Should I look for a new orthodontist?

[rahmama]

Greetings all:
I'm very discouraged about my orthodontist and need some feedback.
A little background - I'll try to be concise, but it's complicated. (Just to let you know I have 3 dentists (regular, ortho and prostho) who all know and consult with each other.)

I've had braces for over a year for a huge open bite, one side of my teeth meeting in only one place. This photo is about Oct. 2011

A. October, 2011-1 smaller.jpg

In Dec. it looked like this.

B. December 2011-1 smaller.jpg

In April 2012, I started wearing rubber bands to help bring my bite together since not much was happening. But the instead of the bands pulling my upper teeth down, my lower teeth were pulled up. My orthodontist did not notice this was happening. When I pointed it out to him, he said it looked ok to him. I was upset and called my prosthodontist who agreed with my observations.

After the 3 dentists conferred they all agreed that I should have a TAD put in (temporary anchor device). Before proceeding, I had to make sure would be ok for me. I'm 65 (yeah, I know—really too old to be going through this brace thing) and wanted to make sure I didn't have any bone density issues.

A month ago, I finally got the TAD in, but it's been nothing but trouble.

November 2012.jpg

 The orthodontist had to put them in 3 times (that's 3 different insertions which hurt like hell!)
 The anchor is really far back on my jaw and the band won't stay hooked on the anchor. It kept popping off. I had to modify the band and triangulate it so it would stay. See photo.
 Every week the anchor has come loose and my orthodontist has to screw it back in. Yikes!

Even with the problems, I saw some closing of my bite after two weeks and was encouraged. When I went to my orthodontist last week, he replaced the band with a metal spring. It felt better but didn't feel like it had much tension. Then the spring broke after 3 days while I was eating soup.

It seemed that my bite closure had come to a standstill or possibly regressed. It happened this last Friday night and I knew I couldn't get a hold of my dentist, so I put the bands back on like I had them before, one triangulated to the anchor. I've also re-instituted a band from my 'eye tooth' on the upper jaw straight down to the tooth below which seems to be the main pull for bringing my bite closer. This is a bit risky, because I don't want my lower teeth pulled up like they were before, but I don't see that happening.

However, I don't have much confidence in my orthodontist. He's very popular with the teenage crowd and seems to do well with normal teeth straightening. But I don't feel like he's paying attention to what's going on with me. He doesn't even measure the gaps which is something my regular dentist did when I saw him recently.

I've wanted to find another dentist for a long time. I even went to consult with one recommended by my prosthodontist but he didn't have a clue what to do with my situation.

What's holding me back from looking for another dentist:
 I wanted to try having the TADs inserted and see what happened. Although the anchor shows signs of working, I'm not sure it's properly placed. Like I say, I don't think my ortho knows what he's doing with these.
 I was hoping the TAD would bring my bite close enough together so that my dentist could take over from there and I'd be done with the orthodontist.
 It's a small town and I'm sure all the dentists know each other.

Has anyone had a situation where they changed they orthodontist because they were so unhappy with him?
Has anyone experienced problems with TADs, (temporary anchor device) similar to mine who could help me out?

I'm feeling pretty discouraged about this whole thing about now.

[Kipepeo]

Hi rahmama. I have not personally had this happen, but I recently posted on clo's diary because he/she went through something like this (times 1000).

You are right to be concerned and informed so the wrong thing doesn't happen and leave you with something permanent.

I say go to as many other orthos s you can until you find one who is familiar with your issue and can offer a valuable professional opinion.

You have to be very careful extruding teeth because they can't easily be intruded.

[rahmama]

You have to be very careful extruding teeth because they can't easily be intruded.

Thank you for your reply Kipepeo. I am embarrassed to say how little I know about the process that is taking place. For example, I hadn't heard the term 'extruded or intruded teeth' before your post.
When it comes to my health, I'm usually very pro-active, but with my teeth... I hardly know the right questions to ask and my orthodontist doesn't talk to me.

Is this what anchor and bands are doing? Extruding my teeth? The only thing I was told was the pressure from the bands/spring would pull my teeth down out of the bone, then bone would be created and fill in the empty pocket. I really wish the dentists would explain things in professional terms so I was more educated about what's going on!

[rahmama]

Kipepeo: I just read Clo's never ending brace story. It sounds like it could be my story too. I learned a lot from reading everything, including the fact that changing ortho is not a solution unless you find the right one. It seems like such a hit or miss prospect and while they experiment on your mouth, you are the one who has to suffer (and pay!) if they don't know what they're doing.

I feel so bad for Clo. She hasn't posted in a while so it seems like she's still left with a worse situation off than before she started.

I'm hoping that I will find some resolution to my horrible bite. It helps just to know other people are going through this. It's kind of a lonely journey.

I'd still like to hear from folks who had to look for another ortho and how they went about that.

[Kipepeo]

I agree the ortho should use professional terms. It helps when we need to google it. Clo's story scared me, because I will need my teeth extruded some...but I'm not sure which teeth will be extruded and which should remain where they are. You better believe I will have that clarified before I leave the chair. And I will also ask how will I know when it's gone too far, when should I call for over extrusion. I'm very concerned about that.

You might not need a new ortho. Arm yourself with education, and have a little chat with him. I live with these teeth and bite 24/7. He sees them all of a few minutes every couple of months. I know what's going on in there, but what I don't know is how everything goes from point a to point b.

[rahmama]

I agree the ortho should use professional terms. It helps when we need to google it. Clo's story scared me, because I will need my teeth extruded some...but I'm not sure which teeth will be extruded and which should remain where they are. You better believe I will have that clarified before I leave the chair. And I will also ask how will I know when it's gone too far, when should I call for over extrusion. I'm very concerned about that.

You might not need a new ortho. Arm yourself with education, and have a little chat with him. I live with these teeth and bite 24/7. He sees them all of a few minutes every couple of months. I know what's going on in there, but what I don't know is how everything goes from point a to point b.

Kipepeo: I agree about Clo's story. It scared me too when I realized she probably never accomplished what she set out to do. I hope she will eventually find 'closure'.

I'm going in tomorrow to the ortho and made an appointment with my prosthodontist to check out the alignment of my teeth. I am fortunate to trust 2 out of my 3 member dental 'team'. They confer with each other and have been able to guide my orthodontist. But I really have to stay on top of things!

Thanks for keeping me company here. Do you have photos? I'd like to see if we have similar situations. I'm still wondering if I understand what extrusion is. The band the anchor is attached to is supposed to pull my upper left teeth down so my teeth meet. Extrusion?

[Kipepeo]

Yeah that's what my understanding of extrusion is. You can see my story in the link in my signature. be forewarned...I haven't had a classic treatment progression either!!

As I type this, my right side has just become more prominent. Since I was just in the ortho chair a couple days ago with these concerns, I'll go ahead and wait until next appt. I haven't started elastics yet.

[rahmama]

Update: I had a good session with my orthodontist today and so I'm feeling better about things. There are time when I get really down about my progress, or lack of it. Occasionally I get so frustrated I think I need to look for another dentist. But there's something to be said for being patient, while remaining vigilant about the progression of tooth movement. This is not as easy as I thought it would be. And apparently this moving of teeth is not an exact science.

For the time being, I've decided to stick with my ortho. I have two other dentists (not orthodontists) I go see to have them check out my progress and give me feedback. One is my awesome regular dentist who patiently explains everything and even calls me up after a particularly traumatic tooth extraction, etc just to see how I'm doing. Love him!

The other dentist is my prosthodontist who worked on my TMJ issues that had to be rectified before I even got braced. I saw him today too and he is satisfied with the movement of my upper teeth.

So, in reality, I think I have a pretty good dental team and am back to feeling positive again.

[rahmama]

Yeah that's what my understanding of extrusion is. You can see my story in the link in my signature. be forewarned...I haven't had a classic treatment progression either!!

As I type this, my right side has just become more prominent. Since I was just in the ortho chair a couple days ago with these concerns, I'll go ahead and wait until next appt. I haven't started elastics yet.

I just read most of your story. I too thought your teeth looked so beautiful even before being braced! But a bad bite is something no one can understand except another person with bite issues.
Argh! It just downright sucks. I haven't had more than one set of molars meet on one side of my mouth for about two years now! You can't imagine what that's like unless it's your mouth.

I hope you don't have to wait too long before you see your ortho. Some shifts in bite seem to correct themselves in a day or so. If things get too 'wonky' though, I wouldn't wait. I make that mistake a few months ago and lost a lot of progress.

Good luck!