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Braces

Getting braces the 2nd time around

07/14/2008

Question:

Hi, I am now a 21 year-old student. I first had braces when I was 11 and had them off after approximately a year and a half of treatment. Although we went to what was regarded as "the best" orthodonist in our area, my parents and I became somewhat suspicious when we noticed that my treatment plan seemed to coincide with the payment plan in terms of timing. In comparison to friends and class-mates, I had braces on for a significantly shorter period of time, even though I`d had a considerable over-bite. I wore my retainer, but by age 15 (the full 2 yrs after) I figured that I had "done my time" and no longer wore it every night. My retainer grew tight and when I went for a check-up, the orthodontist was agitated and very defensive in his demeanor. By age 18, my bottom teeth had begun to shift. I go to a University out-of-state, and during my moving-in, I misplaced my retainer. I figured that the shifting would only be slight. However, by age 19, the shifting was becoming more pronounced, and here we are today. My bottom teeth (the front two) are now more crooked than they ever were to begin with! Furthermore, I switched dentists when I was 20, and my new dentist promptly informed me that my old dentist and orthodontist had left on layers of cement on my bottom and front teeth for EIGHT YEARS!!! I was furious when I found this out! I am currently only in my home-state during the summer, and will return to my out-of-state university at the end of August. I made an appointment with my original orthodontist and I have several questions:

1. What should I say during my consultation with my old Orthodontist? Should I ask for discounted treatment?? I feel like it`s warranted--I don`t want to pursue legal action, but I do feel like my treatment was negligent and that I should have had my braces on for a longer time period.

2. I go to school out of state--so if I did get discounted treatment in-state, could that somehow be transferred out of state to another facility in terms of paying for the braces themselves?

Thank you so much for your time and your advice!!

Answer:

First let me say that as an orthodontist of many years, I can tell you that all orthodontists have patients who undergo post-treatment changes. It is because all of our anatomy changes throughout life. Does that mean that everyone has post-treatment alignment problems? No, but it is very unpredictable. If you would like more information about treatment changes, go to the American Journal of Orthodontics and do a search for Dr. Robert Little, University of Washington. He has done research on the subject.

We cannot warrantee that a patient will not need further treatment, so don't return with a hostile attitude. There are lots of reasons why some have more changes than others. Sometimes it is due to independent or lack of growth of the jaws. The reason we treat in the time frame of your case is that the teeth are easier to move, the direction of growth can be helped, and an imbalance in the path of closure can be corrected.

Bottom line - go back, ask if you need new retainers and what he thinks should be done.

By the way, in the last 15 years I have had at least three new eye prescriptions and three new glasses. Why does the public think that one time orthodontic treatment is always the norm? It is simply not the case.

For more information:

Go to the Braces health topic, where you can:

Response by:

Walter C Buchsieb, DDS, MS Walter C Buchsieb, DDS, MS
Professor Emeritus - Clinical, Associate of Dentistry
College of Dentistry
The Ohio State University