Wednesday, 26 June 2013

Orthodontic treatment - 2nd & 3rd adjustments

Orthodontic Treatment - 2nd & 3rd adjustments


I have been a bit (well OK, very) slow in updating on my treatment despite regular nags of encouragement from my wife.  It is fair to say that progress is slow and there didn't seem to be much to write about.  I'm not known for wasting words so I've been silent for a while.

I have my 4th adjustment in a few weeks and so decided that a quick post was in order to bring everything up to date.

In April I moved up to a 18/25 Niti wire on the top and a 016 Stainless steel on the lower arch.  The idea is that the upper wire will open my arch more and level my right hand teeth.  The stainless steel wire is apparently more rigid than Niti and so will open up the lower arch to match the upper arch.  The round wire allows force to be applied to move the teeth both outwards (widening the arch) but also laterally (to continue to close the extraction gaps) without applying the force that effectively tips your teeth forward.  Because of the gaps I still have powerchain LL7-7.  The main drawback of this is a) it seems to attract food and so you get more food stuck in the brace b) it discolours which the pearl ligatures don't seem to.  Its not a big issue since you can rarely see my lower teeth.

  You can see where the top archwire dips from my UR canine onwards which is the cause of my continued inability to get my bite together.

The lower arch is progressing nicely, closing up the gaps, but its slow work.  All my teeth were a bit tender for a couple of days but nothing serious.


In May I was back again for my 3rd adjustment.  The company running my orthodontic practice was sold to a large corporate at the beginning of April and having completed the handover this was my first appointment as a genuine 100% patient (have I mentioned that I was the Finance Director for the group of practices I attend?).  It was an interesting perspective.  I'd never felt particularly stressed before when attending appointments but it was noticeably more relaxed being just a patient and not being involved in any of the general hustle and bustle that is a feature of a busy mixed NHS / private practice.

I was still having difficulty with my bite so I asked how long it would take for this to correct.  You quickly get used to having brackets and wires on and you hardly notice them but I'm getting really impatient for my bite to correct so that I can eat with confidence again.

The news was not what I wanted, 4-6 months!  I'm hoping it will fly by (at the time of writing one month has already passed).  I shouldn't be surprised really, what took a split second to disrupt in my accident took several years to settle down to a manageable state so properly correcting and repairing the damage isn't going to be quick.

Darren decided to keep the same wire on the bottom as it was still working well and changed to top to a 19/25 Niti.  Again, powerchain LL7-7.

Its odd that you don't feel the pressure the wire exerts day to day and when you go into the surgery you can't feel any pressure at all.  Then they take the wire out, to either change or replace with new ligs, and you can suddenly tell the difference and miss the control, all your teeth feel loose.  When the ligs go back on everything feels tightly held in place again.  By the next day you can't feel it again.


You can see the wire still dipping ,y upper right arch and the molars are clashing which is preventing my bite being functional. It changes day to day but this was a particularly bad day as you can see!

What I'm surprised by is the amount of staining on my teeth that has accumulated.  This definitely isn't from lack of cleaning - between inter dental brushed, long bristled brushes for the bracket side of my teeth and around the brackets and a standard brush for the tops and back cleaning is not a 2 minute job twice a day! I'm sure it will all polish out once I have the brackets off finally but that could be 12 months from now.

As I'm more used to having brackets and wire now I alternate between a standard sensitive / whitening toothpaste and the specialist Vitis Orthodontic toothpaste.


Lower arch just closing the gaps slowly.

Patience has never been my strong point but I'm getting more impatient with this now and want to see some improvement in my bite but I must persevere.  You can't rush these things (well you can but I've seen photos of the results - not pretty and require more serious dental intervention to repair).

If you missed the last instalment then you can find it here.  Orthodontic treatment - first adjustment

If you want to go back to the start then its here.   Orthodontic Treatment - the first step on a long journey