Mother and son starting braces together!

[Protoman2050]

Me and my mom are finally getting braces together! I've always needed them, and mom's noticing her teeth are moving in middle-age; she has this huge gap between her maxillary central incisors.

I finally got braces 10 years after my general dentist, Dr Coffee, told me I'd need them when I first saw him at age 8. My orthodontist, Dr Chang, used to work with my general dentist, so they know each other quite well.

Another ortho I saw wanted everyone to have a $3000 CT before treatment (I'm coming for braces, not orthognathic surgery!), and another (only ortho in a general practice group) looked like he was operating out the back of a truck, wires and boxes everywhere, constant interruptions, etc. Front office looked really nice though...

His staff is excellent, he's extremely knowledgable, office looks like a hotel (the operatories have massage!), and he was never pushy about my treatment, and his financial office was very practical and easy to work with. He does all his adjustments himself, which is nice; Dr. CT-Happy delegated that to the RDAs, and I didn't stick around long enough to figure out what Dr. Shady did.

I have crowding and a deep bite, so I needed bite turbos on my lateral incisors to correct it, which makes eating take forever, since my back teeth don't occlude now.

My friend has the old style of braces, and he kept complaining about all the pain he was in when they were put on, and adjusted. I've got the newest generation of SL brackets, which can use much thinner wires, use less force, and appointments are over much quicker (only took 10 minutes for my archwires to be put on, my friend said it took 30 minutes for his archwires to be put on). I've never noticed any pain at all.

My pain has actually been relieved, as the braces are putting my bite into the proper position, relieving my jaw pain and headches when chewing, and I can breathe better.

Due to the rigorous hygiene I have to do (I'm using a soft brush, so don't start on that; it's the toothpaste and frequency causing the damage), I now have a relatively serious periodontal lesion on my URQ (inflammed and bright red, exposed dentin and maybe cementum, ulceration with a gray pseudomembrane, pain, and bleeding on any pressure, huge groove in my gum and inverted contour, bits of tissue, both gingiva and dental, flaking off); it looks like Acute Necrotizing Ulcerative Gingivitis but I'm sure that's not it, as there's no pus, halitosis, or anything indicating an infection. I've also noticed a few minutes ago I may have popped the archwire from a bracket.

The spacers likely activated whatever latent periodontitis I had (interdental papillae were peeling, swollen, and bleeding, which Dr Chang said was normal, and so did everyone else, so I wasn't too worried), and the hygiene schedule made it 100x worse...my pockets in that area were 3s and 4s, now they're probably 5s and 6s.

When you have a gaping groove in your gumline that's gray surrounded by bright red, have to brush with Orajel, your sink looks like that of a TB patient, and dentin/cementum is exposed and flaking off, you know something's very wrong.

I'll be seeing Dr Chang on Wednesday (my mom'll be getting her braces put on then!) for the archwire to be re-set, and my URQ lesion to be looked at. I'll be seeing Dr Coffee on the following Tuesday for my regular cleaning, and for my lesion to be examined and treated. I'd like the hygienist to do an SRP to debride the area and smooth the roots so the gingiva can hopefully reattach, as they're FUBAR. Most likely, I'm probably going to need to see a periodontist, as it looks bad enough for me to need a connective tissue graft.

Lol, it looks like me and my mom will have the exact same dental care team. Me and mom both see Dr Coffee for our general dental upkeep, both of us see Dr Chang for our braces, and I'll probably be seeing the periodontist who did mom's pre-ortho periodontal exam.

Dr Chang wants all patients over a certain age (aka my mom) to have a periodontal consult before he starts treatment, which means he really cares about his work, as periodontal disease makes orthodontic work more dangerous and complicated...don't want teeth being avulsed or extracted because there's no bone to resist the archwire pulling. The periodontist found a small cavity on Mom, as well as a few fillings beginning to come apart, which Dr Coffee fixed.

He didn't believe a periodontal consult was necessary for me, as I'm only 18, but he did want me to have an SRP of the lingual side of my mandibular incisors, as the pockets were pretty deep there, most likely due to my narrow arch making it nigh-impossible to brush or floss there. I was kind of freaked out at first, but Dr Coffee's hygienist is excellent and explained the procedure to me. From my reading, I thought I'd need a shot (never had that before, as the only thing close to a cavity I have is some minor decalcification), but the hygienist used a ultra-strong topical anesthetic mix of lidocaine, procaine, and tetracaine, which made me unable to feel anything in that area. I never even knew she did the SRP; it felt just like my regular cleaning. My teeth felt so clean after that. My gums were a bit bruised and hurt a little, but nothing too bad, didn't even need to take an ibuprofen.

Wish us luck!!!!

[Sunny]

Hi and welcome to this forum. It must be exciting to be having ortho treatment at the same time as your Mum ... good luck to both of you.

I like your ortho's attitude to peridontal care. Where I work, we do the same and it's a good way to be able to ensure that gum health is at it's best before ortho treatment begins. When necessary we work with a patients perio, incase treatment must be slowed due to pockets reoccuring, becoming deeper etc.

We no longer use spacers as we use buccal molar brackets and one of the latest non sl brackets ... I think it was first produced about a year ago or maybe a little less than that. Due to not using spacers, I'm not sure if they affect they have on the gums, but I'm guessing it can be a bit hard on the gum area if the teeth that are being forced apart are really tight.

Good luck with getting the lesion sorted and here's hoping it will be easily sorted. I've had what looks like 'mouth sores' around the gum area on a couple of molars. These molars already have gum recession and I was confused as to why this happened, as like you I use a soft childs toothbrush and know to brush lightly when near the gum area and usually only brush twice a day to limit gum aggrevation. After a few personal trials, I found this only happened when I used a particular type of listerine. It doesn't happen when I rinse at night only with the whitening listerine prior to brushing, but it happened when I used the listerine fluoride mouthrinse twice a day. I changed to rinsing twice a day with the sensodyne brand of fluoride mouthrinse and I've not had any problems since. I was lucky that my issues were so easy to correct.

All the best and here't to your treatment, and your mother's, going smoothly!

[Protoman2050]

Hi and welcome to this forum. It must be exciting to be having ortho treatment at the same time as your Mum ... good luck to both of you.

I like your ortho's attitude to peridontal care. Where I work, we do the same and it's a good way to be able to ensure that gum health is at it's best before ortho treatment begins. When necessary we work with a patients perio, incase treatment must be slowed due to pockets reoccuring, becoming deeper etc.

We no longer use spacers as we use buccal molar brackets and one of the latest non sl brackets ... I think it was first produced about a year ago or maybe a little less than that. Due to not using spacers, I'm not sure if they affect they have on the gums, but I'm guessing it can be a bit hard on the gum area if the teeth that are being forced apart are really tight.

Good luck with getting the lesion sorted and here's hoping it will be easily sorted. I've had what looks like 'mouth sores' around the gum area on a couple of molars. These molars already have gum recession and I was confused as to why this happened, as like you I use a soft childs toothbrush and know to brush lightly when near the gum area and usually only brush twice a day to limit gum aggrevation. After a few personal trials, I found this only happened when I used a particular type of listerine. It doesn't happen when I rinse at night only with the whitening listerine prior to brushing, but it happened when I used the listerine fluoride mouthrinse twice a day. I changed to rinsing twice a day with the sensodyne brand of fluoride mouthrinse and I've not had any problems since. I was lucky that my issues were so easy to correct.

All the best and here't to your treatment, and your mother's, going smoothly!

Yeah, everything's going quite well for me, save for my lesion, which is causing pain all the way up to my eye. Ibuprofen and Orajel takes care of it. But I'm worried about getting an infection.

I've only got bands on my upper molars, my lower ones simply have brackets.

One ortho's assistant (the one who's doing my friend) I saw said about my choice of SL brackets "But don't you want colors?!" I said "I'm not a tween, I care about function, not looks." I didn't choose white ceramic brackets, as they look great in the office, but then they get unremovable stains after a while, which is why I'll be choosing smokey grey powerchains when it comes time for me to get them. I don't want any unremovable stains.

[catgyrl]

I also have all metal brackets, but my ortho said I could get colored ligs if I still wanted them. I think they're a fun way to "dress things up" and have fun with something that isn't going to be so fun sometimes. You'd be surprised at how many adults get colored ligs. I decided against getting them because it's enough for me to try to keep food out of the brackets themselves, let alone the O-rings. Pure laziness on my part...

As for the clear ceramics staining, it's actually the O-rings around them that stain. The brackets themselves don't stain. Even the powerchains stain (yes, even the gray ones) depending on how much curry, wine, coffee, etc. that you drink. Some colors stain more than others. That said... I'll probably be getting silver powerchains when my time comes, too, because I've heard those are one of the least noticeable when they stain.

Here's hoping you find some relief with your lesion. I agree - Orajel and ibuprofen are wonderful!

[Protoman2050]

Here's hoping you find some relief with your lesion. I agree - Orajel and ibuprofen are wonderful!

Well, the Orajel only numbs the surface, as benzocaine doesn't penetrate nearly as far as the lidocaine/procaine/tetracaine mix Dr Coffee used to numb me for the SRP...I can still feel the deep ache. I've just taken both Orajel and ibuprofen, and the pain's still there, but with "the volume turned down."

What I really need though, is a steroid, hopefully Dr Coffee'll give me some when I see him. And probably some desensitizing cream, and maybe antibiotics.

I'm going to demand bitewings of my URQ when I see Dr Coffee next Tuesday. I hope I don't have an infection. Hopefully he'll put some Arestin in the pockets around the lesion to prevent that.

Likely I'll need a connective tissue graft to cover the exposed root.

And now, when I touch the gum, I get pain in the teeth below the lesion, and the teeth distal to lesion. I really hope I don't have an endodontic lesion secondary to the periodontic lesion. That means infection is getting through the exposed root.

[Sunny]

Here's hoping your gums will heal soon and this terrible pain won't return.

There is no difference in how brackets work ... your teeth will not move any faster no matter if your ortho uses sl or non sl. It's not about the brackets but the skill of your ortho using the archwires.

Also as cat has said, ceramic brackets do not stain. The very old plastic brackets used to, but there weren't many of them around and hopefully all ortho's disposed of them many years ago.

Lig and powerchain colours are loads of fun. I've worked as a counsellor and in prisons with colours ligs and not one person has commented ... but I sure enjoyed not having to concern myself with wearing the light colours, as I eat a load of staining foods and although I can have my ligs and powerchains changed every day, I don't want that, and I don't think my ortho (also my boss) would want to do it.

[Protoman2050]

Here's hoping your gums will heal soon and this terrible pain won't return.

There is no difference in how brackets work ... your teeth will not move any faster no matter if your ortho uses sl or non sl. It's not about the brackets but the skill of your ortho using the archwires.

Also as cat has said, ceramic brackets do not stain. The very old plastic brackets used to, but there weren't many of them around and hopefully all ortho's disposed of them many years ago.

Lig and powerchain colours are loads of fun. I've worked as a counsellor and in prisons with colours ligs and not one person has commented ... but I sure enjoyed not having to concern myself with wearing the light colours, as I eat a load of staining foods and although I can have my ligs and powerchains changed every day, I don't want that, and I don't think my ortho (also my boss) would want to do it.

Well, I've heard gum lesions don't heal on their own...once gingival tissue is gone, it's gone for good.

SL is easier to clean...my friend has non SL, and I've seen him spend 15-20 minutes in the bathroom picking out debris from the ligs. I just have to brush, and use a Waterpik, and the debris is gone from the brackets, and my electric flosser takes care of stuff in between my teeth.

Now I have a 99.5-6 fever, and yellow pus coming out. Dr Chang prescribed warm saltwater rinses, amoxicillin, and Peridex. I'll see him tomorrow morning.

[Sunny]

Your friend mustn't have developed good hygiene practices yet, as the ligs are designed to sit smoothly with the archwire and bracket, which means food can't get behind them or around them. My experience shows that some types of sl brackets cause more issues with food, as it can get caught behind and around the additional bits and pieces of metal that hold the archwire ... but also leave gaps.

Please don't rely on your electric flosser to floss your teeth. As you already have gum issues, please floss properly, as the electric flosser can not floss the important area just below the gum with the correct action. With braces, flossing is slower, but the more you practice the easier it will get. Plus your gums will become healthier for the extra effort.

Good luck with your appointment tomorrow. Now you have a fever and pus the situation sounds even worse. Definitely do the warm salt water rinses, as they're soothing and healing, but first you need the infection sorted.

Take care!

[Protoman2050]

Good luck with your appointment tomorrow. Now you have a fever and pus the situation sounds even worse. Definitely do the warm salt water rinses, as they're soothing and healing, but first you need the infection sorted.

Take care!

Well, Dr Chang specifically said not to brush or floss where the lesion is, because it could aggravate it even more. He said it looks like some sort of burn (how I got a burn there, no-one knows), and ordered an emergency perio consult. I'll be seeing Dr Valenzuela this afternoon.

Dr Chang also took intraoral photos, which showed severe inflammation, and bitewing and periapical X-rays, which were negative according to him. He gently cleaned out the lesion to remove the necrosis and pus, and gave me some Orabase, which is far superior to Orajel, because it stays exactly where I want it, and doesn't run everywhere.

The amoxicillin and Peridex have eliminated my fever, and got rid of the gray pseudomembrane and pus.

[Protoman2050]

Well, Dr Valenzuela figured out that it wasn't an infection, just a nasty chemical burn (burned through both the mucosa and gingiva, and exposed a little bone) from the etchant, which somehow got on my gum. Dr Chang said that in 27 years of practice, he's never seen this.

So Dr Valenzuela said to stop the amoxicillin and keep on with the Peridex.

He also said that it's going to completely heal in two weeks! I go back to him then.

[Sunny]

Fantastic that you had a good result and here's to your gum healing smoothly.

[Protoman2050]

Fantastic that you had a good result and here's to your gum healing smoothly.

Sadly, it's not going too well. Percocet AND Vicodin are not relieving the pain, which kept me up all night. If any sort of air current or object touches it, I shriek. Also, me and mom are beginning to disagree with Dr Valenzuela's recommendation to leave it alone, and it'll heal by itself.

There is exposed bone, and leaving a severe burn without a graft to cover it, and further telling me not to clean the area, is setting me up for a nasty infection like osteomyelitis.

So we called Dr Melnick, Dr Valenzuela's partner (he's not in today), and he'll call us back with a recommendation. We also called Dr Coffee, who said he'll alert Dr Lee, the oral and maxillofacial surgeon who works right next to him, that I might be coming in today. I really need a PSA block to numb my URQ, and a graft to cover the area.

Wish me luck!

[Protoman2050]

Well, the consult with Dr Lee was a disaster; he made me wait for hours while in pain (because he never told us that he'd see us after all of his scheduled patients), attending to some stupid extraction evaluation (which can wait for 10 damn minutes, it's not an emergency) instead of the patient who really needed his expertise, said that it was just a big canker sore (um, I don't know of anyone who needs Vicodin to treat a canker sore, and I've never seen them go down to the bone), and to use some Oragel and warm saltwater rinses. On top of it, he never gave me any anesthetics or analgesics, and he charged us $330 for a wasted ten minutes.

Contrast that with Dr Valenzuela. When he told us to come in at 12:40, he saw us at 12:40, we spent an entire hour with him, we laughed and joked with us, and he applied a peridontal dressing to cover up the exposed bone. He was so upset about Dr Lee's treatment of us that he didn't even charge us for this visit.

I feel a lot better now, and I can cut my Vicodin dose in half now.

[momwithbraces]

I also have all metal brackets, but my ortho said I could get colored ligs if I still wanted them. I think they're a fun way to "dress things up" and have fun with something that isn't going to be so fun sometimes. You'd be surprised at how many adults get colored ligs. I decided against getting them because it's enough for me to try to keep food out of the brackets themselves, let alone the O-rings. Pure laziness on my part...

As for the clear ceramics staining, it's actually the O-rings around them that stain. The brackets themselves don't stain. Even the powerchains stain (yes, even the gray ones) depending on how much curry, wine, coffee, etc. that you drink. Some colors stain more than others. That said... I'll probably be getting silver powerchains when my time comes, too, because I've heard those are one of the least noticeable when they stain.

Here's hoping you find some relief with your lesion. I agree - Orajel and ibuprofen are wonderful!

Thanks for the info....I got clear brackets with white wire. Brushing has worn off the white on the wire, and it is now silver. My "clear" powerchains (are those the little rubberbands that hold the wire to the brackets?) are also staining a tan and are making my teeth look even more stained. You suggest silver bands? Any other colors people have tried that don't look so bad when they stain?

Another problem....I am a coffee drinker and regularly whitened my teeth before braces. How can I whiten my teeth with braces on? I won't be whitening them to the point they are whiter than the part under the braces. The day I had them placed, my teeth were beautifully white. I've tried the strips, but they don't whiten as much as when I used them on teeth, perhaps because they can't completely adhere to the tooth surface with braces in the way.

Help!

[Protoman2050]

Thanks for the info....I got clear brackets with white wire. Brushing has worn off the white on the wire, and it is now silver. My "clear" powerchains (are those the little rubberbands that hold the wire to the brackets?) are also staining a tan and are making my teeth look even more stained. You suggest silver bands? Any other colors people have tried that don't look so bad when they stain?

Another problem....I am a coffee drinker and regularly whitened my teeth before braces. How can I whiten my teeth with braces on? I won't be whitening them to the point they are whiter than the part under the braces. The day I had them placed, my teeth were beautifully white. I've tried the strips, but they don't whiten as much as when I used them on teeth, perhaps because they can't completely adhere to the tooth surface with braces in the way.

Help!

Please don't hijack threads!

I'll be seeing Dr Coffee tomorrow morning for a maxillary nerve block, exam, refill on my Percocet, and a cleaning. Later that day, I see Dr Valenzuela and I'm going to demand he graft the wound.

[MsMichelle]

Good luck with your treatment and hope that all you have been going through it definitely worth it in the end.

You certaintly have had quite a tale at your beginnings!

[momwithbraces]

Please don't hijack threads!

I'll be seeing Dr Coffee tomorrow morning for a maxillary nerve block, exam, refill on my Percocet, and a cleaning. Later that day, I see Dr Valenzuela and I'm going to demand he graft the wound.

I apologize. I've been in online forums for over 8 years and didn't realize to enter a conversation topic with personl connections was hijacking threads. Guess I failed to read the "deed" you get to a topic when you create a thread. Sorry for irritating you so.....hope your ortho experience improves.

[Sunny]

Thanks for the info....I got clear brackets with white wire. Brushing has worn off the white on the wire, and it is now silver. My "clear" powerchains (are those the little rubberbands that hold the wire to the brackets?) are also staining a tan and are making my teeth look even more stained. You suggest silver bands? Any other colors people have tried that don't look so bad when they stain?

Another problem....I am a coffee drinker and regularly whitened my teeth before braces. How can I whiten my teeth with braces on? I won't be whitening them to the point they are whiter than the part under the braces. The day I had them placed, my teeth were beautifully white. I've tried the strips, but they don't whiten as much as when I used them on teeth, perhaps because they can't completely adhere to the tooth surface with braces in the way.

Help!

Hi Mom

You're welcome to join any thread where you're replying to another person in the thread. Protoman is still quite new to this forum and may have thought the rules were different.

Powerchains and ligs are different. Ligatures (ligs) are the rubber rings that go round each individual bracket, where as powerchains are connected to each other and help pull the teeth together or hold the teeth together as a group.

Many of the white coated archwires do chip with brushing, but the best part is they continue to work ... which is the important part.

The clear, tooth coloured and white ligs and powerchains seem to stain the easiest. Silver and dark colours show the stains the least. Also blues will turn a green shade if stained with a yellow food. My favourite non staining colours are purple and black.

Some ortho's will use wire tires around each bracket instead of ligs, and they don't have any chance of staining.

Whitening ... don't use any kind of whitening products, other than toothpaste, when you have braces on. Whitening toothpastes do not whiten, but they will lessen or maybe remove some of the most recent staining. Using interdental brushes around the brackets and under the archwires will help keep your teeth clean. If you brush correctly, you should be able to keep your teeth clean during ortho treatment. Plus seeing your dentist/hygienist twice a year is recommended.

Good luck with your treatment and I look forward to following your story.

[Protoman2050]

I just got back from Dr Valenzuela.

Turns out he cannot graft the wound, because the cancellous bone that's exposed is dead (not the cortical bone, luckily!), and a graft would just die and fall off. He wants me to come back in 10 days (which happens to be when my college summer session starts), and if it hasn't healed by then, he's going to send me to one of his oral and maxillofacial surgeon colleagues.

Dr Coffee numbed me with lidocaine (it felt so good, no pain at all!), which wore off just as I picked up Norco 10/325 he called in at Pavilions. He didn't have the special form needed to prescribe Percocet, but anything's better than nothing.

He also was flabbergasted, and said he hasn't seen anything like this before. Also, my hygienist said I'm doing quite well with my oral hygiene.

Oh, and momwithbraces, it's still nice to just start another thread for your own questions, and also makes it easier on readers.

Also, the whitening toothpaste contains more of the grit than the regular stuff, so it polishes more, and grnds off the plaque better. It usually also contains hydrogen peroxide, which is an oxidizer and bleaching agent.

[momwithbraces]

I just got back from Dr Valenzuela.

Turns out he cannot graft the wound, because the cancellous bone that's exposed is dead (not the cortical bone, luckily!), and a graft would just die and fall off. He wants me to come back in 10 days (which happens to be when my college summer session starts), and if it hasn't healed by then, he's going to send me to one of his oral and maxillofacial surgeon colleagues.

Dr Coffee numbed me with lidocaine (it felt so good, no pain at all!), which wore off just as I picked up Norco 10/325 he called in at Pavilions. He didn't have the special form needed to prescribe Percocet, but anything's better than nothing.

He also was flabbergasted, and said he hasn't seen anything like this before. Also, my hygienist said I'm doing quite well with my oral hygiene.

Oh, and momwithbraces, it's still nice to just start another thread for your own questions, and also makes it easier on readers.

Also, the whitening toothpaste contains more of the grit than the regular stuff, so it polishes more, and grnds off the plaque better. It usually also contains hydrogen peroxide, which is an oxidizer and bleaching agent.

Glad your Dr. was able to give you some pain relief. It sounds like you have a very unique case.

If hydrogen peroxide is used, it MUST be diluted. Many make the mistake of mouthwashing with it straight. In even the 3% strength, my ortho said it will damage healthy tissue, creating new problems if you don't already have them.

Oh, and I head already started a newbie thread for myself....that doesn't preclude me from discussing on other threads as well. Thanks for the "nice" advice, though.

[Protoman2050]

A sliver of bone just fell out!!!! I wonder what this means...

Nothing good, I bet. Luckily, my Norco/Benadryl/ibuprofen mix made this painless.

I'll have my mom call Dr Valenzuela's emergency pager when she gets done brushing her teeth.

[Protoman2050]

My chemical burn is nicely healed up now, I see Dr Valenzuela for the very last time in two weeks. I also had my first adjustment two days ago, and the only problem is some slight sensitivity of my incisors, which is absolutely normal.

I'll also be (hopefully!) moving to Leeds, England next year to study for a BSc in Microbiology with Immunology, so I'll need to change orthodontists. I'm thinking of seeing Dr Alan Gowan of Leeds Dental Institute.