Metal Mouth Message Board

Hi all... Newbie here. I am posting to seek advice on my treatment choices...

So... I have severe crowding in my lower jaw, a cross bite and an overjet (not severe). My two front teeth aren't well aligned. I had fixed braces as a teen and I had extractions... So I have a strange number of teeth... 12 on top, 14 on bottom. My jaw is TINY (like the rest of me) so it doesn't look weird that I have so few teeth.

I really want invisible braces, however I have been told that I am not suitable for Invisalign. I have seen two dentists/orthodontists and my options so far are:

The first (a cosmetic dentist) gave me these options:

Fixed ceramic braces on top and bottom (which I am not keen on as they look pretty visible to me!) OR Clear aligners on top and fixed ceramic on lowers.
He has said I will definitely need (yet another!) extraction of a lower incisor with either treatment method. I like the sound of the clear aligners and fixed ceramics, but he has also said that this may not fix my "malocclusion" as well as fixed braces would... He also uses nickel-titanium wires, however he has assured me that although I get a rash from nickel jewellery, nickel wires in my mouth will not cause a problem I'm not sure whether to trust him on the nickel allergy thing, although he does seem to know his stuff.

The second (a specialist orthodontist) gave me these options:

She has offered me ceramic fixed upper and lower (again I am not keen, the ones she uses look like they'd be really visible) or Lingual braces (either on both arches or lingual on top and lower ceramic fixed brackets). She says I do not need an extraction. This orthodontist IS concerned about my nickel allergy and has said that she would not use nickel archwires, as there are other options available that don't contain nickel. However, she has told me that she only offers one type of lingual bracket and they have a very high nickel content. She said it MAY not be a problem however she wants me to do a trial with one bracket to see if I tolerate it okay. This would cost me £300, which I'd only get back if I go ahead with treatment with her.

Out of the above treatment plans, the lingual option suggested by the second ortho sounds most appealing, as it would fix my bite properly and the braces would be invisible. BUT I've already paid the first ortho £350 for all of the consultations, moulds of my teeth, photos, etc, which I will only "get back" if I have treatment with him!!

I'm so confused about whether to pay the £300 and test the linguals... What do people think? Am I likely to get a nickel allergy and thus lose another £300?

£300 just to have a little nickel put in your mouth? Yeah, no...

I'm by no means suggesting you do this, but if it were me, I'd go buy a cheap nickel bracelet, cut a piece of it, and pop it in my mouth.

:) I have been thinking about doing something like that. But I can't figure out how I could (safely) keep it in my mouth long enough to see if I got a reaction!

Don't mess around with your nickel allergy to save a few bucks! Your allergy will get worse with continued exposure, and you could wind up with a serious problem. It could kill you. They make brackets and wires that don't contain nickel. Tell your orthodontist to get those. DO NOT TAKE THE CHANCE!!!

I strongly agree to not mess around with a nickel allergy. A friend of mine, her sister had braces put on and shortly after ended up in the hospital super sick. It was determined an allergic reaction to the nickel. I don't know the details but she had to have her braces removed!

bbsadmin wrote: Your allergy will get worse with continued exposure....

I'm not a medical professional, but I'm pretty sure -- like 99% sure -- that's false. I was told that there's no predicting the severity of future allergic reactions and that one could be more or less severe than one experienced previously.

At any rate, I agree with the general sentiment of your post. It's something to take seriously, very seriously. If it were me, I'd opt for nickel-free treatment as per your recommendation. Better safe than sorry, right?

And just for the record, I was joking, albeit half-joking, about testing the reaction at home. (I'd probably do it, but I wouldn't recommend that anyone else do it.) But it's neither here nor there, really. If OP knows that she has a nickel allergy, then what's there to test? Just go the nickel-free route as mentioned earlier.

Thanks for the replies!

I am 99% sure I have a nickel allergy (although a GP once explained that it is not an allergy in it's truest sense, but a common form of contact dermatitis to a known irritant - nickel). I am not concerned about it getting worse. Rightly or wrongly. It's been the same for about a decade. I can still wear nickel jewellery on my skin, just not for longer than a day or so as then I start to get a reaction.

I guess the reasoning behind testing out the nickel in my mouth thing is because I have been told that even if you are intolerant of nickel on your skin, the mouth is much more resilient (due to different "conditions" than skin) and therefore it is highly unlikely I'll get a reaction. Both the cosmetic dentist and his supervisor (a very senior professor of orthodontics) have reassured me of this. However, the second ortho I saw did say it *could* be a problem and hence suggested the initial test with one bracket.

I think you are right though - I should take it seriously and pay the money to test the bracket.

This whole situation is frustrating as I was already confused about my treatment options (e.g., about the extraction, the clear aligners and fixed braces on bottom versus linguals) and this nickel thing has thrown another spanner into the works!

Almost tempted just to go with nickel free ceramic fixed braces but I'm still not sure I can face everyone knowing I'm wearing a brace... :(

Verso, I knew you were half joking... We have similar sense of humour I think ;)

You're right, there's no way to predict whether an allergy will get worse. Perhaps I should have said, "may get worse" instead of "will get worse." But as the mother of two kids with severe food allergies, I will quote what several allergists have told me: "It could get worse at any time, for no particular reason." And that goes for ANY sort of allergy, whether it be to a food or to a substance.

So, why take the chance? Repeated constant exposure to your mucus membrane has the potential to do much more damage than just wearing a ring on your finger that contains nickel. Better safe than sorry, IMO.

Good points. It's quite difficult to find orthos here who do nickel-free braces :(

For starters, I would definitely go with the orthodontist who has the necessary training. I would advise you to get the most appropriate treatment based on your actual needs, and forget about it being invisible. I know that sounds harsh, but if you've been scanning this board, you read who little others notice our braces (well, I was debraced nearly a year ago, but you get the drift). As Lynn mentioned, allergies are a serious matter. I am an RN, and can reaffirm that allergies can appear to lie dormant and a person begins to think that they really aren't "all that allergic" and then for some reason, an exposure triggers a serious, sometimes life-threatening reaction. Best of luck to you, in any event!

Braces really aren't that big a deal to most people, you will find that after you get braces, most people will not say anything about them; that goes for even metal braces FYI.

Just find the best orthodontist you can who can treat you while making sure you don't have any allergic reactions, and dont worry about who might notice that you got braces.

Thank you both, that is reassuring. I can't seem to pluck up the courage to get the ceramic fixed ones... I'm not the most confident person as it is and I keep imagining what people will think/say! Even the thought of having people I know asking me questions about it/talking about why I'm doing it or how it looks is horrid. I need to get over this, I know...

MissLou wrote:Thank you both, that is reassuring. I can't seem to pluck up the courage to get the ceramic fixed ones... I'm not the most confident person as it is and I keep imagining what people will think/say! Even the thought of having people I know asking me questions about it/talking about why I'm doing it or how it looks is horrid. I need to get over this, I know...

No one cares. How many adults with braces do you remember seeing and giving any thought to before now? And you've surely seen many more than you might realize. I can't remember giving a second thought to *anyone's* braces, young or old, until now. (And only because I'm interested in what kind of braces they have and things like that. No judgement.)

My friends who know me and see me often, I broached the topic with a bit of self-deprecating humor and that was the end of it. No one's brought it up or mentioned it since, and no one eyeballs me or looks at my teeth or anything.

For the strangers I meet, they don't know me as being any different, so they *really* couldn't care less.

MissLou- I may have a different perspective here than most, since I too opted for linguals instead of ceramic, but don't let anyone tell you you are ridiculous for caring about your appearance/confidence for 2+ years. I wanted treatment for the outcome, but I'm in my late 20s and it was important to me that the treatment be invisible. If that's important to you too and you're willing/able to pay for it, then go for it! If you've decided to do the lingual but are worried about the allergy, I would go with the "test" option since it won't work out to be any more $$ if you are able to continue your treatment with that ortho! Best of luck with that- I really hope the allergy doesn't affect your treatment!

Just my 2 cents! I am always impressed people have the confidence to do two years with full visible braces and I never think there is a thing wrong with adults taking care of themselves and getting visible braces (heck I always get jealous of them for being so brave and confident!) but anyone who says the ceramic aren't noticeable and that they don't notice when someone has braces is full of it.

Last thing I would bring up is maybe try to find an ortho who will do linguals with the incognito brand? I could be wrong but I think those brackets are gold. I just got Harmony which are traditional metal.