Decision time - orthodontic treatment options. Help!

curlywurly1

I have found this forum very useful when I was researching orthodontic options. It's now decision time for me on treatment plans and I was hoping to get some advice on (a) the treatment options recommended for me and (b) to get some reassurance over the prices quoted!


My current issues are as follows:

• My upper front teeth are slightly tipped back compared to average resulting in an increased overbite (ortho #1 described it as a Class II division 2 malocclusion?!);
• There is overcrowding of the upper and lower teeth which has led to overlapping of the lower front teeth and some rotations and overlapping in the upper front teeth; and
• My upper right second tooth has significantly rotated.

Although I have a nice smile in that my teeth look relatively straight from front on I have grown increasingly conscious of my rotated tooth. Prior to visting an orthdontist I did some research on types of braces and was particularly keen to avoid traditional braces and go down the invisalign or lingual route (partly based on age grounds and partly based on vanity!).

I have visited two orthodontists in the past two months. To date I have only received a treatment plan from the first and despite my best efforts I am only attending my follow up with the second at the end of this week (having first seen them a month and a half ago!).

I was referred to the Ortho #1 by my dentist and I immediately liked him and was impressed with the level of patient care I received. He ruled out invisalign due to the significant rotation of my tooth. The two options he has proposed are:

1. Incognito braces - estimated treatment time 18 months. His plan is to start on my bottom arch first so that he can correct the overbite and use some sort of fixed retainer on the top. After 6 month the bottom teeth will have moved enough so that he can put the braces on my top teeth also. Cost €8,000 (includes consultation fee, X-Rays, retainers upon finishing treatment and he will also absorb cost of any extractions if required).
2. Ceramic braces on top teeth, traditional braces on bottom. Same treatment time as above. Reason why he said he would use traditional braces on bottom is that ceramic braces are difficult to remove and can break teeth, particularly the smaller front teeth. Cost €4,500 (includes same as above).

Concern #1: I want to go down the Incognito route for reasons outlined above but am concerned about the price. Having done some further research (without having actually paid out consultation fees for more opinions!) this seems to be the going rate. I have never been the best haggler so not sure whether I can get him down on price at all!

Concern #2: I am worried about the possibility of extractions. He said he won't know until we begin treatment whether there is sufficient space in my mouth to straighten the teeth. I don't like the idea of taking out four perfectly good teeth but maybe I am just being silly if it gets a good result.

I chose Ortho #2 on the grounds that I can get a discount on top of my revenue reclaim as they have a corporate scheme with my employers. I think that this may make the second Ortho significantly more affordable. However, I was less impressed with the level of patient care and subsequently with the inability to get a quick follow up appointment (cancellations by them, no availability for weeks etc). Although I don't yet have a treatment plan, based on the chat with the Ortho at the time of my initial consultation I think he is going to recommend the following:

1. Ceramic braces top and bottom: or
2. Incognito on top arch and cermaic on bottom. He said that although they advertise incognito for both arches they actually no longer do it on the bottom because patients have had trouble with them.

So concern #3 - am I going to have trouble if I go for incognito on top and bottom or is Ortho #2 just saying this because perhaps he is less experienced in the use of incognito braces? Has anyone heard of problems with incognito (I am expecting some speech, discomfort when I first have them applied).

Sorry for the long winded post but just to finish by saying that i would appreciate any guidance or experience that people can share.

day dreamer

Hi there

I cannot give you all the answers without seeing you first but if you want some general info on the issues you outlined I can try to help.

I fyou have crooked teeth then you have done the right thing by going about getting them straightened and seeing an orthodontist. I know you dont want them but I would just say to start that the normal metal type of braces are the easiest way to get straight teeth. The will cost €3500 to 4000, are easier to get used to and wont cut your tongue or stain. Having ruled that out

1) the price for the lingual braces or Incognito is about average so you wont get them much cheaper.
2) dont worry too much about extractions, provided they are necessary you will get a better result
3) the problems you will have from the Incognito will be similar upper and lower: sore tongue and lisping for a few weeks but most adapt well

6 weeks isnt that long to get an appointment but you should go to whichever you feel most comfortable with and who you feel will give the best service

curlywurly1

Thanks Daydreamer. I had my second appointment yesterday and take back my earlier opinions....better experience this time round, must have caught them on a bad day the first time.

Ortho #2 says, following review of X-Rays (which in fairness Ortho #1 didn't have), that I won't need extractions as there is plenty of room. May need a bit of filing on front lower teeth but nothing drastic.

So treatment options are (a) ceramic on top and metal on bottom €3,510, treatment time 12 months, (b) incognito on top, metal on bottom, €5,360, treatment time 18 months. In both cases, significantly more afforable for me.

Leaning towards the second option. Nervous about getting them on and potential speech issues with incognito but quite excited at prospect of straight teeth!