RightMyBite -- 4 weeks down... (updated 4/13/07)

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#1 Post by **RightMyBite** » Wed Mar 14, 2007 7:27 am

So I had braces twice growing up (once on the top only, and once full-mouth) to deal with a number of congenitally missing permanent teeth, and huge gaps between the teeth that did grow in. After the second round, I had bridges put in to fill in the gaps created by missing teeth. I might have chosen differently if I had more information, but I was 17 and my parents wanted to get things "permanently" corrected before I went off their insurance.

A decade or so later, I had some pain in a tooth involved in one of the bridges, which ended up requiring a root canal. When my dentist was looking at ways to repair the bridge after that, she said... "you know, your bite is really strange. Would you be willing to consult with an orthodontist and an implant specialist, just to see what they say?"

I visited the implant specialist first, and he said I was losing bone in the places where I don't have teeth. He also said I might be starting to lose bone around some other teeth because those teeth never actually meet other teeth as I chew.

The orthodontist's summary assessment after meeting me and looking at my dental records was, "you have a really complicated case!". Hmm.

Turns out, the people who did my second round of braces and my bridges (a team) were more concerned with making my mouth look pretty than with long-term functionality. One of my bridges actually added a tooth that doesn't exist in nature! And, the bridge involved in the root canal was not "balanced" in terms of my bite, so it was "rocking", getting loose, and letting stuff under it -- thus the need for a root canal.

I'm not sure of all the technical terms for what's wrong with my bite, so here's my best description. When I close my mouth all the way, my teeth don't meet in front -- it's an open bite. In fact, only about 6 of my teeth actually meet other teeth when I'm clenched. We think this contributes to the fact that I clench at night; I'm unconsciously trying to get my front teeth to meet. I also have some crossbite going on with my molars -- some are correctly aligned, but others are not.

My dentist, orthodontist, and periodontist/implant specialist met together to make a treatment plan. They all said that if my bite isn't corrected now, I'm going to have major problems in 15 or 20 years. So far I've had this much done:

*Dentist cut out pontics (fake teeth) from my bridges on the bottom so teeth can move independently. The ends of the bridges remain as crowns -- they're oddly shaped, but will work until braces are done and I can get nice new crowns to fit my newly arranged mouth.

*Periodontist/implant specialist trimmed some gum tissue and did pocket reductions to get my gums in shape. He also removed my two wisdom teeth, which were covered over (and yes, I have 5 congenitally missing teeth, but I also got 2 wisdom teeth!)

*Spacers went in two weeks ago.

I still have two baby teeth on top (premolars I think). They have no root, but they're not loose at all so the ortho is going to leave them in for now. She'll slim them down to make room for adjusting other teeth. I'm expecting they'll fall out at some point during treatment and I'll eventually get implants there, but my mom has baby teeth in the same two locations and hers are still hanging in there so who knows!

I also still have a bridge on upper front from one front tooth to the canine on that side. That bridge will stay on for part of braces, and at the appropriate time the dentist will cut out the pontic and the ortho will put a flipper on the braces so the "anchor teeth" can move.

Brace day is tomorrow! I'm nervous -- about how I'll look, about the pain (I don't remember my first sets of braces too well, but my mom said I had a lot of problems eating and talking), about interactions with my husband (I wasn't in a relationship the last time I had braces). The cost is a big number, but I've been preparing for nearly a year and got set up with a Flex Spending Account so at least I won't have to pay taxes on the amount I pay to the ortho.

Wish me luck!

#2 Post by **smallbutmighty** » Wed Mar 14, 2007 9:21 am

Hello Right....
You have certainly had a challenging dental history so far. And you are so smart to take charge of making it the best it can be for your future all- over health. People don't realize how much dental issues can compromise their health. Sounds like you have picked a good team to be working for you. I'm looking forward to supporting you on your journey. Best of luck and keep in touch often.

#3 Post by **RightMyBite** » Thu Mar 15, 2007 4:52 am

Thanks for the support, Karen and Mighty!

I leave for the ortho's office in about an hour; I'm about to have a nice big breakfast and fill out the forms for the down payment...

#4 Post by **RightMyBite** » Fri Mar 16, 2007 9:06 am

Well, the braces are on... I have pictures, but need to spend some time with Photoshop to make them clearer before posting them.

I really like the look of the ceramics on my top teeth (bottom are metal). I had all metal when I was a teenager, and I think the ceramic look a lot less jarring. Yes, I still obviously have braces, but it's like the difference between carrying a backpack or carrying a nice briefbag. And the fact that the brackets are bigger doesn't bother me. Plus, they placed the brackets close to the gumline to help my open bite, so if I'm just talking and not opening my mouth much, you really can't see the braces.

Not too sore today -- back teeth are fine, front teeth ached when chewing soft white bread this morning. We'll see how it goes the next few days.

#5 Post by **egocidal** » Fri Mar 16, 2007 2:59 pm

Whew... Glad you're finally on the road to functional teeth, wonder why your second brace team did that, like. Hey, that looks good, who cares if they don't work as well as they should, I mean, who uses teeth, right?

Good luck on brace-day! We're rooting for you:D

#6 Post by **RightMyBite** » Fri Mar 16, 2007 6:15 pm

Okay, illustration time!

Here are the "before" pictures. First, the upper. (Sorry it's a bit blurry). I forgot to mention before that in addition to all the bridgework, they also gave me veneers on my other upper front teeth because my teeth were naturally small. Definitely not a choice I would have made if I'd had full information at the time -- I'd rather have my own natural teeth intact!

Now, the lower. Lots of crowns (which used to be part of bridges), and some gaps. The two back gaps will eventually get implants. The front one will be closed with the braces. And yes, I do have one more molar on each side, but they're hidden in the shadows in this picture.

So, if I had all that work done, why am I undoing it (cutting apart bridges, etc)? Well, that would be illustrated by the following picture. Note how the teeth don't meet at all -- and I'm as far closed as it gets.

Anyway, now that the braces are on, here's a picture of my smile, with ceramic brackets and light grey ligatures. The bottoms don't show unless I grimace, and I'm sure they'll show in lots of later pics!

#7 Post by **lynnm** » Sat Mar 17, 2007 5:53 pm

Thank God you have a dentist who mentioned it to you while there's still time to take action!

We don't have the heredity part in common, but do with issues like openbite, overjet, crossbite on some molars, wear and tear on the supporting structures, and an orthodontist who focused on the teeth being straight and maybe not so much on long term function and stability.

Here's to hoping we all get form and function right this time around!

#8 Post by **RightMyBite** » Fri Apr 13, 2007 2:24 pm

I've had the braces for 4 weeks now, and it's been pretty uneventful. One of my molars seems to be shifting a little bit, as my bite will sometimes change for a day or three and then seem to go back, so maybe something is starting to move to where it's supposed to be. And I can tell that the very mild crowding I had in the lower front teeth is starting to resolve as teeth rotate onto the wire.

What prompted the update is that I had my first cleaning with braces yesterday. I got a good hygiene report card, so it seems my cleaning routine is doing the trick.

4 more weeks until my first adjustment...