Talk Orthodontics to me, Please

[momacacia]

I need a quick primer. Taking dd11 and dd7 to a new dentist who also has an ortho practice. I have a friend who loves this dentist/ortho and her practice and we need a new dentist anyway. She evidently does a good bit of "fixing" what other ortho's have gotten wrong and helping people after face/mouth accidents, etc.

 

What should I ask about? Obviously looking at this more for dd11, but I'm completely new to the new orthodontics. Anyone have good experiences with FastBraces? Invisalign? Enlighten me. What should I know and find out?

 

TIA!

[Laura Corin]

I hear a lot here about two stage orthodontics.  If that is offered, I would get second and third opinions about whether it is medically/aesthetically necessary before all the adult teeth are in.  I'm sure that there are cases where it is, but there seems to be an awful lot of it about, as opposed to a more wait-and-see attitude.

 

FWIW, Calvin had traditional train track braces.  Hobbes had twin blocks followed by train tracks, in order to bring his lower jaw forward.

Edited April 12, 2016 by Laura Corin

[hornblower]

Ask them what rate of their patients need treatment again when they're older, and before you agree to any treatment, get a 2nd opinion.

 

There is a range of acceptable practice for certain treatments and some orthos like to start treatment early but then those kids often need treatment again. Others just wait and do it all at once. Some conditions *do* require an earlier start but my sense was that some orthos push early treatment unnecessarily and the reality is that they make more money that way so there is a bit of an conflict.

 

My kids both had bite and mild crowding issues and they didn't go into braces until early/mid teens. Regular braces are cheaper and our team recommends them as they said they get the best results. They offer the other system and priced them all out but discouraged it.

 

 

 

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[Joker]

Due to my experience with dds, I would be wary of ortho and dentist combinations. We did not have a good experience. The dentist seemed to really push the ortho part and in the end we couldn't trust any of them. We found a new dentist and a separate ortho and things have been much better and treatment was vastly different (less traumatic for dds and less money for us). 

 

 

[MEmama]

Listening, as we will be going down this road soon.

 

I've seen a lot of young kids with braces, but our dentist recommends waiting until the adult teeth are in. DS has a small jaw and he's always had crowding, but I have noticed recently his teeth are far less crowded than they used to be. It makes sense to me to wait and see what sorts itself out due to growth before refining with orthodontics. In his case anyway, which will be purely aesthetic.

[G5052]

We waited until their adult teeth were in, which is actually what our dentist said as well. We've always had to watch finances and didn't have coverage until about that time anyway.

 

When the time came, we went to three and looked at the whole picture. We ended up with the orthodontist our dentist sent his kids to. They had traditional braces. Insurance covered half of it. We put down 20% and did the remainder on payments.  There were times that those payments were hard to make, but I'm glad we did it. One of mine was so misaligned in the front that she was chipping her teeth.

 

And my youngest actually got hers off a year ago and has her final appointment today!

Edited April 12, 2016 by G5052

[SebastianCat]

One of mine was referred for ortho at 9, before all of his baby teeth were gone, but he needed an expander for crowding. The same dentist hasn't yet referred my younger child, now almost 12, because she doesn't have the same crowding issues and still has one baby tooth.

 

As what the price includes - retainers? Unlimited visits and adjustments? How long do they think braces will be on? Our ortho estimated 2 years of treatment for Ada's, which actually ended up being 3 years. Also ask how quickly you can get in for an appointment on short notice if you have a problem.

Edited April 12, 2016 by SebastianCat2

[Chris in VA]

Ds had the first part of two-stage ortho, but we couldn't do the second stage. Boy, do I wish we could have.

 

Dd had one-stage ortho. Her teeth are lovely. She didn't need a ton of correction, but still needed braces. We did the regular kind and had a fabulous orthodontist. I was basically abused by mine when I was a child, so I am very careful about the practices we go to. I make sure to pick someone who will allow parents in the back--I know some don't and are fine, but I needed to be there because the abuse happened at a place where my parents couldn't come back. They had no idea how awful the ortho was, and I deliberately found the best/kindest one I could.

 

Make sure your child wears their retainer until they are....well, as long as humanly possible. Teeth can shift in adults.

[TrixieB]

ITA about the Invisalign.

 

Traditional braces hurt for a day or two after every adjustment..  Nowadays, that happens every 6-8 weeks.

 

Invisalign hurts for a day or two after switching to a new tray/retainer.  That happens every 2 weeks.  And the wearer can remove them at will.  It's very very tempting to do so when they hurt, or to speak more clearly.  You're supposed to remove them to drink anything other than water, and brush afterwards.

 

 

[Amber in SJ]

We are now on dd #3 with the same ortho.  Dd # 1 needed the expander so she started at 11 and then we sat and waited until her baby teeth fell out.  All were gone by 13.  The ortho looked @ dd #2 & said she didn't need the expander so he didn't want to see her until all the baby teeth out.  At 15 the baby teeth were gone & she was a good candidate for invisilign.  I would not have done them any younger.  The responsibility is on the child to wear them and wear them correctly.  Dd #1 started grinding her teeth in her sleep in college & broke her retainer.  When she got home the ortho made her an invisilign style retainer which also keeps her from grinding her teeth.  Now dd #3 at 13 yo has what are called damon braces.  They look like traditional braces but don't use elastics.  Supposedly they cause less blunting of the roots which you find with traditional braces.

 

The cost for all three has been pretty much the same.  $6K.  On the high side nation-wide but average around here.

 

We do have several friends who started braces as young as 9, got them off at 12 and then had them back on at 15.  It is difficult to wait out the jacked up middle school years but later has been a better experience for us.

 

So I would say invisilign for older teens only unless your child is very motivated to wear them and wear them correctly.

 

Amber in SJ

[Elfknitter.#]

Dd 12 got her upper brackets, no bands, in October 2015.

 

Unfortunately, dh's genetics (and probably some of mine) play into her lower jaw. She had oral surgery to place chains into her molars in February. The hope is they are not impacted (fused) to her jaw. If not, the chains will guide them into place. If they are, then they will need to be removed. The orthodontist wanted to try the first procedure of chains as he felt that was less invasive. Better to try this procedure than to outright remove the molars. Dh and I had impacted molars. So chances are pretty good she does, too. However, ther's no reason to not try this procedure, other than the extraneous cost of having to also pay for removal of said molars.

 

Ds1, who just turned 11, will probably go for a consult this fall with the same ortho.

 

The orthodontist we visit is separate from our family dentist. However, our dentist did refer us to him. On a side note, my dd's ortho was also my ortho 20 some odd years ago, so choosing him was somewhat subjective. However, I will admit that his practice has changed significantly since I saw him.

[heartlikealion]

I had old school braces followed by a retainer that looked like an Invisalign product. Well, one of my retainers, anyway. The ortho thought that actual Invisalign was really only meant for mild cases and commented that everyone in the commercials already had straight teeth lol. But that was his opinion when they first came out.

 

For reasons stated up thread I can see why traditional braces might make more sense. Not that they were great, but ugh, I wouldn't want a new mold every so many weeks (is that what they do?). I hated getting molds made and I still don't particularly like it. I think they didn't do a great job with my mouth guard (dental office, not ortho) and I stopped wearing it because it hurts my teeth. I'm not sure if I should wear it. I can see why someone would remove their Invisalign.

 

I wore my retainer as long as possible and my teeth shifted later, anyway. Especially common I think during pregnancy. I don't think there's really any way to stop it from happening outside of a bracket behind the teeth.

[heartlikealion]

In our case, the Ortho used something that seemed similar to an MRI machine to take 3D like images of dd skull (it was crazy to watch) that showed every possible angle of her jaw and teeth and also took a series of molds. Then Invisilign crafts the sets from all of this and sends the entire course of corrections to the ortho. The ortho attached little contact points to her actual teeth and these are what fits into the trays, sort of snapping into place to keep the pressure on. She wears each tray for two weeks at a time, although last visit the ortho gave her the option of three weeks if she was having trouble making the 22 hours. (Once I explained that would only make this take longer she is sticking with two weeks.) When you first put in a new set, you also are supposed to bite on this little hard rubber piece that helps shove the trays further up on your teeth. Then we go to the ortho every 12 weeks for a check up and to receive another 12 weeks of trays.

 

The two biggest pros of Invisilign to me would be a) less embarrassment on the child's part, although they do slightly affect the way they talk, particularly at first, b) you don't have to go to the ortho and have wires removed for dental cleanings, and then return to the ortho to have them replaced. In our case however the cons have far outstripped the pros. In all fairness though my friend's dd who is the same age as mine had traditional braces and did not wear her rubber bands as she should and ended up having to wear them an additional six months. So even with those I guess there is a certain level of responsibility in the hands of the child....but not putting on rubber bands will not cause the same issues as not wearing trays. The teeth won't back shift. With Invisilign once the teeth shift they don't go back into the old position so if that happens you're paying for new trays.

 

Oh, wow.

 

I had to wear rubber bands. I was pretty responsible with my braces. Didn't try to eat popcorn, etc. I don't recall having things removed for the dentist, though I guess that's possible if the dentist required it.

[hornblower]

They can clean around the wires, it just takes them more time. We managed once to get wires off for cleaning but it kills a whole chunk of day with driving back & forth between offices. I just gave up on that idea and made the hygienist figure out a way to clean with the wires on. 

[Laura Corin]

They can clean around the wires, it just takes them more time. We managed once to get wires off for cleaning but it kills a whole chunk of day with driving back & forth between offices. I just gave up on that idea and made the hygienist figure out a way to clean with the wires on. 

 

We never had wires taken off for cleanings either.  The boys came out of the their braces with no decay or staining.