Advice needed!! Please help me out!

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#1 Post by **mara0167** » Mon Feb 22, 2010 4:16 pm

Hey everyone-

I have been perusing this board since I first started thinking about looking into treatment in November. Since then, I have had 5 consultations with orthodontists (i know that's a lot... but i'm kind of nervous about going through with this, especially in college). However, I've gotten a different option from each consultation and I don't know what to go with. I had my last consultation on Friday and am now trying to decide what to do. Some advice would be great, especially since the options are different.

Ortho 1 (liked her a lot):
Hereditary bad bite and some crowding. Specifically, he called it a Class II Division 2 (my upper front teeth slant inward and the upper and lower front teeth overlap too much). My bite according to the ortho is "off." Braces (metal or ceramic), bite turbos and elastics for 18-24 months.

Ortho 2 (thought he was very knowledgeable and seemed in control):
90% deepbite and lower crowding. Fixed appliances (he advocated for metal) in both arches... starting with the upper first to open my bite, and then placement of appliances on the lower. Treatment lasting 2 years.

Ortho 3 (liked him, although not as much as the first two):
Deep vertical overbite. Upper and lower front teeth are supra-erupted and I show an excessive amount of upper gums when I smile. Braces for 11-16 months (shorter!) and forcus (sp.?) springs.

Ortho 4 (liked her as well):
Deep bite, retroinclined upper incisors, and lower crowding. Invisalign or clear braces for 12-18 months.

Ortho 5 (he was definitely one of my favorites):
Deep bite, some overjet, and narrow dental arches. Upper expander, elastics, and metal braces for 2 years. May potentially want to use headgear or a bite-jumping appliance. Has not been successful at correcting my problem with Invisalign.

So... I don't know which one to go with. Money is not a factor, and I really liked all of the orthos and their offices. Personally, I want to go with the one who offers Invisalign, although all of the other orthos said they didn't have success treating Class II bites/deep bites with Invisalign.

Most importantly, if I'm going to go through with this, I want a PERFECT smile in the end. I'm attaching some pictures. I REALLY NEED ADVICE! What do you guys think?

http://img509.imageshack.us/img509/2774 ... at2033.jpg

http://img69.imageshack.us/img69/3900/p ... at2034.jpg

http://img23.imageshack.us/img23/3276/p ... at2035.jpg

http://img69.imageshack.us/img69/8158/p ... at2101.jpg

http://img134.imageshack.us/img134/9286 ... at2105.jpg

Thanks,
Mara

#2 Post by **fosterp** » Mon Feb 22, 2010 4:32 pm

It seems like a different opinion but actually reading that they all sort of agreed on problems that need correcting - overbite, incisor flaring, and crowding. They all just have different tools that will essentially do the same thing.

For example...bite turbos and the upper appliances to open bite essentially do the same thing by making it so your posterior teeth erupt to close your overbite.

The way each doc describes the overbite uses some different terminology like supra erupted or showing too much gum, etc, but all sort of refer to the same thing just in different terms.

Also they all seem to agree that crowding needs correcting by expanding the jaws a little bit. Since adult expansion is really difficult and will only achieve a couple mm or so, the way to go about the expansion will all sort of do the same thing, tipping the teeth outwards.

I probably wouldn't go with the guy that has the treatment plan that deviates from all the other plans since he may just be trying to be overly optimistic to get the business. Invisalign has come a long way in the past years to do some pretty crazy things but if four out of five don't think you are a candidate I would probably stick with the traditional reliable system. Also the fact that he thinks he can do it so much faster than anyone else - sounds great on paper but if you want the perfect smile I think that is something that will take time, and all the others think you need more time.

In all honesty the kind of differences in opinion that would call for really going with one or the other would be when one OD advocates jaw surgery, or one wants to do extractions. But for the most part all your evals sort of call for the same treatment, just the tools being used is each doctors personal preference.

I would say maybe try to research reviews on each doctor, and maybe personal recommendations from friends, and then choose the one that you are most confident in.

#3 Post by **fosterp** » Mon Feb 22, 2010 4:34 pm

I guess I'll add that if you have narrow arches, upper arch expansion really gives the kind of wide smile that everyone seems to like. But your teeth do look pretty good already as far as width is concerned.

#4 Post by **evilnel** » Mon Feb 22, 2010 5:41 pm

I agree with the above poster that it sounds like the invisalign person is the black sheep. Everybody else is offering essentially the same things in different words (or so it seems).

If it's any help, I have a similar problem to you--retroclined teeth, deep overbite, but also some spacing, and I am going with your 'option 1'--ceramic on top, metal on bottom, bite turbos. It seems to be working pretty well, though my teeth are still pretty tipped (they were very far back to begin with, and closing gaps seems to slow it down). Personally, with the exception of the invisalign ortho, I'd go with the one you're most comfortable with.

#5 Post by **mara0167** » Mon Feb 22, 2010 7:52 pm

I know that 4 of the 5 options are relatively similar but does anyone have any advice as to what appliances are best... bite turbos vs. forcus springs vs. expander? Each ortho suggested a different appliance

#6 Post by **fosterp** » Tue Feb 23, 2010 1:59 am

I don't know if its common but in my ortho consultations they didn't exactly go into great detail of exactly what appliances would be used to correct my situation unless I asked for specifics. Namely the ortho I am going with pointed out my problems and how the teeth would be positioned in their final result.

It wasn't until my follow up consultation when I knew more and started asking questions that he talked about how he was going to expand my arch and that I would wear bite turbos and elastics to correct my crossbite.

So its possible when one ortho didn't mention specific appliances compared to the others he may have just been omitting that information, not trying to overwhelm the patient.

Appliances are not necessarily better or worse than others, they all sort of do something different. Bite turbos correct overbites by limiting occlusion so that your back teeth erupt further.

http://www.youtube.com/watch?v=HGb8W0zPdEc

Bite jumpers I am not too familiar with but a quick google search tells me that they are used in younger patients to promote mandible growth and restrict maxillary growth, and using them in adults sort of "pushes" the mandible forward while pushing the top molars backwards.

Expanders increase the width of your arch mostly in the premolar region so that there is room to fix crowding, and wider smiles generally look nice too!

#7 Post by **blindboarder2008** » Tue Feb 23, 2010 5:21 am

another thing to point out is if your self concious ceramics on top would be good cause they'd be harder to see and having the metals on the bottom you don't see them as much. The only thing you really have to watch out with ceramics is staning but that can be dealt with quite eaily.

I agree with what everyone has said above. Invisalign isn't for every one and if the orthos are suggesting that they haven't been sucessful that probably a good way of them saying its not right for you because of your bite. In any case you need to decide which ortho you are most comfortable with. ASk question like "are they open to me asking questions?, do they seem to b knowledgable and reassure you with any concerns, etc.

best of luck who ever you choose!

#8 Post by **mara0167** » Tue Feb 23, 2010 9:05 am

do any of the docs have any thoughts, especially based on my pictures?

#9 Post by **drrick** » Tue Feb 23, 2010 9:17 am

If you just want your teeth straight and are not as concerned with getting your bite perfect than go for teh invisalign. Otherwise fixed braces are probably best. Your bite does not appear to be off by that much (from teh limited info here) ANy of the options are good -- they will all work.

#10 Post by **evilnel** » Tue Feb 23, 2010 4:27 pm

I have bite turbos and have found them to be pretty tolerable. I can't really speak to the others, though. It's kind of like having a firm piece of plastic stuck to your teeth that keeps you from crashing your top teeth into the bottoms.

#11 Post by **mara0167** » Wed Feb 24, 2010 10:33 am

Thanks for the advice guys. I have decided to suck it up and go with Ortho 5. I have my records appointment on Friday. Does anyone know what happens at this appointment? Is it painful?

#12 Post by **Steph in Sac** » Wed Feb 24, 2010 10:43 am

No, not painful. My ortho took various x-rays with fancy equipment, regular photographs, and impressions. Impressions are definitely not my favorite, but they are super quick these days.

#13 Post by **pearls** » Wed Feb 24, 2010 9:31 pm

As far as choosing an ortho, I can't really give too much advice. The orthos who have offered you a shorter treatment time might have adjustments more frequently than the others. The only advice I would give is probably don't go to the ortho wanting to use an expander. It's just a bit odd how only 1 out of 5 orthos suggested an expander. I would also highly recommend traditional braces over invisalign. Their results are just no way near as good as braces.

If you want to get an idea of what your teeth might look like after treatment, click on my www for my story with pictures. I also had a very deep bite (although my teeth were much more crooked than yours to begin with)

Good luck!