Ustwo

I was thinking of doing an 'ask a dentist' post but I see we already have that well taken care of. I am specialized in orthodontics and can maybe help some people out in that department. Orthodontic problems are very hard for a non-dentist to describe so for best results a couple of photos would help a lot. Take the photos from the front (biting) and from the sides. Keep your teeth together in a 'normal' bite like you were chewing something, don't position your teeth forward for a better view. If you can't take any photos I'll do my best.

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pappymojo

OK. This is a bit rambling. Sorry.

So, when I smile my upper lip rides high as it were showing a lot of gum. It's not that bad, but it's one of those things that I notice about myself. People with this problem in worse ways are said to have horse teeth.

Anyways, if I put something up in the space between my lip and my gums like I was dipping (although I don't dip. I usually I use a piece of gum) this works to greatly improve my smile. My upper lip no long rides up.

I love to smile. I'm always laughing and smiling.

If I use gum, the gum breaks down and either falls apart, gets sticky or dries up and gets hard. Is there any procedure or is there a device that can do this for me? I'm thinking that I would like to make a soft plastic mold that could fit up there snugly.

pinklily

I'm not sure if this is in your feild, but do you know any ways to help ease TMJ? When I was younger it was much worse, but my jaw still locks up a bit from time to time.

Ustwo

I wouldn't be surprised if someone out there has a 'quick fix' type of device to keep your lip from riding up. Dozens of things like that come up every year from night guards to snore aids, which in general don't work, or cause side effects. I am not aware of any for your problem myself, but that doesn't mean I don't have a solution.

One thing orthodontics can do is change your smile line. We can literally push your top teeth up, along with the gums, so that when you smile you won't show as much gum tissue. I can't say for sure if it would work for you, as there are a lot of factors involved, but if you go to an orthodontist for a consultation they can tell you for sure. Make sure you tell them WHY you want treatment so they know to address the problem, sometimes the smile line gets lost in fixing the other tooth problems.

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Ustwo

The TMJ is one of the most frustrating parts of dentistry/orthodontics.

We used to do a lot of surgery on them in the 80's and we screwed up a LOT of joints doing so. Now the normal treatment is do a little as possible unless the pain is very great or its a degenerative condition.

There are some problems with the TMJ I can fix with orthodontics, BUT you could take two people with the same apparent problem, and after orthodontics, one might be fine and the other will still have the problem.

Also TMJ problems tend to affect women more, but don't ask us to explain why. We can't.

If you have an occasional lock, but no pain my suggestion is to do nothing. There may be problems with your bite, which might improve the condition, but if your occlusion is sound then treatment is not indicated. The joint tends to re-arrange itself better then we can do it, which is understandable since its pretty important for survival.

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Nazggul

Ok, I posted this for PoPo and he said it was an Ortho topic. Have at it.

I currently have all my teeth including 4 wisdom teeth. With all them teeth in there I have very small spaces between my teeth, this has led to shreading dental floss regularly and many cavities between my teeth, etc. The other problem is that my front teeth on my lower jaw are sort of bending backwards into my mouth creating less space for my tongue. Funny, but this makes me stumble words at times.

Do I need to have the wisdom teeth removed to straighten out that lower jaw? Will removing them help restore some space between my teeth so I can spend less money on dental floss? I have also seen some advertisements for these plastic insert braces that you can wear during the day or only at night, you think these may work in my case?

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HeyAgain

Will the gap between the last and second last tooth in the back where the retainer fits properly ever come closer together. I have noticed a lot of food particules are stuck there quite often.

JStrider

eeek orthodontist... *runs screaming*

hehe nice and straight cuz of you guys...
went through a ton of orthodontist stuff...
started in elementry with a Pallet expander (stupid thing on the roof of the mouth and the key)
Then a lip bumper on the bottom and 4 braces on the front top 4 teeth... a retainer for a couple years... and a herpst appliance (looked like hydraulics... had a couple people believing that my jaw was robotic )
then a full set of braces for a couple years...

but it was all worth it... had 2 good orthodontists... my second one was hand picked by my first...

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Ustwo

Ok couple of issues here.

First is the wisdom teeth. You might need them out, but not for orthodontic reasons. Dentists were taught that wisdom teeth cause crowding, and it sounds like it should be true, but its false. They did some high tech tests in the 90’s to show this, but the easiest way to see it is that a lot of people are born without wisdom teeth and they have the same problem with crowding as the rest of the population.

Second is your bottom teeth tipping back. Its really hard for me to say what is going on (this is where I would need a picture) but if its bad enough that it screws up your speech you really should see someone. Its possible your lower jaw grew forward, or that you have a very deep bite, both can cause long term problems.

As for the clear retainer type braces, they MIGHT work for you, but based on what you have told me I wouldn’t be surprised if they didn’t. They are only good for minor cases, and often require you finish your case with normal braces anyways. They are also VERY expensive, so normal braces are cheaper as well.

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Ustwo

Well it depends on WHY the space is there. If you had teeth taken out and that’s where the extracted teeth were then it may not close. If its due to the clasp of the retainer pushing on that spot then it should close once you stop wearing the retainer. I personally only use that kind of clasp rarely because of the potential to create a space.

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Tomservo

Okay, I'm a liberal... anything you can do about that?

Seriously, I brush twice a day, floss once a day, and use Listerine maybe 3-4 times a day (To avoid cancer sores- a result of all the snickers bars mentioned in another post). So, I try to keep care of my teeth to a fair degree.

However! My bite is *straight*. No overbite, no underbite. My top teeth slam right down on my bottom, and while it's all even and pretty, I'm pretty sure I'll grind my lower teeth to nothing over the years unless I give myself a mild bite differential. One dentist suggested I get braces to correct this- and I'm strongly considering this. I'm 31- so it's not the most common thing in the world. I also still have my lower wisdom teeth, I wonder if removing them would help the braces?

Any advice is welcome, unless it involves voting Republican. Heh.

Ustwo

Don't worry Tom, being a doctor I'm good with diseases, even the socialist disease.

As for braces it depends on how bad your bite is off. Braces can cure grinding but not always and if you are a strong grinder you may stop while in treatment, only to start again later. I've seen it work and fail for grinding and there is no way to predict it. Since your dentist didn't recommend a nightguard I will assume your bite is a bit worse then you think it is, and they may help. As for your age, 31 is nothing. My oldest patient is in her 60's (teeth can still shift as you get older), and I have MANY patients over 30.

As for the wisdom teeth, odds are they won't help with braces. I have never found it useful to have them removed. If the teeth are fully in the mouth there is normally no reason to take them out. There are SOME procedures in orthodontics where removing them might make things easier, but not many.

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ShadowWraith

I had braces before to correct overbite and i've had them off for about a year now. The problem is that while my teeth are straight, i have too many teeth esp. since my four wisdom teeth grew in so i still have a slight overbite and this like pushes my cheeks out and makes them kinda rounded and poofy looking. So my new orthodontist recommended i get my four (bicuspids?) from the bottom and top out and then get braces again to close the gap and that'll correct the problem. However, my old orthodontist (i moved midway through having braces) thought i was going to get my wisdom teeth removed after i got my braces off so that it'd fix the problem.

So i guess my question to you is this, would removing my wisdom teeth fix the problem or would i have to get 4 teeth removed and get braces again? I think another possibility was removing my wisdom teeth and putting braces on again anyway but im not sure how that works.

Thanks for all your help!

Ustwo

Looks like I need to have a sticky about wisdom teeth and braces. This is from a few posts up....

I hate taking out bicuspids for orthodontic problems. I haven't ordered one extracted in the last 2 years. Its now how I work. That doesn't mean there arn't cases that need it, but you might not.

Saddly I can't really say much without some pictures like I mentioned in my first post. There is overjet and OVERJET and I'd need to see it. ( Overjet is what I think you mean by overbite, at least I hope so. Overjet is where the top teeth are in front of the bottom teeth and they don't touch, while overbite is how deep your bite is. You can have both at the same time but they are very different in correction).

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JohnnyRock

OK, I'll give it a shot [I'll try to keep it short]:
I had braces when I was in my early 20's. Ran out of money and kept them on for years without anything being done to them. I had them taken off about 10 years ago and needless to say, I could use them still,. I have an overjet [according to the post above], a tooth that the ortho was turning straight, TMJ and, now, spaces from where teeth were pulled to make room for the move.

I have been told that some orthos would not take me because they don't want to be held at fault for previous work done. Is that true? and is there a quicker fix than traditional braces?

Thanks!

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Ustwo

Some might not, but I just started a 65 year old woman today who had them taken off 50 years ago because she wasn't doing what she was told to do. She has overjet too

So there might be some that might not do anything, and there might be damage you did to your teeth by having the braces on for so long without treatment, but I personally would start you.

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nash

As an orthodontist, do you work towards "perfect teeth" or is it ok to just have symmetrical teeth?

I didn't (still don't) really care about how my teeth look, but, I have one front tooth for both the botton and top set of teeth. I have no idea how I came to be missing those two teeth (actually I have a story about the top one) but that's fine with me. Tooth number 7 (lateral incisor, I hope I got that right) is missing and one of the ones 23-26 are missing. I don't know which one 'cause they all look and feel the same to me but my canines are in the right place and I didn't really need braces for the bottom teeth. Tooth number 9 is shifted so it's in the middle and number 8 and 10 are matched up, even though 8 is slightly bigger than 10.

I only had braces for 1 1/2 years, by the way. Any comments?

Peryn

Not so much a question about advice, and what right for me or whatever, but just a question in general.

At what age do you start to reccommend tooth extractions? At what age is it just to young? I am pretty much finished up with the braces, with my second orthodontist, but i had some really bad experiences with my first. Anyway, by the time i was in 4th or 5th grade, i had already had 8 teeth pulled (two sets of 4, prolly a year or more apart). My teeth weren't especially horrible, i had overbite and that overjet thingy some, but again, nothing horrible. As i look back on it now, i really regret having that much, and that intense, or work done at such an early age. If i had to do it all over again, i would have done what i could to wait on the extractions. Im just curious in your experience, how you handle extraction in young children. Was this guy too agressive, or was i too ignorant of the situation? Or a little of both.

Incedentally, it was pretty tactless imo, when at one of my appointments, he looked into my mouth and said something alone the lines of "Oh boy. Looks like we'll be taking a few trips to Hawaii on your mouth." Glad i got away from that guy...

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Ustwo

Only time for one question, I'll get to the other post later

We work for perfect alignment. If I had you as a patient I'd get every tooth where it should be and then work with a dentist to get the missing ones replaced. Symmetry is important, but perfect teeth are symmetrical, while not all symmetry is esthetic.
Now your teeth may be perfectly healthy like that, and I can't say for sure without seeing. Orthodontics is about 40% function/long term health and 60% looks. Most people, even the ones with major functional issues, come in because of looks. They might have jaw problems and impacted teeth, but they come in because the front ones are a little uneven.

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Ustwo

Well the guy seems like an asshole with his comments, that or he just had a really bad sense of humor and was trying to be funny and instead looked like an ass. I'm also confused as to WHY he would say that as most orthodontists, almost all I'd say, don't take out the teeth themselves. We could, but our offices are not set up for it, and we will either refer to an oral surgeon or back to their dentist depending on what needs to be done. Was he a real orthodontist or a dentist playing around with orthodontics? No law says a general dentist or pedodontist can't do orthodontics, but very few take the time to really understand it. Its not something you can learn at a weekend course, despite some amusing claims.

Also I am hoping you are referring to baby teeth and not permanent ones. There is no SET age at when its good to take out baby teeth. I do have them taken out but the age of the patient, maturity level, and immediate need all play a part. Its pretty rare we would need to take that many out at once, but it can happen. So what I would guess is that you didn't need that many out at once but I can't be sure.

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nash

Cool. I have barely an overbite and don't have any jaw problems, and my teeth look pretty good according to xrays and trips to the dentist around 2-3 times a year. Thanks for the info!

mojobojo

Im 22 and have never been to a dentist or orthodontist of any kind as my mother could not afford it. I now am making decent money on my own and have insurance through my work. I was wondering some of the basics of going. (how much it costs) I know i will need braces as my front two teeth jutin out a bit. Also i have read a lot about triangle braces that are supposed to lower the time of wear braces. And suggestions on them?

Ustwo

#1 Go to a dentist first. Find one you like and ask for a referal to a orthodontist. Key is making sure your teeth are healthy first.

#2 Depends on where you live. Full braces run anywhere from 3600-6400 (and even more in some states).

#3 Every brace maker out there says theirs is the best. Personaly the kind you are talking about I think suck

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mr sticky

Hey Ustwo..

Coupla not so quick dental questions.

I have a good bite, no malocclusion. I have numerous small and some larger lesions which usually appear around my crown regions near the gumline on the facial sides. I have one tooth, #9 that is malailigned, but not bothersome. These cavitary lesions are probably caused by night time gritting, but not grinding of teeth.

Now for the question...are veneers (post restoration) a good option for me? I want a better grill, I was thinking that maybe porcelin veneers could give me the look I want and the coverage could help with my sensitivity and future lesions? Is this a correct assumption?

Would I be wasting my money? And do these last? I'm getting only about three years out of any herculite bonding (mostly secondary to those small fractures I get with the gritting).

I'm looking for an objective opinion before I go interviewing docs. I've had some work done at the local dental school (UNC), but it takes forever. I at least learned a lot from them, none of which helps me in this decision.

Any input is great, thanks in advance.


I

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agball

I would like to hear your comments on Invisalign vs. the standard braces. Does Invisalign work as good/fast? Will insurance companies start covering Invisalign in the near future? How much is Invisalign? How long do you were Invisalign per 24hr.?

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Ustwo

Will get to the last two in a bit, first one is really a question for popo though

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agball

Hi Ustwo, I never saw a response to my question above. Please respond when you have a second.

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sprocket

Utswo:

I had braces as a teenager.. my teeth were perfect. My wisdom teeth came in.. I put off getting them out.. since there wasnt enough room in my mouth they made my teeth crooked. I couldnt stand it, my bite didnt fit together and it was just uncomfortable. Fast forward some, I got my wisdom teeth out and got Invisalign. My teeth werent that out of whack, so I only had 9 pairs of retainers.

Everything was going great but I slipped up and didnt wear them as much on the last 3 or 4 sets. I would take them out when I went out at night. Now it looks like my teeth are molding the aligners instead of the aligners molding my teeth. Is this a common thing with Invisalign if you dont wear your retainers enough? Can it be solved by getting copies of the last few retainers and wearing those the prescribed amount of hours per day? I also tend to clench my teeth when I have them in, and they seem to soften up a bit after wearing them for a while. Mabye thats why?

My teeth are much better than they were but still not close to perfect. I missed my last checkup and wont be able to get in for a while, so I havnt been able to ask my Ortho.

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sprocket

Im in massage therapy school right now, and TMJ Disorder is something that we learn quite a bit about. Neuromuscular massage therapy (NMT) can work miricles for many TMJ cases (if its your musculature thats the issue). Dentists in some parts of the country have started bringing structural massage therapists into their practices specifically for TMJ cases. Check it out.

Craniosacral therapy might be helpful as well.

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noahfor

How long does it take for wisdom teeth to come in all the way. I have one coming in that looks straight but has been protruding for a year and is not even half way "there" yet.