Metal Mouth Message Board

Hi all,

So I never thought I'd come to thinking about orthodontic treatment, let alone joining this particular online community.

I'm 23 years old, and I have an underbite (Class 3 malocclusion) with some crowding that's caused one top tooth to be recessed and one bottom tooth to protrude slightly. I hadn't been too concerned about appearance until I was eventually referred to a periodontist who told me I had a 100% bacteria level in my gums. From this point I was very aware of a bit of gum recession and would be concerned about the appearance of my teeth.

The visit to the perio was a year ago, and since then I've improved my hygiene dramatically. But it got me thinking, in addition to the poor hygiene and sometimes scrubbing with a hard toothbrush, could my bite and crowding have contributed to some of my gum recession? I never really took the thought of braces seriously until I thought it could help the gums. During dental checkups, some dentists didn't think the underbite was an issue if I wasn't presently experiencing pain or trouble eating. Others would just claim the underbite was an issue that had to be fixed; a sentiment that my Mum would consider to be dentists making money.

So the most recent dental checkup I had, the dentist did point out the underbite, but didn't really pass any judgement on what to do except to go to the orthodontist for a consultation. In this case it appeared that the underbite wasn't really an immediate issue, but I went to the orthodontist anyway. It turns out I'd need four teeth taken out due to the crowding. Besides appearance, the functional benefits would be a more even wear on the teeth, and preventing TMJ which may or may not happen.

So it seems at this point, braces would mainly fix an appearance issue. My mum didn't really oppose it until she heard about the 4 teeth needing to be removed, after which she put up quite a lot of resistance. She did make a point that this is how the dental profession makes revenue. Braces are so prevalent in our current society, but being the status quo doesn't mean it's always the best. An orthodontist probably won't back out if a patient doesn't really need treatment for functional reasons, but if they are so concerned about the appearance no matter how big or small the flaw is, the orthodontist isn't going to refuse business.

So now my thoughts constantly flip-flop. Some days I think my teeth look ok enough, and I'm not just going to give away ten thousand dollars so I can be in discomfort for the next 1.5-2 years. Other days I might I feel like I should just indulge in my vanity because I don't know many people with an underbite, and when I fixate on the appearance of my teeth a lot it does seem to look odd. Plus I have been saving away some money in anticipation that I might need such treatment.

I've noticed that some girls from high school are now wearing braces today. In some of their cases, they look like their teeth were totally fine before, nothing but very very minor flaws such as looking just so slightly buck toothed. I've both thought of this as more reason for me to get braces due to how normal it is, and thinking my case is a bit more severe (although my teeth are also mostly quite straight and aligned too outside of the aforementioned issues). Then I also think of it as just an overreaction in our image obsessed and vain society, that girls are being talked into having such minor flaws corrected for such an amount of money. Although I will make the concession that I don't really know of their dental issues.

So to recap, at first I was really quite set on getting braces, but after dwelling on it for some months I really just don't know if I should or not. I can put up the pictures from the orthodontist; which I can definitely say they appear to exaggerate the look of the teeth without the rest of the face to add visual balance. There doesn't seem to be a way to upload images to this board so I'll assume here we rely on external hosting. If that is so, I can post the images following this post.

You can post images after you post enough to become a regular member. So, make more posts and then when your name turns green you will be able to post images. We do it this way to prevent spam postings and fetish postings.

Only you can make the decision to get braces or not. While braces can appear to be cosmetic, often they are not. Having properly aligned teeth and a correct bite can prevent TMJ issues, unnecessary wear on the teeth, and countless other dental issues. Its also good to note that what appears to be a simple case usually isn't. There's a lot that goes into treatment and it takes time.

For what it's worth, my parents didn't see the point in my treatment (braces and surgery). They thought it was too expensive and they didn't think I needed it. But that's easy for them to say when they can eat whatever they want and not have to worry about their jaw popping in and out of socket or their mouth getting locked shut or stuck wide open. Regardless of the cosmetic benefits that have come out of my treatment, it's all been worth it because my mouth works like it's supposed to. I'm not having to stop eating because it hurts my joints to chew, I can actually bite through a sandwich without having to force my jaw forward, and my teeth are my cleaner because it's so much easier to brush and floss.

All I can say is I am 53.....just about to have braces in 2 weeks. I did not have the opportunity as a teenager. I watched my children have braces as I didn't want them to have teeth like mine! Mine aren't terrible!! But they are far from straight. I had a consult 2 years ago having thought about it for 2 years and did not follow it up. They could have been off twice over by now.
You are young....only you can make the decision, my advice as someone older is do it while you are young. My teeth have moved as I get older and they are never going to get better....as you age there are many things you can't do much about! So your teeth you can... and I am!! I say go for it....
Good Luck

Extraction of four teeth is rather serious. Have you consulted other orthodontists?

I'd always suggest consulting with more than one orthodontist, but they key is to find the treatment plan you think makes the most sense. It can be a terrible trap to keep seeing orthodontists until you find one that says what you want to hear.

It's not as if orthodontists get money from the tooth fairy for extracting teeth; in fact, extractions mean extra chair-time (time is money), and those gaps don't close themselves (meaning even more chair-time.) Since orthodontists don't have a monopoly, an ortho that unnecessarily prolonged treatment would price him/herself out of business. Yes, extractions are a big decision to make, but there's no reason to be suspicious of an ortho simply because they suggest them.

And yes, orthodontic diagnostic photos do their best to show defects in your smile; they would not be very useful diagnostic tools if they camoflaged needed corrections.

Sirwired makes many excellent points. If your mother is funding this endeavor then her input and agreement would seem to be important. You may want to wait until you are out on your own, financially. I value function over form when it comes to orthodontics, at least, and try to take the long view in terms of improvements in my bite and the avoidance of dental issues down the road. From what I can see, most people get a nice cosmetic improvement as well as for their bite, so it does not have to be an "either-or" sort of decision.
Also, keep in mind that you are going to need to wear retainers for the rest of your life -- not 24/7 necessarily, but it is an important part of the plan. So if in your heart you cannot abide with that, defer braces until you are ready to accept the entire treatment plan. In any event, best of luck to you!

I would echo what I think someone else touched on and recommend you get a 2nd and maybe even 3rd opinion. This will give you peace of mind that the extractions are really necessary. From reading this board I've learned that sometimes it's necessary, but that there seem to be orthos on different ends of the spectrum: those that almost always favor extractions with the slightest hint of crowding, and those that will work at all costs to avoid extractions. Again it may indeed be necessary but you want to get multiple opinions to make sure this isn't just an extraction-happy ortho.

Also, ask your dentist for their opinion. My ortho and dentist work pretty closely together and one doesn't do anything major without consulting the other.


I think if there is even a chance it will help your gum health, if you dislike it even a little and it affects your self confidence when you smile, even a little bit, you should go for it. Life is too short to not be happy, and there are way worse ways to spend your money than on something that so many people take for granted (straight, correctly positioned, healthy teeth). Just my humble opinion.

I had consulted with another orthodontist before, however it was a "free invisalign consultation" so it was only a quick visual inspection without x-rays or photos. That orthodontist did also mention extraction of two or four teeth, but as I hadn't done a full consultation appointment with him, he suggested that if there were no extractions done, my top teeth may need to be "flared out", which seems like he was trying to get me into some sort of treatment plan no matter it being an ideal result or not. But I think if I had paid for the full consultation, we may be at the same place in needing extractions.

Could consulting with an Oral Surgeon also be helpful? I need to do a consultation anyway for the extractions, as I also have a tooth inside my palate that also needs removal before braces can go on.

The treatment improving gum health was only conjecture, due to my earlier experiences and guesses. I've only been told besides appearance, that the treatment would prevent future TMJ and create a more even wear on the teeth. I will definitely post pictures as soon as I am able to.

I am 38 and just got my braces on January 4th. I have mild crowding on the bottom and a snaggle incisor tooth with another tooth somewhat hidden behind that one and my front tooth on the top. They are fairly straight other than that. Parents didn't have the money when I was younger and growing up I've had the opportunity to get them but really didn't think they looked that bad and I was nervous about how I would look as a brace face. Now I sincerely regret not getting them done years ago. Yeah they are a pain to eat and you do have some pain here and there but I wish I would have bit the bullet a long time ago. But this is up to you and how comfortable you feel with how you look. I would definitely get a second opinion. It never hurts. Good luck!