Adult Class III, Flared Front Teeth, Crowding, Crossbite to Be Treated with Damon, IPR, Acceledent, Possibly TADS - Bloomington

I am a 32 year old woman who has never had braces and in the past few years have developed jaw pain (and clicking at times), gum recession, and the beginnings of tooth destruction from grinding/clenching and a bad bite. Besides a bad bite my teeth are also very crooked and the bottom are crowded. I've wanted braces for years but it hasn't been an option financially until now.

I recently had an orthodontic consultation and am a little uncertain how I should proceed. We seem to be in agreement that if my teeth were straightened then I would actually have an underbite. I would be using elastics, of course, to help correct this, but I'm worried that my jaw joints won't be able to handle the pressure from the elastics. I might just be overly neurotic and it could be fine, but I don't think my concerns are unfounded. He gave a few other options in that case-- IPR (which he might do anyway, and I'm not sure I would want that); removing a bottom front tooth and pulling in my bottom teeth (wouldn't have a good midline then, not that i do now); or TADS.

I am VERY concerned that my profile is going to be even worse than it is now. If my lower teeth are pushed back then my mouth will look completely sunken and I will be very unhappy. Right now my upper jaw is sunken/small and ideally, I think, I would have my upper jaw surgically pulled forward, since I'm happy with my lower jaw pretty much, but I don't think surgery is an option for me financially. I wanted Damon braces because of the purported arch expansion, however I don't know if my upper jaw could even physically accommodate having my top front teeth pushed forward anymore. I haven't had xrays yet to determine the state of my skeletal structure (for braces, I've had them at the dentist of course), so the orthodontist doesn't know, either.

I have scheduled my records appointment for next week (where they would take the scans and xrays) and then the braces would be put on the middle of August.

I'm not sure what to do. I am in school and want my braces put on before school starts so I have some time to adjust, however I'm worried that non-surgical treatment won't give me the results I want. What I want is 1) a good bite; 2) a good midline (at least on the top, I might be able to live without it on the bottom); 3) no more shrinking of my profile, and ideally pushing the upper jaw forward a bit.

Should I have a consultation with a surgeon, even though I'm pretty sure that isn't an option for me? I'm happy with the ortho, they have great reviews and my consult went really well (in terms of time spent, their willingness to answer questions, etc), so I'm not inclined to go to another ortho for their opinion.

What do you think? Might I be happy with non-surgical treatment?

I've scheduled to have my braces put on August 14! They took my x-rays and did a digital scan of my teeth (instead of taking impressions, which was an interesting and long process!). Apparently my x-rays didn't show anything bad/surprising since no one said anything (about my skeletal development, bone density, etc).

The bottom braces will be metal Damon, top will be half metal half clear (front 6 are clear). I debated on whether to get all metal, but decided that the potential risks of the clear (breakage, staining, harder to remove at end of treatment, etc) were worth the possibility of having less noticeable braces.

I'm REALLY nervous to have them put on and to be committed to them for up to 2+ years! I hope the Acceledent really makes a difference in reducing my time in braces. I'm worried about it hurting when they put the brackets on (my teeth are sensitive, especially to blowing air) but that is such a small part of the treatment I shouldn't worry about it. I feel I can handle "regular" pain (abrasions, etc) much better than "nerve" pain, though (like from air, cold, fillings etc).

I got my braces on Aug. 14th and so far so good! I was so worried about it hurting (sensitive teeth) and making me want to gag when they put them on but it was totally fine! The tech was so careful and used warm air and warm water, and lots of suction so it was fine.

Once the wire was placed I felt it immediately. At first it was a "good" pain (like a healthy pain) but then it got more insistent. It wasn't too bad when I wasn't eating but I had pretty bad pain when I chewed on the right side, so I chewed on the left. I never had to limit myself to liquids or mush, though. The pain spread to the left side, too, after a few days but then quickly started to fade so that now I don't have real pain at all just some general discomfort when chewing. It's a weird feeling, it's like I can feel every tooth when I chew and they all feel pointy! Weird.

I've been using the Acceledent daily and I'm not sure if it's doing anything but maybe that's what made the pain go away (or I'm just getting used to the braces).

My mouth is very dry and nothing seems to help it. I'm hoping I just have to get used to the braces and that I'll go back to normal soon. Having dry mouth makes the wires stick to my cheeks, makes it more difficult to talk and even eat. The only good thing about it is that it makes the Acceledent easier to use since I have no spit! The first few days I used the Acceledent it was really gross there was so much spit.

I'm finding that keeping my teeth clean is pretty easy, flossing isn't bad at all it just takes time and patience. I haven't gotten any sores but if my mouth continues to be dry I probably will :( . I used wax at night the first few days in hopes of avoiding sores but I haven't used any lately.

Very few people notice I have braces! It's pretty cool and I'm not very self conscious about them. I haven't really eaten in public yet since a lot of food does get stuck and it's annoying.

I keep looking to see if my teeth have moved but I know it's too early. My 1st adjustment is the middle of September, I hope there's some movement by then!

It's been a little over 1 month and 1 week since I got my braces! I had my first wire change last week. One of my bottom brackets had popped off the Friday before the appt (the appt was on Thursday) but it was no big deal to reattach. She said that since I'm so early in treatment and since it wasn't off that long it didn't matter too much.

They changed both my wires, up to the very next wire. She said they're concerned about flaring my teeth so I may have to go through every single size wire! I don't really mind, though, since it looks like I'll be getting the wires changed every 4 weeks so I can at least feel like I'm making progress. I also don't want my teeth to tip or my roots to have problems, of course.

The wire change was so incredibly easy, she popped open the doors and took out the wire. She let me brush and floss without the wire and it wasn't as nice as I thought it would be! The doors were still open so the brackets were very abrasive, I just wanted her to put the wire back in and close the doors as fast as possible!

One thing that was interesting is she changed the bumpers out and I could see how smooshed and degraded they were! They definitely feel a lot better new, have more cushion. Even if I didn't have an appointment every four weeks I'd still probably want to go in to get the bumpers changed out, it makes a big difference. They also were getting discolored so it was nice to have new ones.

I have almost no pain from the wire change. Maybe that's from the Acceledent or maybe it's because I only went up one size. My teeth have definitely moved, mostly outward increasing the arch. My front teeth have barely started to rotate. I will feel like a new person with straight front teeth, that will be the biggest change for me!

I'm only a bit over a month in and am already getting lax in cleaning :( . Instead of immediately brushing my teeth after eating dinner I wait a few hours sometimes (so I can keep grazing...) bad for my teeth and my weight. I'm getting back on track though.

I'm also finding it difficult to use the Acceledent for 20 min every day. 20 min is a looooong time to sit around when you're in grad school and have a million things to do. I think I've only missed one day, though. My dry mouth is also weird, it comes and goes. Sometimes I can barely stand to use the Acceledent I have so much spit and sometimes I have no spit at all.

I'll post pictures at some point to show the progress. My back molars are still not hooked up to the braces, she didn't say when that would happen. I wonder what that will be like? It's weird to me that my teeth can still move properly even though they're not all hooked up.

The biggest difference so far is in my bottom front teeth. I really have to take some photos so I can compare. I can tell just by looking, though, that the arch is becoming rounded in the front instead of squared off. The teeth are still really crowded, though.

So far so good!

It's been 2 months and 1 day and I'm definitely seeing some movement! I'm glad I've been taking photos since the movement is much easier to notice in comparison to how my teeth were in the beginning.

I have my second adjustment this week. I'm hoping I'll go up another wire size and that they'll take off the bottom bumpers for good, since my top front teeth no longer seem able to hit the brackets on the bottom. I'm really concerned about tartar on the bottom teeth, and those bumpers don't help. I'm going for an extra cleaning in November. I've always had a lot of tartar on the bottom just naturally, and braces don't help. I am concerned about getting a permanent retainer on the bottom because of this, I might see if I can avoid that. But that is a loooooong ways off...

I had my second wire change a few days ago and also started on elastics! They're the fox elastics, and I wear them in the Class III configuration from top back to bottom front. They attach far enough back so that they're not visible during normal conversation, thankfully. The teeth they attach to were sore for a day or two (especially the top ones), but they aren't sore anymore and it was never so bad that I couldn't chew. I only take the elastics out for eating so I wear them probably 20 hours a day or so? I actually look forward to putting them in because they symbolize progress for me!

For the wires, I started with .014 in August and then went on to .016 in September (they were being very cautious because of my crowding, etc). I'm now at .018. I LOVE having my wire changed every month! I know that probably can't continue (I don't think there are that many wire sizes!) but I love feeling that I'm making extra progress that way (even if it's not necessarily true).

I'm still using the Acceledent every day. I wish there was a way to know whether it is making a difference. All I know is that my teeth have moved substantially in just two months and I have had almost no pain (after the first 10 days or so when eating really hurt).

I really hope I can avoid extraction (of a front bottom tooth) or TADS. Maybe at my next appointment I'll ask them what they think my chances are of doing this only with elastics.

TwoPlusOne, I did ask about having a removable retainer instead of a permanent bonded one and they said that would be no problem! She said it's hard to talk with both retainers in, though, and I'd have to wear them 24 hours a day so I'll have to think about that. I think I'd be fine with a permanent retainer on the top, it's the bottom that's the problem for me, so maybe I could do half and half :)

I've been to the ortho two extra times the past few weeks just because the glue popped off the end of one of my wires, so the wire was stabbing me in the cheek. Annoying, but easy for them to fix.

I had my third adjustment about two weeks ago and I was excited and nervous thinking they were going to put me in rectangular wires and hook up my molars (one of the techs told me during one of my "emergency" visits they were going to do this at my next appointment). Well, they didn't do either! My top front teeth haven't moved enough so they put the largest round wire on the top arch, to maximize expansion, and kept the same wire on the bottom (to keep straightening but avoid further expansion). I felt the tiniest bit of discomfort in my top front teeth, but nothing that lasted. I was hoping for some good, productive pain and to finally have straight front teeth, but they're just continuing on with their very slow rotation outward. My upper arch has definitely expanded, though, and I have gaps all around my top front teeth but it's slow going.

My bottom front teeth have some scary gaps between them because of my gum recession (I'm missing the little triangles of gum that are normally there so instead I have empty black triangles). I'm hoping they'll close up at least mostly before I'm done with braces (maybe IPR will help, but probably not because of the shape of teeth).

I had my first dental cleaning with braces a few days ago and it was totally fine until she got to the "flossing" part. Instead of taking the time to thread floss she used a proxy brush with mouthwash on it. DEAR GOD she SCRUBBED so hard I thought she was going to permanently damage my gums (because all I need is MORE gum recession!). She did actually hurt the gums along my bottom front teeth (where the recession is the worst) and they stung really badly the next few days I tried to use the Waterpik. I will NEVER let anyone do that again. Fair warning to all of you, too, if a dental hygienist wants to use a proxy brush on you just say no!

I'm hoping they'll hook up my molars at my next appointment in two weeks and also give me stronger elastics. I can't believe I WANT stronger elastics but I actually do, the ones I have seem so weak now. It sounded like I wasn't going to get rectangular wires until January probably. Might be better that way since I'll be out of town the entire time between my December and January appointments. Probably better to have as few changes as possible. But I AM eager to have straight front teeth!

Oh, I also wanted to comment on my bruxism. I haven't worn a nightguard since my first night in braces (a horrible boil and bite). I do clench at night but I don't think I grind and don't wake up with any pain. Now that my bite is so much better (I think all of my crossbite is almost entirely gone except where my top front teeth still hit my bottom front teeth) clenching feels so much different, almost like a "normal" bite. I suspect the force is applied much more evenly and is much less harmful, hence the lack of pain. I'm very thankful for the elastics because before I got them I did find myself snapping my jaw shut, clicking my teeth, and other weird involuntary jaw movements. The elastics stopped that but now seem to be losing their effectiveness (hence wanting stronger elastics).

I do have progress pictures and will post them soon!

I really need to start taking photos in daylight again, my teeth look so dingy in these dim light iphone pictures! Oh well. Here are the latest photos, November on top, October in middle, August (day after I got braces) on bottom. I'll take a photo of my lower teeth/gum recession when I have a chance (in the daylight!).

I was able to get a decent picture of the gum recession on my bottom teeth. They've looked like this for years (the recession, not the near-straightness :) ! ) except for the one tooth (4th bracket from the left) which now has just the thinnest bit of super pale pink gum going across the bottom. I'm pretty sure it didn't look like that before. Hopefully I'm wrong and that part of the gum *won't* just disappear one night like it looks like it wants to do! Also, that is the same area that still stings after the hygienist murdered it with the proxy brush.

I had my fourth adjustment on Thursday and it's been 4 months since I got my braces on. They did almost everything they could possibly do in one visit!

1) they hooked up all of my molars!!
2) they gave me a rectangular wire on top (16/22 I think they said?)
3) they gave me the largest diameter round wire on bottom
4) they increased my elastic strength to rabbit (the rabbit on the package is not as cute as the fox, bit disappointed about that haha)-- still class 3 elastic configuration

I thought I might have some pain but my teeth have been killing me!! Mostly my front teeth which I didn't really expect since I thought they were going to be really stubborn and slow movers. They seem to have turned a bit already. My bite also feels weird like the teeth are touching where they shouldn't (soft and squishy feeling).

Thursday I had almost no pain until I cleaned my teeth-- flossing and the electric toothbrush HURT! Friday and Saturday I had pain all day and Sunday I mostly just had pain when I ate. Flossing my top front teeth still hurts although the electric toothbrush is bearable.

Looks like I'm going to need some bonding on my front teeth since they're all worn down in the middle into an upside down V from when they were flared. As they turn outward the V becomes more apparent. Not attractive!

Two photos of the front view-- I haven't done a top and bottom arch photo yet, I'm hoping for some more movement, first! Going to give it a week or two :)

I had my fifth adjustment two days ago. They bumped up the top wire to a larger rectangular wire and they put the old rectangular top wire on my bottom teeth, switching it up from a round wire. I was worried my teeth would hurt for a week again like they did when my top was switched to rectangular, but so far it isn't too bad. It hurts, but isn't as intense as the top was (which felt like they were being veeeeerrrrrrry slowly ripped out of my jaw, which in a sense I guess they were!).

My top front teeth have continued to rotate outward, fortunately. I still don't know if I'll need bonding to fix the upside-down "V" or if they're still long enough that the ortho can just shave the pointy edges down. The ortho said he would do it at my appointment next month. I'm really afraid he would shave too much off and I'd have to get the entire edge bonded (seems like the bonding would be a lot less stable that way then just bonding a corner), but I have a few weeks to decide on whether I'll let him or not.

They also took a panoramic xray and said everything looks good. Amazingly, the ortho tech said that I no longer have an underbite!!! I can't really believe it, although the proof is in simply looking at my teeth and feeling how well they fit together. There's a lot of spaces, still, and one of my top incisors is pulled down too far and stupidly sticking out (they need to reposition the bracket but didn't do it this time for some reason and are going to wait for next time!), and of course my front teeth are ugly shaped, but if my bite is REALLY normal now (she said I have an overbite!), then..... WOW!!! I also almost have no shadow between my front teeth in regular photos anymore, amazing!

These photos are from just before this last adjustment.

I had my 6th adjustment two weeks ago and I've had braces for 6.5 months! My teeth hurt for a few days but nothing like when they put a rectangular wire on the top teeth.

They gave me bigger wires on the top and the bottom. They also gave me elastic tiebacks on the bottom to try to pull my bottom front teeth backwards and close a gap on my right side. The gap was more than half closed in less than 2 days and is only noticeable now when I floss (since the floss feels loose in there unlike in the space btw my other teeth).

They said I'd be wearing the tiebacks probably for the rest of my time in braces, urgh. Better than a powerchain though since they seem like they'll be easier to keep clean since they're not flush against my teeth.

The tiebacks go from a back molar to new hooks attached directly to the wire. I've also increased the pull of my class 3 elastics by using the new tieback hooks instead of the old drop in hooks. Doing that made a huge difference-- my bite changed immediately and my teeth didn't fit together for awhile but they're starting to again and the spaces on the right side look better. My entire right side on the bottom needs to move back and it looks like it's on its way.

They said that once my bottom teeth are pulled back they can pull back my top teeth since right now they're flared out a bit.

They repositioned the bracket on my lateral incisor since the tooth is sticking out. The bracket popped right off, I didn't feel a thing! Grinding off the glue was pretty gross and disturbing. Fortunately that tooth isn't sensitive but a lot of the other ones are. Not looking forward to that part of debanding (lots of cold air!). The tooth looked great without the bracket! No staining or damage. Yay

The ortho also did a bit of IPR on the bottom edges of my front teeth to try to make them less triangular. He did a really good job, he didn't take too much off and they look so much better. They still don't look good, though, and my gum recession makes it all look worse, but I'm sure it will all get sorted eventually.

My crossbite was bothering me-- it's kind of edge-to-edge now and my teeth were grinding together at night. Now my very last molar hurts when I touch it and it looks a little funny (like it's broken/worn down on top) but the pain is probably just from it moving and it probably always looked funny I just never noticed before. I'm just surprised a molar hurts. I can't chew back there at all. I have a dentist appt in two weeks so they can tell me, at least, if I cracked the tooth. It feels like normal tooth moving braces pain, just weird it's so far back.

I'm ready to get these off. All the big movement is over and it's just a slog to the finish now!

I haven't updated on here in a long time! I've been really busy with school and my braces have kind of faded into the background. I've had IPR, powerchains, tiebacks, stronger elastics (and now NO elastics! woohoo!), and my teeth are getting really straight (except for one stubborn tooth, isn't that always how it is?). I'm on the last rectangular wires and will likely go into finishing wires at my appointment this month.

Tomorrow I'm going to get a second periodontal opinion. The first guy I saw said I needed gum grafts on all 6 bottom front teeth (no surprise) but I didn't like how he didn't do any measurements or give an actual exam besides simply looking in my mouth. So, I'm getting a second opinion. If I'm paying $100 for an exam I want measurements! I want to have a baseline, since so many of my other teeth have recession and may need grafts in the future. Annoying.

My bite seems to be pretty stable even without elastics, even though I notice I'm pushing my jaw forwards sometimes (and have to stop myself). I've been off them since April 20. They had bumped me up to Impala elastics two adjustments ago and they were TERRIBLE. They pulled my jaw so far back my bite didn't fit at all. I ended up only wearing them during the day, and then at my last adjustment they told me not to wear any at all.

If it weren't for my impending gum surgery I would think I was in the home stretch! If I do get the gum grafts this summer (which is my plan) I wonder if it will delay my debanding. The ortho tech said I could get my braces off probably between September and December, but that's if the surgery doesn't mess with my schedule.

If you have the option to use Acceledent, I would definitely recommend it. I don't think my teeth would be where they are now without it (I am where a lot of people are at almost 2 years, not 9 months!). More than worth the $500, in my opinion.

I've missed a month or two of updates, things have been busy! Right now I'm laying in bed, a bit afraid to get up because this is morning #1 after my gum graft (I started a separate review about that).

My braces are in a holding pattern right now because of the gum graft-- don't want the teeth moving while the new gum is trying to attach! My last adjustment was the end of June and I won't have another adjustment until the end of August :(. I should be having one right now since I always have them once a month. Hopefully I won't be in braces too much longer because of this hold up.

I got my finishing wires in May and then in June they started making some bends in them (boy did that hurt, and they were just the tiniest of bends!). I have tiebacks on top and bottom all the way from the back molar to the front on each side. I was back in elastics again for a bit but the finishing wire changed something so that now I have an overjet and haven't worn my elastics in several weeks. My top teeth are probably flared, I suspect. Once my graft is healed the ortho is going to work on pulling them in.

I'm trying not to freak out about not being able to clean my teeth properly because of the graft. It's pretty much my worst nightmare-- not being able to brush and floss while in braces. Technically I can brush the top but I'm not supposed to spit (!) and can't open my mouth much so I don't see how that's going to happen soon.

Fingers crossed my teeth don't get messed up waiting for this graft to heal. Hope this antibiotic rinse works!