Beginning Braces

Coming back from the dentist, the end result was just one little itty bitty cavity. In all honesty, my dentist probably wouldn't even have bothered to tell me about it if I wasn't going for braces. Instead, it would have been on her "watch" list and would be filled if/when it got bigger. But because it's located right where a bracket will be, she's filling it now. It'll even be done before my oral surgury consult, as well. 18 days to go.

A small cavity on an upper premolar I can handle. My upper jaw freezes much better than my lower, and it's not very deep. I hope. So hopefully this cavity will not cause me the problems the others have. *fingers crossed*

Yesterday I called my dentist, hoping to bump up my regularly scheduled cleaning a bit so I could be sure I'd be cavity free for all this ortho work. I'm pretty sure I still have a cavity or two lurking in there somewhere. When I use my electric toothbrush, there's a bit of pain up in the top right, and I swear I can also see decay on the bottom right premolar. Considering it'll most likely take a couple weeks to months to get the appointments to get these filled, I should probably schedule them sooner than later if they are necessary. The end result was I could either have an appointment for a cleaning this morning, or 3 weeks from now. I chose the former, and have about 20 minutes before I have to leave!

Up until now, the only people I'd told about all this work I'm having done are my parents and a particularly special guy in my life (that's another whole story I won't get into here). He's been amazing and really supportive, but is getting tired of hearing me obsess. My mom's been really supportive about my choice to get braced, but she is not at all happy about the prospect of surgery. I ended up getting the "its your money and your body, so do what you want" routine. Sometimes, no matter how old you get, parents just don't ever stop being parents.

So I finally told my two closest girlfriends about my plans last nite. I really wasn't going to tell anyone else until I could no longer hide the fact I had railroad tracks on my teeth, but I felt I needed the support. They were so wonderful! I love my girlies so much. They both offered to "take care of me" if need be, and Lora has volunteered to find me (and make me) all sorts of yummy smoothie recipes. She's a kick ass cook, and I'm almost looking forward to that!

In another vein, I found this article about the Psychological considerations in orthognathic surgery. It's a little technical and doesn't contain as much info as I would have hoped, but it might be a decent read if you're considering the surgery as well.

That's it for now... I'm off to brush my teeth again and make my way to the dentist! Isn't the journey fun!?! (That was sarcasm, in case you missed it!)

Peridontally boring, that is.

As per usual with potential adult orthodontic patients, I had to have a periodontist check me out before I could go through with everything. I was a little bit freaked out about it, to be honest. I was envisioning even more problems that would have to be fixed, needing even more money and time.

Thank god I was wrong! At the request of my ortho's office, the peridontist squeezed me in yesterday when they had a cancellation, which was nice. (My scheduled appointment wasn't until late November). I wish the peridontist was my orthodontist. He was totally cool, had an awesome & friendly chairside manner, and took the time to explain a lot of things to me. I really, really appreciate that. And as far as he's concerned, peridonatally i'm fine. Boring was the term he used. A perfect candidate. In fact, even if I wasn't fine, he told me he would recommend orthodontics anyway. In my particular case, the benefits of getting the ortho done outweigh any risk of tooth loss later.

Apparently, as it stands right now, if my front teeth were to be knocked out due to an accident, I'd be screwed. A partial or implants or any kind of prosthetic device would be almost impossible with my current bone structure. In the future, if I do loose those teeth, naturally or otherwise, orthodontics now will make them much, much easier to replace. Great... now i'm going to spend the next 3 years afraid of baseballs, hockey pucks and falling on my face. But on the other hand, it got my wheels turning. Maybe, just maybe, I could get this whole thing classified as medically necessary? If it is, then maybe my government would pay for it (Gotta love being a canadian, eh?). It's a long shot, but is something I need to look into. Orthodontics in adults are considered cosmetic. And everything but the surgeon's fee is already covered for oral surgery. But that damn fee is the biggest expense!

We also discussed (again) why the surgery option was best. I know it's the best option, it's just a scary, expensive, potentially painful option. He explained that after I saw the oral surgeon, the three of them (orthodontist, peridontist, and oral surgeon) would get together to discuss my case, present the options to me along with their pros and cons, and let me make my own decision. He promised nobody would strong arm me either way. And then promptly changed his mind, telling me yeah, they probably would try to strong arm me into surgery. Lovely...

My consult with the oral surgeon is Oct 18. That'll cost me even more money. It's going to end up costing me a grand just to get a treatment plan, and I wouldn't have had a single thing done yet. But it's for a good cause, right? Can you really put a price tag on self esteem?

As previously mentioned, yesterday I had my "pre-treatment" appointment with the patient coordinator. She had all sorts of pictures, my impressions, and we were going to discuss my options now that the ortho had taken a look at all the data. (See the previous post for some of the pictures and an xray.)

She said so much, and tried to explain so many things to me, I'm sure I'm going to forget 75% of it.

The problems, on the surface, are obvious. There's the huge overjet. There's the spacing problems. And then there's the problems with my lower jaw: it's much too short.

I was given three options. The first was to try and fix things with orthodontia alone. It would involve an appliance on the roof of my mouth for the entire treatment plan. It would be attached to molar bands, and would serve two purposes; it would keep my lower teeth from touching the roof of my mouth, and would provide some anchorage for moving my front teeth back. I've seen pictures of this device on archwired, unfortunately, i cannot remember it's exact name.

I was warned - ortho alone will not be able to fix everything. At best, it could fix the spaces, and maybe reduce the overjet by half.

The second option was oral surgery. This would bring the lower jaw forward, which would allow the upper teeth to be returned to their normal position. As it stands currently, the movement of the upper teeth is limited by the bone growth, which protrudes outwards. It'd be fine if my lower jaw had grown to match, but obviously, it did not. So the lower jaw needs to move forward, to correct my bite and to allow the upper teeth to be moved to align properly with the lower.

The surgery option is the only option that would fix all my problems completely.

The third option is what floored me. I thought I'd done my research, but this was an option I'd never heard of. It would still involve some input from the oral surgeon, but was not "oral surgery", per se. Instead, the surgeon would install a post (or pair of posts) of some sort into my upper jaw, which would be used as leverage (for elastics?) to further correct the overjet. For whatever reason, my jaw alone is not strong enough to be used as leverage to pull the teeth in as far as we'd like. Being able to accomplish that would defy the laws of physics, apparently. The post(s) would be considerably stronger, and would provide some extra leverage. Of course, this is all providing I understood the process correctly. Even the patient coordinator, who'd been doing this for 25 years, seemed a little foggy on the details. The posts were likened to piercings in either the roof of my mouth, or on the sides (the exact location has not been determined yet). Now, I can deal with piercings, currently sporting 8 holes total in my ears and belly button, but the idea of a piercing is that it goes through flesh... not bone! But I digress...

This option, although not providing 100% correction of my problems, would provide considerably more than ortho alone.

Also - both surgery options would require 4 extractions. I thought with all my spacing problems, I'd be spared the extraction route. Apparently not.

The end result of all this? My nice patient coordinator is going to make an appointment for me with the oral surgeon. That'll be another $250. Just figuring out what the treatment should be is sucking me dry, cost wise, between records, a perio consult, and now the surgeon's fee for his consult. Yikes.

I have no idea what I'm going to do.

I've always been leaning away from the idea of surgery. It's a huge expense, doubling the cost of the whole process, especially considering the lost wages from the time i'll have to take off. Plus, it's surgery... I'm not such a fan of hospitals right now. The third option was presented as a compromise, and I am curious to find out more, but a metal post in my jaw, extruding into my mouth? What is this, frankenstein goes to the orthodontist? (ok, that might be a bit extreme, but that's what came to mind.)

Guess I'll have to wait to see what the surgeon says. And the periodontist. Apparently he also has some say on what happens in my mouth. Talk about a team effort, all needed to fix the freak of nature that is me! ;)

Quick update: My ortho's office is going to send me some info regarding the post procedure. I'll post again when I get it, and maybe I can explain things better then.

Because I know how much evey one loves pictures. Even pre-treatment ones. These came from my records and impressions, taken September 7, 2005. The plan (obviously) is to fix the spacing and that huge overjet, which is actually worse than it appears due to the fact my bottom teeth are also tipped forward. Yikes.











And now for the special treat - The scan of the xray of my head, including all the markups my ortho made. Hey, they gave it to me, might as well post it, right?

Just over a week ago, I went in for my orthodontic records and xrays. They scheduled me for a 90 minute appointment, but I was out in 45. The only part that could be classified as unpleasant was the pink goo they use for impressions, but even that wasn't that bad. And of course, they had to take pictures of me and my "smile", which, for someone with a mouth like mine, is an extremely humiliating experience. I honestly do not know how to smile naturally like a normal person.

I've got my records follow up appointment in a couple hours. I have no idea what to expect, but I'll be back to record whatever it is that happens.

Just a quick note - I fixed the majority of typos in the previous posts. I really should learn to proofread my work better. I have a bad habit of reading what I meant, not what I typed, and the end result is something that looks like a typing test gone mad. ;)

I've been meaning to post for a while, bur for whatever reason, I never got around to it.

I did finally get in for a second consultation with a orthodontist close by.

The ortho's clinical findings:
- Lower jaw is too short
- Distance from nose to chin appears long
- Lower teeth are behind the upper teeth. Upper teeth are tipped forward.
- Lower teeth bite into the roof of the mouth
- Lower fron teeth are too far behind upper front teeth
- Upper front teeth are spaced
- Space between upper front teeth is 3mm
- Overjet measures 10mm
- Lower jaw appears asymmetric to the left
- Attrition to upper incisors

Now, I have to choose an orthodontist. I'm torn.

I really liked the office, and the staff. I like the fact it's considerably closer to home - running in to get a wire clipped, for instance, will not be a problem.

A lot of things were similar to the first office I visited - general treatment plan, cost, financing.

The one thing I wasn't impressed with overall was the ortho's chairside manner. He was very... abrubt. Very clinical, and he did not seem overly sympathetic. I was almost in tears, mainly because he didn't seem to think he could do all that much without surgery, and he didn't seem to understand why I wouldn't want it. (The patient cordinator did, however, and repeatedly told me it would always be my choice, and that I would still see huge results regardless of my treatment plan).

So... decision time.

I chose the second orthodontist. I'm still not sure that was the right decision, but I think it's worth it, for the convinience factor alone. Add that to the fact that I'll probably only see the actual orthodontist for a grand total of 10 minutes over the whole treatment, and that they use the faster self-ligatating 3M Smart Clips. Plus, I was able to schedule records for next week... err, that would be tomorrow.

I'll let y'all know how that goes. But that's the deciding factor - I'm not about to spend $450 for records & xrays and NOT go through with this.

New school year, new things, right?