Lingual Braces

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#1 Post by **lilypily** » Wed Dec 15, 2004 7:55 pm

Anyone out there have lingual braces. I have my appt. for next week to get them and I'm just wondering what it's like to have those and if it really takes longer to adjust than the regualr metal ones.

#2 Post by **drrick** » Thu Dec 16, 2004 9:15 am

i place a lot of lingual braces.

THe adjustment period is about the same as regular braces -- perhaps a bit longer.

Your tongue will get sore, but this is analogus to your lips and cheecks getting sore with traditional braces.

Your speech will be efeected. I rec that you go home and read out loud to practice your speech. This way you will adapt more quickly.

If you have a conscientious doc he/she will place numerous "comfort aids" to ease your fist month. You will also be given wax to help you adapt as well.

Good Luck!!!

#3 Post by **lilypily** » Thu Dec 16, 2004 3:30 pm

Are lingual braces not that common? I did not find many orthos that place lingual braces. Anyone know why that is? Also, are they generaly more expensive? My ortho told me that usually people get top linguals and clears on the bottom so he recommended I do the same rather than get both top and bottom linguals.

#4 Post by **Guest** » Thu Dec 16, 2004 4:06 pm

Here goes,

Lingual braces seem to be a highly controversial topic of discussion among orthos. If you search around the net a little bit, you'll find many orthodontists bad mouthing them as being too hard to work with and not as effective. Other complaints are that they are slow and irritate the tongue, thereby affecting speech, too much. That said, I have lingual braces. I have seen a TON of movement in the (almost) 3 months that I have had them. My ortho is supposed to be one of the most experienced, when it comes to linguals, in Florida and so he seems like he works with them just as easily as w/ conventional braces. His assistants are great with them too. I will admit though, I do tilt my head back a little extra on the chair, but I do that w/o being asked, I just think it might make it a little easier for them. The tongue irritation was minimal for me but many people get it pretty bad. Sores on the tongue can develop. I have only had 1 in these 3 months though and my lower ceramics have given my lips much more hell than the linguals have my tongue. So as you can see, I, at least in my own case, believe most of those complaints aren't valid. The one that definetely is, though, is the speech problems. It took me almost two weeks to speak somewhat normally. After that, I had a lisp. Pretty much on any S sounds but it was HORRIBLE on ST sounds. I real out loud and sang to all my songs just to even get there. I also did not use any wax, as when I first got it, it was the only way to make somewhat of an S sound (I used a ton and created a smooth surface over the back of my teeth and the braces). I knew this would be too troublesome and on top of that knew that if I continued to use it, my tongue would take way too long to become accustomed to the braces. So I used wax for all of 1 day. The only time I've ever used it again was because of my ceramics and only when they caused a canker sore to appear and wouldn't let it heal. At the one month mark, I still had a lisp but not nearly as noticeable as before... My S sounds had improved dramatically and ST was the only thing that still really bugged me. At this point you learn to avoid certain words when speaking to impress (this has helped me in that now I am forced to think before I speak

). Now, just yesterday in fact, I suddenly got a lot better. My S is not a problem at all, and my ST is almost perfect. I think I'm the only one that can detect the problem... and this is all after 3 months. I will say though, even though I had this lisp for a while, if I strayed from ST sounds with other people, no one would detect any problem, everything else was perfect, and when I did hit an ST, not all would notice, and after about a month and a half, barely anyone at all. So I feel like I have finally adapted now, once again, at the 3 month mark. Although, I've not been able to whistle since I got them on. As for how common they are, they're not. Most people I know have never heard of them and most orthos don't use them. It seems that they first came up in the last decade or 15 years, and after a lot of orthos had trouble working with them, they died out a bit. The ones that stuck with it though, seem to be most of the ones still using them today, and with much success since they are the most used to them. As for expense, yes, expect to pay a good bit much more. I don't have my paper work with me right now, but it was a lot. I'm paying over 7 for the lingual/ceramics combo (though insurance handles some of that). The reason for the ceramics on the bottom is a 3 parter:
1. Ceramics are cheaper than linguals and since the bottom teeth are typically less visible, people don't typically have a problem with this. This is the same reason that it is common for ceramic tops and metal bottoms. People tend to cheap it out a little on their bottoms.
2. If you had them on top and bottom, your tongue would have a hard time finding rest. I will say for myself, I feel like my tongue has no trouble relaxing, but do notice, it's because it rests on the lower half a lot (so I suspect braces there might be a pain). It would just be extra tongue trauma, y'know? *In fact, I just remembered this, some people show the inside of their bottoms more than the outside, and so the entire purpose would be defeated.
3. The bottom teeth are a bit smaller than the top set and since the linguals aren't too small, my ortho says that combo (being inside and being on small teeth) are a bit of an annoyance.

I didn't even consider linguals on both since all these reasons made a lot of sense to me (especially the $$$ saved). Because of this, I don't even remember if my ortho would have let me do it anyway... My guess is he would have though, if I really, really wanted that.

If you're worried about visibility with the ceramics, I will admit they are the only thing anyone has ever noticed about my braces. Not one person has ever noticed my linguals. BUT, when they do notice the ceramics, it's not the braces, it's the wire. They all think I have a retainer in (as that's what a hawley looks like when you're wearing it, a wire across your teeth). I don't know if this option is available to you, but there are white wires floating around out there. I've heard pretty bad things in general about these, the white coating comes off a lot and the wire can break a little easier. Someone on here though, did say that their ortho is using a new white wire that is supposed to not have those problems and if it keeps up that way, they'll post what brand it is on here. Just something to keep in mind. Good luck and I have no problem answering any other questions you may have (I know how tough it is to find lingual information).

-Filup

#5 Post by **lilypily** » Thu Dec 16, 2004 4:32 pm

Wow! Thanks alot for the info. You've been very helpful. I had a hard time finding anyone wearing linguals. My ortho told me that he only puts linguals on top because it's easier on your tongue, which I guess makes sense. Your tongues already going through enough trauma, no need to expose it to more. How did you find yourself adjusting to eating? It seems to me like food would get stuck on your braces. I guess you brush everytime you eat? What about adjustments? Do they take longer at the orthos office than if you'd have regulars? Also, what about treatment time? How long are you in for?

#6 Post by **Guest** » Thu Dec 16, 2004 4:55 pm

lilypily wrote:How did you find yourself adjusting to eating? It seems to me like food would get stuck on your braces. I guess you brush everytime you eat? What about adjustments? Do they take longer at the orthos office than if you'd have regulars? Also, what about treatment time? How long are you in for?

At first I thought I wouldn't be able to eat anything at all, since the NoNo list felt like it was actually a cooking encyclopedia. I quickly found though that I can eat almost everything I ate before. The only things I don't are nuts really... They seem just way too hard. The key is to be careful and pay close attention. I had a lingual bracket pop off while eating chocolate chip ice cream because the chips were massing (ew) under the wire and put too much pressure on it. I've had popcorn once, but that just didn't feel right so I don't know if i'll do that again. I've even had gum, twice, but just been extremely careful and kept it really small in there. You should at least swish around after each meal and try to get in around 3 brushing periods a day. I'm a college student and have trouble eating on a schedule, let alone clean after, so I'll admit, I tend to only do mornings and nights, but I swish a lot in between. Also, when I get to it, I give it a good go, using different brush heads for the braces, my teeth, and my gums, and a water irrigator (which I highly recommend... they are great for the linguals as you don't always know something is there and it'll shoot it right out). That little dental mirror is great too. I've only had one adjustment so far, you can ask again after the 21st (my 2nd adjustment). But as far as I can tell, it was a pretty quick thing. It was mostly dealing with my ceramics though. For the linguals, one of the ligatures was replaced with steal ties and that popped bracket was replaced, but it was all pretty quick. Out of there in about 20 minutes. I'm in for 21 more months, of a 24 month total. I answered this question and a little more under your other post in the other "lingual braces" topic.

And the help is no problem... we gotta stick together... we being the superficial, non-confident, low self-esteemed, weenies w/ linguals. (JK!)

-Filup

#7 Post by **Dr. Randall** » Thu Dec 16, 2004 5:04 pm

lilypily wrote:Are lingual braces not that common? I did not find many orthos that place lingual braces. Anyone know why that is? Also, are they generaly more expensive? My ortho told me that usually people get top linguals and clears on the bottom so he recommended I do the same rather than get both top and bottom linguals.

One reason that lingual braces are less commonamong orthodontists is that they are more difficult to work with (which also makes them more expensive). There are some limitations to what an orthodontist can do with them without adding something to the front of the teeth. I am not trying to "bad mouth" them but I was very interested in learning about them when I was in my residency. I went to Chicago to observe an orthodontist that did a very large percentage of his practice as lingual and saw the limitation (and he explained many to me as well). From the mechanics of moving teeth, the lingual braces are not in as good a position as one could place conventional braces, and the varying thicknesses of teeth from the lingual also create some issues. The bottom line is that they still move teeth, though it may be a bit longer. My preference, not that it matters, is conventional braces.

Randall

#8 Post by **drrick** » Fri Dec 17, 2004 9:24 am

not a lot of docs use lingual.

When lingual first came out there werent much by way of clear braces.
Also, any new procedure there is a learning curve. In the beginning they didnt know how to compensate for varying anatomy on the back of the teeth. Now they do. We also have much better bonding systems now than ever before which is a big help.

The lab procedures for lingual are now astronomically better than ever before.

Sure there are some limitations with lingual -- there are with traditional braces as well. There are many more limitations with invisalign than lingual.

I do a fair number of lingual cases and dont find them much harder than traditional braces. Uppers are fairly simple, lowers are more difficult. I do enjoy the challenge though and the pts are very pleased having an invisible altenative.