Faster Treatment

[davidsg]

Hi everyone,

I am new in this forum and also new in braces as i only had my braces done for two months.

Can anybody out there please advise me of any tips or heard anything as to expedite the treatment and straighten my teeths faster.

[Stephanie]

Hi David. I wanted the same fast treatment.

Several orthodontist will allow you to come to get the braces tightened and such every 2 weeks instead of every 4 weeks. This cuts the treatment time in half.

You will most likely have to pay extra.

But studies have shown that once the braces are tightened and adjusted, you are ready for another adjustment after 1 week and a half.

Most orthos schedule you every 3-4 weeks and this is too long.. this is uslaly becuase they are busy and it is standard practice.

Good Luck

[hulsshel]

If you get the expidited treatment, they will come off in half the time so wouldn't they hurt twice as badly? I am considering braces and am a real wimp. I don't want to hurt any more than is necessary.

[GiveUDeals]

Is this accurate cause you just made my day, I will call my dentist tomorrow. I got lingual braces on Wednesday and the pain is horrible. The first day I was able to speak, the following two it did nothing but get worse.

I'll await your response

[BracesTwice]

I am just about a braces bro. Over 4 years experince

Anyways if you can get the ortho to see you every 3 weeks instead of 4 weeks, this will speed up your treatment. The braces really need to be adjusted every 2-3 but if an office is busy they can only see you every 4.

The trick is, when you reschedule, telll the secretary you cant make it that week and make them schedule it the week before

[mariahfromchicago]

do you think that getting my braces tightened more often (and for me speaking in a different accent more often) will be beneficial?
I am 13 and have one baby tooth that is not loose (a molar). my two canine teeth (on top) are not yet fully grown. One is close to fully erupted. The other one is a little bit erupted. my top teeth are almost straight except for three teeth (the two canines (that one isn't so bad) and the molar) My bottom teeth are very very close to straight except for a tooth that is behind the rest.
so what do you think?
-mariah

[michaelY]

I really think it depends, but I hate when I hear that some orthos only do adjustments every 7 to 8 weeks since they took on more patients than they can handle. You should be going in for adjustments evey 4 weeks. Some go even every 3 and I do agree that this speeds up treatment time.

[perfect_smile]

Really?? I go every 3 weeks, but I am now 2 years behind schedule!! Been wearing braces for 6 years... I'm trying to go every 2 weeks now, and hopefully get them off this year!! It only hurts the first max. 3 days. So tightening every two weeks really isn't bad.

I've heard that teeth move 1mm per month? So would tightening it more often speed the movement up too?

[mariahfromchicago]

I now go in every 8 weeks a little too long, eh?

[Sunny]

The time between adjustments usually will not speed up or slow down progress, as adjustments don't often move teeth, but assist with the process that is already underway. This may mean changing something, adding something, adjusting something, removing something etc.

If a person tries to increase the speed by which their teeth move, it can in fact have the opposite affect and slow progress down. Also over correction, when not part of the overall plan is a negative.

We have one ortho in our practice who likes the 'once every six weeks' appointments and it works well for him. He agrees that many of his appointments are of 'zero value' with regard to progress, but this is how he likes to do things and will work longer hours to ensure he maintains his client numbers.

Mariah 8 weeks seems to be about average. The trend is to have longer between appointments (10-14 weeks) to allow movement to continue without hinderance. This obviously has to be reviewed if a specific movement is being monitored and progress needs to be checked. My appointments have varied from between 5 and 16 weeks. The interesting part is that now I'm working at the practice, my chair appointments have even longer times between them.

Choose your ortho well and then trust them to know what is the best time frame for your teeth.

[Zoso]

Let's just think this through for a moment. If having adjustments every 8 weeks instead of every 4 weeks would double your overall treatment time, then that would still add up to the exact same number of appointments, which would still cost the orthodontist the exact same amount ... more in fact, as his costs would go up over time.

The key to squeezing more patients (revenue) into a practice without increasing working hours (costs) is to do fewer adjustments per patient. And some orthodontists are seizing on the idea that self-ligating brackets allow them to do less frequent adjustments without impacting treatment time; now granted this is an "advantage" that I believe is somewhat overstated. But the key point here is that the archwires can continue to move the teeth over fairly long perids of time - who here has had a new archwire (and by new I mean one of a size) at every single adjustment?

The best things you can do if not to speed up your treatment, at least to minimimse the chances it might be delayed, are to follow to the letter any instructions regarding any removable appliances, elastics, etc., and to be sure to keep your teeth clean, since those same acids that can cause tooth decay can also lead to loose brackets.

[perfect_smile]

But the key point here is that the archwires can continue to move the teeth over fairly long perids of time - who here has had a new archwire (and by new I mean one of a size) at every single adjustment?

My ortho changes/adjusts the archwire almost every appointment. I'm not exactly sure if she uses a new one or just fix the old one, but she removes it from my mouth and works with it for a pretty long time.

Also, I thought the tight feeling you get is the teeth moving/growing/adjusting. So once you don't feel that pain anymore (usu. after a few days), doesn't it mean the teeth are done moving to the new location, and therefore the pressure isn't there anymore???

At to people going every 4+ weeks, doesn't that hinder the treatment? I used to go every month, or even two months, because I keep missing meetings, and according to my ortho, this is what caused the delay of my treatment (2 years). She has NEVER given me a meeting over 4 weeks from the previous one. Why are my teeth so weird????

Can someone PLEASE explain this to me?

I have the traditional braces and no elastics in my control (ortho fixes rubber band around to teeth to pull them closer, and changes this at every meeting); no mouthguard or other extra appliances.

current problem: to close gaps (pretty wide); my teeth look pretty straight, and gaps seem to be the only problem.

[Zoso]

You said that you are in braces with traditional ties. These little rubber ligs do tend to lose some of their elasticity over time, and this is the main reason that the proponents of self-ligating bracket systems tout for being able to spread adjustments out to longer intervals for patients in SL brackets. It's also why your braces would feel a little tighter when the ligs are changed even if no change is made to the wire - the new ligs will engage the wire more snugly into the slots in the brackets, and therefore the forces from the archwire will be transferred better to the teeth. But that doesn't mean that no forces are being applied the rest of the time, and as long as there is a force on the tooth, then the processes necessry for tooth movement will continue.

Whether a patient is in SL or non-SL braces, each orthodontist does have his own particular preferences around call-back times. Some prefer to see patients more often - sometimes even if only to give the patient a sense of progress. It's also common for orthodontists to vary the call-back period, depending what is going on in treatment, and whether or not the particular work at hand needs to be monitored more or less closely. You mentioned that you have rubber bands to close gaps and that these are placed by your ortho, and not replaced by you. I'm not sure if you mean a simple monomandibular rubber band, or a powerchain, but either way this too will lose its elasticity over time, which would be a good reason for the more frequent appointments.

[Sunny]

Perfect Smile much of the reason for orthodontist's not requiring to see patients for active adjustments so frequently is due to the archwires being used, especially in the alignment phase, but often throughout treatment. These wires have 'memory' which means they will continue to try to get to return to the shape they were, prior to being put in the brackets that are attached to your teeth. These archwires are usually the shape of a nearly perfect arch, so they can continue working for many months, and often patients don't require many archwires during two years of treatment.

When 'tweaking' work is required, an orthodontist will put bends in the archwires and then adjustments may vary to work out with the timing the ortho considers necessary for the work to be done.

At to people going every 4+ weeks, doesn't that hinder the treatment? I used to go every month, or even two months, because I keep missing meetings, and according to my ortho, this is what caused the delay of my treatment (2 years).

Some orthodontist see patients at regular intervals, as it can be easier to set appointments this way, and some patients do feel that they are getting more attention this way. Often during these appointments an ortho will check progress and oral hygiene and maybe change the ligatures, or move something around, without affecting the progress that is being done. Generally seeing a patient every eight weeks, rather than every four, will not affect progress, but in your case, your teeth must have needed more attention. I'm having issues with a gap closing and I've had an in chair appointment 14 weeks after the previous one, with no changes, due to the gap still not having moved enough. My next in chair was 16 weeks later ... and again not sufficient change for any more work to be done on my upper arch due to the gap still not having closed sufficiently. I think it's going to be 14 weeks till my next in chair appointment, and here's hoping there'll be progress so something can be done! During these long spaced appointments, I've been given instructions, that if the gap closes, I'm to let my orthodontist know and I'll get a time for an adjustment.

On average teeth move 1 mm a month ... which means many move faster and many slower. Also teeth usually move the quickest during the alignment phase, although again this is an individual thing.

Good luck with your gap closing!

[perfect_smile]

Thank you! That was very informative. Because my treatment seems so much different than other people's, I just wanted to make sure that I am getting the correct treatment.

No, I don't have a powerchain yet. The tightness I feel is more so from the bands tied to my teeth than the archwire. If the elacity of the rubber band lessens over time, and therefore my frequent visits, why doesn't my orthodontist just let me change them myself?

How do the gaps caused by the bands around the teeth close? (I have bands on some of my front teeth).

[Sunny]

If the elacity of the rubber band lessens over time, and therefore my frequent visits, why doesn't my orthodontist just let me change them myself?

This is one of the many things you are paying your ortho to do. Also ligatures are not always put on the same, and this is another reason why you need someone trained to oversee this process.

(ortho fixes rubber band around to teeth to pull them closer, and changes this at every meeting);

What do you mean these bands are pulling your teeth closer? Powerchains will do this job, but you state you don't have them.

For my gaps, I have powerchains on my lowers and class III elastics. Both are working well, it's just the stubborn roots of my teeth that don't like the moving process.

I don't know about the bands on your front teeth, as I've not seen it, or know of it being used with current practise. I'd guess you should check with your orthodontist about this, and since bands are still used on molars by some orthodontist's, the closing of the small gaps must be easy. Maybe it's a natural movement when in retainers. Sorry I can't help with that one.

[Zoso]

What do you mean these bands are pulling your teeth closer? Powerchains will do this job, but you state you don't have them.

That's why I mentioned monomandibular rubber bands - orthodontic elastics that run along a single dental arch, rather than going from one arch to the other as most configurations do. These can be used, like powerchains, to close gaps, so I wondered based on PerfectSmile's assertion that she had elastics to close gaps whether this might be the case.

Metal bands on anterior teeth would seem to be rather unusual these days. Bicuspid (premolar) bands are still fairly readily available, but I am not sure about the teeth anterior to those. How far forward do your bands go, PerfectSmile? Where just the molars are banded, it is no problem after debanding just to go straight into a Hawley, and the spaces between the previously banded molars will tend to diminish as the teeth settle. In the past, before the advent of directly bonded brackets (i.e. when all teeth were banded) it was typical for a tooth positioner to be used immediately after debanding to close the spaces the bands had caused, and then after the spaces were closed impressions would be taken for a Hawley.

[perfect_smile]

That's why I mentioned monomandibular rubber bands - orthodontic elastics that run along a single dental arch, rather than going from one arch to the other as most configurations do. These can be used, like powerchains, to close gaps, so I wondered based on PerfectSmile's assertion that she had elastics to close gaps whether this might be the case.

How far forward do your bands go, PerfectSmile?

I'm not sure if they're monomandibular rubber bands. Before they're put in, they're just long elastic strings (like when you cut a rubber band so it's a straight line). My ortho only ties it around the brackets of two teeth of the same dental arch. I'm pretty sure they are used to close gaps because there used to be a huge gap (where another tooth was extracted) and now the gap is diminishing. Only now the problem is my teeth (lower) aren't pointing straight upwards, but are leaning towards the side the rubber bands pulling.

I have bands on all my molars and some of my upper front teeth. The upper arch: bands on all molars and alternating on front 6 teeth. The front teeth used to all be normal square brackets. The ones that were switched to bands were the ones I accidentally knocked off sometime before. I used to think orthos would just replace a knocked off square bracket with another one.

If I do have to wear a teeth positioner, how long will that take?

Thank you, by the way, the answers all of you give are extremely informative.

[Zoso]

Some sort of elastic thread then, such as Zing String.

It does seem odd that your doc has banded anterior teeth instead of rebonding brackets. But what do I know? I'm not an orthodontist

No idea how long a positioner would be worn, I'm afraid, even if your ortho does have that planned for you - I just know that's what used to be done.

In fact, it sounds like you need to sit down with your ortho or his treatment coordinator as you seem to have a lot of questions to which you need answers, and really all we can do is speculate.

Good luck with it all.