Conflicting orthodontist opinions?

[Angel21]

Hi,

I'm wondering if anyone has faced a similar situation?

I had braces taken off a while back but wasn't 100% happy with the positions of two of my teeth (central incisor and lateral incisor). I was told this was due to their shapes and that the teeth are as straight as can be. Recently I've been considering having bonding work done because my lateral incisors are very small, but before doing that I wanted to make sure the teeth truly were all in the correct alignment first, so I went to get further opinions elsewhere. The dentist and orthodontist at this other practice both agreed that these teeth could do with a little more adjustment.
I went back to my orthodontist but she was adamant that others don't know the history of my teeth and this was the best possible result.

It's a frustrating situation for me. I'd gone through 2 and a half years of braces so I want to make sure they're 100% correct. I thought I was just being too obsessive but having other professionals confirm my doubts hasn't helped. Surely if it was just a matter of different tooth shapes, they would take that into account? I really don't feel I should have to pay further thousands for some very minor adjustments (if they can even be fixed in the first place), and of course having to go through more months of braces isn't very appealing. I enquired about Invisalign but this could only work on one tooth.

Here are my pictures to demonstrate what I mean: http://www.picturetrail.com/sfx/album/view/24540964

Thanks

[Beks]

That sounds really tricky. While you want to trust your original orthodontist, you want the teeth to look perfect. Is there a way to go back to the consulting orthodontists, and double check that it would not be the tooth shape that causes the issue? Your pictures look perfect in some, but I can see a couple where the teeth don't look aligned all the way (though barely). But I'm no orthodontist! Would your orthodontist consider continuing treatment if you will pay? It will most likely be less than if someone else took over treatment.
I completely understand not wanting anything less that what you expected! I'm in braces for a 3rd (omg) time. The first time I got my braces off, I had issues with the retainer that didn't get completed until the next week or so. With no permanent wire put in initially. My husband threw away my retainers, and no amount of digging in the trash (yes, I definitely did that!) found them. My ortho was 2 hours away at that point, and couldn't get in to see them for a week. My teeth had shifted so much, that I was put back in braces for another year. Now, years later, my permanent retainer broke, and after having dental work my essix retainers didn't fit. I didn't spend 4 years in braces before to have my teeth move and create a huge gap, so here I am again. If you aren't comfortable with how your teeth look, then don't be afraid to get yet another opinion! If you feel it's worth the money...!

[djspeece]

Out of curiosity, what part of your history was the original ortho referring to? I have to assume the second one must have asked you some standard questions about your medical and dental history. I'd probably ask your original ortho if he/ she worked be willing to discuss your case with the consultant so that everyone is working with the same information. Physicians do this routinely, and i don't see why an ethical ortho would not agree to do so. Best of luck to you.

[Angel21]

Thanks for your replies.

Sorry to hear that Beks! That sounds very frustrating I hope you manage to get it sorted!
They did acknowledge the teeth were slightly different shapes, but also agreed that there are some minor adjustments that could still be done.

djspeece, I believe she was referring to how my teeth moved at each adjustment. Bending the wire a certain way to fix one thing ends up moving another out of alignment. Although shouldn't you be able to adjust each teeth to an exact position perfectly?
I'm not sure if having both the orthodontists talk to each other about this will help, as she'd most likely just tell her the same things she told me.

The practice I had my braces with also offers SureSmile, maybe that could give more precision and a clearer idea of how my teeth could look digitally and what could be physically possible?

[djspeece]

Orthodontics is still an art as well as a science... proceed with caution with sure smiles, because it sounds a bit fishy to me in so far that software can better predict tooth movement. I still think they should talk.

[Angel21]

I'll mention it but I really don't think she'll speak with the other orthodontist, her views were pretty strong.

I just thought having a 3D digital image of my teeth/roots and what could possibly be achieved would help in a case like this.
It wouldn't be great if I ended up paying for further treatment at the original practice and it did actually turn out I couldn't get a better result. Even going with the other orthodontist doesn't 100% guarantee I'll get what I want.

[Jethro]

After viewing your pics, I must say that I think your teeth are beautiful. I agree that a Suresmile imaging scan may provide some info regarding possible tweaking of tooth alignment, but ultimately it's the ortho that determines the outcome. I'm currently in braces for the 3rd time due to some unusual relapse/failed retainers (I posted about it), and can say from experience that brackets and archwires can't "spot correct" specific teeth. I only had a few teeth that needed alignment, but since getting braced 2 months ago, my bite is now completely off, some teeth now have height discrepancies and I have gaps everywhere. I know this will all be corrected during treatment, but it's going to take 12+ months to do so. I will also need some bonding on my narrow top lateral incisors.

My suggestion would be to proceed with caution before getting braces again. You could potentially spend a lot more time and money and end up with a similar result (and as I said earlier, I think your teeth are beautiful as they are). Ultimately though, you're certainly entitled to be happy with how your teeth look.

All the Best,
Jethro

[Angel21]

Thanks Jethro! Sorry to hear your teeth have relapsed They're looking great at the moment.

Overall I'm pretty happy with my smile and the bite is good, I know it's a huge improvement compared to what I started with, but I just want them to be as perfect as physically possible. If I know for sure that this is the best that can be achieved then that's okay.
It's hard when other professionals in the industry see my teeth and immediately notice the issues, it seems strange they can be confident in fixing them. Surely if you can't always spot correct specific teeth they would show a little doubt? I guess they can only just go by what they see.

Good luck with your treatment!

[assertives]

Perhaps you should go back and ask those orthos what they propose to do that would be different from what 2.5 years of braces did not manage to achieve. I wonder also if the shape of our bones and our arch have a part to play in how the teeth line up in the mouth as well. I also seem to be having the same problem, and it's been like that for the past 7 or so months in treatment.

I guess at the end of the day, you could by all means get treatment and try again, but it may be good to be mentally prepared for the outcome to be the same (and hopefully not worse). Your teeth look good as it is, and I would leave them alone if I were you though.. perfect is the enemy of good. Good luck in what you ultimately choose to do!

[Angel21]

Thanks to everyone for your replies.

So I went back to the practice enquiring about bonding and funnily enough the cosmetic dentist noticed the central incisor being out of alignment immediately. I didn't even have to mention it! He actually asked if I'd been wearing my retainer, even though I have a permanent retainer fitted and the teeth haven't shifted at all. I explained the situation and he then went to chat with the other orthodontist who said he'll fix it if my orthodontist won't (most likely with Invisalign). Not sure about the other lateral incisor beside it though, the dentist says it's better for it to be slightly tilted for the bonding.

Moral of the story, if you feel the work carried out wasn't quite finished, don't be afraid to get multiple opinions! They are your teeth and you have to live with them. Trust your gut feeling.

[solo321]

Thanks to everyone for your replies.

So I went back to the practice enquiring about bonding and funnily enough the cosmetic dentist noticed the central incisor being out of alignment immediately. I didn't even have to mention it! He actually asked if I'd been wearing my retainer, even though I have a permanent retainer fitted and the teeth haven't shifted at all. I explained the situation and he then went to chat with the other orthodontist who said he'll fix it if my orthodontist won't (most likely with Invisalign). Not sure about the other lateral incisor beside it though, the dentist says it's better for it to be slightly tilted for the bonding.

Moral of the story, if you feel the work carried out wasn't quite finished, don't be afraid to get multiple opinions! They are your teeth and you have to live with them. Trust your gut feeling.

Glad to hear you got a positive resolution. I bet sometimes these orthos must think we're crazy with the things we bring up. YOU couldn't be more correct about trusting your gut