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Posted by H on May 03, 2000 at 22:43:27:

In Reply to: Re: orthodontic positioner posted by Brad on May 01, 2000 at 21:42:15:

: H. I'm no orthodontist So I don't claim to have all the answers to your case, but I do know this: For teeth to move they must have continual force on them 24/7. Thats why braces are glued on to make that happen all the time. Removable appliances ONLY work when they are in. When they are out the teeth don't move or begin to relapse due to the abscence of constant pressure. Teeth like to return to their original position. Much the same reason that your teeth relapsed. The appliance is much like two football mouthguards glued together one for the top and one for the bottom. When you say that you must clench into it thats how you create the pressure or force to move the teeth imagine biting into a rubber guard 4 hours a day..sure your facial muscles get tired. Try clenching your teeth continuously for just 5 minutes and see if your face gets tired! The drooling is part of the fact that you have this bulky appliance in your mouth that stimulates saliva and makes it somewhat difficult to close mouth swallow. There is no eating or talking at least coherently. So I would say there is not a lot of pain but some soreness associated with it. I certainly respect your practitioners views. Just remember though when your not wearing it its not working. If you wore it 1 hour a day it would take forever if at all. If you wore it 24/7 (for the most part) then the treatment (the straight teeth part) will happen quicker. I have no idea about the tongue habit and how long it would take to correct that. When I wore my postitioner I wore it 24/7 so that the treatment phase would go quicker. As far as fixed retainers go I (in my opinion) am a firm believer in them. I think they should be left on indefinately and will contradict any orthodontist who says its okay after 3 to 5 years to remove or loose it simply because I have seen too many relapse cases with disappointed patients who thought it was okay to remove them. Keeping them on is to fight against the laws of nature and established tooth movement. In my opinion retention after ortho is underemphasized!
: Brad

Oh Brad,
Tell me you didnt say it was difficult to close your mouth fully to swallow....great, I'll be spraying myself all day long with a tongue thrust, my tongue thrusts forward when I swallow and without being able to close my lips the saliva will come squirting out. yuk.
My ortho actually told me to insure that I took breaks form the positioner (because he said it would hurt like heck if I tried to wear it all the time) but that in the first few days I should try to wear it more than the 4 hours because it would more than likely end up coming out at night. hmmm.
I don't think that bonded retainers are possible on my upper and considering that I was classIII might not even be useful on the bottom (since they go on the back of the lowers) and besides that did I mention the fact that I just found out last week that in 3 months we have to move about 1800 miles away? oh yeah. So I think he wants me to not have to worry about getting back for appts if the bonded ones come out or whatever... I agree with you that bonded retainers are actually best but I also know that in certain cases they are pretty useless also. I can't see me wearing this positioner 24/7 and I covered it several times with my ortho as to what the expectancy for success was and that was never even a consideration so I don't know. I also agree with you that retention is EXTREMELY under rated in orthodontics. I will wear this thing as much as possible but I'm not going to ruin my last 3 months here by being antisocial in order to wear it all those hours. I'm not sure what your reasons were for needing it etc...but I know that my actual tooth movement is likely to be very minor my ortho has done a great job, just cannot make the final tuning as the tongue thrust keeps ruining everything he tries to do there so this is the way to make the fine tuning and also to hopefully break the tongue thrust. I know that he and I are committed to breaking the habit so if it can be done I'm sure we'll succeed. So, in the mean time if you see a drugged up on painkillers person on the east coast who is not speaking to anyone, drooling excessively and rubbing her cheeks just smile and introduce yourself!! LOL! Thanks for all your help as it has helped me to know what to expect.

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