Brace yourself!

November 1, 2012 3:02 AM

When you had braces, did your orthodontist want to replace your wires a week before taking your braces off? Or is this a ploy to prolong treatment?

To begin, my teeth were pretty straight already and the orthodontist originally told me I'd only need braces for 12 months. I took care of the braces, followed instructions and my teeth have responded well. However, it's since dragged on to 13, then 15, and we're now at 18 months but it keeps limping on.

So I put my foot down, and asked to have them removed. We set a date for this, and also to collect a retainer. I've also agreed to sign a waiver in case my teeth move in future. But now they've set up another appointment about a week earlier than that to have the arch wires replaced with new ones. The receptionist says that this is to make some 'final adjustments'.

What I want to know is, isn't it a bit silly to change the wires a week before removing the braces? Won't my teeth begin to move again? Will a week really be enough to make any significant adjustment? Is this normal? What's going on?

YANMOrtho.

posted by Sutekh to Health & Fitness (15 answers total)

Get a second opinion.
posted by Gonestarfishing at 3:58 AM on November 1, 2012 [2 favorites]

Well, what I'd do before they remove the present arch wires is to let them explain very precisely what "last minute adjustments" they think they need to make that can't be done with a well-designed retainer. Let them be as specific as possible. You're well at home in your own mouth, and since you don't seem to have had serious malalignment or -occlusion or -whatever problems to start with, the consequences are unlikely to be dire even if you don't agree to that last leg of their treatment plan.

In short and fwiw: it seems weird to me, yes.

[I was treated (in Holland, age 24) for badly crowded fronts (with fixed braces and a nighttime headgear), following extractions of a premolar in each corner (so altogether four). My braces were in and out within a year and a few months, I had retainers for about 1 1/2 year after that. The general result still stands, 29 years later.]
posted by Namlit at 4:22 AM on November 1, 2012 [3 favorites]

I've had so much orthodontic work that it's not even funny, but for each different process it was a flat rate. So while it did cost a separate fee to get a palate expander put in (because it was a different appliance entirely from the braces), to get a wire replaced or additional visits related to any of the appliances never cost any extra. It may just be in this area, but that's how every orthodontist I know of around here charges. To add extra visits doesn't really gain them anything other than more time spent with yours truly. I'd get a second opinion. This is odd.
posted by takoukla at 5:05 AM on November 1, 2012 [1 favorite]

You aren't paying extra, right? Right? Because normally orthodontic is a flat rate to a result. If they don't think they've reached the result, they'll prolong treatment. It seems like either they gave you a bad estimate or are not very good. If you're paying extra, you're being totally scammed.
posted by DoubleLune at 5:49 AM on November 1, 2012 [1 favorite]

My orthodontia was also a flat fee. (In Phoenix, AZ, 1976-1979) I had the worst overbite and wore headgear and full metal mouth for 3 years, then a retainer. My teeth haven't moved AT ALL in the past 32 years.

That said, I didn't pay by the visit. Do you pay by the visit? That doesn't seem to make much sense.

I'd see another orthodontist for a second opinion. The whole thing sounds really weird to me.
posted by Ruthless Bunny at 5:50 AM on November 1, 2012 [1 favorite]

Response by poster: It is a flat fee, payable in instalments. I wonder if that has something to do with it.
posted by Sutekh at 6:02 AM on November 1, 2012

It really could be that they think your teeth aren't up to the results they want to see. I had braces for ages and while they fixed most of the major issues, I've got stubborn teeth and they just weren't aligning properly. Finally had them taken off when I moved to Italy in high school because there was no way to have them adjusted for a year, and yes, I think they did do adjustments fairly close to the end date? But they were really dissatisfied that I wanted them off. I would ask them why they think it's necessary.
posted by jetlagaddict at 6:13 AM on November 1, 2012

Ok, with the flat fee I'd say they're just trying to get a perfect result. Maybe it's their incompetence, maybe it's that your teeth are being stubborn (even if they responded well at the beginning). Ask them what they are still trying to fix.

As someone who had braces off too early (because I moved out of state and it would have cost an arm and a leg to switch orthos and I was sort of done, but the wire was digging into my cheek and it was the best option) and now has to get them again (because my bottom wisdom teeth moved things), I really encourage you to stick with it to the end result. It's only a couple months and no extra money; if they shift, you're looking at another year or two and $5,000.
posted by DoubleLune at 6:29 AM on November 1, 2012 [3 favorites]

It certainly sounds suspicious to me. I had a similar experience, was told 18 months, but from then on it was "just another couple of months" every month for another six.

I really don't see how one week with adjusted wires will make any difference, I think if it was me I wouldn't even bother with a second opinion, I'd just refuse.
posted by *becca* at 7:00 AM on November 1, 2012

Keep in mind that anything you don't want you CAN turn down. However, if you've already paid for it and they're not causing any major problems/pain, and the appointment isn't a major inconvenience... it's probably worth going along with it, and maybe even keeping them in a bit longer.

*I turned down having anything more than a retainer since more was, to quote, "Only for cosmetic reasons" despite my parents being willing to pay for it. I haven't regretted it.
However, my teeth did move after the retainer was removed kinda early and I had to have a second one.
posted by Ashlyth at 7:04 AM on November 1, 2012

FWIW, my bite guard acts as a retainer. So I've never NOT had a dental appliance for over 30 years.

A beautiful smile is worth it though.
posted by Ruthless Bunny at 8:13 AM on November 1, 2012

They may be using that appointment to try to convince you to stick with it a little longer. They're not making any money off of you by prolonging it, and I would agree that they likely just want you to have the best result possible. I doubt they are doing this just to make you uncomfortable or miserable.
posted by two lights above the sea at 10:57 AM on November 1, 2012 [2 favorites]

Maybe sit down with the orthodontist and ask for an explanation of where you are in your treatment? They clearly aren't trying to profit from you here, because you've presumably already paid for the braces. Your orthodontist should be able to demonstrate (using your molds/impressions/computer 3D models/etc...) the original state of your mouth, the current state of your mouth, and where they want you to end up. Then you can look at the situation and decide whether more time is worthwhile.
posted by zachlipton at 2:52 PM on November 1, 2012

If they won't be making any additional money from you for this, I'd be inclined to think they're simply trying to get the best results. (I had years of orthodontia and then screwed up by not following through on my ortho's treatment recommendations in a timely manner. My lower front teeth are now mildly-but-annoyingly snaggly and I'm wondering if I'm vain enough to spend the money and time to get them realigned.)
posted by Lexica at 6:30 PM on November 1, 2012

I had invisalign and they told me 18 months. It actually went past two years. However, they never got any more money from me (flat rate) and I genuinely think he was doing what he thought was best. But boy oh boy do I know that paranoid feeling that he's dragging this craziness out for some reason.

A second opinion wouldn't hurt.
posted by chairface at 10:20 PM on November 1, 2012