Regrets about treatment...

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BeeBee80
Posts: 2
Joined: Mon Jun 24, 2013 2:04 pm

Regrets about treatment...

#1 Post by BeeBee80 »

I’m wondering if anyone on this site has had experience of having an impacted canine tooth pulled down. I have recently had a brace fitted to try to address this and am really starting to regret it. I am not confident about what I am being told by the orthodontist as he keeps changing his mind. However, now the brace is fitted I am not sure what my options are and what damage could be caused if I stop the treatment.

I am in my early thirties and had one canine milk tooth (right upper) that never came out. I have health problems that may have been a contributory factor to this. This did not cause me any problems until last year, when it started to become loose after the dentist poked and prodded it. He took an X-Ray and told me the adult tooth was in a good position and could be pulled down. He said that this would be a better option than having a bridge or implant. He told me to have the treatment done when I had six quiet months in my life.

Following this advice I went back to the dentist in February 2013 shortly after a major inspection at work. This now meant that I had six quiet months. What followed was delay after delay, first the dentist was on holiday, then I had to wait a nearly two months to actually see the orthodontist, then I had to wait a week for some questions I had to be answered, then I had to wait another month for another appointment etc, etc. Eventually the brace was fitted at the end of June, five months after my six month quiet period had begun. (September to December is the busiest time of year at my work).

My milk tooth has been removed and I now have to wait three weeks before I can see the orthodontist again to get something fitted to cover the gap. He has said that he wants to wait six months to see if the tooth will move on it’s own, even though my regular dentist said it wouldn’t move without help. After six months I would then have to go to have the tooth exposed if it is not moving. This means that the treatment would be significantly longer than I was led to believe and the orthodontist will now not commit to a timescale.

At the initial appointment the orthodontist was quite upbeat and made it all sound quite easy. After I had signed up for the treatment he then revealed that he wanted to remove another healthy tooth and also put braces on my lower teeth to fix a crossbite at the back. I was not happy about this as I had only gone to see him about the canine tooth and I have refused to have anything on my lower jaw. The main reason I decided against having a bridge was to protect the neighbouring teeth from damage but the orthodontist is now pushing for me to have the premolar removed completely. This would leave a huge gap that would need to be closed and could also cause my wisdom tooth to move (it has never erupted). The reason he gives for this is that he is not sure whether or not there is enough room for the canine tooth to come down and that he would have to spend more time manoeuvring the tooth into a smaller gap. I am upset that I wasn’t told this at the initial consultation as I would have asked for more information about the implant route if I had known. What he is proposing feels far too drastic and invasive for me. The main reason I initially decided against an implant was because I have an underlying health problem that could complicate the extraction of the adult canine tooth from my gum, so I was trying to go for an option that would have less risks for my health. The extraction of the milk tooth wasn’t too bad as it was already loose but the extraction of an adult tooth could cause me a lot more problems.

At the initial consultation the orthodontist said that he could pull the tooth into place within a couple of months once exposed but apparently this was only if he took out the premolar, something that he never explained at the time. After the initial consultation I emailed some questions to the dentist for clarification, as I understood that only the teeth either side of the canine tooth would need to be moved. An email came back explaining that the neighbouring teeth would need to be moved to make room, no mention of removal or of the need to do anything to any other teeth. As a result of this I went into this treatment expecting it to last around 8 or 9 months. It now seems highly unlikely that this is the case.

The orthodontist also keeps making worrying little comments such as ‘don’t worry about the wire being bent, once we start moving it’ll straighten out’ – this is in relation to the wire attached to my left canine, but I as far as I am concerned this tooth is in the brace to support the other teeth only and I have not given permission for it to be moved. The rest of my teeth are fine to me – they may not be perfect by an orthodontist’s standards, but I would never in a million years have had a brace for any other reason than this impacted tooth. In fact, I am worried about the damage this could cause to my other teeth, as I have a friend who ended up with badly chipped teeth as a result of having a brace.

I feel very lost about what to do really. I just don’t trust what I am being told and I don’t know what to do for the best. Now the milk tooth has been removed I can’t just have the brace taken out or the gap will start to close and cause problems if the adult canine tooth does start to move down. My life is on hold really until this is sorted out, both due to cost and the practicalities of going to the appointments etc. I have recently had to miss out on the chance of applying for a promotion at work as they would not have been happy about the time I have had to take off to go to the orthodontists (it is a four hour round trip away from where I live so I have been having to use my annual leave). I am also stuck living at my parent’s house and have had to use a huge chunk of my house deposit savings towards this treatment. Now I have spent this money I would not be able to afford an implant as well.

I don’t know if anyone else has had an experience like this. I’ve had a look at some of the other posts and everyone seems so upbeat. I know this is probably because most people do this by choice rather than feeling that they have been backed into a corner. I just feel so upset about it all at the moment but don’t know where to go to for advice.

jem
Posts: 926
Joined: Wed Aug 20, 2008 10:05 am
Location: UK

Re: Regrets about treatment...

#2 Post by jem »

Hi BeeBee,

There are a number of people on this site who have dealt with impacted canines successfully and if you search you will find a long-standing thread entitled "impacted canines club". Not having this issue, I have not really looked at the thread, but I am sure you will find a lot of helpful info.

I can't imagine pulling down an impacted canine would ever be a speedy process.Orthodontic treatment for most people seems to be 18 months plus and I would imagine that would be likely in the case of an impacted canine. And once you are making changes for one tooth, that may well impact on other teeth in the same arch and possibly also on the opposing arch, so you should expect other teeth to be moved around by your brace until the arch as a whole is sorted out. A bit like a rubik's cube perhaps.

I think I would also be uneasy about having a healthy premolar extracted, especially when that was not previously discussed. Is the ortho planning to extract the premolar on the other side too? If not, would the resulting asymmetry not cause problems?

I can understand why you have reservations about your orthodontist.And given the importance of your treatment and the amount of time and money you will be spending in his care, it is essential that you have confidence in him. This may just be a question of poor communication ( remember orthos spend much of their time around teenagers ) But perhaps it would be a good idea to get a second opinion even if that means you have to travel some way and pay a fee (? around £100 if you are in the UK).

Good luck with whatever you decide. Orthodontic treatment can be a bit of a rollercoaster, but in the end, very few people regret doing it. My apparently simple case is taking twice as long as expected, but I am getting towards the end and am glad I did it.

Jem
Sectional brace with Damon clear brackets fitted to front 6 upper teeth 3 January 2012
Brackets added to premolars 2 April 2012
Estimated treatment time originally 6-9 months
. Brace removed on 22 July 2013 after 18 months and 19 days
Now enjoying bonded upper retainer plus part time essix/hawley( I have both)

Click here for my story http://www.archwired.com/phpbb2/viewtop ... =9&t=42194

BeeBee80
Posts: 2
Joined: Mon Jun 24, 2013 2:04 pm

Re: Regrets about treatment...

#3 Post by BeeBee80 »

Hi Jem

Thank you for your reply and for taking the time to read my very long post! There are some very scary stories on that thread and they all suggest that the treatment time would be much longer than my orthodontist led me to believe.

I have already had the brace fitted so I don't know if I can go elsewhere now and I don't have the money to keep going for different consultations. The news about possibly having to remove the premolar was given to me about five minutes before the brace was fitted so I had no time to think about it or do any research. There was no mention of doing any work on the other side and I would never have agreed to it if it had been suggested. I am now really worried about what to do if the Orthodontist pushes for this as I don't know what the effects would be if I asked for the brace to be removed at this stage. There is a gap now where the milk tooth has been removed so I can't just leave it or the teeth either side may close it over the impacted tooth.

I just feel as though I have been tricked into something far more invasive and protracted than I want. If I had known that he was planning to move so many teeth I would not have agreed to this, I was under the impression that he was aligning the teeth either side of the gap and attempting to pull the adult canine tooth - that's all. I really, really wish that I had not gone ahead with this but it feels like it's too late to do anything about it. I really don't know what my options are and don't feel that the orthodontist explains things well. I have told him quite clearly about what my expectations were and he never raised any issues at the time. (The orthodontist practice is owned by the same people as my regular dentist so I can't really go there for advice either).

User avatar
sablequeenie
Posts: 32
Joined: Tue Mar 19, 2013 8:35 am

Re: Regrets about treatment...

#4 Post by sablequeenie »

Hey there BeeBee80,

Sorry that your impacted canine treatment's not going as planned. I too had an impacted canine, and was very concerned about treatment time/effectiveness before I got braces. I'm surprised your orthodontist only predicted several months for overrall treatment time, even if you did only intend to get your upper's braced. The minimum amount of time I've heard when bracing impacted canines is a year, and that's bare minimum, depending on when you're braced and when the canine is exposed. Do you plan on having your exposure surgery at an oral surgeon's any time soon? It sounds like you'll have more than enough space for the tooth to grow in now, especially since your ortho is talking about removing a premolar.

I'd feel uneasy about that extraction too, especially since a lot of orthos like to keep the premolar there just in case the impacted canine is ankylosed (fused to the palate) and they need to move the premolar into the canine gap as an alternative. I'd ask about that option before agreeing to pulling that tooth, especially since if your canine is fused, not having a premolar would mean a bridge/implant and my ortho told me that it's always, always best to try to work with the teeth you've got, no matter how difficult/time-consuming it may be. I know it's tempting to think that a bridge/implant are a quick fix, but my ortho and general dentist told me that the risk with those is that the canine tooth is very tricky to do that for, because of how and where they are positioned in the mouth, especially when it comes to bite, which is why I think your ortho wants to fix your crossbite with lower braces. If your canine does come in using braces, your upper teeth's position will be drastically different from the lower teeth which could cause complications in your bite later on such as teeth grinding in your sleep, which could wear down the enamel. The better your teeth are lined up, the healthier it will be in the long-run for their upkeep.

I know what you're going through must be rough. Speaking for myself, I guess I was just one of the lucky ones with an impacted canine; I had my exposure surgery in December, and now my tooth has almost fully grown in. I just have to have it turned a little in the next few months. However, I'm still only a little under halfway through my total estimated treatment time; my ortho gave me about 24 months and I'm at about 9 so far. That just goes to show that with braces, getting the impacted canine to grow in is really only half the work; it's about perfecting your entire smile too and that's just a process that takes time. It sucks as a 23 year old to have to deal with, but I just comforting myself with the knowledge that one day it'll all have been worth it because I've taken the necessary steps to fix this, one way or another.

Hope your situation gets better, let me know if you need to talk or have any more questions about impacted canine treatment!
Image

jem
Posts: 926
Joined: Wed Aug 20, 2008 10:05 am
Location: UK

Re: Regrets about treatment...

#5 Post by jem »

Hi Bee Bee,

Great advice from Sablequeenie.

Your ortho cannot force you to have the premolar extracted and I agree you should hang on to it if at all possible and not get it removed unless a second opinion also says it is the only way to go.

Would your ortho not be able to create some more space by using a coil spring? Have a look at the braces blog on here for psily who has had had a decent gap created by coil springs to allow a lateral incisor into the arch which is currently blocked behind it.

I think that once you have embarked on orthodontic treatment it would be a huge shame and waste of money not to see it through even if it takes longer much than you expected. The time does go by quickly and at your age you have most of your life ahead of you to enjoy the results.

It should have been explained to you that treatment with a fixed brace will not just impact on a couple of teeth which might concern you, but on the whole of the arch.

You should also be prepared to get your bottom teeth braced if that is necessary to give you a good bite.That was a possible issue for me, but happily we are managing to complete the treatment of my upper arch only with the fit with the unbraced bottom arch actually now being much better.

All the best

Jem
Sectional brace with Damon clear brackets fitted to front 6 upper teeth 3 January 2012
Brackets added to premolars 2 April 2012
Estimated treatment time originally 6-9 months
. Brace removed on 22 July 2013 after 18 months and 19 days
Now enjoying bonded upper retainer plus part time essix/hawley( I have both)

Click here for my story http://www.archwired.com/phpbb2/viewtop ... =9&t=42194

jem
Posts: 926
Joined: Wed Aug 20, 2008 10:05 am
Location: UK

Re: Regrets about treatment...

#6 Post by jem »

Hi BeeBee,

Sorry, the blog that I should have pointed you to was quentin, not psily.

Jem
Sectional brace with Damon clear brackets fitted to front 6 upper teeth 3 January 2012
Brackets added to premolars 2 April 2012
Estimated treatment time originally 6-9 months
. Brace removed on 22 July 2013 after 18 months and 19 days
Now enjoying bonded upper retainer plus part time essix/hawley( I have both)

Click here for my story http://www.archwired.com/phpbb2/viewtop ... =9&t=42194

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