Braces to come off in 3 months, 2nd time in 2 years but not so sure

[samoorelaw]

Hi everyone,

I was a jaw surgery patient who had braces removed in September 2014 but since that time, my posterior open bite has relapsed, in conjunction with having gum surgery and crowns, etc. So we put the braces back on exactly 6 months ago today, with an estimated treatment time of 12 months. Today at my adjustment, my ortho indicated that if my teeth/bite are the same at the next appointment, which is in 6 weeks, we will schedule the removal. While I want these blasted things to come off and for good this time, he also said he would leave it up to me if I wanted them removed.

I don't know if there is much point in keeping them on beyond the 3 months, as my ortho said there is always a chance the posterior open bite will relapse even if I wear them the full 12 months or longer. It doesn't help that the one side of my mouth that keeps relapsing the most has teeth more wore down on the other side where the bite is holding. I am no longer wearing elastics: haven't worn any for around 10-12 weeks on left side that's holding but right side doesn't stay closed because the lower molar is so worn down from having a bad bite pre-jaw surgery, so I've stopped wearing elastics on the right side because the bite never holds. I was already told by my dentist I would need around 6 crowns to fix those teeth that are severely worn down so I am not optimistic that orthodontics alone will ever solve my bite woes completely.

I'm looking for opinions and advice on this: in light of the above and if you were given the option, would you keep the braces on the full 12 months even if your ortho is not sure it will make a difference?

[jem]

If you get your braces removed now and then have relapse of your open bite, aren't you are likely to speculate on whether the relapse would still have occurred if you had kept them on longer? I think in your shoes, I would want to know that I had done everything I possibly could to prevent relapse occurring rather han fretting over it for the rest of my life.

Good luck with whatever you decide.

Jem

[djspeece]

If you get your braces removed now and then have relapse of your open bite, aren't you are likely to speculate on whether the relapse would still have occurred if you had kept them on longer? I think in your shoes, I would want to know that I had done everything I possibly could to prevent relapse occurring rather han fretting over it for the rest of my life.

Good luck with whatever you decide.

Jem

This makes sense to me. Best of luck to you.

[jaime]

I'm with the others...I would probably just suck it up. What's an extra 3 months anyway? It'll be over before you know it. I say this from a position similar to yours...I've had surgery and 2 years of braces and I will probably always have a unilateral open bite (my left side refuses to make contact, and we've been trying for 11 months).

[oldfart]

I think I talked to you before about posterior open bites. I actually had to have mine taken off early due to finances, and wish I would have kept them on longer. My bite (measuring at pre molars mostly) was closed to within about 1-2 mm. So far with a upper Hawley retainer with a posterior tongue guard on it the space hasn't increased at all. So far what was gained is holding. I'll be in retainers as much as possible (20+ hours a day) for a whole year, then start trying to back off a bit.

This is five months after braces removed.

[samoorelaw]

Here's the thing: this isn't me insisting on removing them. He suggested it's time to come off in 3 months but then left it up to me "for piece of mind," but when I asked him the chances of relapse even if I wait, he said the relapse could still happen. So he doesn't seem to think waiting makes much of a difference. This is why I'm torn: I can't wear these for the rest of my life. I think the only way the bite on the right side will hold is if I get crowns but I was told I'd have to wait until the braces come off to do that and only after they settled. But the last time I was told they would settle and the open bite just returned. Perhaps it's not meant to be and this is the best I'll ever achieve.

[oldfart]

Ask for a Hawley like mine with a bit of a posterior tongue guard. It does take a bit to get used to talking with it, but im about 90% sounding normal.

[samoorelaw]

I'll ask about that but I don't have a tongue thrust issue. If I had, my ortho would have told me by now. But I'll ask. I already asked him about a positioner but he thinks a positioner won't do anything. Maybe I should insist on one anyway.

[oldfart]

Unless your ortho sees you resting your tongue on your molars, it is quite possible he wouldn't notice it. I'm kinda the same boat even after braces. Crowns are the only way left to close the rest of mine. Just trying to keep what i have gained.

[samoorelaw]

I feel your pain. I put on an elastic on the right side again, the first time in around 8 weeks, and within hours it closed back up but now it feels like it clashes too much. This is why I stopped wearing them entirely. We are able to get the teeth touching vertically: it just doesn't want to stay on that one side. I would think if I had a tongue thrust issue that my left side wouldn't stay closed. My teeth on the right are very worn down (especially the lower molar) and that is why I'm being told it won't hold. Eh who knows at this point: I'm just ready to be done. I think I've made my decision to have them removed in 3 months.

[Aspiring]

Some of the tissue that anchors your teeth has elastic fibers in it. These elastic fibers are thought to be a significant cause of relapse, as they pull the teeth back to their old positions once the braces are off. This is one reason why over correction can work. Another option is to hold the correction for longer, because that gives more time for the elastic fibers to relax in the new position and to build more bone density in the areas where the teeth moved away.

By keeping the braces on longer even without moving the teeth, it will act like a sure-fire retainer during the early months, which is when most relapse happens.

You also mentioned that wearing the elastic on the right causes your teeth on that side to feel like they are clashing too much. It's possible that they are, indeed, slightly over erupted. That's not a bad thing necessarily, at this point. See above about over correcting. The other possibility is that you just are not used to having contacts on those teeth, so you are a bit extra aware when they do contact.

It's also possible that indeed, you cannot achieve the correction needed and do need the crowns to finish fixing your bite. The only way to know for sure is to keep the braces on, wear the elastic on both sides, and give time a chance.

Or you could take them off sooner than later, knowing that you will definitely have an open bite on the right and it could only get worse.

People whose teeth move very easily and quickly during treatment, as your right side is doing now (closing the bite in one day), are more likely to have significant relapse. Think about it, if the braces are easily able to move your teeth, then the structures to hold them in place aren't very solid. You also haven't had time to build bone density, which in adults can be a year or more. Now I'm not saying you should keep your braces on for a year after finishing active treatment, certainly not, but an extra month or three gives your tissues more time to stabilize and increases chances of having a long-term result you can be happy with.

Good luck with whatever you decide.

[samoorelaw]

Thanks for your post. I saw another person indicating their open bite came back after 20 years, so I believe that there may not be much point to having these on any longer but I don't know. I have a lot of thinking to do.

Some of the tissue that anchors your teeth has elastic fibers in it. These elastic fibers are thought to be a significant cause of relapse, as they pull the teeth back to their old positions once the braces are off. This is one reason why over correction can work. Another option is to hold the correction for longer, because that gives more time for the elastic fibers to relax in the new position and to build more bone density in the areas where the teeth moved away.

By keeping the braces on longer even without moving the teeth, it will act like a sure-fire retainer during the early months, which is when most relapse happens.

You also mentioned that wearing the elastic on the right causes your teeth on that side to feel like they are clashing too much. It's possible that they are, indeed, slightly over erupted. That's not a bad thing necessarily, at this point. See above about over correcting. The other possibility is that you just are not used to having contacts on those teeth, so you are a bit extra aware when they do contact.

It's also possible that indeed, you cannot achieve the correction needed and do need the crowns to finish fixing your bite. The only way to know for sure is to keep the braces on, wear the elastic on both sides, and give time a chance.

Or you could take them off sooner than later, knowing that you will definitely have an open bite on the right and it could only get worse.

People whose teeth move very easily and quickly during treatment, as your right side is doing now (closing the bite in one day), are more likely to have significant relapse. Think about it, if the braces are easily able to move your teeth, then the structures to hold them in place aren't very solid. You also haven't had time to build bone density, which in adults can be a year or more. Now I'm not saying you should keep your braces on for a year after finishing active treatment, certainly not, but an extra month or three gives your tissues more time to stabilize and increases chances of having a long-term result you can be happy with.

Good luck with whatever you decide.