassle) is taking it in and out. Since, I hate the feeling of my attachments uncovered (and I can scrape the inside of my mouth on them when eating if I'm not careful), and I actually look better with my aligners in now (as it reduces the overbite look in the front) it's really really easy to be compliant. Look better, don't have my mouth torn up = 22 hours wearing time easy.