Need ortho advice? Off centre midline

MizMix

Any orthodontists that could give me some advice?

I started treatment 6 months before my wedding. My teeth were pretty good but I had a slight indent in my too front teeth and they were ever so slightly crooked. Ortho said 9 months would have been ideal but he could get it fixed in 6. If not he'd put them back on after my wedding. I noticed during treatment that my left tooth was more prominent (further out). Ortho said it was an optical illusion- it wasn't! Took them off the week of my wedding, didn't ask if I was happy etc. I called him that evening to say there is more work to be done but I really had to persuade him to put them back it- my smile didn't look symmetrical at all. Got them back in November (just on the top and for the front 8 teeth). Then I noticed what the big problem was- just couldn't really put my finger on it before but my midline is a good half tooth to the right. I think it was always a bit off centre but it is much more noticeable now. I'm not looking for 100% perfection but everytime I mention it he dismisses it. First time I said it he let on he didn't know what I meant (another optical illusion!). Next appointment he said 'nothing I can do at this stage'!

Just curious if orthondontists usually look at the midline? He only ever seemed concerned with my bite. Even if it could be moved 2mm to the left (I asked if he could not shave a tiny bit off my teeth on the left) it would look so much better. Perhaps I should have mentioned it but it's honestly not something I noticed- I just knew my smile wasn't quite right. I probably sound very vain but after spending 3k and the fact that I had pretty ok teeth I was expecting them to be pretty close to perfect. I am really having trouble communicating with him and I feel he just wants me finished- he didn't give me a discount for fast treatment so I am annoyed he doesn't want to spend the time on me. He also charged another 250euro to put the top ones back in.

Any advice much appreciated- should this not have been part of my treatment? Or are orthodontists normally just concerned with the bite and 'straightness' of teeth as opposed to midline/symmetry etc.

Thanks in advance and apologies for my long winded post

lexa

Found myself in a similar situation.


Ask him to explain why it can’t be fixed and why it wasn’t mentioned before you started treatment. There might be a reason it can’t be fixed.


If you’re not happy with the response, ask him to refer you to another orthodontist for a second opinion. He is obliged to do this under the code of ethics (my dentist didn’t comply with my request, but I didn’t know at the time that he should have otherwise I would certainly have demanded it).


Do not let him take the braces off until you are happy. If you do that, you have no comeback. Be as difficult with him as you need to be because in my experience, you have very little rights as a dental patient. Unfortunately I discovered this after treatment.



Also if you want to get this fixed after treatment, you will probably find it hard to get an orthodontist to treat you. Dentists don’t really like fixing other dentists’ work.

dublinannie

I would have assumed that it was expected the teeth would be all in correct postion as that is what you are getting braces for.
My bottom teeth are way out of line, they are one whole tooth off the midline.
I didn't discuss tooth/midline problem specifically with the ortho, nor did he mention it. My request was for straight teeth, which he said yes, I can do that for you

One of the Orthodontists on here can probably confirm if the treatment can't get the teeth midline, that an ortho would let you know about it as soon as they know your teeth wont be corrected to midline.

MizMix

Thank you both for the replies. Lex I replied to your PM, really helpful so thanks. I am so peed off at this stage, everytime I bring it up it's dismissed. Dublinannie, exactly I just presumed everything would be in position so didn't feel I had to explicitly outline every little issue, he's the expert not me. Looking at before and after pics while my teeth are straighter (they weren't bad to start with) my overall smile is probably less aesthetically pleasing. Yes it's vanity but I paid 3k for it so I expected a vast improvement!!

Dianthus

When you say the midline is a good half a tooth to the right, do you mean to the right of your facial midline, or to the right of the opposing lower teeth?
Has anyone else (family, new husband!) noticed/commented?
Not that it's any consolation, and not being glib here, but you're in good company- check out Tom Cruises' midline!:D

btkm8unsl0w5r4

Also be sure you nose is straight, most peoples nose point one direct or the other, Post a pic or preferably two with your eyes blocked out and see if we notice it.

MizMix

Fitzme since my obsession with my midline began I've noticed my nose isn't totally straight- not a good idea to take such a close look at your face symmetry! So that prob isn't helping.

The pic attached is me after our wedding (funny it's the only head on pic I could find, I seem to have always disguised it without even knowing by turning my head to the side slightly- god I sound like Mariah Carey only allowing pics of of one side of her face!). Even in our wedding photo's, there's no real head on shots. I've the braces back on now so they are even straighter now but the midline is the same.

Dianthus my husband always loved my teeth & their slight imperfections, truth be told I reckon he preferred them as they were. He notices now because I've pointed it out but he said he would have never noticed otherwise.

Had a good chat with my orthondontist yesterday evening and he explained why shifting my midline is so difficult- I had extractions previously when I had braces as a teenager. He simply can't do anymore extractions. He has said he should be able to shift it by 1- 1.5mm towards the centre by shaving a small amount from the teeth on my left side and he will do everything he can to make sure i'm happy. I'm happy with this- now I understand the limitations and know he is doing everything he can. Plus it's something that was always there I just didn't notice before....you examine your teeth in a way you never did before when you get braces so I prob need to be less obsessive about it and stop using celebrities with a mouthful of veneers as my benchmark!

Good point on Tom Cruise- I always loved his smile and it's only since I started googling midlines that I cam across how off centre his is! Hasn't done him any harm.

btkm8unsl0w5r4

Your midline look off to me too, and the lateral incisors are not symmetrically placed. Was this a complete course of orthodontics or one of the 6 month jobs?

MizMix

No it wasn't invisalign. My ortho was more concerned with my bite than anything so I went with fixed braces. Now I only had them on for 6 months when this pic was taken and got them back on in November.

When I went in to my orthondontist yesterday he mentioned my nose also and since you posted I took a look at that pic and drew a line- I actually think it's my nose and lips that are more out of line!! Why oh why did I start looking at my face so closely Time for me to stop obsessing I think! You can take a look at the attached but my teeth midline isn't that far off afterall (I think). My nose and lips are making my midline appear more to the right! Anyway if he can shift it 1.5mm to the right my smile will look more symmetrical but I do think my other features aren't that symmetrical so my midline looks more off than it is. Do you agree?

Also in this pic my right front tooth was further out and since then they are more aligned so they look a bit better now....

btkm8unsl0w5r4

Second pic looks better, but you should make sure your happy before the braces are taken off. However best not to obsess over details but take a general overview approach. Look in the mirror for 2-3 seconds and anything you have to look for longer is not a concern. Stand at least 2-3 feet from the mirror, anyone else closer to you than that will not be checking out your midline.

Getting the midline to look correct with a facial asymmetry is difficult especially if the extractions you had previously were asymmetric (not the same tooth on each side). The wire will align the teeth dead straight but to get it looking straight on a "crooked" face may take longer.

Oral Surgeon

Andy Wet Photograph wrote: »

anyone else closer to you than that will not be checking out your midline.

Brilliant....

Op, these are very small problems, I'm sure a lot of people would kill for your teeth as most would not notice this asymmetry. A lot of work and time would be needed to treat this....
All the best,
OS