Feeling discouraged :-(

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Feeling discouraged :-(

#1 Post by sara2280 »

Had my ortho appointment today. He cut my wires so that I only have them in from second premolars on the top and bottom. He said he wanted to take the molars out of play. Then he said at my next appointment they will cut it back one more. I was very confused by this. He said my smile looked great but I said my bite is still open on the sides. My ortho then says, "It will probably always be a little open. I am starting to question why I even did all this. Was it a waste? I got braces because my regular dentist recommended that I fix my bite due to excessive wear on my back teeth. If he thinks my bite will always be open then why did he say he could close it back when I did my consult?? I feel like I am wasting my money. Sorry for my rant.

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Re: Feeling discouraged :-(

#2 Post by djspeece »

I suspect the answer lies somewhere around the sentence "It will probably always be a little open." This may imply that it will be 99% fixed, or at least to the point where there is little functional impact. I'd be annoyed as well, at the very least. It might be helpful to look at your baseline to more accurately assess progress, or the lack thereof. I hope this is resolved to your complete satisfaction in any event.

Pain is inevitable. Suffering is optional. -- Buddist saying

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Re: Feeling discouraged :-(

#3 Post by sirwired »

I guess the big question is: Is it less open? Any stable result is an improvement.

An anterior open bite is always difficult to close, even with surgery.

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Re: Feeling discouraged :-(

#4 Post by sara2280 »

Thanks guys for the replies! I emailed my ortho yesterday to get some more clarification as to what this all means and what the over all goal is. My bite is way improved! It's just not completely closed. From the front things look closed but on my sides you can tell it's still open. My dentist even commented on this at my last check up in May.

When I had my 1st and follow up consult my ortho stressed how a proper bite should line up and even showed me how his teeth line up properly. He said that with a proper bite it distributes bite pressure across all of the teeth, where I was only primarily having all bite pressure on my molars causing the wear. He also said My molars on my right side were in cross bite. The cross bite remains on the right. If my bite can't be closed completely, I wish he would've been more forth coming with that at the follow up consult, at least. I am just catching wind of all this now. I just want to make sure in the end my bite lines up right so I can stop wearing my molars down. He also said I have a tongue thrust habit and my tongue is what keeps popping my bite open. Other than wearing vertical elastics since day 1, nothing else had been done.

I think my real fear at this point is getting to debanding and retention. I don't want to get to that point and do the "woulda, coulda, shoulda". Or have everything shift because of my tongue. I would rather deal with everything while in the active phase of treatment. Is this wrong?

I'm just a girl who wants to keep her teeth and her dental bills down throughout my life.

Thank you for hearing me out. Feel like this is the only place I can talk about this stuff.

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Re: Feeling discouraged :-(

#5 Post by TMJJill »

I finished my braces treatment last fall. I learned a lot with some similar bite issues that were being addressed.

I was a nighttime bruxer (grinder). My back molars were worn down pretty far. As part of my braces treatment, I wore elastics to 'erupt' the molars taller. In my case, I wore fairly strong 'V' elastic configurations on the molars at night through most of my treatment. (teeth hurt every morning) A couple of my molars erupted nicely, but the others just wouldn't come up quite enough. They were close though. My dentist ended up putting a composite on top of those teeth to give me that last bit of height so my bite was complete. He was very up front during my records visit. I was given several options on how to help me re-establish my bite and I chose braces as a more 'natural' option. I was offered caps on all the teeth as another option. Overall, I was happy with the braces choice and had no problem with a bit of composite to finish my bite, I would have gone with the caps if I'd needed to though. Ironically, I ended up with Essix retainers that left my molars free to 'settle'. It has been almost a year and my bite has maintained the same as when the braces came off.

I agree with your discouragement. If your teeth won't come up to the height you need them, I'd discuss the options with your Orthodontist. How far open is your bite? Is there any chance of getting those teeth to erupt? Would a composite build up work for you? Would caps be an option? What are the long-term issues you will have if the bite isn't fully established? Some with bites that are off end up with TMJD issues. I'd hate for that to be something that you have to deal with later.

Just something to think about.

Good luck.

Braces as Phase II treatment for TMJD.
Lower mandibular repositioning splint 26 months.
Lower braces on 10.75 months into Phase II treatment.
Duration in braces: 2 years, 2 weeks, 5 days
Removal of Braces: September 18, 2013

TMJD treatment now complete!

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Re: Feeling discouraged :-(

#6 Post by sara2280 »

Thank you so much for all the info!! As for how far my bite is open I'm not exactly sure. I am more open in my right than my left. The left side is almost completely closed. The right was more open to start. When my dentist made the initial referral to an orthodontist she said that over time if I continued to wear my molars down, my whole bite would eventually collapse, causing my jaw to shift forward giving me an underbite due to the lack of support from the molars. Another possibility is teeth breaking over time that would need repaired, root canals, etc. It was all things that I haven't experienced yet and didn't want to. My parents have lots of dental issues (dentures, bridges, wearing teeth down to expose the roots, etc.) These are all things that are crazy expensive to deal with and made paying for braces seem like a smart investment.

I was never given the option of composite or caps. That is interesting though and will have to explore that more. It is my hope to get full closure going my original orthodontic route. There are times that I feel like my ortho is not being aggressive enough with my treatment. I have read an researched all different ways that other people and orthos have gotten open bites to close and maintained them. Sometimes this was with different elastic configurations. From what I read a majority of the time, open bites caused by a tongue thrust habit need to have the tongue trust fixed/retrained before the bite can be truly fixed. My ortho is hoping just the vertical elastics would help with this and then when I am done with the active phase he will give me a special retainer to wear only at night that has a tongue crib built in. My fear in this is that things will start to relapse due to the tongue thrust and just a crib at night is not going to be enough. I would have rather dealt with the tongue thrust now buy my several times of bringing it up to my ortho has fallen on deaf ears.

I emailed my ortho 2 days ago so I will be patient and wait and see what he says. I have an appointment again September 22nd.

Thank you again!!!

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