First time poster on these boards, it's great to see a forum like this exists! Great information and support from others
I am a 23 year old female congenitally missing both upper lateral incisors (teeth #7 and #10, the ones right next to my two front teeth), I had them as baby teeth but when they fell out when I was young the adult teeth never came in. Back when I was 10, I had braces put on (had them for a total of two years) to straighten my teeth overall, close the gap between my two front teeth (I had beaver buck teeth! Haha, cute as a little kid but not so cute when you're older...) correct my bite, and most importantly make spaces where my missing teeth were with the ultimate plan to get permanent dental implants or bridgework done once my mouth stopped growing (late teens/early 20s).
After braces, I went through several different retainer styles to fill my two gaps and maintain the spaces for future restoratives... immediately after the braces were taken off when I was 12, I got a Hawley retainer with two fake teeth attached to the wire. After having that for about two years, I was given an Essix type retainer (similar to a clear Invisalign tray) that had two fake teeth set into it to fill the spaces, this definitely looked a little better than having a visible wire retainer with OBVIOUSLY fake teeth... looking back at middle school photos, I can see why I never had a boyfriend then hahaha!
But the Essix retainer had its drawbacks, it stained pretty badly over the years because I would often eat and drink with it in while in public, I was (and still am) too embarrassed about my gaps that I couldn't bear to remove my "teeth" in front of others. I had that retainer for about two years or so, and then when I was 14 or so I received a new device called a flipper. The flipper, for those who don't know, is an acrylic plate with false teeth attached, like the Hawley retainer but without the metal wire running in front. I still wear this flipper, but it is now 8 years old, they are NOT meant to last this long!!! Over the years, the teeth broke off several times and were re-attached and eventually re-supported with little strips of metal bonded into the acrylic to give the teeth extra support to withstand biting forces. Also, the little metal clasps in the back that loop around my molars a bit to anchor it in place have since broken off, for the past two years or so I have held the flipper in place using denture adhesive.Long story short, the flipper is not meant to be a permanent solution, and my dentist has even remarked that he is very surprised it has lasted this long. Aesthetically, it's OK.... but definitely not great, the teeth themselves are now worn a bit, the metal support gives them an off-color tinge, the teeth are too "short" (the top edges of the fake teeth do not match up with my gum line to look like they are the same height as my other teeth), and eating with it in is becoming more difficult (I know I shouldn't do this, but once again I'm too embarrassed to take it out in front of others) and affects my bite, I absolutely cannot bite into anything too hard or chewy while wearing it knowing that the teeth will definitely break off.
I've consulted with my regular dentist (I see him every 6 months on the dot for regular cleanings and examinations, always been good about oral hygiene and am proud to say I've never had a cavity ever!), a cosmetic dentist who is very well reviewed and accredited in his practice, an oral surgeon, and in less than 3 weeks I have an appointment with an orthodontist, and the plan is to FINALLY GET IMPLANTS!!! I am very excited to finally be moving forward with this and getting a permanent solution to my missing teeth, I can't even imagine what it will feel like to not have to constantly worry about my smile, or be able to bite into a fresh juicy apple or corn on the cob normally... I've had these gaps way too long and I feel like my self confidence will greatly improve once I can finally put my worries about my teeth to rest and not have to deal with an annoying, unsightly removable appliance.
So 10 years after getting my braces off, it turns out I will be needing them again as part of my treatment plan! Since getting the braces off, despite the retainers I have worn CONSTANTLY (literally, I've worn an appliance full time day and night every day since getting braces off for fear of the spaces closing up again, only taking it out to clean it), my teeth have shifted a little and the gaps are just slightly too small for implants. The oral surgeon needs at least 6 mm of space to place a 3 mm implant with room so as not to be right up against the adjacent tooth roots and have sufficient room for crown placement. The spaces are now approximately 4 mm wide each, meaning my canines and molars need to be shifted back anywheres from 2 to 4 mm to make enough space for implants. I was kind of disappointed to hear this, as I thought having braces when I was younger would have made enough room and I could simply get the implants when I was older. Also, I will more than likely have to get bone grafts to add bone to the implant areas, as it's usually the case with congenitally missing teeth that there is not enough bone developed properly in those areas to be able to support an implant post.
But I guess it's one small step back, and in the end it will be worth it. So I have an appointment in 3 weeks with the orthodontist who will be coordinating the treatment with the cosmetic dentist and oral surgeon. The plan is basically as follows:
1. Get braces put on as soon as possible (I will probably have them by Thanksgiving this year or sooner) to move canines and molars back 2 to 4 mm on each side of my mouth to widen gaps in lateral incisor areas, estimated time in braces is only 6 to 9 months but I will get a more definite estimate once the orthodontist thoroughly examines my case.
2. In 6 months from now on March 19th, I will see the oral surgeon again so he can evaluate the progress of the orthodontics and the implant areas. At this point, radiographs and impressions will be done to determine if bone grafts are necessary.
3. About 3 months before braces are taken off, I may be able to get bone grafts and/or implant screws placed. This all depends on the progress of orthodontics though, and it may be the case that I have to wait for the braces to come off, THEN have bone graft and implant placement.
4. During healing phase of the implants, I will be supplied with a flipper-like device to maintain esthetics while the implant posts integrate with the bone in my jaw... I asked the cosmetic dentist, who will be placing the permanent implant crowns, about temporary crowns for the implants. He said that in his practice, he has had success using a removable device like a flipper to fill the space rather than screwed-on or cemented temp crowns. Not entirely thrilled about having yet ANOTHER removable device, but it should only be for the 3 to 6 months it takes for the posts to heal.
5. Finally, when the braces are off, bone grafts healed, and implant posts healed, I will get final crowns on the implants.
I am preparing myself mentally, physically, and financially for the next year and a half or so to be an interesting and trying journey... I am anxious about the procedures, pain, teeth looking worse before they ultimately get better, possibly having to be "toothless" at times when my surgery sites are healing, dealing with mediocre-looking temporaries until the final crowns are in place, etc. etc. very nervous about getting braces again, as I remember what a pain (literally) they were back when I had them as a kid! But at least back then, braces didn't seem like such a big deal because everyone around my age was having them. Being 23 and about to start a new school next year, looking for job opportunities, and trying to expand my social circle makes me apprehensive to being a "brace-face" again.
One of the biggest concerns I have is making sure that during the time I have braces on, there is some sort of coverage in the areas of missing teeth. I mentioned this concern during my consultations with the cosmetic dentist and oral surgeon, and both said that when I see the orthodontist to discuss pontics (fake teeth) being attached to the braces. Basically, I know this is doable as I've researched it and seen a couple of cases where missing teeth are filled in with fake teeth that have brackets attached to them and are tied on to the archwire. I am worried, however, that these pontics attached to the braces will be very unstable and frequently break off with any type of biting action.
Has anyone had a similar situation? What are your experiences with pontics attached to braces? I am very interested to hear first-hand from other people who have had fake teeth attached to their braces. How is eating/biting with them? How stable are they, do they move around a lot? Do they look obviously fake? Have they broken off at all? Any input is greatly appreciated!!
Let me know your thoughts on orthodontic treatment and implants in general, I would love to talk with other people in similar situations to know that I am not alone! I know I am certainly not the only 20-something to get braces, but it doesn't make me any less nervous. Thanks for your input!