Metal Mouth Message Board

I'm over a year into a year-and-a-half sentence to resolve some mild crowding and a crossbite, including an edge-to-edge bite in the front. The bite issues are skeletal and ideally I need surgery to correct 100% but I didn't want to go that far. Therefore I'm in braces and so far it's been fine for the most part.

For 6 months I wore class III elastics to firmly bring my top teeth in front of my bottom teeth. That worked wonders. It was 4 months of 24/7 wear and 2 months of nighttime-only wear.

After that the ortho started me on posterior box elastics to help lock my teeth into place on both sides. My left side is ever so slightly a bit more open than the right, which closed fairly well even beforehand. I was supposed to wear these at night only until further notice.

Problem was, she instructed me to wear class II box elastics, which started to undo some of the progress I'd made with my top arch being ahead of my bottom arch. After a month of wearing these at night I started to see my front teeth relapsing a bit and not fitting together as well as they had before. And I was seeing absolutely no progress with the closure of my teeth on the left-hand side.

At my last appointment I voiced my concerns about the apparent relapse and as she was reviewing my progress since my last visit, she had her assistant scroll up on my chart, presumably so that she could check the box elastic instructions. I know this because immediately afterward she handed me a mirror and asked me to point out which teeth I was putting the elastics on.

Me: canine and first molar upper, first and second molar lower, is this right?
Ortho: yes that's right, but now I am going to have you switch, just so that I can keep targeting certain teeth to close better

And she had me switch to class III box elastics. After 4 days in these, my teeth are already fitting together SO much better and the weird gap on the left side is finally closing.

Why do I get the feeling that she messed up and told me to wear the wrong thing in the beginning, and it was only after I complained about some relapsing that she realized it?

If I'm right, it just goes to show that we really do need to be our own advocates.

Yes, we definitely need to be our own advocates. It is afterall our own teeth, bodies, time and money. We are also the ones who spend more time looking at our teeth and we are definitely more familiar with how our teeth are responding to each step of the treatment than the ortho who only sees us once every 4 to 8 weeks.

I can't say if your ortho has messed up in your case. For me, one thing I have noticed is that my ortho seems to prescribe the next steps based on how my teeth responded to the last appointments' work each time he sees me.

I'm wondering if that's also the case for you. She may not necessarily have told you to wear the wrong thing, perhaps she was trying to achieve a certain outcome (closing certain gaps between certain teeth etc?) when prescribing the class 2 and then review again at the next appointment?

I guess what I'm trying to say is, good that you gave your feedback and she has heard you. I would say yes do be your own advocate, but don't fret over it as it can lead to the very slippery slope of not trusting and questioning everything your ortho does later.

Yes definitely I hear you. This is the only time I've questioned and been concerned about something she's told me to do. I just can't help but wonder if I'd still be in the old configuration if I hadn't said anything, wasting precious months of time and adding to the overall amount of time I'm in braces, or worse, not giving me the best bite I could have had in the end.

I do find that my treatment has been very linear and it's the same instructions every month until she sees the desired result. Resolving the crowding for 6 months, then bite correction for 6 months, and now final tweaks for 6 months before they come off. I have a friend whose orthodontist bounces around every visit--elastics, no elastics, adding brackets, removing brackets, chains, no chains, etc. In all fairness she has several gaps to close, versus none for me, so it's probably more of a roller coaster ride in terms of how her teeth respond to things every month.

Yes it does happen. The comment about instructions responding to developments since the last one etc etc definitely seems on point. Generally, I think as long as there is forward progress and things are gradually improving, situations like yours aren’t cause for concern. However, orthos are doctors, and doctors are people. They mess up and some are incompetent and shouldn’t
be in practice. A lot of people here strongly advocate the view of “your ortho is always right” and I say that’s an overstatement. In my mind, they’re usually right, or at least they are trained, licensed professionals who know more than me. But you should ask questions and if things don’t improve in a reasonable timeframe or adverse effects are popping up, you should seek a second opinion. I switched orthos 6 months into treatment after obtaining a refund. My original ortho wasn’t capable of treating my case. Progress has been relatively great with the new one. Trust your (educated) instincts!