Two weeks ago on Tuesday evening I went to the ortho to give them my lower plate for the missing elements to be added. It felt weird only having the upper plate. I was used to having only the lower plate in during the first week, and both plates since then. But this was the first time I had the upper plate in alone. As expected, talking is very different in all three cases. Only having the upper one in is the easiest talking-wise. That's probably due to the bite plane on the lower one blocking me from making proper "s" sounds and instead requiring me to approximate them somehow without being able to bring my incisors close to each other.

I went back Thursday morning to get back the lower plate. The labial bow and two wires, each resting on the occlusal surface of a molar (does someone know the name of those?), were added. Here are new pictures of the modified lower appliance.

https://dereferer.me/?https://cdn.discordapp.com/attachments/530075173014077451/842400994846703616/1.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/530075173014077451/842401023275958331/2.jpg
https://dereferer.me/?https://cdn.discordapp.com/attachments/530075173014077451/842401044880556052/3.jpg

The modifications changed the bite planes, so they needed to be ground down in some places again to allow for good occlusion. This is always an ordeal as the ortho only has blue foil for detecting bite marks to be ground away, which is near invisible on the blue plastic. I asked her if there aren't foils with other colours to which she responded that she'll probably end up ordering another colour. I wonder why she hasn't already done so in the past. Maybe there aren't many people with bite planes who choose blue acrylic?

During the appointment pretty much all active springs of both plates were activated in one way or another. At least it felt that way later on when the pain set in.

I guess another difference is that only some of teeth were activated

Regarding the pain that statement is probably the root cause for my lower pain the week before. While I was confident last time that my teeth won't ache too much and that I can work around it by having most of the pain during the night, this time I woke up several times during the night due to the pain. Interestingly, mostly my molars hurt, which don't have any active elements. That was probably due to the addition of the occlusal wires and modifications of the bite plane. At least now I know that next time I won't leave the strongest pain for the night Instead, when the pain comes during the day, I can see if it is bearable or if I should take painkillers.

Before beginning treatment, I expected speech to be affected but become better over time. What I didn't expect was that after each adjustment I'd need to relearn how to talk anew. The activations of the upper plate during that appointment resulted in the appliance sitting different and yet even lower in my mouth. Therefore, the way I was finally able to pronounce some letters were now void again. It took nearly a week for me to pronounce "s" sounds properly again…

My jaw joints started aching a few weeks ago, which I asked the ortho about during the appointment. She said that as long as it's only a slight ache and they aren't cracking it should be fine. However, if it stays or becomes worse, we can try to make the bite plane a few mm thicker to try to relax the jaw muscles more.
Since then, the jaw pain mostly subsided, but the right joint started cracking sometimes when I take out the braces to eat. Either way, I'll ask her about it again during the next appointment in four weeks. Because to be honest, I'll probably enjoy the thicker bite plane anyway


Initially I feared that I reality with braces will hit me quickly after getting the braces and I'll start to see them like more of an annoyance than enjoyment. I'm glad to say that that hasn't happened so far. I'm still enjoying them every single day with their smooth acrylic, the lisp they give me, and the way they restrict my mouth and my tongue movement. I'm so happy I convinced myself to get them after years of missing courage and chickening out several times!

I agree it would be very interesting to see close up photos of your braces on your teeth. Obviously with no more than your mouth in picture so you are not identifiable.

If you are uncomfortable making pictures of you wearing the appliance, do you perhaps have the moulds of your teeth? showing both plates on those would make it much easier to understand as well!

Hope you get them the way you want them.
It will be interesting to see how you find the thick bite plate as I find mine makes speaking easier than the one with less plastic behind the front teeth.
Although I asked for the most coverage possible with mine and the plate went a long way back, I would still like a bit more.
Maybe I will get around to asking for that when I order a new hawley with a tooth on it from the Braces Shop to fill the gap where I had a tooth extracted a few years ago.

That really is a mouthful now. Yes you are right, it is a shame they didnt make the plate cover the palate fully. It is that feeling that I particularly like, although mine could still go back further.
There are certainly enough springs to move things around a bit!
Looks like they keep your mouth much further open than my activator does.
Interesting, isnt it, that you find s sounds a little easier with the thicker plate.
I also found that the bite plate made that easier and a little more 'forward' than the thiner retainer, although I have to be a little more careful to avoid excess saliva.

If they had increased the acrylic coverage of your palate, they could probably have squeezed in a second expansion screw as well'- which again would have required fairly thick acrylic. It still seems odd to me that they have installed expansion screws top and bottom but are not using them.

From an orthodontic perspective, your case would be managed much more easily with fixed braces, so kudos to your ortho for accepting your demand for removables. I can't imagine there has ever been a more complex set of removable braces. very impressive.

Don't worry about the IPR. It is not at all painful and the amount of enamel removed is minimal and should not impact on the health of your teeth. My orthodontist told me her invisalign practice was reliant on IPR; should could not have done most of her invisalign cases without it. 

I just realized that I never updated you on my last appointment 7 weeks ago. As I'll have the next appointment tomorrow, I thought I'd give a quick update beforehand.

Last appointment the planned IPR was performed between my lower incisors. Due to that I wasn't in a separate room as was the case for all previous appointments. Instead, I was in the open treatment area with three chairs next to each other. Next to me was a teenager with fixed braces getting a wire change.
The ortho explained to me the stripping procedure. She said that it can be done either with a machine or by hand. For me she prefers by hand. She had two different strips of sort-of sand paper. She started with a coarse one and finished with a more finer one. It really felt weird. Even though it was exactly as I imagined having sandpaper between your teeth feels like, it still felt somewhat unexpected. I definitely didn't enjoy the feeling one bit. Luckily, it was over pretty quickly after only a few minutes. Afterwards, she applied some fluoride. She said that she took away very little and that the gaps should be barely visible. Looking in the mirror and pressing my tongue against the incisors, however, I was easily able to see tongue through the gaps. Though noone apart from me would be able to notice it.

The top plate wasn't adjusted, as she wanted to wait with that until the lower teeth have gone backwards. She did trim away some acrylic that was digging into my gums at the left wisdom tooth. Unfortunately, as a result that wisdom tooth moved inwards quite a bit in the last seven weeks, probably because there isn't anything holding it back anymore (as the plastic there was ground away). On the other side the wisdom tooth is where it was left as inward movement is prevented by the plate going back there. I'll mention it tomorrow and am interested in how that will be undone.
I asked her about the two additional springs that I noticed last time when all the springs were replaced. She said that those are maybe because the lab tech couldn't remember between which teeth the springs were exactly once they removed all the springs. They most likely decided to add them in both places where they thought they were. They won't be needed or used.
One thing that annoys me quite a lot, is that the spring between my left canine and incisor is pressing against the incisor. That resulted in both incisors on that site tilting quite a lot. The central incisor is trying to push in front of the right central incisor but is blocked by the labial bow. Thus, the right central incisor is pushed back, leaving me not able to bite properly at all. It's also extremely visible. In fact, I was asked by a colleague if the corner of my tooth broke off because it looks just like that. Additionally, that central incisor was already tilted slightly to begin with. During the initial consultation the ortho said that this kind of untilting can't be done with removable braces. I really hope that it can be fixed somehow.

On the bottom plate the ortho ground away a bit of the plastic behind my incisors, allowing them to move back and adjusted the labial bow to apply quite some pressure. Since the adjustment, those four incisors have moved back amazingly and I'm really starting to love how straight they are. There are still some very slight gaps between some of them, but they are barely noticeable even for me. I'm sure they'll be gone very quickly after the next adjustment. However, all four incisors are still pretty sensitive to pressure. When flossing, the gaps where IPR was performed feel pretty rough compared to how smooth it fells between all other teeth.
Finally, the ortho fastened the holding clasps, as the lower plate was sitting rather loosely. Unfortunately, that resulted in the space opening up between my right premolars yet again.

Once finished, she inserted my plates back in my mouth and said that she usually expects the braces to be worn at least 3-4 hours after IPR. Having had the adjustment in the morning hours, I'm pretty glad I didn't have any work meetings afterwards. Otherwise that wouldn't really have been possible.

I have to be a little more careful to avoid excess saliva.

I definitely noticed myself spitting quite a bit more when talking since I've gotten the thick bite planes when I'm not careful with my saliva management. In general speech hasn't improved much since the last time. While my family says that they don't hear much of a difference, especially when wearing a mask, I still notice quite a difference. I can pronounce most words without much trouble intelligibly. Except for my last name. Already without braces I usually need to repeat it several times. But with braces it just feels like the worst combination of sounds ever. Spelling it out doesn't help either. And when I try to speak super clearly and think about every word (e.g. when asked to repeat something), talking becomes much harder. So being asked to repeat my last name results in even less understandable gibberish.

If they had increased the acrylic coverage of your palate, they could probably have squeezed in a second expansion screw as well

Yeah, I still feel a bit bummed about that. But I'll try again for more acrylic coverage when it's time for retainers. Even if they did increase the acrylic, I wouldn't have expected a second expansion screw, since I don't expect them to ever be used. But one can always dream

From an orthodontic perspective, your case would be managed much more easily with fixed braces, so kudos to your ortho for accepting your demand for removables. I can't imagine there has ever been a more complex set of removable braces. very impressive.

I'm also really glad that in the end I finally found an ortho willing to treat my case with removable plates. Otherwise I wouldn't have gone for any treatment at all. The plates are definitely quite complicated compared to most "normal" ones. Since years I've been thinking about what removable braces would look like for me. Most of the things I expected are actually there exactly as I thought (the modified upper labial bow, the springs to move the canines back, …). But then there are so many more springs all over the place that I would never have thought about. Definitely quite some metal in there!

the amount of enamel removed is minimal and should not impact on the health of your teeth.

That's what my ortho told me and what I'm telling myself as well. But as an avid teeth grinder, I've already lost so much enamel that it just feels bad to have even more removed.

All in all some stuff is getting better while other stuff is getting worse. I really like the changes of the lower incisors and I'm sure that the upper teeth will be fixed in due time.

PS: "quick update" apparently equals over 1200 words…

A lot happened since the last update. In fact, I had two adjustments and will have the next one tomorrow.

In the last update before the first of those adjustments, I wrote that my teeth had shifted quite a lot in the seven weeks since the adjustment before. When the ortho asked me how it went since the last adjustment, I answered that a lot of stuff moved in ways they probably shouldn't. She looked at my teeth and acknowledged the very same things I noticed.
My 11 (I'm going to use FDI from now on if that's fine with you) moving back and blocking my bite was promptly moved forwards. Regarding my rotated 21 and 22, the ortho said that it's mainly due to intrusion. She explained that some intrusion is to be expected when using removable braces, but she has never seen a patient where teeth intrude as quickly and strongly as mine do. She also mentioned that my teeth seem to move very fast in general. She relieved the pressure on 21 in the hope that the tooth will extrude back out.
After mentioning that my 28 had moved inwards quite a bit as the acrylic counterpart was missing, she reduced the pressure of that spring.

In the bottom she increased the pressure of the labial bow a bit to close the minimal gaps I was still noticing. I mentioned that those incisors still feel sensitive even after 7 weeks, probably due to the bottom plate being pushed forward when I'm clenching subconsciously. She spent quite a lot of time removing any pressure I felt from all the springs behind those teeth, adjusting them little by little for each individual tooth. She also pushed out the holding clasp between my 44 and 45, ground away a little from the acrylic on the inside and increased the tension of the triangular clasp behind 45 such that the 44 can move back and the 45 is pushed slightly to the front, reducing that gap. That definitely helped as that gap is gone again.
I also asked when my 38 will be derotated which I initially requested before getting the braces. She wants to have my bottom from teeth finished before starting on that tooth, as there are currently already enough things to work on. It'll require another modification to the bottom plate. The acrylic on the inside will need to go back even further to fully cover that tooth. A spring will also need to be added similar to the ones I had for my top wisdom teeth. From that description I guess the original idea during the first consultations of using a button won't be happening...

Due to my teeth moving quite fast, the ortho wants to see me more often with less time between appointments. I agreed on another appointment three weeks later.

As my teeth and bite were shifting all over the place again, already the evening after the adjustment I bit of a bit from the corner of my 12 as I hit that tooth once 11 was moved out of the way. Luckily it's only a small piece without any further problems. Apart from that, not much happened. The bottom incisors improved rotation- and alignment-wise. The top got slightly better but I still can't bite properly. I can't bite off things like pizza and can't chew properly due to a posterior open bite resulting from everything being in flux.

Three weeks later, two weeks ago, I had the next adjustment. All gaps between the bottom incisors had closed. My 42 was still out of line a bit. The ortho said that she'd like to strip the space between the 42 and 43 a bit more to move 42 back a bit more. I think I'll never get used to the feeling of IPR. It just feels so ... weird. I can't describe it. On one side it's exactly as expected, sandpaper between teeth, on the other side it makes me feel like when I hear fingernails on a chalkboard. Anyway, she added more pressure to that tooth from the labial bow, which now makes a curve inwards in front of that tooth. She said that from now on she wants to only apply very slight pressure as my teeth again moved quite a lot in the three weeks. When I asked her in how far that was unusual, she said that usually with adults movements aren't that fast and teeth don't react that strongly. I told her I wear the braces about 18-20 hours each day, which she meant could explain part of it. Anyway, she'll try to move ahead with using only slight pressure and adjustments every 2 weeks now.

On the top plate, the spring for the 28 dug into my gum since the last appointment. The ortho said that my 18 and 28 are in their final position and have been retained there for some time already. The springs shouldn't be needed anymore and are causing more harm than good. Thusly, she removed them. She clipped them off and smoothed the places where they met the acrylic. She also adjusted the spring behind my 12 to move it forward and out of harms way. And then the unexpected happened: She turned the expansion screw of the upper plate. Only half of a turn, so 1/8 of a full rotation, but she turned it! She said that she needs a bit more space in the front.

As I've always been highly intrigued by expanders, I was on cloud nine. It was just such a slight expansion, but I was able to fully enjoy the feeling of the sideways pressure. Though unfortunately it was very slight and only lasted for about a day. Still an amazing experience I had only dreamed of before.

In the weeks since, my top teeth didn't change much, but the top plate also wasn't modified much. The alignment of the bottom incisors improves ever so slightly bit by bit. However, they are at completely different heights now, probably due to different pressure and rates of intrusion.
Last week I had a painful sore spot in my lower gums, which the lower brace pressed against. I wasn't able to wear the plate for three days, letting the spot heal and disappear on its own. Interestingly, the differing heights of my lower incisors started to equalize a little during that time, as if some of the teeth were extruding again. Also the posterior open bite started to close a little. However, all of that was undone within a day of starting to wear the lower plate again.

I'm at a point where first doubts start to set in. Some things improve a bit here and there, while other parts go haywire. I still absolutely enjoy the whole experience with lots of elated moments. However, I'm thinking about if I'll ever be able to bite as well again as I did before starting with all of this. I guess I'm currently just frustrated that stuff is moving around in ways it shouldn't. But then again I've read a lot that it always gets worse before it gets better.


In my region, some places start to open up a bit more with mask mandates being partially lifted. This means that in some places I'm now wearing the braces around without a mask to hide them behind. I have to say that it's a very different feeling. Beforehand, noone could see the braces and given my speech having become quite good (with only a bit of the "braces-accent" left), I think hardly anyone would even notice that I have braces. But now everyone can see them when I'm talking or laughing. There are some times where I completely forget about them and act just normal, and then there are times where I become extremely self-aware about them and try to hide them. The switch between those happens instantly, sometimes while I'm talking. I guess I'm not used to that "exposed" feeling yet. On the other side, not wearing a mask in public places doesn't prevent me from wearing the braces anymore as was the case when I initially got the braces. Still, I don't wear them during work meetings or in the office. Luckily, it's still mostly home office for the foreseeable future.

It will be interesting to know how it is to speak without the plates when you eventually finish with them.

I'm not sure I understand what you mean. I still speak quite a lot without the braces in as I don't wear them during work meetings or when eating. It takes a few seconds to adapt to not having them in when I take them out where my mouth still tries to swallow and speak as if I had them in and fails miserably. But after those few seconds everything's back to normal.

(One small thing, and please excuse me for saying....but it is 'ground' not 'grinded')

(On the contrary, thanks a lot. I thought "ground" might be correct, but it just sounded wrong to me for some reason.)