Orthodontics non-compliance shame and next steps
June 2, 2023 7:59 AM Subscribe
About two years ago, I decided to take advantage of the sudden work-from-home situation and start Invisalign. I found an orthodontist nearby and initiated treatment. Now, two+ years and two failed attempts later, and I'm wondering what my options are.
About four or five months after starting, I went through a breakup and a period of instability. I moved three times over the course of three months. I bought a house on my own, during what was perhaps the most competitive, stressful, and cut-throat time to try to buy a house. I got laid off from a good job and started a new (and ultimately terrible) job a week later. The low-grade but constant irritation of new trays made it impossible to sleep and difficult to focus at my new job. I simply had no fortitude or willpower left to work through it. A few missed days turned into a few missed weeks, and then months.
A year later, I worked through my shame and went back to the orthodontist, asked them to re-fit me for a new set of trays (one new set of trays was included as part of the price), and I started anew. Except it wasn't ANY better the second time around. I would take the trays out to drink coffee, and forget to put them back in. Or I'd plan to go out with friends after work, and would leave them off to avoid lisping, and then oops, forgot to wear them the entire night. Gradually, I ended up back here again.
I've been avoiding calling my orthodontist for a few months now, even though they've left me some voicemails. I need to AT LEAST go back and have the alignment tabs removed from my teeth. I don't think trying a third time is going to work for me unless I switch to the regular version of braces, but I've wasted $6,000 already and I don't exactly want to waste more money on doing it over. I feel so much SHAME about the whole thing. Will my orthodontist even work with me now, a full two years later? Do I have any rights, given I paid $6000 up front and got nothing out of it?
FWIW, diagnosed ADHD this year, and now on Strattera, but still not good at sticking with things.
About four or five months after starting, I went through a breakup and a period of instability. I moved three times over the course of three months. I bought a house on my own, during what was perhaps the most competitive, stressful, and cut-throat time to try to buy a house. I got laid off from a good job and started a new (and ultimately terrible) job a week later. The low-grade but constant irritation of new trays made it impossible to sleep and difficult to focus at my new job. I simply had no fortitude or willpower left to work through it. A few missed days turned into a few missed weeks, and then months.
A year later, I worked through my shame and went back to the orthodontist, asked them to re-fit me for a new set of trays (one new set of trays was included as part of the price), and I started anew. Except it wasn't ANY better the second time around. I would take the trays out to drink coffee, and forget to put them back in. Or I'd plan to go out with friends after work, and would leave them off to avoid lisping, and then oops, forgot to wear them the entire night. Gradually, I ended up back here again.
I've been avoiding calling my orthodontist for a few months now, even though they've left me some voicemails. I need to AT LEAST go back and have the alignment tabs removed from my teeth. I don't think trying a third time is going to work for me unless I switch to the regular version of braces, but I've wasted $6,000 already and I don't exactly want to waste more money on doing it over. I feel so much SHAME about the whole thing. Will my orthodontist even work with me now, a full two years later? Do I have any rights, given I paid $6000 up front and got nothing out of it?
FWIW, diagnosed ADHD this year, and now on Strattera, but still not good at sticking with things.
Best answer: I am so glad that you mentioned ADHD. In an upside down way, that might be your way through.
Shame and ADHD go hand in hand. As a person with ADHD you have spent your entire life, being made to feel ashamed of something that is *not your fault*.
You will most likely have created all kinds of systems to help you function, to help you stick to routines, remember to do things, START doing things.
Just from this post I can tell that you're extremely good at forcing your way through the challenges you face.
But now that you know that you're not to blame for the way you are, you're literally born this way, it's time to find methods other than shame and force.
Start with kindness. Feel your feelings, crap as they are, and let all that sunk cost go.
I don't know what the right decision is about your teeth. But I think if you start with compassion and kindness and patience for the person you actually are, and let go of the idea of who you are *supposed* to be, or how "should" be, you'll find the way that works for you.
posted by Zumbador at 8:18 AM on June 2, 2023 [10 favorites]
Shame and ADHD go hand in hand. As a person with ADHD you have spent your entire life, being made to feel ashamed of something that is *not your fault*.
You will most likely have created all kinds of systems to help you function, to help you stick to routines, remember to do things, START doing things.
Just from this post I can tell that you're extremely good at forcing your way through the challenges you face.
But now that you know that you're not to blame for the way you are, you're literally born this way, it's time to find methods other than shame and force.
Start with kindness. Feel your feelings, crap as they are, and let all that sunk cost go.
I don't know what the right decision is about your teeth. But I think if you start with compassion and kindness and patience for the person you actually are, and let go of the idea of who you are *supposed* to be, or how "should" be, you'll find the way that works for you.
posted by Zumbador at 8:18 AM on June 2, 2023 [10 favorites]
My dentist has always told me that they recognize that oral health is one of the first things to go when you're under stress. Your Ortho has seen this before. Please try your best to take your feelings of shame out of the equation.
posted by bookmammal at 8:25 AM on June 2, 2023 [13 favorites]
posted by bookmammal at 8:25 AM on June 2, 2023 [13 favorites]
Yes, please don’t feel any shame about this! It’s totally normal and common too. Definitely call your orthodontist: you can ask them to be extra kind because the situation is complicated. We have ALL had health things we have neglected at some point and that kindness from healthcare providers is extra beautiful and appreciated.
You didn’t waste money: you tried it and that’s enough. You can try again or just let go and decide your teeth are ok as is. Very few people actually “need” braces. It’s ok to decide they’re not for you!
posted by smorgasbord at 8:33 AM on June 2, 2023 [2 favorites]
You didn’t waste money: you tried it and that’s enough. You can try again or just let go and decide your teeth are ok as is. Very few people actually “need” braces. It’s ok to decide they’re not for you!
posted by smorgasbord at 8:33 AM on June 2, 2023 [2 favorites]
Best answer: Invisalign can be really difficult! It was for me. I did eventually finish it-- in about twice as long as projected-- but still have kind of an embarrassing note in my medical files about how I claimed I was feeling badly overall due to the problems I had managing the aligners and eating. Seriously, I almost fainted at work a couple of times from the stress of it all. (I felt validated when I noticed some discussion of this issue on reddit.) I really needed to correct my bite prior to getting some other work done, or I would have just said screw it.
I am sure your orthodontist has dealt with this before, so don't let shame stop you from communicating. But maybe talk to your ordinary dentist and see if they support just forgetting about it. My orthodontist was very nice but it was kind of an assembly line there, and my dentist was the one that was really on top of all my issues. YMMV, of course.
posted by BibiRose at 10:04 AM on June 2, 2023 [1 favorite]
I am sure your orthodontist has dealt with this before, so don't let shame stop you from communicating. But maybe talk to your ordinary dentist and see if they support just forgetting about it. My orthodontist was very nice but it was kind of an assembly line there, and my dentist was the one that was really on top of all my issues. YMMV, of course.
posted by BibiRose at 10:04 AM on June 2, 2023 [1 favorite]
Invisalign hasn't worked so far. Yes, see your orthodontist, or a different one, and explore options. Maybe similarly-discreet lingual braces are for you.
If you want to try Invisalign again:
- Address rough edges and discomfort with dental wax, and/or sand down trays
- Set reminder timers before you remove them for eating
- Numb your gums with Orajel or a similar product before re-insertion (especially helpful in the first few days of a new tray)
Then, depending on the issues addressed by orthodontic treatment, get post-treatment bonded retainers.
posted by Iris Gambol at 11:26 AM on June 2, 2023 [2 favorites]
If you want to try Invisalign again:
- Address rough edges and discomfort with dental wax, and/or sand down trays
- Set reminder timers before you remove them for eating
- Numb your gums with Orajel or a similar product before re-insertion (especially helpful in the first few days of a new tray)
Then, depending on the issues addressed by orthodontic treatment, get post-treatment bonded retainers.
posted by Iris Gambol at 11:26 AM on June 2, 2023 [2 favorites]
Will my orthodontist even work with me now, a full two years later? Do I have any rights, given I paid $6000 up front and got nothing out of it?
Your orthodontist may not even care that much, if they get paid by the procedure. Your situation is not that strange. When I got Invisalign, they literally described a previous patient that couldn't handle Invisalign and had traditional braces put in. They were not trying to shame this person; they just described that it was a possibility.
However, braces are far from foolproof. You still have to go into the orthodontist office for a possibly annoying or painful procedure on a regular basis. You have to maintain better-than-normal dental hygiene because there's now a bunch of things glued to your teeth. Braces may be just as irritating as Invisalign trays with respect to eating, talking, and sleeping.
Before committing to anything further, discuss your history with your orthodontist/dentist first and see if they can recommend something different that would address your previous issues.
posted by meowzilla at 12:03 PM on June 2, 2023 [2 favorites]
Your orthodontist may not even care that much, if they get paid by the procedure. Your situation is not that strange. When I got Invisalign, they literally described a previous patient that couldn't handle Invisalign and had traditional braces put in. They were not trying to shame this person; they just described that it was a possibility.
However, braces are far from foolproof. You still have to go into the orthodontist office for a possibly annoying or painful procedure on a regular basis. You have to maintain better-than-normal dental hygiene because there's now a bunch of things glued to your teeth. Braces may be just as irritating as Invisalign trays with respect to eating, talking, and sleeping.
Before committing to anything further, discuss your history with your orthodontist/dentist first and see if they can recommend something different that would address your previous issues.
posted by meowzilla at 12:03 PM on June 2, 2023 [2 favorites]
The thing about full braces (ADHD here, got braces in my fifties after failing bite correction in my teens because I kept losing my appliance) is that once you're done, you still have to wear bite-plates (first all day, later only at night) or your teeth happily wander out of alignment again, within a few months. In other words, you end up in the same pickle.
It was worth it to me and I trained myself to connect the bite-plates with going to sleep, so I haven't lost them yet and now I'm in my seventies.
I would just go back to the Invisalign and spare yourself the joy of having a threshing machine in your mouth (I couldn't because I had a really complicated situation).
Speaking from my own experience of severe ADHD, it's more important to fix the shame than the teeth. When I drop/break/lose/mislay precious possessions, buy the same airline tickets twice, or show up on the wrong day for an event, I experience a moment of sadness now, and then I shrug my shoulders. People with more apparently-orderly minds will never understand, and I do not care.
posted by Peach at 1:29 PM on June 2, 2023 [4 favorites]
It was worth it to me and I trained myself to connect the bite-plates with going to sleep, so I haven't lost them yet and now I'm in my seventies.
I would just go back to the Invisalign and spare yourself the joy of having a threshing machine in your mouth (I couldn't because I had a really complicated situation).
Speaking from my own experience of severe ADHD, it's more important to fix the shame than the teeth. When I drop/break/lose/mislay precious possessions, buy the same airline tickets twice, or show up on the wrong day for an event, I experience a moment of sadness now, and then I shrug my shoulders. People with more apparently-orderly minds will never understand, and I do not care.
posted by Peach at 1:29 PM on June 2, 2023 [4 favorites]
Most orthodontic patients are teenagers. Please trust that you are still way more together than the modal patient with braces. I could barely get it together to brush my teeth as a teen.
posted by potrzebie at 6:35 PM on June 2, 2023 [2 favorites]
posted by potrzebie at 6:35 PM on June 2, 2023 [2 favorites]
Best answer: If an orthodontist or medical professional shames you, please find a different one to work with. Medical professionals should understand that life gets in the way of what's ideal, especially ones that specialize in dentistry. In any case, time travel does not exist, so what good would the shame do anyway? They should and most likely will take you where you're at and try to help you to get you where you need to be. If they don't, they do not deserve you as a patient.
Incidentally, if you have been diagnosed with ADHD and haven't already done so, you might look into Rejection Sensitive Dysphoria which is commonly associated with it and may be linked to your feelings of shame around this.
posted by Aleyn at 7:21 PM on June 2, 2023 [3 favorites]
Incidentally, if you have been diagnosed with ADHD and haven't already done so, you might look into Rejection Sensitive Dysphoria which is commonly associated with it and may be linked to your feelings of shame around this.
posted by Aleyn at 7:21 PM on June 2, 2023 [3 favorites]
Best answer: The low-grade but constant irritation of new trays made it impossible to sleep and difficult to focus at my new job.
I don’t know exactly how Invisalign works but you mentioned this constant irritation. I -and a lot of eighties kids - had traditional metal braces and I remember going to the orthodontist maybe once a month to get your “braces tightened” and your teeth would hurt for a couple days but there was never constant pain.
I’m guessing that Invisalign claims to be faster than traditional braces - that to me means they put all the “tightening” back-to-back. It sounds miserable.
There are options these days for clear, non-metallic traditional braces - no need to be a “brace face” or get asked “what radio stations do you get” like we all heard in the 80s.
Also, your orthodontist will of course still see you. But if they make you uncomfortable in any way, please let yourself find another one. Dental crap is so horrific for me I’m always searching for kinder dentists. There are lots of dentists and orthodontists who market themselves now as “kind”, “good for scared patients”, “painless”, etc. It’s even pretty easy to find a dentist who will anesthetize you for any procedure.
Last time I had great insurance I went to a dentist who had a spa-like price list on the table next to the exam chair. You could get free coffee and wintergreen lifesavers, an eye-mask, a blanket or an inhale of nitrous.
posted by bendy at 8:18 PM on June 2, 2023 [1 favorite]
I don’t know exactly how Invisalign works but you mentioned this constant irritation. I -and a lot of eighties kids - had traditional metal braces and I remember going to the orthodontist maybe once a month to get your “braces tightened” and your teeth would hurt for a couple days but there was never constant pain.
I’m guessing that Invisalign claims to be faster than traditional braces - that to me means they put all the “tightening” back-to-back. It sounds miserable.
There are options these days for clear, non-metallic traditional braces - no need to be a “brace face” or get asked “what radio stations do you get” like we all heard in the 80s.
Also, your orthodontist will of course still see you. But if they make you uncomfortable in any way, please let yourself find another one. Dental crap is so horrific for me I’m always searching for kinder dentists. There are lots of dentists and orthodontists who market themselves now as “kind”, “good for scared patients”, “painless”, etc. It’s even pretty easy to find a dentist who will anesthetize you for any procedure.
Last time I had great insurance I went to a dentist who had a spa-like price list on the table next to the exam chair. You could get free coffee and wintergreen lifesavers, an eye-mask, a blanket or an inhale of nitrous.
posted by bendy at 8:18 PM on June 2, 2023 [1 favorite]
The thing about full braces… is that once you're done, you still have to wear bite-plates (first all day, later only at night) or your teeth happily wander out of alignment again, within a few months.
Two more notes:
Yeah, I stopped wearing my retainers too early. My bottom teeth went back to being somewhat crooked but my top teeth are still fine.
Also, in case you play a brass instrument, I played the trumpet while I had braces. I used dental wax to hide the edges of the sharp metal things digging into the insides of my embouchure. It wasn’t impossible.
posted by bendy at 8:25 PM on June 2, 2023 [1 favorite]
Two more notes:
Yeah, I stopped wearing my retainers too early. My bottom teeth went back to being somewhat crooked but my top teeth are still fine.
Also, in case you play a brass instrument, I played the trumpet while I had braces. I used dental wax to hide the edges of the sharp metal things digging into the insides of my embouchure. It wasn’t impossible.
posted by bendy at 8:25 PM on June 2, 2023 [1 favorite]
Just another Invisalign washout here. I won’t get Invisalign for my kids because the effort to put incredibly uncomfortable trays back in was just more than I could do. I’ll probably never get braces now, but I’m only just getting over the shame of just wasting all that money and time.
posted by chesty_a_arthur at 8:37 PM on June 2, 2023 [2 favorites]
posted by chesty_a_arthur at 8:37 PM on June 2, 2023 [2 favorites]
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