Metal Mouth Message Board

Hi. My doctor told me he is proud of my result. I have issues that I have discussed with my doctor, but have not gotten a satisfactory response.

One issue: In all four quadrants, my second molars are wider than the rest of my arch. I was told this is not very important. That widening both
arches to line up with the second molars could "open up a can of
worms", and to move the second molars in to line up with the
arches is counter to the original plan. I had a palate expander for about three months. My doctor says my occlusion is good now and he is afraid to widenthe arches. Please give me your opinions.

Issue two: My bottom arch is not yet symetrical. On the right side of the arch, the canine, first and second bicuspids, and first molar seem to be rotated. I requested to have my bottom teeth rebracketed to address the rotation of these teeth. Do you feel this is called for?

I would greatly appreciate your opinions. Here are my pictures. (Sorry about the size.)






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Hi!

My 2nd molars tend to be a little farther "outward" as well... they were neither bracketed nor banded. My ortho's opinion was that the upper and lowers were in occlusion with each other, and they are anchored well, so it is ok. I dont have an issue with mine, but mine stick out just a little less than yours, plus, when I smile, you can't see that far back... Plus, I can eat/chew fine!

I noticed mine were sticking out too and my second molars were never bracketed. I just got my braces off and the issue was never addressed.

Hi - I saw your query while browsing through old entries. I noticed you never got a reply from a doctor on the site. My lower teeth (I'm nearly done) look similar to your photos (that tooth near to the canine just isn't lined up with the others) so I was wondering if and how you resolved the issue. Maybe someone could comment now?

CT

My ortho banded my second molars because he wanted everything to line up. Maybe it depends on the ortho and how off the molars are. If I were in your place and the ortho wasn't too responsive to your concerns, I would get a second opinion from another ortho.

My back molars aren't banded or bracketed either and they stick outwards somewhat too.

My third molar sticks out on one side.. really why would that be an issue if you can chew right.. its so back there..

I am not begin critical of your doc. In fact treating second molars can open a can of worms at times. Many great docs don't treat second molars. Some of us do - more for us than for the patient. But: your teeth on the lower are not straight. The lower left lateral is still mesial in and your lower right teeth are still rotated. You can see on the lower right that you have brackets that clearly need rebonding to eliminate the rotations. this is not a slam against your doc. We all have to rebond teeth on our patients. It stinks to have to do it, it slows you down a bit but it must be done at times. Or: the doc can bend your wires to lead the teeth to the correct spot instead of bracket replacement - why not just do that!
Archwire bends = rebonding (they both achieve the same result)
dr.j

Dear Dr. J,

I read your comment on rebonding and/or bending the wire. I am getting my teeth done in Italy and have a similar problem to the guy in the photos (but only with one tooth and a little less twisted). I keep asking (and have been doing so for the past 7/8 months) for my dentist to do something like this (move the bracket, slenderize the neighbor teeth to make room, bend a wire, etc.). He keeps telling me that he's the orthodontist....I have been to get two other opinions. Both thought my teeth were coming very well but that that tooth in fact needed turning still. Why on earth won't my dentist do anything? I'm so desperate - now he's talking about the finishing bits and final elastics and just ignoring that tooth. Should I switch at this late point?
p.s. I already sent photos on Dec. 9th but never got a reply from you (they are not so clear but a professional should be able to tell something).
CT

dr.j wrote:... treating second molars can open a can of worms at times. Many great docs don't treat second molars. Some of us do - more for us than for the patient.
dr.j

Please, can you elaborate on what problems can happen when second molars are treated. I am very curious since many of us don't have our second molars in the arch wire.

I'm not sure I want to know...mine are in the archwire

fins wrote:I'm not sure I want to know...mine are in the archwire

ok, so close your eyes.

Sometimes bringing your second molars into the arch can induce changes in the width of your 1st molars and add more time to your treatment. Most of all, leveling of second molars can render an openbite in some folks. This should be something your doc has diagnosed and has a plan for. In openbite folks, if the second molars are in ok shape I leave them alone or put a lite wire on them at the end of treatment to "tweak" them.

dr.j

Intersting about the second molars. Mine were in line with my arch before treatment, but are now further out compared to the rest of the arch. Both top and bottom. I guess like the others said, if my bite's OK I guess I'm OK with it, but it has been something I've thought about.

yours look almos like mine...do you perhaps clench your teeth by any chance? I do and I think that's why my molar is out of line.