Tuesday, October 31, 2006

October 2006--The Oral Surgeon

Ah yes. Finally. On October 23, 2006, the day before my 30th birthday, I met with my new oral surgeon Dr. C for the very first time. There was a $70 fee for the consultation and I intended to get my money's worth. I found a list online called "Questions to ask your surgeon" and I printed it off. I was ready.

Dr. C told me right off that I was special. I was one of the unlucky 5% of people who need this surgery. Yeah, I'm that bad off. Woo hoo!
Dr. C explained the surgery to me in depth, told me exactly what to expect (a lot of which I already knew from the Yahoo group), told me the risks, and answered all my questions and more. He had me stand against the door and he looked in my mouth, felt my jaws and studied by facial bones. He didn't even get offended when I questioned his competence by asking him how many surgeries he's done. He has done lots, by the way. He also told me I'd probably be done with the surgery by summer. I was relieved.

After we spoke for a while, Dr. J came in and then he made me stand by the door, looked in my mouth and told me I still had a little ways to go with those bottom teeth (they had finally just started moving). Then he told me I may be ready for surgery by March! My jaw dropped (no pun intended). If I have the surgery in March, that means I'm halfway there.

Then the two good doctors both studied me and spoke using all these medical terms I've never heard of and conferred with each other. It felt really strange to be looked at and talked about like that, but the way they spoke to each other--and me--made me trust their judgement completely. These are two guys who seem to know what they're doing. Can I trust them with my jaws? I think so.

Time will tell though, I guess.

Update--My uncle is a doctor, and it turns out he knows Dr. C personally. My uncle says he's an excellent OS and that I'm in good hands. He also knows my OD and says he's excellent as well. How do all these doctors know each other? In any case, I feel better.

September 2006--They Ain't Moving

My top teeth had moved so fast, I wasn't prepared for the loooong time it took for my bottom teeth to shift. I got a new strong titanium wire in there, and they still didn't budge. I kept waiting to feel that tingly, loose-teeth sensation that told me they were moving, and it never happened. I figured the teeth must be deeper into the bone or something. Impatient? Yes. I want to get this all over with quickly!

August 2006--Brace Yourself Again

I have to go to orthodontist appointments every 5 weeks, which is hard because 1) I work Mon-Thurs 8am-5:30pm and Dr. J's office is closed on Fridays 2) His office is a a 30 min drive from here, in downtown traffic and 3) I have two kids that I must drag along with me. But I digress. It must be done.

So in August I went in for a routine wire change and they said I was ready for my bottom braces. Yay! After 3 months in my top braces,
they had accomplished a lot of hard work. My overbite was a lot worse (common occurance when you're in braces in prep for surgery), but my teeth were a lot straighter. There was now lots of room for the bottom brackets. On they went, a breeze like last time. And a hell of a lot uglier! All metal this time. My bottom teeth are really crooked so the braces looked like a metal pretzel. Yuck.

Bottom braces are a lot harder to clean for me. All the food seems to settle in there. Flossing is more difficult. I had some pain the day after again, but not as bad as last time. My mouth is a MESS!

July 2006--The Greatest Resource

Now that I had decided to take the plunge, I started Googling. Normally a bad idea. But it wasn't bad at all. Most of what I read was very comforting. Somehow, one day I stumbled across one of the greatest resources in existance when it comes to orthognathic surgery:


Everyone who is considering this surgery should join this site. You'll get real people who are pre-op or post-op, you can read about orthodontists and oral surgeons, you can read about recovery, you'll see hundreds of pictures. Just an invaluable resource. Because of this site, I know exactly what I am getting myself into. Education is the key.

June 2006--Takin' Care of Braces

My teeth did indeed start moving right away. By week 3, I could see a difference already.

The care and cleaning of my braces, plus the diet change, proved to be a big adjustment for me. Flossing was really hard at first. I used the little floss threader for a while, but it got to be too inconvienient. I bought the Super Floss with the thick end, but found it too thick. Finally I stuck on regular old waxed floss and with a lot of practise, could floss easily in about 5 minutes.

I gave up popcorn for about a month, and then found I could eat it if I did so carefully. I gave up gum not because it stuck to my braces, but because it hurt my jaw to chew it. The only thing that really irked me, and still irks me, is that my o-rings stain like crazy. They look horrible against my clear brackets! I don't know what stains them. Tea or Pepsi maybe. I don't smoke or drink coffee or eat curry.

The first month in braces was hard. Right after I got them I caught a bad cold and on top of that, a headache, and PMS, I was quite grouchy for a while. What got me through that first week was watching an entire season of Grey's Anatomy
on the computer. That, and packing. We were due to move at the end of June. For a few weeks I was too busy to think about my braces.

To my surprise, not many people even noticed them. Truth be told though, I do not come into a lot of contact with people every day. I work out of my home as a child care provider. The only people I see are kids and the occasional neighbor. Maybe if I worked outside the home it would be different. But when you're 30 and you have braces, you don't really care what people think. To me, my braces tell the world that I'm doing something about my dental problems. They say that I'm lucky to be have them and not everyone has this opportunity. They're a status symbol, in a way. I have a lot of $$$ in my mouth. It's my bling-bling, baby! Look around....it's not just teens who have braces anymore.

Late May 2006--Brace Yourself

On May 30, 2006, I strutted into Dr. J's office with the attitude of "Let's get this over with." I got the financial stuff squared away with Mary, and was sent off for more pictures and some plaster molds (I hate doing those! I felt like puking). Then, I sat in The Chair. I expected Dr. J to do the bracing, but I didn't even see him at first. One of his qualified and professional staff members was going to do the job. Fine by me.

I had braces once before, when I was 11 or 12, but I barely remember it at all. Maybe because they didn't help. This time, at age 29, I figured it would be a breeze. And getting the braces put on WAS a breeze. I could only get the top ones because of the position of my two front teeth. I got 6 clear ones and the rest were metal. After she was finished she handed me a mirror and I stared in horror and resignation at my braced top teeth, all the while reminding myself that with pain and awkwardness comes beauty and a nice smile. After all, I always wanted a nice smile and here I was, doing something about it. Go me!

Dr. J took a peek at me before I left and told me I'd start feeling my teeth move within a week. And he was right. The pain the next day was excruciating. I couldn't chew any food at all and I got a monster headache. My nerves were jumping like crazy and the inside of my lip was rubbed raw from the brackets and hooks.

I suddenly remembered what a huge pain in the ass braces are. Don't even get me started on the first few days of flossing!

Early May 2006--The Problem

I left that first appointment feeling totally discouraged. How were we going to afford this? My husband was supportive, but he had the same concerns. Money. But then there was my health, which he cared about even more. Me too. This was an extremely stressful time as it was. We had just bought a house!

I was on an emotional roller coaster. What could I do? I talked to my mother and mentioned casually that I might ask my father for a loan. If not, I would HAVE to find a way to pay for this myself because, bottom line, I NEEDED to have this surgery. And, bottom line again, we could not afford braces. Our mortgage was more than our rent. We had so many other bills. My teeth would have to wait.

Then a few hours after I talked to my mom, I talked to her again. My father would pay for my braces. No problem. I immediately burst into tears. I was so touched and grateful that my father would do this for me. Right away I called Dr. J's office to set up an appointment. But, just so I could be 100% sure I wanted to go through with this, I asked the receptionist to get Dr. J to call me. I had more questions. A long list, in fact. He did call me, and answered all my questions and then some. I gave the OK for the ball to start rolling.

A few days later I got my orthodontic plan in the mail. I learned that I had a Class I malocclusion: deep overbite, severe crowding, 2mm overjet, deep curve of spee, unfavorable axial inclination, maxillary transverse micrognathia, incisal misguidance, mandibular retropositioning, mandibular thrusting, severe anterior bruxing, mandibular left closing shift, severe temporomandibular joint disfunction, bilateral temporomandibular joint crepitus, micrognathia, 4mm anterior vertical maxillary excess, posterior vertical maxillary excess, steep madibular plane angle, skeletal asymmetry, dental asymmetry, and bilateral condylar osteoarthritic degeneration.

Whew. I am MESSED UP!

I also learned that because of severe skeletal disharmony and lack of favorable growth, I would require comprehensive orthodontic treatment utilizing fixed appliances for a period of 24 months:

1. 12 months of presurgical orthodontic treatment to coordinate both arches
2. This will be followed by orthognathic surgery with splinting (6 weeks). The patient will be on a soft diet during this period but will not be immobilized
3. Finally, a 11 month period of post-surgical orthodontic treatment will be necessary to complete the alignment of the teeth and retaining of the surrounding tissue

The man had a plan.

April 2006--Dr. J Tells It Like It Is

On April 25, 2006, I went to see Dr. J, a well-known orthodontist in my city. I'd scoured his site beforehand, read up on his credentials, and was very impressed. He's in the RCD (Royal College of Dentists) and that's nothing to sneeze at. He is widely known for his treatment of TMJ disorders, among other things. I knew this was the kind of guy I needed.

So I went in for a (free) consultation, got some x-rays, pictures, the works. At the end, my face and x-rays came up on this computer screen so that I could see with my own eyes what was wrong with me. Dr. J met me in the consultation room and we went over it all. Right away, just by looking at my face, he told me I could really benefit from the surgery. Like the dental assistant said, I was an excellent candidate. Dr. J told me that he'd had the surgery himself, so I knew he must know a lot about it. And he does.

We went over my x-rays together. Dr. J was the first doctor ever to actually pinpoint the reasons for my pain. Literally pinpoint, on that computer screen that showed my joints and jaws. I saw how my TMJ joint was worn down into a cone shape. I saw how my jaw joints were too far away from my ear canals. I saw my overbite. I saw that little tiny nerve that my jaws are hitting against but shouldn't be. I literally saw and understood--for the very first time--why I was having pain there. It was a huge "ah ha" moment.

I was told if I didn't have my jaws fixed into a harmonious position, I would eventually have to deal with arthritis of the jaw, root canals, gum disease, among other unsavory effects. I knew something had to be done.

Then, after all my questions were answered except for one (prices!), Dr. J got out the pricing chart. That is a list of prices for orthodontic treatment as set by the Canadian Dental Association. It went from non-severe (around $3000) to very severe (around $10,000). It turned out I was more on the severe side ($7800). Just my luck.

The financial consultant came in to talk to me. She outlined the fee and told me exactly what it would cover. She told me what MSI (my provincial health plan) would cover (it turns out that only covers the surgery itself). I don't have dental insurance, so the price quoted to me was the price I would have to pay. I was told about the payment plan, which for me worked out to be $262.50 a month. For 24 months of treatment. This incuded braces, all appointments, and retainers. For someone in debt, whose husband's pay went to rent and bills and his debt, and my pay being only $400 a month, this payment was high. Not to mention we were in the midst of buying a house at the time!

That first visit with Dr. J was a huge eye-opener for me. I had a lot to think about.

March 2006--Introduction. The Journey Begins.

On March 14, 2006, I went to the dentist for a cleaning and to ask about treatment for my TMJ syndrome, which I'd been dealing with for about 6 years at that point. The dentist didn't have much to say, but it was his assistant that mentioned orthognathic surgery to me. I didn't know what that was, but when she mentioned what it entailed, I remembered that I had heard of the surgery itself, but didn't know what it was called. Anyway, she said I looked like an excellent candidate for it. So I asked the dentist to refer me to an orthodontist so I could find out more.

All the while this was happening, my husband and I were trying to get preapproved for a mortgage. Very busy time!