Requested retraction - received abnormal painful bimaxillary protrusion

I originally had perfect teeth from orthodontic treatment in college. I had 4 pre-molars extracted and he worked magic to get them to look awesome. I LOVED my smile. It was a huge asset as I modeled & performed in additional to my daytime profession. I had finished graduate school recently and I had broken my upper retainer in a recent move (March 2013). I kept wearing it and my upper teeth shifted slightly to the right and forward. Believing all orthodontists were magicians, I went to a local orthodontist who agreed to fix these minor movements. However, he instead "opened up" and "broadened" my smile, effectively taking away the small elegant shape of my mouth and perfect teeth. It took me a little while to wise up but ultimately I left that orthodontist. I chalked it up to him being a bad orthodontist, me doing poor research or maybe my having an ineffective communication style. I sought someone who would repair the damage that this orthodontist caused. That is when I found Dr. David Alpan.

Initially he was very nice. I was open, transparent and clear in my story of wanting to restore my original beautiful result via retraction of my incisors. I brought literally 30 pictures of myself from every single angle in order to make sure he clearly understood what my request was. He said that he understood and suggested the highly costly insignia smile design system. I was such a fan because it was supposed to be detail-oriented, precise and effective. It was very expensive but I was happy to spend the money in order to have my teeth restored. I have attached an e-mail which shows that the plan was "posterior expansion" and anterior retraction as well as the "before" pictures which show the position my teeth were in the day I arrived at Dr. Alpan's office. I wanted my teeth retracted from that point. I wanted the retraction $5,500 worth. Considering I had just received some highly questionable orthodontic assistance, I was understandably very hesitant and a few weeks before treatment (and again the night before) I sent e-mails to their office saying that we could still cancel the treatment if in any way Dr. Alpan did not think he could accomplish my goal. Staying how my teeth were when I arrived at his office was so much more preferable than risking any further protrusion or "opening up" of my teeth. My one and only goal was retraction toward preserving my bone structure and restoring my original result. I was so clear and honest.

They re-confirmed that it would all be great and that my communication would be key in ensuring that the system was customized along the way to get the result I requested. I was in heaven and looking forward to having my pretty smile back. They quoted total treatment time to be 12 months.

What actually happened, however, was that the Insigna system along with the Daemon brackets pushed my teeth abnormally further forward - the direct opposite of our agreed upon treatment goal. None of what was planned happened. My posterior teeth did not expand, but became extruded. All my teeth tipped outward/forward. White roots began to stick out all around my gums in front and on the sides due to the rapid over-expansion and severe protrusion (see the 'after' pictures from an in-treatment consult in December of 2014). This all happened in only 4 appointments and was very perplexing..but mistakes happen. I attempted to keep the doctor informed that the movements were counter-productive to "our" goal and his attitude was to allow the automated system to just do it's thing and to "wait and see". I liked him and believed that he knew what he was doing so I kept going.

At 4 months into treatment, during an in-treatment consultation I brought to his attention again the excessive and damaging additional forward and outward movement of my anterior teeth. He seemed pretty relaxed about it and said that we could still get them back to my personal standard of retraction. It seemed like a ridiculous claim. He just projected my teeth an additional 1/2 inch in pursuit of maybe a 5mm retraction. They were now 3/4 inch away from their original position. I asked him how this was going to be possible with all the additional damage. I told them that I thought it would be more appropriate to leave treatment so as not to risk any further protrusion. I was told that we had just done "rotations" and now that the rotations were done we could move toward retraction. A suggestion was made for the extraction of 4 additional healthy teeth...but wait...that was never part of the plan. His original plan did not work and now due to the severe expansion that he caused I was facing the decision to take 4 more teeth out of my mouth or be stuck with my teeth in this awful position. This was very unfair. Any attempt I made to try to understand why the treatment he sold to me sold did not work were met with either anger or accusations that I was impatient. I only wanted to make sure that treatment was on-track toward my goals so that I could get back to my life in front of the camera.

I kept attending for a few more appointments during which he also shaved all my teeth to narrow them and suggested that we use T.A.D.S. to bring them backwards. As we moved forward with these treatments that should have addressed not just the original protrusion, but the additional severe protrusion that he created...all I saw was cartoonishly appropriate ADDITIONAL protrusion! It was so crazy that I became fascinated. How far forward could teeth actually go?? As we progressed my teeth continued to expand and protrude even from their additionally and absurdly protruded position back during the December 2014 consult. I began to have severe headaches due to the pulling and stretching of my teeth away from their comfortable central position in my jaw. I began to have white roots sticking farther and farther out of my gums and I could no longer close my mouth. During each appointment Dr. Alpan's attitude was always "we can fix that later". It was perplexing that he would cause a new series of problems just to cost me more money and risk for additional extractions, T.A.D.S. or whatever else. At one point his office suggested that we had discussed jaw surgery! That was never on the table and never discussed with me. I attended a total of only 7 appointments. After 9 months of treatment (which included me relocating 2 hours away from his office-causing a crazy commute to get there) I finally just quit. Their lack of empathy, complete dismissal of the negative side effects and their audacity to somehow blame me for the treatment failing added insult to my severe injury. They said that I did not understand orthodontics, that I was impatient and for those reasons I could not "make the treatment work".

The treatment sold to me was to expand my posterior teeth to retract my incisors. Today, after having two very unabashedly awful doctors move my teeth in a manner completely opposite my expensive wishes, I have become much more fascinated with orthodontics. I have read at least 50 research articles on the subjects of molar intrusion/extrusion, palate expansion, bimaxilary retraction and other topics. I realize that the minor imperfection I originally wanted fixed could have simply been resolved with a new retainer with a "spring" in it. That was all. I never needed braces and the orthodontist who placed the braces before Dr. Alpan was completely wrong. Dr. Alpan was given every advantage and opportunity to deliver a successful result but I really believe he lacked the motivation to do it. This is actually a reason to push the "automated" treatment. The goal was to put more expensive butts in his chair. I was a number. That was all. He would not intervene to stop that automated system from maiming me and he offered no apology, empathy or explanation for the damage I suffered.

I was appropriate to leave both orthodontic offices. I did my due diligence when I searched to find Dr. Alpan to restore my smile. However, his plan was an inappropriate treatment plan and was really a "magical" claim. It isn't really possible to expand adult posterior arches (I was 28), but what really happens is buccal tipping (outward tipping) and expansion in the pre-molar/canine region. Basically, the insignia system + the daemon brackets I had were well known to expand and protrude teeth...which exactly was my experience. It just wasn't what I wanted and it was not going to address my reasons for coming to his office. He should have known that. He should have known that this treatment would take me solar systems away from my original goal.

The truth is that orthodontics or any medical or cosmetic procedure is about business. So if I had continued to study orthodontics for another year or two I would have been able to find my own ideal treatment, my ideal orthodontist and done 3 consults to ensure we were on the same page. But there is still a need to have a real committment from the professional to meeting the patients needs. That is where passion and compassion step-in, and you really can't predict that. A consult is like a date, they want to put their best foot forward.

I had made a mistake with the first "local" ortho guy, but I thought that I had a really successful consultation with Dr. Alpan. I was detail oriented, I presented photos both in-person and via e-mail. I checked-in with his office regularly. I was open with my communication and I genuinely did all I could to ensure the treatment would be successful. What I ultimately could not overcome, however, was an orthodontist who really didn't actually care about me or my achieving my goals.

If he didn't care, he should have turned down the money. This has been a horrible experience and my pretty bone structure is completely gone now. My confidence is suffering majorly and now this is my new life with teeth worse than even before my original orthodontic treatment. I can't be in front of the camera anymore and I am not confident in my daily profession working with people. This is really not good and what is shocking is that there is little to no sense of responsibility on the part of these professionals. They just go on to the next patient who may either get a great result, or become another victim. #lifelesson

I was diligent in making sure I was open, clear and thorough with my communication. But as I said before, Orthodontics is a business first. The reality of my treatment was the complete opposite of what I was told. An apology would have made me stay in order to allow them to try to fix it, but they just tried to pass it all off as somehow my fault. Thank God I keep great records. If you see something inappropriate happening in your treatment, please know that it is your right to ask questions or that sometimes you just need to get up and leave. I was prepared to leave after 4 appointments because I saw the excess damage. They appealed to me, saying that they were only human (very true) and that they were just beginning to start retraction. It literally only got worse from that point. It's like a waking nightmare. Please protect yourselves.

It is really unfortunate that these orthodontist were not honest. Dr. Alpan and Dr. Florman both knew clearly that my request was to maintain my bone structure and original treatment result. People can avoid these types of incidents if they treat their patients with respect, deference and utilize transparency. They should learn to say no to money when appropriate.