Bottom Teeth have shifted in my son after ortho treatment

Discussion in 'Dental Archive' started by MSEagan, Sep 29, 2003.

  1. MSEagan

    MSEagan Guest

    My son had braces for 2 years and got them off at about age 14.5. All looked
    great. Ortho suggested wisdom teeth come out due to their positions.
    Denstist recommened this too. Had them out without incident at age 16. A few
    months later he informed me his bottom (permanent ) retainer had broken and
    it was poking him. So, I made an immediate appointment for a new one, but
    was called by the office that his teeth had shifted and he needed a "spring
    retainer" to move the teeth back in place. He got his first one and we were
    billed $135. After a few months, the retainer just disintegrated. So, we had
    him go back and I requested they have it made with a durable material. They
    told me they would charge me only the lab cost for it (since I complained
    about being given a poorly made retainer) and said it would be $90 for the
    new one. My husband opened the bill and it was $200+ and they told him they
    erred and the new material was more costly. So, after having already paid
    $4,000 we were racking up even more bills to get this fixed.

    More recently the hygenist was quite amazed at how much movement his bottom
    teeth have had. She was amazed that they would continue to charge us like
    this to fix it after he had full braces at full cost. Originally the ortho
    said he would charge (even more than a retainer) if we wanted to put
    brackets back on the bottom teeth, but I called him the other day and he
    agreed if we want to take the bracket route he will retreat him for free (my
    feeling is this spring retainer, if it works, is going to take years at the
    rate it is going....and he will be gone possibly this summer for college).
    But, now my son wants to give the retainer longer to work.

    How successful are these spring retainers? He will only wear it when he
    sleeps, though I have insisted he wear it 24/7 except when eating. Lower
    brackets will be quick and done and do not require compliance on his
    part....How much longer do we give this retainer before we either kiss
    goodbye our investment in getting his teeth straight (his tops were always
    straight, though ortho moved them back) or force (if this is possible with
    a 17.5 yr old ?) him to get the brackets on?

    Marianne
     
    MSEagan, Sep 29, 2003
    #1
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  2. MSEagan

    Dr. Steve Guest

    Hey orthodontists,,,,,,,,,, do you think parafunction has a role in cases
    like this.

    Marianne,,,,, sorry I do not have an answer to your dilemma.

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    Dr. Steve, Sep 29, 2003
    #2
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  3. MSEagan

    carabelli Guest

    I don't either. One of the problems with fixed retainers, I would bet this
    one had been loose for awhile before the patient noticed and by then the
    teeth are moving. At least with removables the patient knows if it lost,
    broken, etc. Charlie presents a very good argument recommending fixed
    retention.

    Regarding parafunction, it don't think this was probably an issue. I would
    suspect a more probable answer is treating an extraction case
    non-extraction. The pendulum seems to have swung this way again. This
    debate has gone on since the dawn of modern orthodontics. There isn't a
    perfect answer either, however I think too many cases are being treated
    non-extraction now, which is a perfect selling point during your
    consultation. No Mom, no teeth need to come out, it will be wonderful.

    Throughout the history of orthodontics this debate has led to
    finger-pointing and name calling within the profession. Personally, I
    believe God intended for us to have 32 teeth for our entire life, right up
    until Adam took a bite of the apple.


    OTOH, many males will have a late mandibular growth spurt, resulting in
    either mandibular crowding and\or maxillary spacing.

    Gotta go tend the ribs on the smoker - I'll have more to say if anyone cares
    to hear it.

    carabelli
     
    carabelli, Sep 29, 2003
    #3
  4. MSEagan

    MSEagan Guest

    I was not blaming this all on the orthodontist...I am also upset about the
    attitude of my son, who by the way says he is certain the glued-in retainer
    broke when he first noticed it broke, which brings up another question. Is
    it possible that his growth during this time caused the teeth to shift,
    breaking the first retainer that was glued in? Can this happen?

    One thing my dentist mentioned is that the ortho may have to "polish the
    edges" of the teeth to make slightly more room so that even if they are
    straight, they are not pushing against one another which will only make them
    tend to move again. But, he said it was best left to the ortho. Does this
    make any sense to even discuss?

    Actually I am glad to hear your take on this because it helps me look at
    this from all angles and not just my emotional one which is that after all
    the time and money his teeth are crooked again!

    Marianne
     
    MSEagan, Sep 29, 2003
    #4
  5. MSEagan

    Dr Steve Guest

    The polishing referred to is similar to facets on a sphere. If you had four
    perfect spheres and four spheres with flat spots touching, which set would
    you expect to rotate against each other?

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    This posting is intended for informational or conversational purposes only.
    Always seek the opinion of a licensed dental professional before acting on
    the advice or opinion expressed here. Only a dentist who has examined you
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    Dr Steve, Sep 29, 2003
    #5
  6. MSEagan

    carabelli Guest

    Maybe, maybe not. Your ortho would have the best guess at that



    , which brings up another question. Is
    Anything is possible, I truly doubt it though. These retainers are bonded
    to teeth the same way orthodontic brackets are. Think about it, we couldn't
    tighten things if the brackets would fall off from the pressure. One
    caveat, lingual enamel doesn't etch as well during preparation for bonding.
    This is common knowledge however, and most will increase the etching time as
    needed.

    My experience has been that only a truly exceptional 17 yr old will respond
    positively to the suggestion of more treatment with fixed appliances.

    carabelli
     
    carabelli, Oct 1, 2003
    #6
  7. MSEagan

    MSEagan Guest

    As our ortho told us too. So, I have told him I will leave this between him
    and my son. He said the retainer will work, just more slowly, but is
    typically better accepted in this age group.

    Marianne
     
    MSEagan, Oct 1, 2003
    #7
  8. MSEagan

    MSEagan Guest

    I wish so, but he will not eat it. I love it and eat it all the time.

     
    MSEagan, Oct 2, 2003
    #8
  9. MSEagan

    MSEagan Guest

    Thanks so much for such a comprehensive answer.

    Marianne

     
    MSEagan, Oct 3, 2003
    #9
  10. MSEagan

    carabelli Guest

    Excellent response Charlie. I have posted this before, but for the life of
    me I cannot attribute it to anybody.

    The essence of the quote, while I do not agree with it - but appreciate the
    sentiment, was orthodontics is at best an interruption of a natural process.

    carabelli
     
    carabelli, Oct 3, 2003
    #10
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