I am 34 and just got braces put on a month ago. I went to the dentist a day ago and he was not sure braces were the best option for my issues. He was discussing with me a plastic expander to be worn during the day and night. He told me to discuss this with the orthodontist when I go tomorrow. I just do not want to spend all this money on braces if they are not going to help with the crossbite or tmj. Thank you for your help
I Have a Crossbite(right Side Upper Teeth) and Tmj. Are Braces the Best Fix for Me?
Doctor Answers (2)
The Plastic Expander is a Poor Choice for a 34 Year Old
The removable "plastic expander" your dentist is talking about is certainly not a better option than braces, and will deliver an inferior result because all it will do is tip your molars out to fix your crossbite, which usually doesn't look good or fit well with your lower teeth. I also find it strange that your dentist would be undermining your treatment without consulting first with your orthodontist (who is the specialist in this area after all).
Additionally, given your mention of TMD (tempormandibular disorder), I certainly would not want to tip out your teeth with that plastic expander, since there would be a higher likelihood of the teeth in crossbite interfering with normal jaw function when you are all done. This happens because, as they tip, the palatal cusps (google it) hang down further and can get in the way of you moving your jaw around normally.
Many times with more severe crossbites, adults will actually need a surgical procedure to broaden their smile so saying that a little piece of plastic with a spring will deliver a good result (at least up to my standards) is a bit of a stretch. By using braces and biologically sensible forces (to help maintain the health of your gums) your orthodontist can broaden your smile in a controlled fashion and it will look great when you are done and fit together much better.
"plastic expander" or braces.
I would recommend that you talk to your orthodontist. In many cases braces CAN expand the upper arch and correct the cross bite without an expander. The newer Damon braces are especially good at this. Elastics can also help to do this. I would take the advice of the orthodontist who has probably done several thousand cases vs. the the dentist who may not have done any and just "heard about" the plastic expander in a class or discussion somewhere. Best take the advice of the person who has to be actually doing it every day. If you are really worried about it go talk to another ADA recognized orthodontic specialist and see if he agrees with your orthodontist, If he doesn't, go talk to another one and see what he says also, but stick with actual orthodontic specialists who are doing this every day. Next issue, even if you get the cross bite corrected it may NOT solve the TMJ issues. You should discuss this with your orthodontist also and other orthodontists as well if you still have questions.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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