"A Very Difficult Case!"

[catphones]

Hello everyone! I'm 26 years old, and I'm just starting my braces journey! I've had quite a few dental problems as a child, mainly revolving around baby teeth not falling out when they should (with the adult teeth growing infront of or behind them), and my parents not being able to afford consistent dental care for my brother and I. We were also brought to some suspicious-looking dentists with dubious methods for pulling teeth...

I've had incredible luck with my work and personal life these past 2 years, and I'm much more financially stable now which means I can afford things I wasn't able to in the past. My mother is all gung-ho about me getting braces, maybe moreso than I am! But she doesn't know that I went to my first consultation. I'm thinking of leaving it as a surprise!

She's a bit afraid of dental work, so I'm also hoping to encourage her into regular dental visits. I can't recall her ever going to the dentist, and her beautiful teeth have shifted and changed a lot over the years, and have been giving her occasional pain. It worries me. And I know she wishes she had the same smile she use to. I saved enough so that she can visit a dentist and an ortho if she wants to, but I don't want her to feel negative about the past and our dental care taking a backseat. She's done her absolute best to raise a happy and healthy family and is an outstanding mom. Maybe we can go to my brace fitting together so she can see how it's done



Alright! So my first ortho consult was 3 days ago, and wow was it surreal! I felt like Homer Simpson in the Land of Chocolate! I think the tune kept playing in my mind while the dental assistant took my photos and x-rays, just felt really exciting lol! Both the assistant and the orthodontist's comments when looking at my teeth for the first time was "this is going to be a very difficult case!" I knew it was going to be, but not for the reasons he mentioned. This is what he briefly discussed with me:

-My deep overbite
-Cross bite on both eyeteeth
-Bone loss in an area on my lowers where one tooth was extracted (I don't remember why), and one beside it never had an adult tooth grow in
-A tooth on the uppers had slowly started dipping into the extraction side below it
-A tooth missing on my uppers that would cause alignment issues; this really concerned him
-An impacted wisdom tooth on the lowers
-A very large root canal on the back tooth infront of the impacted wisdom tooth; this concerned him too
-Very small laterals, with one being a peg lateral
-A gummy smile
-Lots of spacing

He mentioned that I would need jaw surgery if I wanted something done about my gummy smile, but it truly doesn't bother me so I will not be having surgery. He also asked if the large gap where the bone loss occurred bothered me, but it really does not. He said I have the option of getting an implant or a bridge in the future and I agreed.

The bigger issues so far is the missing tooth in my uppers, my peg lateral, and the tooth dipping into the bone loss space. I'm extremely glad that he wants to do everything he can to not have to extract any teeth; I feel like I don't have much to work with as it is! He also said that the deep bite and cross bites will be easy to fix with braces.

After the consultation (photos, x-rays, notes, and discussion took about an hour or so), he said he needed more time to plan a course of action and scheduled another appointment in two weeks. Since I recently moved to the area, he also recommended me a dentist (the same dentist I was going to schedule an appointment with!), and said he'd ask them to give me a call to set a date for cleaning before the next ortho visit. This makes me happy because things area finally starting to roll!

Photos will paint a better picture so I'll post some in a moment! The camera battery died

[catphones]

Some toothy photos:

[dobiegil]

I think is great that you have done so well, and now you are taking care of your teeth and hopefully your mother's. My parents never had the money for orthodontics, but we did have regular check ups. Now that I am older, I can afford ortho, and did it for myself (after the kids were paid for). Keep us posted on your progress.

Congratulations!!!!

[Kurisu]

Oh wow! Your teeth look interesting, to say the least. I'm really looking forward to your journey! It's never too late to improve dental health - please tell your mother that! I'm glad you're doing well in your career thus far, especially since you're still quite young (mid-20s). :]

[Ellabelle]

I look forward to following your journey; congrats on getting the ball rolling!!

[catphones]

Thanks so much for the encouragement and kindness guys ! I'll be sure to update right after my next appointment with my ortho's plans for treatment! Dobiegil, it's great that you're able to provide braces for your kids and yourself! And I'll be sure to tell my mom that, Kurisu! If she does visit a dentist, I also don't want her to be afraid to ask questions and bring up what concerns her the most about her oral health.

Speaking of concerns, I want to make a small list of things to ask my ortho that I didn't think to ask right after the initial consult, but I'm positive he'll discuss them with me regardless:

-Will my problem wisdom tooth shift my other teeth and impact my treatment? Will it need to be removed?

-Is my root-canaled tooth too fragile to work with? (He showed concern on this)

-Will I need an implant to replace that missing tooth during or after braces so my uppers will line up well? (He was concerned about this too, and wanted to prevent pulling a tooth to compensate)

-What brackets do you recommend for my case? (Does this matter? I'm afraid of ceramics on the frontal 6 because of how large they seem, stories of teeth chipping on them, and my crossbite. But the aesthetics of them on a metal wire is growing on me! But I'll go with what he thinks is best either way)

[SunshineRay]

I heard the same exact thing and Im actually missing the same teeth except add one more. I just wanted to go in and get braces but all of these past dental mistakes are severly holding me back.

[catphones]

I feel you, SunshineRay! It's sometimes hard to be patient and relaxed, even though fixing your teeth should be a very positive experience. With cases like ours with so much going on in the mouth, I wish it were as simple as going in and getting them fitted ASAP. It also feels so good to just get everything going, I'm sure time will fly and we'll both get our problems fixed and a brace day set After my brace day I'm planning on getting a silver french manicure or a nice pair of summer flats or sandals, something really cute to counter the mess of metal I'm sure my teeth will be at first. Gotta balance the force!



I had my second consult today! Scroll to the bottom if you want to skip my rambling, it's a bit of a word-bomb!



So I wasn't able to book an appointment with my general dentist beforehand, so that will be next week. When I did call though, I was happy that they received my photos and x-rays from the ortho, so I may not have to pay to take more.

It's also good that I'll meet my dentist next week, because he's cooperating with my orthodontist on the plans. I will have to have my impacted wisdom tooth removed by a dental surgeon. This can be before or after treatment though, and it isn't worrying my ortho much at the moment. What is worrisome is the root canal tooth. It's a very big cavity and will need a cap in the future, and he recommended I see an endodontist to assess it. So a good cleaning, a plan for that wisdom tooth, and a look at that root canal. I might also need a filing for a small cavity on my lateral. I can see that these will take some weeks to get through! Hopefully everything will be ok with those teeth!

Onto the braces: I will not need to have an implant to replace the tooth on my upper arch, nor will I have to pull a tooth to compensate! Phew! The implant is an added surgery and a cost that my ortho and I are glad to be rid of! He said he'll be able to move the teeth forward and into place, and not have anything shift where they're not suppose to, by using a screw instead. It'll be something like in these photos (found via Google):




My tinier lateral will need to be built up, and in the future I will be getting an implant to replace the 2 missing teeth on my lowers. I don't like the idea of shaving the nearby teeth to create a bridge for it, so that option works just fine I may be missing something we talked about, but he'll be sending the dentist and I a copy of the detailed plan for my pre-brace preparations.

We also talked about brackets, wires, and retainers. I will be wearing a fixed retainer after treatment, as well as 2 removable retainers that I have to wear at night. I also have the option of all metal traditional brackets or ceramic on top with metal on the bottom. I will say right now: the traditional brackets are TINY!!!! Really, REALLY small! I don't know if it's just me, but they are much smaller in person than they appear in photos on this site! A couple of the assistants had traditional and ceramic brackets, and both are hardly as bold-looking as people on the forums sometimes make it out to be. I guess it's all relative? We're only posting gigantic pics of our mouths afterall But with everyone saying how big and noticeable the metal is, it really, really isn't.

The ceramics look cool. Up close, they were noticeably chunkier when I compared them to the all-metal (they had plastic models of teeth with the braces fixed on, and I was playing with them a bit lol). I brought this to attention and we talked about the pros and cons of the ceramics (a bit more discomfort, feeling of the size in the mouth, and the lig staining. Ceramics on the bottom are not done there unless your bite isn't deep and you sign a waiver first; if your teeth chip, it's all on you!). We talked about adults in braces, soreness, wax, food, all of that fun stuff And as I suspected, coloured ligs look great on ceramic brackets. Blue and silver especially! I think I'm in love.

Overall they said the brackets didn't matter, and I can wait to decide which I'd prefer up until the day I get braced. I didn't expect to be so torn over this! The metals will be a few hundred dollars cheaper than the ceramic. They'll also be more comfortable and smaller, as my teeth protrude a bit and I'm afraid of getting my lip caught on them a lot. I don't care about the near-invisibility of ceramics, but they look so good with the subtle-coloured ligs and the metal wire. I just don't know which I'd be happier with. SIGH!!!!!! LOL




Ramble Skip: An overview on what needs to be done in order:

DENTIST
-Visit the dentist for an exam and a good cleaning
-Discuss the impacted wisdom tooth and plans for extraction by a surgeon
-Small cavity on one of my laterals
COST: $300 (for exam and cleaning, estimate so far)

ENDODONTIST
-Assessing large root canal filling on my molar and seeing what needs to be done with it now, if anything
COST: ???

ORTHODONTIST
-Braces! Which so far will include:
--A dental screw to help the gap in my uppers, caused by a missing tooth
--Building up my peg lateral to a nicer shape
--Fixed and removable retainers afterwards
COST: $8500, 2.5 year treatment plan

AFTER TREATMENT
-Dental implants to replace two missing teeth in an area with boneloss
COST: ???


I have better photos from the ortho office that I'll post in a moment I wish I had the x-rays too, they were interesting to look at.

[catphones]

Pictures taken at the ortho office. Sorry for the random scratches and paper particles! I need to wipe my scanner You can see the bone loss area more clearly in these ones, as well as the bite and alignment issues.

I also learned a new word today: Malocclusion! lol

[SunshineRay]

Yay, I'm glad you are getting somewhere. Is your root canal on the tooth thats alone past the missing teeth? Thats where mine is. I have heard that implants are like $2000 each. That's why I was leaning more towards a bridge in that area in my case.

[catphones]

My root canal tooth is on the other side I put up a pic with it circled because it's a bit hard to notice at first, how smooth the top of that tooth is. The blue splotch shows the size of the filling. Both roots had been filled too (one only partially?). So yeah, much of that tooth is gone! I will most definitely need a cap fitted over it in the future, and my ortho said the same.

Yeah, implants are very expensive! If I absolutely had to fill my gap before or during braces, I would've opted for a bridge as well. I'm happy I can put it off until after the braces are removed. I think if my root canal were in the same place as yours, I'd choose the bridge for sure

I have a new respect for parents who have or will be providing orthodontics for their children. There's just so much planning involved and shuffling around finances. It's like preparing to jump over a ravine but it suddenly morphs into an ocean before you.



It's the Victoria Day weekend! And right after, I'll have my appointment with the general dentist! My mom wants to go see Iron Man 3 tomorrow (b-but I want to see THIS IS SPAM PLEASE REPORT TO ADMINISTRATOR THIS IS SPAM PLEASE REPORT TO ADMINISTRATOR THIS IS SPAM PLEASE REPORT TO ADMINISTRATOR THIS IS SPAM PLEASE REPORT TO ADMINISTRATOR THIS IS SPAM PLEASE REPORT TO ADMINISTRATOR too!). I'm also going to show her the folder my ortho gave me with my photos and the Welcome letter and general information about orthodontics (but not the expense form. She'll be really bothered by it I think). I want to see her reaction to the goofy smiles in the photos LOL.

I kind of wish I made my general dentist appointment at a time so she could come and check out the office with me. I want ask if she wants to make an appointment for a cleaning and x-rays, but I'm not sure how to approach that without making her feel uncomfortable about my footing the bill... or be scared to sit with the doctor and hygienist. Thinking about it is making me really upset now

[Sheryl 54]

Hi catphones

I'm new to this form and haven't got braces yet but going in for my 8 yes I said 8 spacers all on my upper teeth ( for a palate expander later) on May 30th.
I was very touched by your story about you and your Mom how wonderful of you for doing all this for her and your self. I hope every thing go's as planed for both of you and you have very good progress. And oh by the way I just saw THIS IS SPAM PLEASE REPORT TO ADMINISTRATOR THIS IS SPAM PLEASE REPORT TO ADMINISTRATOR THIS IS SPAM PLEASE REPORT TO ADMINISTRATOR THIS IS SPAM PLEASE REPORT TO ADMINISTRATOR THIS IS SPAM PLEASE REPORT TO ADMINISTRATOR it was good.

[SunshineRay]

when is your next appt and what will they be doing?

[Winkos]

Glad to read your experience. I too am a difficult case.

[catphones]

Thank you, Winkos! And thank you, Sheryl 54! I've managed to convince my mom to go in for a dental checkup I hope everything goes well for you, too! Your 8 spacers go in tomorrow, wow! How long are they staying in for? Hopefully they're not too much of a pain in that time!

Hi Sunshine! My next appointment isn't until July 17th, eek! But it's with a dental surgeon and not my orthodontist or dentist. It's for 2 wisdom tooth extractions A bit more info below on what's happened so far:





My visit with the general dentist was a little while's back, and it went very well. I like the office and the staff is very friendly and knowledgeable. They're less chatty and have a more serious demeanor than the staff at the ortho office, but that doesn't bother me. It might put my mom a bit on edge so I'm thinking of finding a different dental office for her. We'll see.

They already had the x-rays that the ortho emailed them, but they took 2 extra ones of my molars on either side. The dentist took a REALLY long time just examining my teeth, much longer than I ever remember a dentist doing. He had my x-rays up on a computer monitor so I could check them out again, and he also had some sort of program that showed a full set of teeth. As he was examining mine, he'd copy the findings into the program; he deleted teeth that I was missing, he made notes on the bone loss and the gums, it was cool to see the final mock-up

We discussed the rootcanal tooth and there's quite a lot of gum loss in between one side of it. But he thinks that orthodontics might be able to help that too as my teeth shift. The tooth will be fine in braces, hurray! But in the future, it'll most likely be too fragile to leave in the mouth and it'll have to be replaced with an implant or bridge. My large gap will need a bone and gum graft before it can get implants. All of these are a long way's away, so nothing immediate to worry about.

The dentist recommended that I get both of my lower wisdom teeth removed (one is impacted and the other is not), and that's the extent of pre-brace work needed.

After we talked about wisdom teeth and implants a little more, I was sent over to the dental hygienist and she took awhile to measure my gums and scour my teeth clean lol. There was a little bit of discomfort but it didn't linger. We chatted a bit about oral hygiene and whatnot, and she gave me a goodie bag. Pics below the post She also said I should get an electric toothbrush once I'm in braces, but the ortho gives out mega-goodie bags with an electric brush included. Huzzah!

The appointment cost about $100 more than I thought it would! Details on the bill:

Permanent Dentition-Complete Oral $128
Two films-Intraoral $31
Half unit of time-Polishing $18
Four unit of time-Scaling $220
=$397

I needed a very good cleaning, and they kept in mind that I needed it for braces too. Now I have a pretty good indication of what my mom's first visit will be like, but she'll need full x-rays.

The front-desk woman also made an appointment with an oral surgeon for July 17th to get both of my wisdom teeth removed. I hadn't even thought much about the date until days later I realized that I have a meeting and a convention out of town a week and a half after that day! I called the oral surgery clinic yesterday to see if they had any earlier dates available. The woman who answered was a bit rude and confirmed that there were no other dates available, but I could try calling the hospital that the surgeon also performed in. I think I'll just keep my date, but I'm really afraid of swelling and discomfort. I rearranged my schedule so I can relax the week between my wisdom teeth removals and the convention.

July and August are my busy months, and I'm not sure I'll be able to see my ortho again until September. But the awesome news is by then, I'll be fully ready to start treatment! (...I think!) Wisdom teeth gone, no need to see an endodontist about the rootcanal tooth, it'll all be perfect

A couple of days after my dentist visit, I got a letter in the mail from my ortho office detailing my treatment, as well as a copy of another letter sent to my dentist. I think they hoped it would arrive before the visit with the dentist, but that's ok It was a very nice letter welcoming me to the practice again, etc, and that a full comprehensive orthodontic treatment would be best, consisting of upper and lower braces, stuff we already talked about. This is a summary of my teeth that was included in the letter for anyone into the technical:

-Gummy smile (vertical anterior maxillary excess)
-Missing teeth #2.5, 4.5, 4.6 and severe bone loss
-Large restoration at tooth #3.6 that is rooot canal treated
-Mutilated Class I malocclusion
-Supra-eruption on unopposed tooth #1.5
-Anterior crossbite of teeth #1.3 with 4.2; and #2.3 with 3.3/3.4
-Upper midline discrepancy of 2mm to the left and lower 2mm to the right of the facial midline
-Generalized enamel decalcification
-Overbite of 80% and overjet of 4mm
-Small upper lateral incisors with #2.2 a peg-lateral incisor
-Tapered maxillary archform

That list was in the dentist's version of the letter, including some extras:

Treatment Plan:
1.) Dental check up and cleaning
2.) Evaluate restorability and vitality of tooth #3.6
3.) Upper and lower braces, open bite to assist in correcting crossbites
4.) Prepare tooth #2.2 for composite resin restoration
5.) Option for upper left space of implant or ortho miniscrew to close space [we opted for the miniscrew at my last ortho visit]
6.) Dental implants in lower right quadrant
7.) Finish and detail
8.) Upper and lower fixed and removable retainers

Phew! And that's it! Maybe too detailed but I hope it's interesting to someone with a steady trickle of planning like mine. Nothing more to report until after July 17th Perhaps closer to my extraction date I'll get in contact with the ortho office to see what we can do in September.