Saturday, December 22, 2007

I Suppose I Should Be Happy

My mouth is creating no discomfort whatsoever. Hmph! I'm getting the whole circle of pain, discomfort, excitement, resignation, impatience process I've read about. "You've been moving, don't stop now!!" The only annoyance I find now is with the sheer volume of time it takes to be constantly brushing, flossing, picking. I just might need to get a bigger purse....or dig out an old diaper bag....with which to haul around the exponentially increasing amount of paraphanelia required to stay on top of this. My new best friend? A pocket knife. Cutting everything into bite size pieces is a royal pain in my rear! Now to find a folding fork...

It is exciting to note I can now venture out in public, carry on a conversation, and actually forget I have braces on! The constant awareness of figuring out where my lips should be was a bit awkward for a while. Clever lips..they figured it out all on their own. The fetching lisp seems to have disappeared as well.

I am kicking myself for not taking a good "first day in braces pic" as the changes are kind of cool: that initial up-down zig-zagging wire linking each tooth as a drunken train now a perfectly straight line. Such a boring concept really, except to the train's conductor :) Throw me a bone, these are early days.

Wednesday, December 19, 2007

It's the little things

It has already struck me as amazing how fast things can change. I am no where near those who have gone before regarding experiences and goals attained in the mouth department, but everyday there's some little thing of note.

For the first weeks in braces, I was too busy trying to get used to the very concept of what it actually feels like to have a mouth full of foreign substance. Did anyone else wake themselves up in the night with the outside of their lips ripped up? I found myself trying to push the braces off my teeth with my upper lip, mid-slumber and in a complete panic. There were a few conscious moments I had to tell myself to just relax and get used to it already. My mouth felt claustrophobic. Weird.

Then my front teeth, if I tried really hard, I could make them tap, tap, tap against each other. This wasn't altogether comfortable but it's like a scab you can't stop picking and I had learned a new trick! Two days later, I couldn't tap them for the life of me. In fact, I imagine myself half snake now with the new found skill of swallowing my 'prey' whole; it is impossible to make ANY of my teeth touch. Due to the cross bite on the side, my bottom teeth merely encounter the presence of the metal attached to the uppers. NOT a fun feeling when it happens unawares! The same is also true for my front teeth: Bottoms clashing on the top brackets - OUCH! My entire mouth is now an open bite. Hence the reptilian approach to nourishment.

(D'uh moment of the week: I was craving a nice garden salad and added one to the family table at supper. No sooner had I put the fork in my mouth when I cursed my stupidity. Salad really is impossible to chew can't chew! Swallowing whole spelled instant gag, so I jumped up, threw the thing in my juicer, added a couple of carrots and ~voila! I had my salad. Not quite the same. Live and learn.)

It really are these very subtle shifts that take the mind off the nuisance of the whole process, and focusing on these changes day-by-day just might help the time pass more quickly. Baby steps.

Monday, December 17, 2007

Treatment Specifics

Okay, Enough of the ranting and raving for a bit. No Ortho blog is complete without the oral details and **shudder** accompanying pictures

None of these glorious full-face shots has me with a teeth closed position. Pictured is my comfortable jaw position. Unfortunately comfort doesn't allow contact between any of my teeth. The closed bite you see stresses my TMJ, but it's the only way I can have contact to chew. I guess I could stop eating...

Note: If you consume coffee in copious amounts and smoke...It will most certainly come back to haunt you. Disgusting.

My assessment is as follows:

  • Lower jaw protrusion

  • Excessive vertical development

  • Negative protrusion of upper front teeth

  • Upper & lower crowding & malalignment

  • Upper midline shifted left/ Lower midline shifted right

  • Tapered upper arch

  • Anterior crossbites, plus crossbites of upper right side

Duh! I could have told them that without making me radioactive and bite into all that bubblegum goo. Ha ha. We've got the official points of reference anyhow.

By the Way...(Part 3)

What the heck is the deal with people noticing you've got braces, (assuming they don't just take for granted you only want to flaunt your money and pride in striving to obtain straighter teeth-this does seem a popular response) ask what's up, then just start talking about having their wisdom teeth out. Rule #1 people: If you don't care to hear the answer, don't freaking ask me! I'd rather it not even come up at all. At first I would try to clarify but it's kind of hard to due justice via a sound bite and then expect them to understand. But I don't get it. It's as though they're trying to 'one-up' your deal without knowing what the deal even is. It's not a competition or even a beg for pity- It just is what it is.

It is by times making me sufficiently angry. It was a huge step for me even to share with those outside of the immediate family circle in the first place. I've already given up & just let people think what they want & do the old nod & smile while feeling a little bitter inside. I have GOT to let this go! Please tell me it gets easier! I'm thinking of drafting an "Orthognathic Surgery for Dummies" leaflet to hand out. Actually, two. A nicely phrased one for those who would really like to understand, and a scathingly witty one for those that are just butt's (and by this passive-aggressive approach, whether they get that they are being mocked or not, would put just a little bit of bounce in my step. HA~! Oh my, I've reverted to my kindergarten self) I take some measure of solace in knowing this seems to be a common response to others in similar position.
Deep breath out..........

So the Story Goes... (Part 2)

Given that my lower jaw is the most obvious of my features, the assumption has been that it is the culprit guilty of throwing everything out of whack. Apparently this is not the case as things sit right now. My upper jaw didn't grow enough. Dr. C is hoping to correct the underbite & crossbite using a Lefort 1 (upper jaw) and genioplasty (aka chin job) only. I must confess to being unsure if I'm slated for a 1 or 2 piece Lefort. I'll be confirming this at my January appointment.
Diagram illustrates a one piece Lefort I procedure. A two piece involves an additional fracture vertical underneath the nose for horizontal expansion or re angling.

Illustrates fracture made to reposition the chin. This is sometimes necessary to aesthetically balance the jaw repositioning and/or to make sure the lips are in a natural position after structural movement. The things you don't think of!
I was figuring he would need to work on both jaws, so imagine the sigh of relief upon hearing this. Yes, quite a laundry list of challenges to hurdle with upper jaw surgery, but escaping the additional list accompanying a BSSO (lower jaw) surgery is a treat. This is the plan, anyways, pending the Ortho's ability to get my chompers into the most beneficial position. I am aware that this can all change up to the 11th hour to include BSSO but to those that ask, I tell them upper jaw only, while mentally preparing myself for the possibility of both - not obsessively though.

Okay, I'm kind of on a roll now that I've started sharing so I'll give you my rationale for being happy not to have this already well behind me and paid for by my parents. By default, it also includes my personal feeling on the cosmetic vs function debate as it pertains to me ONLY.

*The disclaimer: this is in no way a dis against those who take an opposing view on the subject as it's a highly individual matter of perspective, just my opinion on how it fits with my story, personally. With this in mind, please don't bite my head off if you disagree...I have no problem with others choosing to the contrary :) *

I find it strange that my #1 motivation for wanting this as a teen was aesthetics, whereas now it's one of my biggest fears. Heck, I'm no beauty queen, but this is what I've looked like for just shy of 30 years and I've gotten rather used to it. This is me. Perhaps there's a bit of "the devil you know is better than..." going on, but really I'm quite happily married to an extremely handsome man and we have 3 very beautiful (if I do say so myself) children, malocclusion be darned. If I were to do anything for aesthetics, I would get a boob job : simpler (even with complications) cheaper, and more instantly gratifying (though I'd never actually get one!). But change my face? What if I hate it?Not exactly something you can hide under a bulky sweater and chose to show off now and then with a nice push-up, if you know what I mean! Bottom line: for ME (again just my personal choice...), cosmetics is not sufficient to entice me to take such drastic measures. Matters of character just seem much more important. I'm thankful my parents chose not to proceed. Circumstances change. Pain is a stronger motivator.

In light of the above paragraph, I don't believe I was informed or cared enough about all the risks and complications. Heck, even just the routine road blocks of a picture perfect recovery would've been nasty. (True, we'll never know for sure and maybe if it was done I would never have the discomfort of wearing disks, strained joint and whacked out teeth. But it was a crap shoot - lots of folks have bite issues to varying degrees and don't seem to suffer at all. I wish that was me!) I doubt I'd have been able to go through this process with the amount of grace and long-term vision that I would like to think I can rustle up now. That gift of hindsight: I thought I was mature and capable in so many things but let's face it, my priorities at that age were just so narrow/ different. I look back and realize just how naive and blissfully unaware, as well. Even emotionally I know there will be challenges, but I'm past trying to (re)invent myself and hope to be able to remember the big picture & where I fit within it. (If anyone stumbles across this blog, feel free to remind meof this later!) I can make more well-informed decisions as an adult, and have no one else to blame but myself regarding the outcome.

Wow, Guess I should have warned you I'm a windy talker...nothing a quick scroll wouldn't have revealed anyways! Meh, once all the history's out of the way I imagine I'll pipe it down a bit.

History Repeating (Part 1)

It's true what they say, history really does repeat itself. Or should the cliche being bandied about really read..."will come back to haunt you.."? It's the latter that has been all consuming in the life of Yours Truly the last few years, the past 6 months particularly, and I don't see that changing anytime soon.

As so many fellow ortho-bloggers have shared, Orthognathic Surgery was the recommendation of the day whilst still a teenager 15 years ago, and there would be no straight teeth for me without it. The initial records were taken, impacted wisdom teeth & an impacted canine were all removed, the surgeon consulted and the brakes applied. You see, at this time all I cared about was how different I looked than the people around me. I know now that it's called a class III malocclusion, but at the time I couldn't care less what it was called. I looked funny -'nough said! I had no trouble eating, talking was a sport I excelled in and pain was not an issue. Why, in the name of all that is holy, would one's parents put their child through such a huge procedure for the sake of vanity? Some wish their parents had gone for it back in the day....I am not one of those people. Perhaps I'll share about this later.

Fast forward to the more recent past and safety-pinning the bottom of one's pants is no longer De rigour. Humour me by bearing with a few rather mundane-sounding examples :The way I eat, which has always been normal to me, pushes my lower jaw even farther forward than would be naturally comfortable but it's the only way to make molars meet in able to chew. The joys of being an adult and the everyday stresses which accompany this usher in the dreaded clench and grind. A routine visit to the dentist ends the ability to open my mouth for a couple of weeks, a complete lock down. Oh right. They are also all accompanied by a fair amount of discomfort and I don't normally consider myself a pansy in this department. Boo-hoo for me. Who doesn't have variations on this theme? Find a power animal & take up yoga, you might suggest. Don't go to the dentist, Duh! Just stop eating - poof! Just a couple silly examples, but they now have the power to turn me into a useless, drug-seeking puddle who always has to ask herself, "How many days of no sleep have I endured? Am I sufficiently incapacitated to warrant treating myself to that Percocet hiding in the back of my cupboard?" Ibuprofen used to be my best friend, but apparently living on the stuff can lead to developing an allergy to the stuff. Look! I'm a human hive with a tongue the size of a Mack truck! Drat the luck. I'm self-aware enough to know I have an addictive personality, hence the strict narcotic rationing.

Enter the doctors, dentists, orthodontists, and TMJ guys. I sought out a cross section of care-givers for 1st 2nd & 3rd opinions, options available other than surgery, to have each and every one of them eventually point me back to the suggestion of origin-Orthognathic Surgery. Bummer. I won't suggest for a moment that this decision is easy for anyone regardless of what stage of life they may be in. This option scares the bejeebies out of me on so many levels. I'm not exactly old but I'm not a youngster anymore either. I've got a farm to run, a husband and kids to look after, School and Church responsibilities. How can we justify spending all that money on braces and a surgeon for me, when there's never enough to go around? What if I turn into a whining wussy who can't talk (or think) about anything but her mouth? What if all the other kids make fun of me?! What if my peers think I'm just doing this because I'm *gasp* VAIN - the horror!

Enter my wise and caring husband, without whom I really don't think I could rationally make this decision. His advise:

  • Throw out any concerns that involve other people or organizations. If they can't at least be sensitive and flexible you don't want them around anyways.

  • Look at your quality of life sucks. And it's only going to get worse.

  • You asked for opinions from those that should know, and this is what they are all telling you. Listen to them.

  • I'm here to help you whether you handle it stalwart as a soldier or bawling like a baby.

  • You have people more than happy to help with kids and responsibilities...but you have to let them.

  • It took you years to get to this point & you tell no one the pain you put up with, you can't expect others to just "get it".

  • Ummm...that's what payment plans are for and you're worth it. One day at a time.

He's a good man! Decision made. My big Sis makes a heck of a sounding board, too.

It's actually scary how quickly everything fell into place once proclaiming the final "Bring it on and let's Git' er done!". I decided on my childhood orthodontist, Dr. D., whom I trust and has the advantage of already knowing my past history. Seeing how much my records have changed from the '90's to today was rather ominous of what I could look forward to. He has another ortho working in the office now, Dr.K. who is a completely different style but also left me with a good impression. (A built in 2nd opinion on all things tooth-placement related is rather nice, too!) I saw them the same week I called and was back for my round two initial records appointment 2 weeks after that. I had already chosen the surgeon I wanted, pending how I felt about him in person. A little inside help from one of the other doc's I consulted with got me in to see Dr. C (oral surgeon) the following week, November 8. Made it a bit hairy for the Ortho's to get everything together on time, but wow, they were awesome! The drive to the surgeon's office was rather nerve-wracking. I just kept praying,"Let me love him or hate him, I don't care which. I just want a sense of surety that this is the guy for me..or not!" The ball was rolling so fast I wasn't sure if it was a sign that this really was meant to be, or if I was racing into a grievous error. I had to remind myself that the hemming and hawing had already ran it's years-long course, that I had already made this decision. The rest is just details. I loved Dr. C. We'll see how I like driving back-and-forth to Toronto.

Okay, we're at today. I have a mouth almost full of metal as everything but molars where joined by wire on Nov 28. I'm no longer drowning on my own saliva or sporting a mouth shredded by the shrapnel within. Dr. K even called me at home to see how I was making out, with which I was very impressed. Spacers go in January 14, followed by banding on the 21st. Then we can say the show is officially on the road. My dentist pulled out my lower 4th tooth (to match up with the missing upper canine) two weeks ago, and honestly, it was this removal that gave me the most grief. It could be having a healthy tooth pulled while still getting used to braces was just a bit much, but it just felt wrong. I am now a strong believer that one is meant to keep their teeth firmly embedded in one's jaws thank-you-very-much.