Selecting an orthodontist

In all, I visited three orthos for consultation. Every time I had a procedure done with a periodontist or another specialist, I'd generally ask for feedback on how they thought braces would go down when they met my teeth. I got one referral from my periodontist, one from my regular dentist, and one through my insurance company's list of doctors.

1. Sat in the chair, ortho wordlessly examained my teeth, and when he was finished, said that I would need at least four extractions and treatment time would be three years. When I asked about my TMJ pains, he said that he would send me to a physiotherapist to deal with that. He also wondered aloud if I had seen a periodontist, probably for gum recession (perhaps he spotted the crown lengthening in the back and thought my gums were receeding? I'm not sure -- I listed it in my medical history.)

My main problem with this guy is that they didn't discuss the hardware that could be put on, what the process was at the office, or that he wanted to refer me to several other people for various parts of my treatment.

2. The orthodontist was on vacation, but they had another orthodontist in to discuss treatment options. Explained the various kinds of braces and went over the various problems in my mouth, including their diagnosis (Class II division I). I was told they would do an xray to determine if one of the front teeth had enough support to be saved (it's nearly in front of another tooth at this point). They downplayed the four teeth extraction when I asked about it, but did say the doctor would make the final call on that.

3. They very quickly sat me down and said that no extractions would be necessary. They did, however, want me to first get a soft tissue graft on that front tooth that sticks out. The office was only open one day a month, with the rest of the ortho's time spent in the suburbs. She said no extractions would be necesssary based on that single 15 minute appointment and, when I sat down with the "treatment coordinator" they scheduled me immediately to have my braces put on that next month.

So, I went with option 2. They seemed cautious, but also included what I wanted in the decision making process (i.e. making the selection of one type of braces over another). Following the records appointment, I sat down with the orthodontist for about half an hour to go over my options and his treatment recommendations. The verdict: removal of my four first pre-molars. Not as pain-free as I had hoped, but not completely unexpected either. On the positive side, the front tooth is savable, which means I won't have non-symetric teeth.

He recommended having my teeth cleaned (done), the four teeth extracted (done), and returning as soon as I wanted to have the brackets put on (scheduled for this Wednesday). I hope I made the right decision.