Confused adult

[3stars]

Hi,

I am mid-thirties, looking to correct overcrowding that has made me feel uncomfortable about my smile since forever.

I have one missing (congenitally) lateral incisor.

I have been to two orthodontists, both as recommended by my dentist, but ortho 2 was their first recommendation, and from my research before meeting them was the one that gave the better impression.

Anyway, I've just came back from that second meeting and I'm confused as both said very different things.

Ortho 1 said to remove my wisdom teeth (which are at an angle but have never caused me any problems) removed to make room, then to use Invisalign to move everything back into that space and into line, and possibly use some filing to address the asymmetry of the front teeth.

Ortho 2 said to remove three teeth - the other incisor and two at the bottom in order to create the space, and then to use a metal brace to sort out the alignment. I had rather decided I didn't want a metal brace, as it worries me, and the thought of it rather had my anxiety raised. Ortho 2 refused to use Invisalign as it wouldn't help me correct rotation. I'm not after perfection but I understand that the Ortho has professional standards - did say that he does Invisalign but wouldn't for me, which I respected but I'm petrified of metal (well, ceramic) braces nonetheless!

Now I don't know what to do. I'm also worried about the permanence of having teeth removed!

I don't 'need' to do this for anything other than aesthetic reasons. But I also feel that I 'need' to do it for myself, as otherwise I'm going to regret not fixing my smile that I'm sadly rather ashamed of. I can smile, but it's always a suppressed one so that I can keep my mouth closed.

[Prometheus]

Hi 3Stars,

I had an orthodontist convince me to go with Invisalign for a tough case. Had them for 18 months and it did a poor job. Three years later I ended up with bad TMJ problems and had to get full braces, metal on the bottom and ceramic on the top, for three years to fix everything correctly. My advice to you is if a trusted orthodontist is telling you Invisalign won't work for you, you should believe them. Braces were no big deal and I felt more comfortable not having to take the Invisalign trays in and out all the time. They are really not invisible and I found them very annoying covering the biting surfaces of my teeth. -P

[djspeece]

Based on what you have described I would probably go with Ortho 2, and metal braces. My understanding that invisalign only works for very minor issues, and your case certainly is not minor. Ortho 1 may have been telling you what he thought you wanted to hear.
I would ask each one bluntly -- what are the risks, benefits, expected outcomes, pros and cons for your suggested case. I'd also pose the option provided by the other option and ask the same questions, or at least get their reaction. If either gets defensive, I would think twice about using that person. Best of luck to you in any event.

[trifecta]

Hi 3Stars,
I would second both of the previous replies. I have worn metal brackets twice, once as a late teen and again in my fifties. They are noting to be scared about. If your orthodontist recommends the fixed appliance over invisalign I would take that recommendation. I have had some space open up between my bottom molars and am having treatment starting next month. The orthodontist said invisalign could work but that metal brackets would be more efficient so I am going with the metal bracket. Depending on space available and the positioning of the wisdom teeth, having them removed may be beneficial either way. As far as the lateral incisor is concerned, it is relatively common the be congenitally missing and thus moving the cuspid into the lateral position then reshaping the cuspid for cosmetics to look like a lateral incisor.
Good luck!