Ortho? Again?
I get asked a lot about what the best options are when it comes to expansion and orthotropic or “airway” orthodontics
I always find this answer difficult in that I need to be somehow politically correct in my response because there is data supporting so many different types of orthotropic devices and appliances.
Considering recent new articles regarding the use of dental appliances in orthodontics I thought I’d share my opinion and my experience. I will start with this: I am no expert on orthodontic appliances, so I won’t speak to the efficacy of any appliance out there. This blog post is my opinion only, based on my experience as a patient, a Myofunctional therapist and Registered Dental Hygienist. So, this post is about helping people navigate their discussions with providers.
You are well within your right to ask questions. Do not have blind faith in your provider, even if you’ve known your provider for many years. We can be complacent about our own health, and we’ve come to trust our providers but make no mistake, Dentistry is a FOR PROFIT industry and not every provider is looking at your bottom line, they are looking at theirs. There are many providers who just want to help. Don’t mistake my cynicism as a generalist statement.
As someone who has had bi cuspid extractions and RPE at a young age and then ortho in my late 20’s. Then a few years later an A.L.F. and then A.G.G.A. and Controlled Arch Braces, and finished with Invisalign I think I can strongly suggest the following:
Questions to ask the provider you may be considering treating you.
1. Do they have examples of finished cases and how many?
This will give you some insight as to how long this provider has been using these appliances and how successful the outcomes may be
2. Where did they learn about the appliances, and how long was their education?
·Was it a weekend course or can they display an extended period of time of learning about the theory and practice?
3. How long will the process take?
This is a reasonable question to ask
4. What is the endgame?
Are you going to have an expansion device for 18-24 months and then backets/Invisalign for another 2 years? Or will there need to be some restorative work done at the end of the process
5. What are the risks?
Could you lose teeth in the process? What about gum surgery after the fact, is that a possibility?
6. How much will it cost?
If there isn’t a clear answer to this , then get another opinion. Any provider should be confident in the costs of their treatment and if there are unknowns, then why and what might those unknown costs be. Yes, there are always broken appliances, broken brackets, lost appliances etc. etc but once your initial paid treatment is done and the expander comes out what are the costs of the next steps.
7. Are you required to see other providers as part of the treatment?
Often there are referrals to body workers in some treatment. What if you don’t see them. Will your treatment fail?
8. READ THE FINE PRINT
If there is no transparency with the provider, there will be no transparency with your treatment. If they brush off questions with “don’t worry, that will be taken care of” or “we’ll cross that bridge when we get to it”, be concerned.
Many providers are very qualified in the use of evidence supported appliances to help with pain and have helped thousands of people worldwide. I work as a Myofunctional therapist with many of them!
Do I regret revisiting orthodontics after completing with a licensed orthodontist 10 years ago?
No.
I knew what I was having done, I somewhat blindly trusted what was happening and felt pretty good in all of my various appliances. I spent hours and hours learning about them.
Would I do it again? I’m not so sure.
After almost 8 years I am left with 3 spaces that need implants. This was part of my treatment plan. I do have root resorption, but I won’t lose any teeth. I do have bone loss and recession. Prior to placing implants, I will need bone placed prior. I still have some costly procedures ahead and frankly I’m not sure when I’ll be able to get to them.
I often wish I’d asked more questions.