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  1. #1
    trales's Avatar
    trales is offline Emerald level (3000+ posts)
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    Default Orthodontics dilema

    We live in a reasonably small, ruralish town. There are 2 orthodontists in town. I have heard very good things about both practices, about half the kids we know go to each one. I thought I would get treatment plans from both to make sure they were similar and then let DD decide which one she was more comfortable with.

    Well, they sure as heck were not similar at all.

    Practice 1- wants to do traditional braces for 2 years to straighten, saw some crowding, did not think tooth removal was needed and would use rubber bands to correct a minor over jet.

    Practice 2- wants to have 4 teeth pulled, 2 top front pre-molars and 2 bottom back pre-molars. Then do 18mo braces which will straighten, fill in gaps and correct the over jet. Wants 2k more.

    How does one make a decision? I don't want to say keep the teeth and then come to regret that b/c as they straighten, they will start to stick her lip out and it will be aesthetically unappealing, and she will be unhappy. I also don't want to pull permanent teeth that you can't get back if I don't need to.

    I made an appointment for another orthodontist that is 40 minutes away to see what they say, while it would kill me to have to drive that far for appointments, I would do it if needed. The practice is not open on friday and that is the day I have no classes, the others days I have classes all day till 320, so it is hard to make appointment times. I really want to make the right decision, and just don't know how to do that.
    Tracey

    DD1 3/07 Itching to take over the universe.
    DD2 1/14 My mellow little snuggler.

  2. #2
    nfowife is offline Diamond level (5000+ posts)
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    I would go to a 3rd or 4th until you have a consensus. Hopefully it will validate one of the ones in your town. There are many approaches to orthodontics and both of those approaches would likely have a good result.
    M, mommy to A 2005, E 2007, and L 2010

  3. #3
    Liziz is offline Sapphire level (2000+ posts)
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    That is tough! I think getting the third opinion will be helpful - remember, you don't necessarily have to go to that third far away practice -- you just need them to give you confidence in the treatment plan of one of the more local options!

    I'd probably lean towards the non-teeth pulling option. There's a lot of gray areas in dentistry. I'd figure that if her teeth are at a point that one person thinks they need to come out and the other doesn't, it means it'll probably work out either way, and so I'd choose the less aggressive, less costly option.
    Lizi
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  4. #4
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    Personally I’d probably go for the non extraction option. If things don’t correct well enough you can do it but you can’t put them back. There are cases for extraction for sure, but I’d go without first. Is the one that wants to pull teeth older by any chance?
    Mama to my boys (04,07,11)

  5. #5
    SnuggleBuggles is online now Black Diamond level (25,000+ posts)
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    Quote Originally Posted by smilequeen View Post
    Personally Iíd probably go for the non extraction option. If things donít correct well enough you can do it but you canít put them back. There are cases for extraction for sure, but Iíd go without first. Is the one that wants to pull teeth older by any chance?
    My thought too.


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  6. #6
    ciw is offline Gold level (500+ posts)
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    Quote Originally Posted by trales View Post
    We live in a reasonably small, ruralish town. There are 2 orthodontists in town. I have heard very good things about both practices, about half the kids we know go to each one. I thought I would get treatment plans from both to make sure they were similar and then let DD decide which one she was more comfortable with.

    Well, they sure as heck were not similar at all.

    Practice 1- wants to do traditional braces for 2 years to straighten, saw some crowding, did not think tooth removal was needed and would use rubber bands to correct a minor over jet.

    Practice 2- wants to have 4 teeth pulled, 2 top front pre-molars and 2 bottom back pre-molars. Then do 18mo braces which will straighten, fill in gaps and correct the over jet. Wants 2k more.

    How does one make a decision? I don't want to say keep the teeth and then come to regret that b/c as they straighten, they will start to stick her lip out and it will be aesthetically unappealing, and she will be unhappy. I also don't want to pull permanent teeth that you can't get back if I don't need to.

    I made an appointment for another orthodontist that is 40 minutes away to see what they say, while it would kill me to have to drive that far for appointments, I would do it if needed. The practice is not open on friday and that is the day I have no classes, the others days I have classes all day till 320, so it is hard to make appointment times. I really want to make the right decision, and just don't know how to do that.
    I would go with Practice 1. If you have to pull teeth later so be it, but I would want to give her every chance possible to keep her teeth. We faced a similar decision two years ago for my DS who is a year younger than your DD. He had minor overcrowding of the top teeth, a mild-moderate overbite and a growing problem with jetting. We saw four orthodontists and not surprisingly, each had a different plan. The first wanted to use an expander on the top teeth and transition to regular braces when DS hit 12-13. The second wanted to wait until DS hit 13 and then pull teeth and place regular braces on afterward. The third doctor wanted to use headgear to correct the overjet, followed by a retainer and traditional braces. The fourth doctor had a similar plan but wanted to start with a twin block instead of headgear. I am confident that the first doctor would have had good results, but it would have meant living with the jet for years. DS is active in sports and I was very concerned about the front teeth chipping due to the severity of the overjet. I know that both headgear and twin blocks are controversial, but I felt like either was a better option than pulling teeth, so we quickly narrowed the list to the third and fourth doctors. One year after the first phase of his treatment plan, his teeth looked absolutely amazing, and he transitioned to a retainer to wait until his adult teeth were in and ready for phase 2. He had a HUGE growth spurt this year, and despite religiously wearing his retainer, his teeth still shifted, so we had to make some adjustments to the original plan. Still, it is very, very clear that his teeth can be corrected without any teeth needing to be pulled. As far as cost, the orthodontist who wanted to pull teeth was significantly cheaper than any of our other options (by more than $4,000). I have zero regrets about shelling out that money; it was worth it to keep the teeth.

    I would check at least one more orthodontist just to see what the opinion is on pulling teeth. If they agree that the teeth don't need to be pulled, that should give you more peace of mind about the first practice you visited.

  7. #7
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    I would go with the more conservative option (#1) that does not involve immediate teeth pulling. It can always be done later but having it as part of the initial treatment plan doesn't seem right to me.

  8. #8
    bisous is offline Red Diamond level (10,000+ posts)
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    Quote Originally Posted by JElaineB View Post
    I would go with the more conservative option (#1) that does not involve immediate teeth pulling. It can always be done later but having it as part of the initial treatment plan doesn't seem right to me.
    Same. I thought that was kind of an old school way to treat crowding? (DH had EIGHT permanent teeth pulled and he's fine but it was traumatic!)

  9. #9
    trales's Avatar
    trales is offline Emerald level (3000+ posts)
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    Quote Originally Posted by smilequeen View Post
    Personally I’d probably go for the non extraction option. If things don’t correct well enough you can do it but you can’t put them back. There are cases for extraction for sure, but I’d go without first. Is the one that wants to pull teeth older by any chance?
    They are both the same age, in practice about the same amount of time. The extraction guy is board certified in ortho, the other is not. The extraction guy mentioned that if we did not pull the teeth, her teeth would lean outward and cause her lips to pop out. I really want to be conservative, even if it means having to shell out more money later if we need to pull teeth.

    The 3rd opinion I am going to get has 2 ortho's (father and daughter) that are also board certified in ortho. The dental hygiene program at my college gave me their name. I could make the driving work if I had to. I just really want to make the best decision for her.

    DH had to lose some molars as an adult, he had some implants, 4 or 5 total, including one front. But he complains all the time it is hard to chew and he has 3 on each side on the bottom, I don't want to do that to her.

    This is just so hard, that the opinions were so disparate.
    Tracey

    DD1 3/07 Itching to take over the universe.
    DD2 1/14 My mellow little snuggler.

  10. #10
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    Quote Originally Posted by trales View Post
    They are both the same age, in practice about the same amount of time. The extraction guy is board certified in ortho, the other is not. The extraction guy mentioned that if we did not pull the teeth, her teeth would lean outward and cause her lips to pop out. I really want to be conservative, even if it means having to shell out more money later if we need to pull teeth.

    The 3rd opinion I am going to get has 2 ortho's (father and daughter) that are also board certified in ortho. The dental hygiene program at my college gave me their name. I could make the driving work if I had to. I just really want to make the best decision for her.

    DH had to lose some molars as an adult, he had some implants, 4 or 5 total, including one front. But he complains all the time it is hard to chew and he has 3 on each side on the bottom, I don't want to do that to her.

    This is just so hard, that the opinions were so disparate.
    With that info, I’d get the third opinion first
    Mama to my boys (04,07,11)

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