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Are braces/aligners always bad?  

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Craigj
New Member

I’ve been wearing an ALF appliance for the last few months and have had 5mm of expansion, to the point where my molar width is 51mm (I think) as measured by my dentist (see photo, sorry for close up!). I am told I do not need to expand any more.

My dentist has recommended aligners (Smiledirect UK) to create the U-arch and close gaps. Is this a bad decision, are braces always a bad idea?

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Posted : 04/07/2019 2:39 pm
WrongNotes
Active Member

Braces are mostly a cosmetic thing, so I would be wary about the likelihood of recession/palatal change once ALF is removed.  Are you seeing a myofunctional therapist?  As I understand, a crucial component in any treatment involving palatal expansion devices, is to ensure that the tongue learns to work correctly.  In the (eventual) absence of external devices, your tongue function is everything for maintaining results.

 

I would be interested in knowing a bit more about how ALF has worked out for you so far.  How is your airway/breathing?  I'm exploring the possibility of getting ALF myself,   - did you get it through the dentist you mentioned, or somewhere else?  How much has everything cost?

Congrats on your progress, and any further information would be much appreciated.

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Posted : 05/07/2019 5:24 am
Craigj
New Member

During the next stage of treatment there will be no need to shrink my palate though? My teeth have always been positioned like this with the third molar positioned much further out compared to the other molars (see photo- 1 month into treatment)

The braces will be to bring out the first an second molar (to create a “full smile”). For my teeth size the molar width is supposed to be 51mm (which it now is, it was 46mm before treatment). I don’t quite know where on the tooth this measurement is taken from though?

Also, breathing has never been an issue- I am having treatment because of migraines and for cosmetic reasons.

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Posted : 05/07/2019 10:34 am
Craigj
New Member
Posted by: WrongNotes

Braces are mostly a cosmetic thing, so I would be wary about the likelihood of recession/palatal change once ALF is removed.  Are you seeing a myofunctional therapist?  As I understand, a crucial component in any treatment involving palatal expansion devices, is to ensure that the tongue learns to work correctly.  In the (eventual) absence of external devices, your tongue function is everything for maintaining results.

 

I would be interested in knowing a bit more about how ALF has worked out for you so far.  How is your airway/breathing?  I'm exploring the possibility of getting ALF myself,   - did you get it through the dentist you mentioned, or somewhere else?  How much has everything cost?

Congrats on your progress, and any further information would be much appreciated.

I am not seeing a myofunctional therapist, I have however been practicing correct tongue posture for the last couple of years. It is cosmetic changes to teeth that I am seeking now that my palate has widened.

As mentioned above, my breathing has always been fine, I am undergoing treatment for migraines and cosmetic reasons. Yes I got it through a dentist, she specialises in migraine research etc so I decided to go with her. Cost wise it’s been around £2000 so far.

See below for front view before and during treatment. There has been a bit of flaring on one side, this is because of the position the ALF was for the first couple of months (closer to the gum on one side). This has been corrected now and the flaring teeth is slowly reducing.

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Posted : 05/07/2019 10:47 am
Craigj
New Member
Posted by: darkindigo

The after photo is on the left?  It looks a bit gapped.  Has the widening helped with migranes??

Yes, doesn’t all palatal expansion cause a diastema? The other gaps on the one side are from flaring.

it definitely has helped with migraines and general tension in my neck and head.

The flaring happened on the side  where the ALF was closest to the gum, I believe it was because of an unequal level of force rather than the actual position as I would’ve thought the opposite.. Both sides of the ALF are now anchored close to the gum and I no longer feel a pressure on the front incisors (which were previously flaring). 

I get what you’re saying about shrinking the front, wouldn’t I still have “buccal corridors” though? I was thinking the 2nd and 3rd molar would be expanded outwards (see photo).

I believe my dentist said the aligners would then shift all of the teeth around towards the front to fill the gaps between the teeth.

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Posted : 05/07/2019 2:27 pm
dm222
Trusted Member

your palate was not 46mm in the before. NO WAY.

not even now it is 46mm.

is he measuring with the teeth or what? it should be only the inside

mine is 45mm and it is way wider than yours in the after

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Posted : 05/07/2019 4:50 pm
Fred
 Fred
Estimable Member

This lady by the name of ccarribe. Said she got age lines which is just wrinkles like nasolabial folds and whatever the upper ones are called. She got agelines after closing her gaps, she got her premolars removed for no good reason.

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Posted : 05/07/2019 7:48 pm
Craigj
New Member
Posted by: dm222

your palate was not 46mm in the before. NO WAY.

not even now it is 46mm.

is he measuring with the teeth or what? it should be only the inside

mine is 45mm and it is way wider than yours in the after

I thought the same.. I cannot find a solid source showing me where the IMW is measured from along with ideal dimensions? A lot of photos show it like this, including some of the tooth width (which is probably what my dentist is doing)

I’ve just measured using the cardboard technique, measuring inside only, and it’s coming up around 45mm, do I even need more expansion or is this decent? 

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Posted : 06/07/2019 6:30 am
dm222
Trusted Member

I think you are measuring the second molar in that picture

 

If it is 45 I think it is decent

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Posted : 06/07/2019 7:39 am
Craigj
New Member
Posted by: dm222

I think you are measuring the second molar in that picture

 

If it is 45 I think it is decent

It’s tooth number 6 which is the first molar, I didn’t bother pushing up on the second molar to avoid confusing things

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Posted : 06/07/2019 12:49 pm