Mouthwear Stories: Paula You Need Orthodontic Treatment

This story was retrieved from the old M's Mouthwear website from an internet archive. Paula, You Need Orthodontics Treatment

It was a beautiful June day back in 1961 just a couple of days after my 14th birthday; OK I had to go to the dentist's but when I went six months earlier I had had X-rays and been told there were no cavities so I was not anticipating anything needing doing. I did not like my mother accompanying me. I sat in the waiting room blissfully unaware of what was to ensue. 'Paula Browne, please go through to surgery number 2.' I lay back in the chair and shuddered at the dentist's hairy hand as he opened a drawer and selected a small, dingy metal tray. He tried it over my lower teeth. In fact he tried four different ones before selecting one and handed it to the nurse. He then repeated the procedure to select an upper one. The nurse handed him the lower one loaded with a wet material which he forced down over my teeth. Horrid! There was a 'plop' as he removed it and I thought my fillings had come out with it. Before I could ask what was going on the upper tray was inserted and (I shall now use terms I have come to know) the upper impression was taken. I nearly gagged from the mouth full of metal and alginate. 'What is this for?', I blurted out. 'Paula, you need orthodontics treatment: braces on both sets of teeth. I need to take the bite register now. On your next appointment I shall advise you and your mother of the treatment plan. You will need an extraction each side upper and lower because the teeth are so crowded. But the results should be really good. I shall telephone your mother and tell her I have done your impressions and ask her to attend at our next session.' Mum was late coming home but hardly had she got in than the telephone rang. 'So, it is time for you to have bands?' (I had never heard the term 'bands'; we talked of girls having 'plates' at school and I assumed the 'bands' were the shiny wires round their front teeth.) 'I can't; I shall be in senior school next year and I'll talk funny with two plates. Noone at school has two plates.' 'No, Paula, you are not having plates. The dentist said you would need fixed braces, he called it multi-band therapy. You will need plates when the bands are removed: they call them retainers then. Don't you remember that girl at the ballet, she had multi-band appliances?' 'No, I cannot look like that. I thought she had smashed her teeth in an accident.' 'Paula, you really must have braces.' 'It's all right for you, you have lovely teeth.' With that I rushed to my room, trembling but strangely aroused. I took up a mirror and tried to imagine myself looking like that self-conscious dancer. Only two weeks ago one of my friends had had a plate fitted and we had teased her because she could not say 's' sounds. She had shown me the appliance and I had wondered how on earth she could accommodate such a thing in her mouth. I did not sleep much that night but by breakfast time I had at least recognized that my teeth were very crowded. Mum did not raise the subject again until she told me the day for my next appointment. 'I have agreed a schedule of appointments for you with the nurse: we are going to be at the dentist's quite a lot until the appliances are completed then there are appointments every four weeks.' 'I'm not going to have bands, or plates!' 'Paula, you are not being sensible. You must at the very least listen to what the dentist has to say.' 'But Mum, I'll be teased at school, they already tease me because of my accent and my big breasts.' 'Paula, you are 14 and intelligent and very attractive, you cannot go through life with such overcrowded teeth. It really is important. Believe me, darling, but you really must take the dentist's advice.' We arrived at the surgery and I presented myself at reception. Against my name in the diary was written 'Ortho'. 'OK, Paula, sit down for five minutes, we are nearly ready for you.' Funny, she did not seem to react as I had expected: that this was such an important event, even catastrophic. I sat on an upright chair and swung my long, bare legs wishing I did not have to wear the silly school uniform. 'Mrs. Browne, please come through with Paula.' The dentist asked us to go and sit at his desk. Two sandy-colored casts of teeth were on the desk, both bore my name in full and my date of birth. The dentist switched on the X-ray screen. 'Paula has moderate upper overcrowding and very severe lower overcrowding. This lower left premolar (number 4) cannot even erupt. Note the very large fillings to her lower first molars but that all the other teeth are excellent. We describe this as a class I incisor relationship with excessive overbite: see how the upper incisors completely cover the lower ones: they should be in this relationship. The molars are in a class 3 relationship. I need to extract the upper 7s and those filled lower 6s. This has the added benefit that the wisdom teeth will then not be impeded. I have to retract that lower left number 5 very rapidly so the number 4 can erupt. Now, this can only be done with fixed appliances, what you probably refer to as 'multi-band braces' in order to control all these movements and apply the necessary forces. We always consider the lower teeth first and match them with the lower ones. What we have to do is retract the 5s then the 4s and then the 3s so the incisors can be aligned. The 7s will move forward a bit into the 6 position. Eventually the wisdom teeth will come into the 7 position. Look at this cast model from the side: see the dip curve? That is called the Curve of Von Spee and need correcting to get the vertical relationship right. The lower brace archwire will contribute to correcting that but I shall put a bite plane on your facebow: your lower incisors will impinge on that and be slightly intruded but, more important, the lower premolars will erupt more. So the first stage for the lower teeth is to retract the 5s and I shall fit what is termed a 'sliding jig' each side. During the day an elastic each side from the upper 7s will connect to the jigs near the canines and transfer force back to the 5s: this must only be applied when your facebow is in place. At home and certainly at night I shall want you to wear J-hook traction straight onto the sliding jigs. Simultaneously to retracting the lower 5s I shall put a facebow traction on your upper 6s to retract them. I am afraid you MUST wear the facebow all the time except during sport. Yes, even during meals. You will have a facebow with a bite plate incorporated for normal wear and one without for wear during meals. The headgear is this type .....see?.....an Interlandi. Mrs. Browne, Paula, I promise you that the results are going to be excellent providing you wear the headgear as prescribed. How long? It is difficult to predict but expect 24 months in headgear, up to a year further still with fixed appliances with edgewise archwires and, preferably, headgear at night, then a couple of years with removable retainers. I may use a fixed lower retainer, we are getting very good results with those. I shall need to keep an eye on you for ten years. Now, sometimes there is a relapse which could mean back in bands. The more consistent you are at wearing your headgear the more remote is that possibility. I have written all this down and included diagrams so read it and come back with any questions. Today I shall place spacers to assist fitting bands in a fortnight. Tomorrow you have an appointment at the hospital for the four molar extractions.' 'Carol, please bring Paula's Interlandi.' 'Paula, jump into the chair. First I shall measure you for your headgear. I recommend dark blue, the alternatives are black or brown. Right, blue it is. Please hold these C-pieces each side. Just .... so. OK. The nurse will rivet that up. These spacers will hurt a bit ..... and there are lots of them.' Can you imagine how I felt as Mum and I left the surgery? My mouth was smarting from the numerous spacers. I was clutching the notes I had been given. My stomach was in a knot from the thought of bands, sliding jigs, archwires, elastics and, far worst of all, Interlandi headgear. We did not exchange a word as we walked home. I rushed to my room to read the notes, cry and generally work myself into a right state. At dinner Mum called me down but she could not say a word about braces. She hugged me for a long time until the tears ceased and she just remarked that I must be brave. She too had eyes filled with tears. We took dinner in the garden. I had a glass of wine and we fed the ducks. We sat out late. I had a spell of hysterical crying and Mum came in to comfort me. On my own with the moonlight streaming onto my bed I felt that overwhelming feminine feeling flood through me again. Surprisingly I slept straight through only to wake as the church bell chimed 8. I grabbed the notes and devoured them again. I lived through these strange procedures described. I tried to imagine what it was going to be like at school, in the town, at dancing classes, at the tennis club, at cadets, on holiday. Paula, the girl in that blue headgear. Gosh, I was going to be in braces when I was 17!!!