Overenthusiastic orthodontist

[Anycrispsleft]

I was wondering if anyone could give me a bit of perspective who has kids whove already had braces? My DD (11) had one molar come in a bit funny due to the milk tooth not coming out, she was then referred to an orthodontist and once they had a look at her teeth they found a whole lot more stuff they wanted to work on. They say her bottom teeth are too far back and that her bite isn't correct because of this, and so they recommend a non-fixed brace, top and bottom for a year to 18 months to correct these big problems, then a similar time period with fixed braces (these sort of studs that fix onto the individual teeth) followed by maybe 6 months of a retainer. It seems a long time of braces for what we initially thought was not that serious a problem, and what worries me a bit is that where we live (in Germany on the border to Switzerland) there is a big trade in cross border dentistry, especially cosmetic treatments, as it's a lot cheaper here than in Switzerland. I was asking the orthodontist whether there were any differences in comfort in terms of the various options and she seemed really surprised and unprepared for that question, she spent more time explaining how lucky we were that the health insurance will pay for all the work! I would prefer that my DD gets the work done that she needs for her teeth to be healthy, and that if there is a cosmetic aspect to the treatment, that is something she could decide to go for herself when she is a bit older. I don't know what I'm asking here exactly, just that if you have experiences good or bad, could you share them? Is it just not an issue about the comfort, am I worrying for nothing? Or is it like with childbirth where wheb pressed they say things like "well of course you will feel some discomfort, that's to be expected" and actually it means it will hurt like he'll?

Out of interest - why? Surely once the teeth have moved and been allowed to "set" (for want of a better word) they will be the same whether a removable or fixed brace was used?

OP - go for it. Adult with braces here. One of the things I found out was that the gums grow back around the teeth when you're young, but not in adults. So better results younger. And won't set you back £4000+ as mine have! (Also mine were overcrowded and got worse with age due to the pressure of all the teeth vying for room, though it sounds like that's not an issue here.)

The "slight discomfort" thing... Yes, it's a lie but only at first. Teeth do ache a bit when the brace is tightened but what they don't say is that you have bits of metal in your mouth acting like a cheese grater on your gums every time you speak or eat. That stage was agonising. But after a week or two the gums toughen up and it's fine. Just warning you to be prepared for the first bit!

If you are in Germany, health insurance typically won't pay for braces when kids turn 18, so if it's necessary anyways, waiting for later will mean you'll have to pay for it yourself. However, if the child turns 18 while in the process of having braces (as that is usually over several years) then the payment by insurance should continue. In any case, you can call your health insurance or go to an appointment in their office and ask about the details, if necessary.

If you doubt the scenario laid out by the orthodontist, then you can also ask your health insurance if you are permitted to go for a so-called second opinion / at another doctor. That is sometimes possible for important issues, like surgeries, too.

Agree with PP that they don't pay for cosmetic reasons anyways, so the orthodontist's suggestions should be medically founded.

What I don't quite get is why they start with removable braces and move on to fixed ones; from what I remember, the usual order is to start with fixed ones as they take care of the main problems and move on to removable ones for the last phase to stabilize. Maybe that is something to ask from them again.

One-piece brace vs two piece: the first one makes it harder to talk.

Because teeth move forward all during your life. It's called mesial drift , it's why , as you age , your lower front teeth often become more crowded.

The problem with retainer type braces is they tend to only move the front six teeth to produce a nice looking result , but don't address the whole way teeth bite together and meet. Therefore the tendency for teeth to move back into a more neutral position is higher in retainer type braces rather than the gold standard which is fixed "train track" braces or , when necessary, functional appliances which address the growth of jaws because it's often discrepancies with size or relationship of jaws which cause crooked teeth.

You almost always start with removable appliances , where necessary , because they can be used when there are still some baby teeth and are used to correct eg teeth trapped behind the bite or can be used to expand the palate where the upper jaw is narrow.

Fixed is much more refined and where removable braces tip teeth , fixed actually moves teeth bodily and refines angulation of teeth. It is used after removable, if removable has been necessary.

@Lollygaggle thanks for explaining this; I guess the cases I knew were very severe, which is why they started with fixed braces, but good to know it does not always have to be that way - and probably things have moved on from how they were years ago.

Everyone that has braces should be wearing retainers for life. My son had train track braces and he has to wear his retainer every other night. It may come down gradually to three or two nights a week.

Yes, my DD has been told once her braces are off she has to wear her retainer forever. Her friend didn't and her teeth have moved back.

My 11 year old needs them and in the US we have to pay most of it, insurance covers 1k and we pay the other 2600$, treatment for 2-2.5 years. Must be so good to get it on the NH, I thought that stopped being possible years ago so glad some people are still getting it.

We had a similar situation. I took DS at 13 thinking it would be a simple train track procedure and the orthodontist recommended a twin block brace to bring his lower jaw forward, followed by train tracks. He HATED the removable appliance and it really affected his confidence. We ended up ditching it after about 6 months and have gone for a simpler route but will probably be less than perfect.

You do have to remember that private orthodontists have to offer you as close to aesthetic perfection as possible. My DS is gorgeous but he does have a tiny bit less than Buzz Lightyear’s jaw. Definitely not out of the ordinary though. It’s a balance to strike between how the procedure will affect them and the outcome they want to achieve.