Beginning Braces

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.