Hello from Vancouver, BC

[Jude63]

Hi. I'm Jude and thought I'd take advantage of the chance to say "whuzzup eh?"

I'm from Vancouver, Canada and my teeth have been shifting a lot over the past year or so. It started with one lower front tooth and after almost a year things got progressively worse, top and bottom. Top teeth goin' in, bottom's stickin' out. My back bite has "always" been a bit off too and is getting worse. Yipes.

I've been "auditioning" orthodontists this month, 2 down 3 to go. It's not a question of if I get braces but when...something has to be done. I'm definitely going to be an adult in braces as I'm 47 (er, I mean "39".)

I didn't wear braces when I was a child; and my teeth have always been fairly straight. I have a bit of a bruxism issue (I *love* that word, so ferocious) which has only become worse worrying about my teeth. I'm trying to keep calm. I'm pretty sure it's the simple act of aging that is the culprit but perhaps the bruxism is partially to blame?

I am concerned with how the teeth grinding may affect the braces I get. Will I do a number on my teeth & braces while I sleep?

I was initially leaning towards Invisalign (I saw Dr. Daher for a consult he thinks 1.5 yrs) which I feel may be best for the bruxism, but the on-off and constant cleaning, not to mention pain and cavity issues I've heard of, have me wary. Well, I guess a certain amount of pain is going to be a given no matter what. I'm a brave scaredy cat.

The second ortho I saw will use Damon w/ceramic on top, thinks 2 year stint but wants to take out a tooth (top or bottom he hasn't decided) (!) I'd really rather keep my teeth and 2 years? Eep. I really was hoping 1.5 would be the max. I thought the Damon's looked okay and I kind of like (well "like" is a bit strong) the idea of just having them in my mouth 24-7.

The 3rd ortho I'll be seeing seems to specialize in Damon yet also does Invisalign.

The 4th ortho has been at it a long time, also part-time teacher at UBC dental school, and seems to specialize in in-ovation (which everyone seems to spell innovation so I will too.) I understand from reading the forum pages here that all braces are going to do the same thing regardless of their shape. I must say tho the innovations are kind of funky, looking and not in a good way. People said the brackets were larger than other braces, but I thought all brackets had to be the same size. Anyhow, I will find out more when I see her.

The 5th ortho I'll be seeing is actually a dentist who does everything and has been at it for 35 years. Apparently his office was redone not too long ago and he's all state of the art equipment wise. I love Old School and look forward to the consult. I don't know how crazy I am with the fact that apparently he uses an all metal brace.

My consults will all be over before the end of this month. I hope to have made up my mind soon. It feel's like my teeth are shifting more each day (but that might just be my imagination.)

I wouldn't mind some advice! Esp about the bruxism and which brace system "regular" VS Invisalign might be best.

If any Vancouver locals have orthodontist suggestions or advice I'm all ears too.

regards, Jude

[Sunny]

Hi and welcome to this forum Jude!

I think you're doing a fantastic job, by checking with so many ortho's. You show that you are a wise person and realise there are many products on the market and they do need to be checked out before you make a decision.

Brackets ... they can be a variety of sizes, although there's not much of a difference between them. The in-ovation brackets are funky ... especially the ones with the hooks. They make me think of an insect with claws out. They're very popular and I think this is due to how well they blend with peoples teeth and a slightly bigger bracket is more comfy than a smaller one, due to it covering a larger area in your mouth and being less pokey.

Grinding is quite common and mostly due to stress. It's important to work out what's causing your bruxism and remove it from your life. Learning relaxing skills may also help. When you're not having orthodontric treatment, dentist's will have a special guard made (a bit similar to an invisalign aligner) for you to wear while you sleep, that prevents you from grinding, but it doesn't fix the problem if it's stress related. During ortho treatment, a similar type guard is possible, but it has to be changed regularly, so that you don't prevent your teeth from progressing.

Brackets vs Invisalign ... the choice is your's. Weigh up what the ortho's have to say, cost, your ability to be disciplined to wear aligners for 22 hours a day ... etc.

It's cool that you're checking out a dentist, but I'd definitely recommend you go with an orthodontist, as they have a load more training in how teeth move.

Good luck!

[Jude63]

Sunny, thanks for your reply! I know you're like the Den mother around here and it's appreciated to hear from you.

I thought I'd give an update. I did see the 3rd and 4th ortho mentioned in my above post. I actually saw them in reverse order 4th before 3rd (my mention of this will be apparent soon.) The 4th "3rd" is the only woman I've seen, we hit it off, and she seems very caring and the most genuine of everyone I've met, although everyone has been pleasant.

She's the one who teaches at UBC and was a dentist for 16 years before switching to Ortho in the last decade (like me she's OLD.) Her office charges $1,600 less ($5,4000) than the other 2 Invisalign quotes ($7,500) I got and they do a lot of business (of course it's not just about $$$ these are just the facts.) However, I have brought up with everyone I've seen that I brux and no one, including this person mentioned what the 3rd "4th" ortho told me. Which was...

Get this, he confirmed to me that ALL my tooth issues are caused by the bruxing. He said that because of the grinding the roots are going to be extra hard to move (not take more time, just difficult.) I'm not sure if this means more pain. He said that he would not want to work on my teeth until I got the bruxing under control or to stop.

He strongly suggested I get a night mouth guard asap, give it a try, and if I am comfortable in using the guard I may just want to continue to use the guard which will keep any further shifting from happening. [Let's be clear: I know it won't fix the problem just keep it stable.]

He seemed to realize that while I am bummed out (I believe this being the technical word for my feelings <grin>) with my situation, that I could probably be happy with keeping my teeth the way they are now with firm guarantee they won't get worse (with continual night guard wear.) The problem is worse on the bottom where they aren't as noticeable (well, yeah, they are noticeable, but not as much...)

He also said that if my grinding continued after braces that even with a regular night retainer the teeth would shift back to their original, and in fact, worse, position. Now I can't see any reason the man would want to scare me, nor turn away business. [He does not have a sideline in mouth guard production, and wouldn't recommend a dentist that did so, he urged me to see my regular dentist.]

I've made an appt with my dentist for Friday to discuss a mouth guard, and she'll probably make the impression at that time, turnaround is one week. The complete cost will be $293 and it's going to be thermo flex which even after Googling I can't quite determine is the material OR brand name. I was actually walking by the office today and popped in and they showed me someone's guard that had just been made. Looks like a clear Invisalign or retainer and will fit on either upper OR lower's depending on what my dentist thinks best. I believe I soak the hard material in hot water for a minute, stick it in my mouth and they it hardens again.

I'm still going to see my last set ortho appt (the real dentist) tomorrow, to get his take. [Your comments noted Sunny and I think they make sense, but hey at least I'll be getting another opinion.] I'll try the night guard for a bit and see what I'll do next.

I'll tell ya, my bruxing this week has been off the charts w/all my thinking about my teeth. I'm contemplating setting up an appt to see if I have TMJ (I'm thinking not but I definitely do have some signs, tho not jaw related.)

I guess I'll end on a positive note that if I do wind up w/my teeth as they are now it won't be the end of the world. I've also found that if I professionally whiten them, as I did w/home trays about 4 years ago, my teeth look lots better and hence I feel better. I may see more orthos and check other options but right now I'm a little irked that none of the first people I saw mentioned how serious bruxing can affect the results of braces. I may discuss this over the phone or in person w/the woman I connected with and see what her take is, I may have underplayed the bruxing.


It's an adventure.

[Jude63]

And it's me again. Another update on this journey. This is really starting to feel like a radio serial from the great days of radio.

When you last heard from me (look up) I was seriously freaked out about the possibility my grinding issue has been the cause of all my tooth problems. I now feel this is NOT the case (having spoken to and corresponded with a number of people.) I'm not downplaying what a drag bruxing is, but I don't feel it is what's causing my shifting and rotating "tooth-ies." And once I'm braced pics will be forthcoming!

On July 28th I saw my last (5th) consultation for braces, this time with a regular dentist with many (35!) years of experience. He greatly put me at ease by disregarding most of what the previous ortho said re: grinding. He also thought I should not get night guards. He, and his assistant were great listeners, and after seeing four other ortho's I had lots to talk about <grin.> Ultimately I decided not to go with this fellow, who although I felt comfortable with, he's a bit too old school with ligating all metal brackets. I don't want to go that route, plus he didn't give me a firm price, it seems to be "about" $6,5000-ish which I felt was too high. *I should say that I have thought of all metal self-litigating brackets, but ultimately I'd probably prefer the ceramic, at least on the "social six" teeth. I do agree that all metal prob does move teeth a bit quicker, but "what price vanity, etc."

The next day I saw my regular dentist for her advice. I'm relatively new to this person, but I have to say the consult -- concerning night guards / bruxism / shifting teeth / why different opinions from various Orthodontists? -- was under-whelming to say the least (and I did pay $29.00 for this consult.) I expected her to look at my teeth (nope!) and give real answers (she was "Switzerland" all theh way. Bummer. Her hygienist does a helluva great job tho!

Happily just a few hours after that meeting I had made a second consult to see the female ortho I had hit it off with originally. This time I wanted to discuss "regular" braces as I'm just not feeling the luv I initially had for Invisalign. Great meeting! Through her office braces are more costly than Invisalign ($6,250 for braces but still the least costly of any consult yet -- tho still it's not about the $$$) I also discovered that her office does not deal exclusively with GAC (In-ovation C) brackets as I thought was the case. She seemed more than willing to order whichever bracket I wanted; in fact, she brought up the Ormco page to show me the brand new-ish (hot off market research a few month's now) Damon Clear braces (clear uptop, metal below) well....Jude want!

So! Yeah these Damon Clears are pretty nifty, and when I called the office to discuss pricing w/the coordinator she intimated the price is the same no matter which bracket they use, but it's a question of whether or not the office orders them in (this office is part of a mini-conglomerate as it were.) Anyhoo. The ortho appears very keen to give them a try and is familiar with using all sorts of brackets.

MY soon to be ortho is on vacation until the 10th. As, it seems, most of the dental profession (at least in Vancouver) go on vacation at the end of July, first week of August (which includes a holiday here in British Columbia "B.C. Day" we're 151 years old. Whoo!)

The people who order the brackets are on R & R until next week. With luck I'll get the Damon Clears I wish, or at the very least I want another option compared to the Inno C's (which, hey, I'm sure are swell, but if I'm going to get any input, and pay many thousands of $$$ it would be nice to have the bracket of my choice.) I am going to root hard for the Damon Clear's. Will keep you posted.

[Sunny]

It's great you've made your decision Jude and I'm sure you'll be thrilled with your treatment and outcome.

For others who read your post, I need to clarify a couple of things -

he's a bit too old school with ligating all metal brackets.

The newest brackets on the market are ligating. The most made brackets are ligating, as these are also the most commonly used and most requested. There's a few reasons for this, but mostly it's to do with the comfort for the patient. Brackets with ligs have continually proven to be more comfortable due to comfort issues with doors and clips. Also quite a few people make excessive amounts of plaque, which mean that the doors and clips become fastened and have to be 'chipped' before opening. The ligs are made of material that does not allow plaque to attach to it, so there's no issue.

With regard to the staining of ligs, this is a real issue for many people. The thing to remember is that if you have self ligating brackets, there's still a good chance you'll have powerchains for many months ... and these are just ligs joined together and stain the same. More ortho's are using teflon coated wire ties, which means discretion without any staining issues, but it will be wonderful when a lig is developed that doesn't stain. What's equally important is making sure the ligs remain as they are now, so that they don't attract bacteria etc ... as it's yucky what gets stuck behind the doors and clips of the self ligating brackets ... a huge advantage for the ligating brackets.

I do agree that all metal prob does move teeth a bit quicker

Brackets don't move teeth, so it's not possible for one type of bracket to move teeth faster than another.

I think it's great you're able to choose what you'd prefer, but it's important that this information is accurate for others to read.

Good luck with getting your treatment started and also finding ways to relax so that your 'grinding' can come to an end.

Take care!

[Jude63]

Brackets with ligs have continually proven to be more comfortable due to comfort issues with doors and clips. Also quite a few people make excessive amounts of plaque, which mean that the doors and clips become fastened and have to be 'chipped' before opening. The ligs are made of material that does not allow plaque to attach to it, so there's no issue.

Holy Smokes! This is the first I've thought or heard about plaque and self-ligating braces. What you're saying makes sense. [Actually, that's not true, I've seen the postings by sol here on bracesreview, poor kid.] I would also imagine some people don't exactly want to brag if they're having problems w/their system so there may be more unhappy campers out there.

I hadn't considered comfort issues w/doors, in fact if anything I'd think -- at least in comparison to rubber bands -- that the "door" systems are a comfy innovation.

Food for thought (no pun intended), thank you Sunny. I have been giving the duty of cleaning my braces lots of thought and plan to buy a waterpik unit to help with that.

And hey, as ever, I'd just like to add that when I make comments about a lot of braces related things, I am a newbie (moderately well informed and learning more every day yet still...) I would hate to think I'm annoying anyone out there (say, who has braces w/rubber band ligs.)

[Jude63]

Today is August 12th and I've picked my Orthodontist. Whew. I'm tired. Let's review.

The ortho I was feeling a connection with left for vacation and I was to deal with her office re: ordering Damon Clear's. It turns out they are, in fact, loyal to GAC brackets although maybe the Dr could have had them ordered I found the situation rather odd.

So, knowing there was a good chance I might not get the brackets my heart yearned for, coupled with the fact the Dr wouldn't be back for another week I did what any gal would do...I went for a final consult. That brings it up to 6 total.

This Dr wanted to see a panoramic xray so luckily my old dentist had one from 2007. I have chosen this fellow, let's refer to him as "Dr. Six" for now, for a few reasons. He's dealt with Damon for years and is well familiar with the product. I liked him right off the bat and he has loads of experience. Plus like me he's not too young and not too old.

He's the only ortho who brought to my attention that there will be a gap where the lower tooth (2nd molar I believe) that had been removed when I was about 10 is. [You know that's kind of big, and something I hadn't considered. He suggested a few options I can consider down the road.]

I gotta say tho ooh-la-la remember what I've been saying it's not about the money? I've wound up with the most expensive cat in town $8,500. Gadzooks. An investment into my future well being and peace of mind, but truly, I couldn't have gone much higher. Their payment plan options are fair.

Unfortunately, Dr. Six is going on vacation for three weeks, and the soonest they can see me is September 30th. I'm pretty much revved up and ready to go RIGHT NOW so that's too bad, but on the bright side, I can enjoy corn-on-the-cob and the rest of the summer for another 1.5 months. So barring catastrophe: Brace day September 30th.

[Sunny]

Fantastic that you've made the decision and can now prepare for your big day Jude!

Great that you've found the doc you feel is right for you and due to do heaps of research, you've set a great foundation for smooth treatment!

During the weeks leading up to 30 September, preparing a small travel dental kit is a great idea. A small container with a travel sized toothbrush and travel sized toothpaste, plus container of wax, a small mirror, tooth picks and interdental brushes. These kits are fantastic as you can take them with you whenever you're away from home and you'll always have everything you need, if you need to brush after a meal. I've had the same kit travelling with me for all this time ... and I'm sure I'll keep it with me after my big event, as it's great having those important items with me.

Good luck with prepareing for your treatment!

[Jude63]

And she's back! Okay, some changes, but I have absolutely positively found my orthodontist. I'm going for the impressions on Sept 8th, spacers on Sept 29th and braces in early October. I'm feeling confident about my decision.

When I last wrote in mid August I had chosen my ortho, but seeing that he couldn't do my braces until Sept 30th I decided to go for one more consult. The fact this ortho was 2 grand more than some of the others had a fair bit to do with my decision for one last consult. I also went ahead and had the xrays taken (panoramic/ceph/set.)

I saw this last ortho (lucky seven!) on Sept 2nd. I had read very positive reviews on ratemds.com about this fellow and had not seen him only before because it's a 40 minute bus trip to the suburbs.

Anyhow, glad I went, he's a sweet man. I'm glad he wasn't the first consult I had because he said I will be using the Forsus spring for about six months. Then he showed it to me on a tooth model.

After the initial "The-horror-gadzooks!-are-you-mad-Doctor?-no-flipping-way" thoughts quit running through my head -- I mean, have you SEEN these things -- and we discussed the appliance I was sold.

The forsus will replace any elastic work. I wouldn't say I'm lazy, but not having to deal with elastics, and have constant, better pressure then would be provided by elastics 24-7 what's not to love (er, make that tolerate.) I also won't have to wear the Forsus until about 16 weeks of brace wear, by then I'll be an old pro.

I found this page has a very good writeup and pix of Forsus:

Class II Correction Under Control | 2009 Special Issue | Orthodontic Products

Pricing with this fellow is different then other's. An initial $1,050 upfront plus $200 a month (2 years = $4,800) + $350 for Ice ceramic on top + $200 molds/treatment plan + 200 for my earlier xrays which they'll use, I also brought them to consult. So grand total ballpark will be $6,600.

I'm raring to go. Wish me luck! I'll probably do a blog on my progress.

[Sunny]

Wow ... isn't that amazing ... what can happen when you have time to plan! Good luck with your new ortho and it all sounds really exciting for you!

It's great they can see advantages to you using the forsus appliance. We have a similar appliance ... different name, but I think it's probably only a manufacturing thing, but it's only used when patients are non compliant with elastic wear, but really want help. We don't use if a patient is non compliant with elastic wear and also non compliant with other ortho care, like oral hygiene and stuff. I see a positive in the way it's being explained to you, as it will provide a definite force over a longer period and although it will most likely take a bit of getting used to, you will adjust, as we all do to the orthodontic 'stuff' we need.

All the best with your appointments and please do keep a blog of your progress, as it's a great way to see the changes!

[chiclet]

Jude63 and Sunny -- I'm new to this board and just spent an enjoyable coffee time this morning reading through your saga (with Sunny's encouraging interjections). :-) I was impressed by your careful research! It's the exact opposite of my braces decision, which consisted of asking a friend (who is an ortho) about the quickest fix for my teeth, and ending up a month later with a full set of metal braces. She said there is no such thing as a quick fix, which is *not* the answer I was looking for, and although the thought of being in braces for 2 years (I'm 55) initially sent me reeling, I realize the time will pass and I can either end up at the end the next 2 years with straight teeth or with crooked teeth and I'd prefer straight! At any rate, I went into a funk the first week I had my braces -- I couldn't *believe* I'd done this to myself with very little research or thought. Oy! But now I'm really getting into it and am SO happy at the thought of having a lovely smile at the end of it all. I probably could have lived with my snaggletooth look the way it was, but the thought of having a nice straight smile really is a life-altering, mind-blowing thing to think about, and now I'm all about teeth. :-D I was surprised to learn that the tooth movement starts so quickly, within months. I had been under the impression that it took a full 2 years to move everything into place. Now I'm looking forward to seeing where I'm at by the end of this year (I got my braces mid-September). I'm learning (very slowly) that watching your teeth every few minutes apparently doesn't speed things along. :-/ But I'll still keep watching... I'll look forward meanwhile to hearing about your progress -- and yours too, Sunny (aka Den Mother)!

[Sunny]

Hey Chiclet the main thing is to be happy with your decision and you definitely sound happy!

The whole movement thing is amazing and for people who have loads of alignment issues, movement will usually happen within days of the flexible archwire being put on. The alignment phase is the first phase and when most movement occurs ... so it's also the most exciting and motivational phase. Aligning the roots of your teeth and bite issues can take a lot longer ... but they happen with the help of a great ortho.

About movement ... taking photos is one of the best ways to see it. Before treatment and every month after that, take photos using the macro setting of your smile, left and right profile, upper and lower arches. These are fantastic to compare and you'll be amazed at what you may not have noticed without them.

Good luck!

[Jude63]

Hi Chiclet,

Thanks for your kind words. I started looking for my Orthodontist on July 14th and am getting my braces next week on Oct 6th so it'll be one week shy of three months. It's felt like a longer time because I have been raring to go, but I'm glad things have worked out as they have.

I've just started a blog here on Bracesreview so I'd be delighted if people wish to follow my adventure. I hope I'll keep things up!

Sunny has been...well...in a word Sunny! We are SO LUCKY to have someone in our midst who not only cares but is truly interested in what's going on.

[mzkimx3]

Hey jude good luck on your treatment. I semi started mine today just threw up a blog about it so i wont go into alot of detail in or but just wanted to say good luck hope you enjoy it

[chiclet]

That's great, Jude63-- I'll look for your blog! :-)