After 3 consults, I think I'll do regular braces!

[Meowmeowbeans2]

I've had quite a summer of dental dilemmas! Dental insurance changed, so in June I went to a new dentist who pointed out an upper canine in crossbite, hinted that I grind my teeth, and said there's some stress lines in my teeth and said I need braces or a $600 mouth guard because "your teeth could crack I don't know"... she also gave me an ultrasonic cleaning which was extremely painful (gums bleeding, some receded quite a bit afterwards!) and told me I need a second cleaning 2 weeks later. Needless to say I did not go back to this woman!

Traumatized by that experience, I went back to my dentist of the 5 previous years to ask if he had noticed these issues. He said yes but because I never complained of pain he didn't recommend doing anything - he's conservative in treatment generally. He did say he recommends night mouthguards to all his loved ones as a great preventative measure to teeth grinding. He also gave me an ortho referral and suggested I go to put my mind at ease. My teeth look pretty straight but now the one tooth crossbite is bothering me, so I decide to try the ortho.

In July the 1st ortho was at very a fancy office with a woman who took a series of photos to show him before he came in the room. He walks in and says I need jaw surgery because my upper jaw is too small and my right lower jaw is longer than left so my chin points off to side. Or if I don't want surgery he can try 20 months carrière motion 3 and Invisalign but no guarantees... At this point I start crying because my mother had double jaw surgery in 80s and says it was a huge mistake because she has no feeling in her lower face at all. Growing up she made sure our dentist and orthodontist knew of her issues so we wouldn't have to go through the same thing - I had braces age 13-14 and wore my retainers for about 8 years before I gave up on them. I leave this appointment with referrals to oral surgeons and a periodontist I have to see before they'll start treatment. I leave more traumatized considering that I thought my teeth were mostly fine - straight looking, no pain - and now I'm told I have major issues!

I go back to nice dentist to ask for a 2nd ortho reccomendation and his periodontist recc, which ends up matching the name I have. I make appointments with those two in August.

2nd ortho walks in, very pleasant younger woman. I only tell her I'm worried about the crossbite to start. She looks at my mouth directly and recommends 16 months in regular braces. I'm so relieved I say "so you wouldn't recommend surgery?" She says she used to work in craniofacial surgery with kids with cleft palates and has seen more surgery than any other ortho in the area and would not recommend it for me - it would be purely cosmetic in my case and my face is fine! I'm so relieved at this point I'm ready to sign up, but I do my best to ask rational questions. She said the carrière/Invisalign route would be harder/take much longer to correct the bite issues I want to address, so braces is most practical option. I tell her about perio appointment and it turns out that the office is literally above hers and she works with him all the time, including co- scheduling appointments with him throughout braces treatment to keep track of everything together. It all seems very convenient, and I leave feeling more optimistic and get a consult gift of 2 stemless wine glasses with her logo on it!

Two days later I see the periodontist everyone loves so far. He points out 3 teeth with gum recession - lower premolars, one on each side due to a bad bite, and one front lower incisor with no obvious cause, which I blame on the ultrasonic cleaning trauma because it was fine before! He said the 2 premolars should be grafted before braces because they didn't have enough attached gum after 3mm of recession. The incisor could wait until after braces. My dental insurance was about to change again, so he kindly moved another patient to do the first gum graft the following Monday so I could use up those benefits with one tooth and then do second tooth on new insurance! I called my good dentist after to confirm this treatment plan, he takes to the perio and said he trusts his judgement, so I agreed to the surgery.

Surgery 1 went well. One day of pain, one day of swelling, then a week of discomfort eating soft food and having to talk around the stitches on the roof of my mouth. After stitches came out 10 days after, I was told to brush just the tooth and not the gums until the next appt (Sep 21). I waited for about 3 weeks post surgery to eat chips again, but otherwise feel back to normal and my exposed root is covered well! The perio said 4 weeks after the 2nd surgery I could start braces.

In the meantime, I flew to visit my parents and stopped in to see my childhood ortho and dentist for their opinions. The both confirmed my teeth had shifted a lot (oops...) and the ortho did think my lower jaw grew a bit in my 20s, but he said he would only need 12 months of regular braces to fix my bite! Since it wasn't practical to fly to him to actually get the braces, I showed him ortho 2's website and he said her credentials were fine and he agreed with her approach. He also said he'd dig out my old records and mail them to me for reference. On the gum grafts, the ortho said I should wait more like 2-3 months to let them heal before braces and the dentist said he didn't think I needed grafts at all! But then I looked at my dad's multiple receded gums and I think that dentist is just REALLY conservative in any gum treatments...

So I'm leaning towards ortho 2 for the 16 month braces approach. Her office called today to check in, and I explained the gum graft timeline and said I'd have the records sent to her. I want to know what she thinks of 1-3 months of healing from the grafts. With the Sep 21 perio check up on surgery 1, I hope to schedule surgery 2 in October then start braces in Dec/Jan.

Is there anything else I should be asking orthodontist 2 before I start??? It's a bit scary to be an adult CHOOSING to move my teeth around vs. a teenager whose parents made her do it, haha! I did set up my Flex Spending to the max to help pay for this, so I'm eager to get started!

I'll try to post a photo as soon as I can!

[Meowmeowbeans2]

Photos of current teeth: https://imgur.com/a/kW7imVc

Questions that ortho 2 responded to via email - love that she does this too!

My Email:
I did have a few follow up questions:

You said we need to "make space" to move my lower teeth back. What does that entail?

Would the first appointment be to put on full braces, or is there a step before that?

Would I get my retainers the same day the braces come off, or is there a gap in timing?

Thanks again! Hope to be in touch when my insurance switches over.

Ortho response:
Hope you're having a great weekend! To answer your questions:
1) We need to make some space between the teeth in order to be able to move them backwards towards your tongue more. This space is created by widening your arch form (moving the teeth sideways) or moving the teeth back with torque. These movements will be done with the braces. It is easier for me to explain and show you on the models of the teeth since teeth move in 3-dimensions.

2) At the first appointment, we will be taking some orthodontic x-rays, photos, measurements, as well as placing your braces on that day. This appointment takes about 1.5 hours.

3) You would receive your retainers the same day that braces come off. I don't want anything to shift after our hard work and retainers are made ASAP! ;)

Please let me know if you have any other questions! I look forward to hearing from you

[Meowmeowbeans2]

To clarify - the photos are from ortho 1 consult PRIOR to the gum surgery. So far, I have had my right lower premolars grafted :)

[EmilyTravels]

Thanks for sharing your story. It sounds like you have found a good and thorough orthodontist. I would have loved to get any email from my ortho...he is old school. Best of luck to you in your treatment!

[kplatt2010]

Hi There- I like ortho #2. Just remember though, they can all make predictions regarding the length of treatment but is truly up to how your teeth respond.

I was supposed to be out of braces 7 months ago and I'm still in them. They are my new norm and I don't even ask anymore when the braces are coming off. I actually don't want them removed until the bite is fixed. I've invested a lot of time and effort and I want it right.

I would suggest you write out your goals of care and review them with ortho so that you are both on the same page from the beginning.

[djspeece]

Sounds to me like you have found an outstanding ortho. Board-certified? My ortho would also respond promptly to emails which I really appreciated and didn't abuse. Best of luck to you!

[Meowmeowbeans2]

Second gum surgery scheduled Oct 11, then braces go on Dec 18!

I'm giving my gums 10 weeks to heal. Perio said I'd be good to go after 4 weeks, but right now I'm 7 weeks out from surgery one and still have on and off sensitivity in the teeth at both surgery and donor sites. I also have a work trip and dance performance in early Dec that I don't want to be self conscious for!

So will I be still in pain a week after braces, or will I be able to enjoy a nice Christmas dinner?! Stay tuned!

[assertives]

Congrats on getting started!! I'm pretty sure you will be in pain for up to a week after getting braced, but hang in there, it will be worth it in the end.

[Meowmeowbeans2]

Second gum surgery was a breeze compared to first. Not sure if that was more psychological since I knew what to expect The weird part was that this time my gum grew OVER some of the non-dissolvable stitches, so they have to do some cutting to get those out later this week.

I’m getting on and off nervous about braces - worried about black triangles, facial changes, and potentially more gum recession. My teeth look straight, so this treatment is all about fixing my crossbite and tilting upper premolars and canines out, which should hopefully alleviate my whole jaw biting off to the left! I feel like it’s worth it to fix a bite issue and to save my premolar gums from receding again after putting them through these surgeries, but there’s so many unknowns!

I was reading my orthodontist’s credentials again, and I think it’ll be ok - she seems super accomplished!

Dr. Markova is a specialist in Orthodontics and Dentofacial Orthopedics. She received her Doctorate of Dental Medicine from the Harvard School of Dental Medicine. She completed her Orthodontic Residency at the Washington Hospital Center in DC and was Resident Team Leader at Children's National Medical Center Cleft Lip and Palate Craniofacial Clinic. Prior to dental school, she obtained her B.S. in Kinesiology at the University of Michigan.

Dr. Markova is a clinical lecturer at the University of Maryland School of Dentistry and a featured lecturer at Harvard School of Dental Medicine. Dr. Markova has published research articles in various dental publications. She is a member of the American Association of Orthodontists, the DC Dental Society, and President of the NOVA Academy for Dentists.

Interesting fact: Dr. Markova holds 2 patents for innovative orthodontic bracket designs.

[kplatt2010]

I think you've got a winner MeowMeow Beans. I would respectfully suggest one thing...Go earlier than December 18th or go after Christmas. There is a high probability that if you got braces on the 18th that your teeth/ cheeks might still be uncomfortable. My braces were uncomfortable a few hours after placement and I think for at least one week. The really painful part though was when the brackets and wires tore up the inside of my cheeks. Unfortunately I did not use the wax enough during the first few days. I also somehow bit the inside of my cheek while sleeping which resulted in painful swelling and major bite marks on the inner aspect of my cheek.

[Meowmeowbeans2]

I'm in a dance show on December 16, so I vainly want to do it afterwards

I don't have any Christmas holiday plans since my family is doing a cruise in February as our "holiday" celebration this year, so I'll just be at home with my husband and covering work over the holidays for the folks who want to be out! I can suffer in silence in the empty office, lol!

Usually, I like to do a roast beef for Christmas dinner, so I hope that'll be soft enough! Or maybe more of a pot roast so the meat falls apart this year.

[Meowmeowbeans2]

Are there any people who were told they needed jaw surgery who chose to just do braces?

Not sure if I’m just getting cold feet or what, but today I’m freaking out that I really *need* the jaw surgery. 1 ortho said surgery and 2 others said just braces is all I need, so my first reaction was majority rules for braces.

My mother had double jaw surgery in the 80’s and calls it the biggest regret of her life. She lost all feeling in lower part of her face, the recovery was much more difficult than was explained, and from that point on she never smiled in a way that showed her teeth again - she hates them to this day.

So with that family experience and the 2 v 1 recommendation, I thought braces must be the answer. Now I’m wondering I i should get more opinions??

[AndAndAnd]

When you mentioned surgery I thought there would be some big issues with your teeth, but after looking at your photos in an earlier thread I can’t see any real problems that would warrant surgery. I am guessing you are in the US? If so, it seems it’s almost the norm to offer surgery even when it’s not needed. You can probably guess my opinion... I would suggest you just stay with braces and take on board your mothers advice.

[Meowmeowbeans2]

I think the ortho recommending surgery is interpreting my midline shift as one side of my jaw having grown longer than the other... which would need surgical correction.

I actually think my midline will be correct and perfect just by tilting some upper teeth out buccally to fix my crossbite - I.e. my jaw is fine, I just tend to bite off to the side at the last moment to keep the crossbite teeth from knocking together. When I relax my jaw down, the mid lines match up!

Argh these decisions are so hard! It’s a real physical, emotional, mental, and financial investment all in one.

[wendydong]

i personally don't care that much about midline matching. I lived 40 years with midline off about 2mm, and one side was maloclussion class I and the other side was maloclusion class II

and for 40 years, i didn't even know phrases like "midline" and "maloclusion" as my bite was totally comfortable. i didn't even know these phrases even when i went to the ortho for consults. I only learned these phrase on my own until about 3,4 months into my treatment and my bite got uncomfortable.

i would never do any jaw surgery just go get a few MM of midline shift... as long as you end up with a comfortable bit and your top midline is aligned to your upper lip. Nobody see your bottom teeth unless they stare at it...