I Wish I Did Invisalign Instead of Lingual Braces

I went for three consults for braces, one for...

I went for three consults for braces, one for invisalign, one for regular ceramic braces and one for lingual braces. I picked the wrong one - the lingual braces. My life is ruined, I had 3 teeth removed which has complelety changed the shape and width of my face and has moved my bone structure causing facial collaspe. It has aged me by 10 years, and taken all the balance out of my beautiful features.

These orthodontists need to tell you the real truth about what happens when teeth are extracted. I am now looking into very invasive plastic surgery and dental implants to try to get my face back. The ironic thing is plastic surgery can only make subtle changes to the face and can't truely get it back... I never would have thought dental work would make such drastic changes to the face..but why would I? None of these "professionals" ever told me, it should be their duty to inform patients of what is going to happen to their face, not just their teeth!

I can't stand linguals any more..five days now i am like zombie..it' s horrible torture..not speak not eat and constant pain..they must go to jail
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Hey everyone. I am an orthodontic resident and I feel compelled to give my 2 cents here... Orthodontists treat a very wide spectrum of problems. An easy way I like to explain to my patients about what we do is that we examine a patient's skeletal issues, dental issues, and soft tissue (lips, musculature, etc.) and determine which components are out of balance and what our options can be to give the patient the most well-balanced result possible that takes into account all of these factors. Now with each one of those components there are 3 dimensions... 1. The transverse (width, for example, a narrow palate would be a skeletal deficiency in the transverse dimension, while perhaps one tooth in crossbite would be a dental deficiency in the transverse dimension.) 2. The sagittal (front-to-back, for example a large and protrusive lower jaw is a skeletal discrepancy in the sagittal dimension.) This can lead to front teeth that are edge-to-edge and without proper overbite. These front teeth can wear down over time. This also produces an unaesthetic concave appearance to the profile. So you can see here how a skeletal problem can produce dental and soft-tissue consequences. 3. The vertical dimension (long-face or short face skeletal structures, deep-bite or open bite dental problems.) Now, like I mentioned in the beginning, orthodontists deal with a wide variety of problems. You can imagine that a large combination of issues can be occurring in any one person at any one time, all of which are inter-related. Let me give you just a couple of examples: 1. Imagine a patient with a lower jaw that is deficient relative to his upper jaw. This patient would present with a profile that is convex (weakly defined chin since the lower jaw is too far back and an ill-defined mentolabial sulcus--the little groove between your lower-lip and chin), and also a deep bite (lower front teeth hitting the palate since the lower teeth sit on the lower jaw--which is too far back). In this case (keep in mind, I'm keeping this very simple, there usually is a HOST of other issues going on at the same time) correcting the skeletal deficiency will have positive effects on both the dental and soft tissue imbalances. Bringing the lower jaw forward will bring the lower teeth with it (allowing us to correct the deep-bite) and it will bring the chin forward producing an esthetically pleasing, straight soft-tissue profile. 2. Now consider someone that presents with severe-crowding (the jaws are not big enough to accommodate the amount and size of teeth present) as well as very thin lips (that react very quickly to the tooth support behind them). Orthodontists have several ways to create space for teeth. We can skeletally expand a narrow palate, we can flare teeth, we can reduce the width of the teeth by stripping, or we can extract teeth. A very important key here is that with an adult patient (anyone past their growth-spurt) an orthodontist is strictly an orthodontist (meaning he can only move teeth, not bones). He becomes an orthodontist and dentofacial orthopedist once more (like he is with children) only if the case involves invasive orthognathic surgery and an oral and maxillofacial surgeon is collaborating. In this scheme, the orthodontist can once again plan both dental and skeletal movements, except now the oral surgeon provides the skeletal correction, rather than the orthodontist--who can provide skeletal improvement with children by maximizing their growth potential (as is the case with the appliances we use in children, for example palatal expanders to correct narrow upper jaws, facemasks to correct protrusive lower jaws and deficient upper jaws, functional appliances to advance deficient lower jaws like a Herbst appliance, and etc.) Back to case 2... You can see now that with an adult, the orthodontist has lost some of the tools in his arsenal. I described this specific case because unlike case 1, the correction of the dental imbalance (too many teeth) may work against the soft-tissue (thin lips that may dish in when teeth are removed to correct the dental issue of crowding.) Some people are equipped with better soft-tissue to accommodate extractions than others (people with thicker and full lips.) It is, like everything else in orthodontics, a case-to-case basis. Furthermore, we must assure dental health by maintaining teeth in the center of bone (so we cannot flare them to kingdom come to accommodate moderate-to-severe crowding.) These are the cases that orthodontists work extremely hard to manage. I myself, love my patients and feel extremely blessed and honored to be in a position to help. People come to see me with situations that I did not create. We can only do our best together (patient+doctor) to manage whatever situations we are working with. There are limits to the jaws, there are limits to the dentition, and there are limits to all of our growth potential. We must work together towards the most healthy and well-balanced result within those limits. One final note regarding lingual braces vs traditional braces vs invisalign vs etc. Any appliance an orthodontist uses is merely an instrument to get to the patient and doctor's mutual result. All appliances have pros and cons, this will continue to be true until the end of time. Some cons involve limitations on what the appliance can do (invisalign being weak at extruding teeth for example), some cons involve esthetics (lingual braces that cannot be seen vs traditional braces that everyone can see,) and some cons involve mechanics (ceramic braces which are bulkier, more brittle, and have higher frictional forces--so you can imagine the hooks and posts on the brackets tending to break off if lots of sliding mechanics are involved to close extraction spaces). By reading the initial post, I doubt that invisalign would have been the optimal choice if extractions were needed to resolve crowding, since invisalign is very poor at closing extraction spaces. If your orthodontist was not as clear or thorough with explaining your unique skeletal, dental, and soft-tissue circumstances to you, I am sorry for that. I hope at least you can find peace of mind knowing that it was probably not your choice of lingual braces that provided you with a result you are unhappy with, but more likely limits to what could be done to solve your concerns based on your unique skeletal, dental, and soft-tissue dimensions. I hope my post elucidated some of the mystery of what an orthodontist takes into consideration when treating a patient. I would like to say on my behalf (and I believe this rings true among the entire orthodontic community) that it really is a pleasure getting to work with and know all of you. All the best, David Dayan, DMD
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Sorry for the wordy post. I initially separated it into paragraphs but for some reason it did not post that way :)
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