In braces for 12 years straight, and now toothless smile : (

[BracedSurgeryStudent]

Ps. That's super messed up that you've had braces on for 12 years. Seems like there's a HUGE problem with that. Btw braces have to get removed if you're having an MRI? I never knew that but, anywho, It seeems like your case should be done in 2 more years at a new orthodontist. I think you need a new one ASAP.

[Betsy]

So the only way to get tooth show is by getting the 2 implants? There is no other way? One ortho said to me online it was caused by of my your maxillary incisors being intruded and the other said it was caused by upper teeth being retracted to fill the excess space from missing teeth. So I don't know if it's retraction or intrusion?

And can undoing this retraction and intrusion not help me get my vertical show back? Because I never had those lateral incisors from the start, but had some tooth show. The only difference now is the pontic is gone (where my baby lateral was), so to just get what I had before, can I just get one implant in the space there is now? I know it's far from ideal but to make room where the canines are would take years, and that's if my teeth want to move 1 mm a month like normal. I deserve a perfect result after all these years but can't keep going like this. Mistakes were made that will no doubt come back on me.

For instance, I will ask, why did I not get implants in those places, we never discussed that option. He would then say, I refused implants. But the only thing I refused was last year when he wanted an implant where the baby tooth lateral/pontic was. I asked why? Before you said you'd close it. He said, it would be faster this way. I asked any other benefit? He said no. I had come a long way at that point and didn't want not only the expense and risk, but also I didn't understand how it would be good to add an implant there and have an extra tooth. I asked, shouldn't both sides be equal? Keep in mind I suffer from tmjd to this day as a result of getting braces. He never said that my bite would totally collapse if we didn't do the implant so I can make an informed decision. Plus, it was NEVER an option to put an implant on the other side. If it was, we would have discussed it, from day 1 he planned on moving the canine to lateral position. The only difference was, the baby tooth was till hanging on from the other side which is why things became an issue. What should have happened is that both the baby lateral that was falling should have been treated the same as the other side where I was also missing a lateral and implants put in years ago. I don't get what's been happening for the past 12+ years? There was ample time for that.

Sorry this is getting so long. So is there any way to get my tooth show back without years more in braces? I guess that's my bottom line question, because I do not think my bones can handle it. I spoke with the periodontist and he said that I have bone loss worse than most people my age due to the ortho. But he said considering how long it's been, he would have expected even worse. So I don't have much time to get it all DONE somehow.

[Betsy]

Yes my braces were removed twice for an MRI, but only were off a couple weeks each time till I could get back in, the rest of the dozen years I wore them, I don't remember what it's like to not have braces :/

As far as an open bite, I don't think I had one? At least no one told me, if I did, it would be due to braces because from the getgo, I had a 100% overbite and missing laterals, those were the 2 challenges.

I asked him last time if I needed palettal expander and he said NO. And yet, like you said, I am narrower now and less side teeth show.

The nice orthodontist that had emailed me I have not heard back from since I replied. I needed clarification, kind of a bummer. I am considering posting his response on here, without identifying info of course. I want to be done already, but I also deal with major tmjd which makes it even more impossible to get another ortho in addition to the 12+ years that scares them.

Despite my bad bite for so many years, never had tmjd before the braces came on. Which means that a better bite does not mean pain free, though that is the only logical direction, at this point.

Do orthodontists ever come on this board? I feel like at this point I need the Dr. House of orthodontics. Someone skilled who puts the patient first, rather than only want to deal with the simpler cases.

[BracedSurgeryStudent]

Yes undoing this will un-retract your teeth and open those spaces to give you the natural arch you should have. You need to get the implants in every space where there is those missing teeth. Yes it will fix all those issues. So whereever you are missing teeth either congenitally or them falling out and what not get the implants in EVERY single missing tooth space it will not make it uneven if you implant every missing tooth you have. Like I said it shouldt be more than 2.5 years to reverse this. But you need braces and an expander to get this done. Well you probably have bone loss because your what sounds like a dumb orthodontist you've have for twelve years ruined your bone density by leaving those braces on too long.

Oh wow on the MRI thing, am I cool to wear braces and get a CT scan? Oh that i probably what it was from the beginning, the overbite I saw. Maybe you should go to different orthodontist and ask them all tat their free consults about expanders, someone should tell you yes, because of your narrow arch and the less teeth show on the side thing going on. Sorry he has not responded. You can always call them and if they don't let you talk to him you can always wait until after hours and call the office number which their answering machine will send you to page him therefore you can ask him. There is one orthodontist Jonathan Kim DDS I think is his username, or something to that effect. You can always try him. I agree with you on wanting that type of orthodontist. Mine is like that. Every orthodontist told me no but then told me I needed both upper and lower expanders then a month later decided not to do my case. Time after time it was like that for me. Until I found my current orthodontist, she doesn't even use expanders onn me at all. Ifeel more comfortable for her treatment plan.

[Betsy]

Hi Braced. So definitely you're saying NO on simply getting the implant where I have the space?

God it would take nearly 3 years if I am lucky to open up the space on the other side too, that would be 15.5 years from today, and that's assuming I start right now! How much bone loss can I take? All these years he never offered to open up 2 spaces and put in 2 lateral implants. God knows there was ample time to do it. It was always only about the space where the baby tooth fell out, that is where the lateral should have been.

Can spaces be closed without losing my lip support in another way than he did? How come he didn't tell me what can happen with closing spaces So then if i get one implant I will have the same tooth show as before all this, but if i get two I will have more? In addition to being balanced, one implant only would mean one more tooth on that side and I would be miserable if my tmjd got even worse. Plus my face I guess would look different with one versus two.

Well I will let you know how it goes, thanks for being helpful and supportive. How's your case coming along? Are you on your first ortho? Glad you did what is best for you in regards to the expanders and stuff. What are they doing in place of them? Were the other orthodontists just consults? As far as your CAT scan, you should ask, their expensive you don't want anything but a clear shot. But depends on the area, they may very well be able to do it without removing your hardware.

[BracedSurgeryStudent]

Hey Im definatly saying YEs on the implants in the space, it will help a little until you can get an orthodontist down the road to reverce the closing up of spacers where the missing teeth are in your mouth.

No not just to open up the spaces, the three years to open up the spaces get the implants in there and it will be all finnished. If i were you i'd be super mad at an orthodontist for keeping me in braces for 12 years. It honestly makes absolutely no sense as to why you had the braces on for the long. NORMAL orthodontists don't do that to patients, the longest a person's had braces on for is 6 years. And that is if you add up the two phases as a 9 yr old and as a 16 yr old. If you were in the boston area I'd give you a reccomendation for a few fantastic orthos who would probably take your case. But it should have been forseen that it was ababy tooth and was obviously going to fall out, your orthodontist should have taken that into consideration.

No when you close spaces you're making your arch smaller. Causing loss of lip suppourt. No matter what orthodontist is closing your spaces it will happen everytime. Yes you will get more. What I am saying is for all the missing teeth from the normal 28 you have, get all the implants where the missing teeth should be, molars and all. So that way here you can get the full normal arch and perfect vertical show. And no TMJ when you have the correct amount of teeth in your mouth.

Thanks, I should be glad to hear how you made out. Not a problem I am always here. My case is coming along fantasticly, all my teeth are straight except my seocnd molars which we jsut have to start over from smallest wire sized to get them dowm from my gums. My overbite has drastically improved a lot. Technically only the first who actually said yes to giving braces and put them on me. I went to four orthodontist's total, three of which who told me all these plans but then decided they didn't want to do my braces. I agree I feel like the treatment I am doing now is what ended up best for me in the long run. I ahve self ligating braces and we do Interproximal reduction which is where they sand in between the teeth to make room, and even out my teeth. Oh, well I walked in there today for my appointment with my braces on and they didn't say anything, probably because I wasn't having a head scan. Yeah it was just a kidney and abdominal scan.

[Betsy]

Hi Braced,
If the braces came off today, I would have a huge space where the 1st molar is, so that is very close to the front, it's like the front side. Now I am told I do have loss of bone, before i thought it wasn't too bad, but it was my gums that weren't great but better than expected considering everything. Now I am so bummed because I can't get that bone back and all this time my ortho said I had NO bone loss. Even just 2 weeks ago I asked yet again, and that is what he said. I've asked before though.

Yeah I am really frustrated and the head/neck pain don't help. It's always been there since I got braces. To think before I got them I was doing just fine with no pain, despite my bad bite. I am literally getting sick because of this but trying not to since stress has already damaged me permanently before.

I hope everything went well with your CT. Glad your ortho is going so well I went to Boston once, it was the coolest city. I am so ready to be out of Portland.

[BracedSurgeryStudent]

Yeah don't take off the braces right now they can do implants with the braces on. Too bad you didnt have an orthodontist who used to be a dentist. Mine used to do general denistry.

Yeah its unfortunate you have that bad pain Yeah stress is a really bad thing just relax everything will work out in the end.

Thanks I find out tomorrow what the verdict is. Well I already know there is something wrong we just wanted to check the verdict of it. Boston is amazing I love it there.

[Betsy]

So I spoke with a couple dentists, one of which only does invisalighn, another which does conventional braces and self taught himself to do braces, and I saw an orthodontist. My own orthodontist does not know why I lost the tooth show. He said he could move my teeth down some but that it would give me an overbite more, then what was the purpose of all these years of braces and tmjd? The other guy said my teeth can't move down, they would hit something, forget what. He said my lack of tooth show was because my upper teeth are tipped forward, but my ortho said their suppose to be. Sigh. He also said by untipping them and opening my bite, that I would get back a longer bottom face, right now my bottom half is shorter than ever, he compared photos, he also said it would help my tmjd. Another said I was clenching and grinding and now their shorter. Yet everyone else disagrees with that I do any clenching. For sure, my teeth are tipped a bit, but also, it does seem like their shorter than before, at just 6 milimmeters long! Their fatter than they are longer before they were longer than fatter, I guess theirs stocky incisors now! Then one ortho in another state told me it appears the problem is due to lacking tooth support when my pontic was removed and the space began closing. The rest don't agree with that. Anyway, the more people I ask, the more answers I get that are not the same. And of course, no one will take my case. Anyone run into this toothless smile problem and figure out the exact cause?

[illay]

OMG, it's so complicated case. i can only pray for you since i don't know what suggestion i can give.
But i think you need to leave that 12 years dentist. It's my first time to hear people wear braces for 12 years straight.
Where do you live? why it seems it's so hard to find a nice one and helpful?

[ArchWired28]

Betsy
unfortunately, I see what you mean. To me, looks like your upper teeth are dragged up too much making them less vertical and more horizontal. I think it is very obvious (at least to my untrained eye) that you need to either increase the size of your mandible bone, or reduce the size of the maxilla bone. Because now they don't match it seems, maxilla is too big and dragging the lower teeth forward to compensate makes the uppers drag forward as well, leading to horizontal alignment as I said.

Have you ever had a consultation with a trained orthognatic surgeon? If surgery is not an option for you, maybe think of cosmetic dentistry. maybe they can make veneers or crowns on your front teeth to make it look bigger.

[ArchWired28]

Betsy
I have finally read your complete story. I do feel for you a lot, and I wanted to thank you for posting this. I am currently missing 2 upper premolars (one on each side) and the plan is to replace them with implants once I am done with braces. I wanted to just have the spaces closed to save time and money on implants, but my ortho felt it was a terrible decision for me. He said, terrible both functionally and aesthetically. I have since questioned this, but now I feel that perhaps he was right. Perhaps it is better to replace the missing teeth with implants rather than simply close the spaces. I too have suffered with TMJ pain, but it is mostly gone with braces. My bite is still allover the place but it could have been so much worse. I know how frustrating this is, and I dont know how to help you... I wish you find something that works for you... Sending lots of hugs your way!

[Betsy]

Hi archwired 28. Thank you for your reply. So you haven't then had the spaces closed yet? I agree that you should get implants, I hear it changes peoples faces so much when their molars are not there.

I am shocked to think that after all these years in braces, that I would need orthognathic surgery, I went with my current ortho do avoid that. I have been through too much, I can't do that surgery now, or ever. But you're saying that's the only way to get my tooth show back? I am so scared now. Why would he do something that would cause this? I am so worried it's not reversible. As far as veneers, it would help a little, but not as much as needed, only a few milimmeters but also give me back my overbite, which is fine if the orthodontics alone would do that, but to pay for the overbite we tried to fix for so long is so hard. Gosh, I would have gotten those veneers from the start if I knew this would happen. I need more tooth show from the top, not the bottom up ideally, veneers would be from the bottom.

I appreciate your honest opinion, regardless if it's what I want to hear or not.

[ArchWired28]

Betsy
I don't even know what to tell you, although I want to help. How about you bring this with your ortho, that you agree to have an overbite as long as he pulls your upper teeth down? Is this possible?

My gaps are not closed because he keeps them open on purpose. I think I will just have to swallow the expense of the implants since it is so much better logn term...

[Betsy]

Hi Ilay,
Sorry I just saw your response. Thank you. I agree with what you say, it's what everyone says, but no orthodontist will take me even when I say I will sign any medical release waiver so their not legally responsible if something goes wrong while I am in treatment with them. They don't want the liability I assume, and I guess my once challenging case when I began, has become more challenging with the changes my orthodontist has made, albeit his attempt at doing good.

Hi Archwired,
Orthognathic surgery holds the potential to exacerbate my tmjd, it can go either way, just like how your braces helped your tmjd, mine started the problem. I wonder what needs to happen orthodontically to help my tmjd because my ortho has not been able to do that either.

I still can't believe that ortho for this long would not only not improve things, but would actually make things worse. I feel like I am in the twilight zone because it's all so weird and the lack of answers. Why and how would he put me in a state where I would need this major surgery to get back tooth show I always had before? I am so upset right now, I feel like there is zero hope. Maybe the orthos I consulted with purposely didn't tell me what you're saying so I wouldn't freak out!?!? Maybe this is why their so evasive with answers.

Yes the expense on implants is ridiculous, it amazes me that they can charge that much, you really need to be well off to afford them and yet people of all income levels need them, it's such a luxury when it shouldn’t be.

I FINALLY after all these years got a referral to a periodontist from my general dentist, I don't get why it took so very long. The perio said I have bone loss as a result of all these years in braces, this scares me so much. I don't know how much braces I can handle, but I can't be left looking like I need dentures, I just can't.