Orthognathic Surgery and Braces

Unsure and pissed off.

2011-02-12T13:14:00.000-08:00

As you all know I had my tooth extractions last October (2010) and then had to change orthodontist to a new one in my own home country (travel costs were becoming inpractical).

Unfortunately the new orthodontist (20 years experience) tells me that he doesn't know why I let my teeth being extracted if I was unsure about having orthognathic surgery. I was told it would take 1.5 years to close the spaces but with the side effect of a class-2 bite (which I wasn't happy about). The new one tells me it can be a lot longer than 1.5 years! I am tired of these braces, had I known I would have ended it last October with a satisfactory (yet unperfect in terms of bite) result.

I am told that now my only alternative is to have orthognatic surgery to close those spaces and align my teeth properly. Needless to say I have never been "put to sleep". My palate is kind of weird because it is not quite an arched roof but something like an inverted klingon forhead (a protrussion on the middle) which makes me think how on earth they can put all of that together.

Anyway, I haven't heard from my new orthodontist in several weeks. I am awaiting for his study about my bite (he took some pictures) and prepare some sort of before and possibly after presentation. In Colombia -where I started treatment- it would have costed around $2000 (US Dollars) but here about $5000 and I don't even have health insurance.

Oh no, wire power chain again

2010-10-15T20:23:00.000-07:00

Earlier this week I had my two bicuspids extracted. This gap has to be closed, since I opted for no surgery my ortho told me closing this gap would require at least 1.5 years more of braces! Naturally I was quite disappointed, disconcerted and unhappy about that. I was hoping to have them off by my next birthday in 6-7 months.

This also meant I would end up with a class-2 bite (mild overlap) as opposed to a perfect 1-on-1 bite from top to bottom. I was worried about it and started considering orthognathic surgery again. I was hoping to have it done in Colombia to lower my costs but there comes the issue about they pain, the months of rehabilitation and having my palate broken and put back together. I don’t think I want to go through more pain (back pain is already bad enough). I was given 1 month to decide, haven’t made up my mind because I have not been able to meet a surgeon that would do it.

In the meantime my gaping holes were healing properly without any infections, pain or other discomfort other than having to eat somewhat different to avoid hurting my healing gum.

My lower teeth/molars have been hurting for a few days due to the new archwire. I have barely eaten anything other than liquid. My ex-girlfriend’s family has been kind and aware of my extractions so they prepared some suitable food. Very nice, Colombian people are nice.

Today however, after having spent most of the past 8 days coming to the orthodontist, I was going to have my last appt. prior to my return. The orthodontist removed the 3 sections of archwire on the top jaw and installed a new continuous one as it was before. This one however, has a “T” on the place where I had the extractions, these act as mechanical springs to pull the molars forward and the teeth back, the two force vectors shown in green.

In that picture (I spare you from another one) you can also partly appreciate the metallic powerchain that is meshed in both directions from one end to the other (the whole jaw). This replaces the old rubber powerchain which IMHO was more comfortable. This helps keep the teeth together for what I know. One thing I don’t want is the gap opening between my front teeth again, I went through quite some pain and discomfort to have that closed down with some oral surgery!

Now and for the next week or so my upper teeth are going to be hurting too. So I will probably not be able to eat my meal in the airplane :( From now on and for the next 18 months (at least) I will need my upper wire adjusted (tightened) every 1.5 to 2 months! This will be done by my local orthodontist as I cannot afford to travel abroad so often.

Now I really feel it, my upper teeth feel as if I had been put a mouth piece as they do with horses (perhaps head gear feels like that). I can feel it tightened backwards. For days I was not able to even floss my upper front teeth, too painful!!!

Now I can finally put the tips of my lower and upper front teeth together with minimal effort! wow! I waited so many years for this moment! Now I just have to wait patiently for these darn braces to come off and be FREE!!! Most definitely, orthodontic treatment is a long journey with good things in sight and pain in the process of achieving it.

Christopher Columbus & Tooth Extraction Day!

2010-10-12T19:12:00.000-07:00

It is October 12th, the "Hispanic Heritage Day" or in better words the 512th anniversary since Cristobal Colón had sight of this wonderful continent, the Americas.
Today I had my appt. at 11 A.M. and my “architect” orthodontist examined both the panoramic (all teeth) and the lateral encephalography to re-evaluate. Yes, sad news are as expected: I need extractions of both of my upper bicuspids :’(.
As you know I had decided earlier (variety of reasons) not to go through with orthognathic surgery. During that surgery they would have extracted both bicuspids and made the cut of my upper jaw just there, and move it back. If after that patch up the adjustment was not enough they would have proceeded with lower jaw surgery to advance it a little bit. Ugh, a lot to go through. The make a measurement more like the one shown on the Rx above, my front teeth are at an angle of 126º when the normal angle is 114º so a lot of correction is needed there.
Since there was quite some delay between the removal of bicuspid brackets and actual extractions (2+ months) I felt they had moved forward again (increased angle). Anyway, today the extractions were to be made. First I had anesthetics on both sides, while it took effect I had my cleanup (hygienist), just fine, less pain. Afterwards both bicuspids were extracted, I was very nervous but everything went alright and I suffered no pain. Never in my life had I two extractions in one day! I had some bleeding, especially by the time I got to the hotel I had quite some blood in my mouth but that was natural.
I used the very cold bottles from the hotel fridge (my water bottles) as an ice pack and kept them on both sides nearly the rest of the day. As a result I had no swelling!
After the extractions I still had three archwire sections on my upper jaw, two on the molars behind the bicuspid and one on the 4 front teeth and gaping holes where my bicuspids were “amputated” :( I was worried “oh my God, what have I done! now I have two teeth less!” but well, all in the name of a better (more functional) smile. I used pain killers as instructed by my orthodontist and suffered no pain discomfort.
I was given my two bicuspids :-) and told how to clean them with Oxigenated Water (H2O2). I was hoping to have them both buried with me when I died. Unfortunately that was not so… while cleaning them one of them fell on the sink and was lost forever :’( and I was very upset. Now I am leaving both my heart and a tooth in Medellin.

Prepare for Extraction!

2010-10-11T11:38:00.000-07:00

OK, I am dealing now with two orthodontists, one abroad (my original one) and one local. Since my local ortho was still not fully aware of my treatment history I decided to visit my ortho abroad and kill two birds with one stone. Luckily he is aware of my situation and told me I just needed to call and they would give me priority during that whole week! and it was indeed so!.

A week prior to my visit abroad the metallic power chain on my upper jaw’s front teeth (1 to 3) started to fall apart. During the past months I had swallowed a ton of orthodontic wax and my cheeks inside where torn with the damn wire. The problem with that is that when you brush the tie point moves and comes out and starts stabbing your cheeks. I was really sick and tired of that. So, I removed it myself, what a relief!

So I arrived Friday, October 8th and on Saturday 9th at 11:00 I had my first appointment of the week. He examined my mouth, saw the two brackets (on the bicuspids) that were missing prior to the extraction. We discussed my situation and my treatment and made another appointment for Monday.

On Monday I had my 2nd priority visit. The lower archwire was removed and replaced by another that seemed thicker but he said it is softer and may bend more easily. A bit of force had to be done to put it through the last two brackets on the molars but no pains. This was good news because earlier this year (in January) a new archwire was installed and a bracket on the lower front tooth replaced to make it turn. That was a painful procedure because the tooth was not aligned and getting the wire in was of screaming proportions!

This time it went easily, the left front lower tooth is now properly aligned, one more problem down.

Now the hard part… Since he knows I have anxiety problems with dental treatment he asked if I was ready for the extractions tomorrow Tuesday! or perhaps Wednesday if I wanted to chill down. Problem is I fly on Sunday so the sooner the better for checking possible complications. I said, what the hell, I have been postponing it since August, they have to go so let’s do it.

I had to get two X-Rays prior to extraction, a Panoramic and a Lateral Encephalograph (something like that). To save time I did it in the neighborhood of the hotel. The Orthodontist said they had not sufficient quality so I had to then go to another branch of the same people in the city center (near the Ortho). Uff! venturing on my own in the city center of Medellin, watch out!

They did the RX again at no cost. And then again, and again, and again. Yes 4 times because there were problems with the lateral RX. Finally I took them back to my ortho to check my positions prior to the extractions.

He was right on Saturday when he told me to eat everything I could because after this new archwire my lower molars where aching, I ate soft things for the next few days, good bye Colombian delicacies :(

Some videos about orthognatic surgery

2010-09-18T13:12:00.001-07:00

Found these excellent videos about the operation without any blood spills (animations):

Good animations (a few others available from the same video author) without the horrific real-life blood & swelling that scare people off (I sure am!)

A delay...

2010-09-09T21:00:00.000-07:00

Things have been awkward locally, orthodontists from two sides of the family asking me to follow my treatments with them. In fact I had already started with one but this is just two awkward. Either way you end up annoying some part of the family!

Also, I really liked my original orthodontist and he had been doing my treatment for 21 months, 2 weeks and 5 days by now! Unfortunately, if I want to continue treatment with him it means I have to spend quite some money travelling abroad, not only the plane ticket but also the 1 week hotel stay! pfew! that really adds up! The dilemma is also, if extractions are going to be made then I won't be able to enjoy delicious Colombian food! and way to many times I had to miss great dishes due to aching teeth.

Another complication, the extractions were planned for Aug. but that couldn't go through because a friend came over for 5 weeks. In the meantime my upper teet had a missing link on both sides because the orthodontist had removed the brackets on the 4th tooth/molars that were "sentenced to death". Given the delay, I worried about having my front teeth displaced again. I found one of my old elastic power chains and installed it myself for the time being until I visit the ortho. I had a little tooth pain for a few days, meaning there had been some movement. That means I have to take action soon.

Extractions planned for August

2010-07-16T09:43:00.000-07:00

I have decided not to go on with the orthognathic surgery for several reasons. At this age I simply don’t want to go through months of bucal recovery and pain. I have had enough of that already. Anyway, both my previous and current orthodontists said it was an option not to do it. The new one thinks I don’t even need it but adjustments need to be made.

So… the shocking news came although I had heard them from my previous orthodontist as well: tooth extractions! it is necessary to move my upper bite backwards to align the teeth with the lower jaw. Unfortunately two healthy teeth (rather than the one that had heavy reconstruction) will be “amputated”. Yes, that is how it feels.

She, my new orthodontist first cut the Damon archwire and removed the brackets from the two teeth (the 4th on each upper side) that have been condemned to death…

As you can see on the photo I still have an overbite but it is much less than it was prior to treatment, it has quite improved my smile, confidence and speech.

Another thing that was done in this last visit was to remove the old, yellowish rubber power chain. It was replaced by a real metal wire. looks “nicer” because it doesn’t get dirty with the first coloured food you eat but it is a pain. My lips and cheeks are stung all over by this new wire. Extractions have been planned for end of August.

Change of Orthodontist :(

2010-07-12T09:35:00.000-07:00

Well, all good things come to an end. Unfortunately the “miss” has decided to break dipomatic relations with your truly. It is well known that latin women have a special gene in their ADN that precludes any friendship from remaining after break-up, even if it was a friendly one.
Having said that, it had consequences. Going to Medellin for a week to visit my orthodontist would cost me nearly $1000 (USD) without extras (medical/dental expenses, food, transport). My orthodontist was a particularly good one but I have to be practical, especially with unemployment. So, now I have a (trusted) local orthodontist where I will continue my treatment. Here in this country however, Damon brackets are almost not used because nobody wants to pay the extra cost.
Double sadness, the end of a long standing relationship and leaving my current orthodontist. In particular this means that what was going to happen after the ortho treatment is now not in the list. He was going to rework my lower frontal teeth to restore the top of them that has been churn over the years.

Waterpik W-360 – Product Review

2010-06-26T09:01:00.001-07:00

I bought this unit a little over a year ago because I wanted a quick way to dislodge items prior to flossing and brushing.

The WP-360E2 that I have (bought in Europe) has a water reservoir (5) that is too small. Luckily I could do with one filling but not spending 5 seconds on every tooth. At the beginning I had to watch out not to get that pulsating jet into my eye (would cause eye damage).
It also has two sets (high and low power) replaceable nozzles (3) that you should rotate with your finger (4) while doing the job but be careful not to accidentally point the water jet at your eye unless you want to cause your eyes some serious damage. The on/off button (2) is very conveniently placed. The electrical charger plug (1) has a rubber cover to prevent water from entering.

This device is fantastic for everybody, especially us, brace wearers and even more if you have a power chain installed on your braces. It is also tubeless (I wouldn't call it wireless) because there is no rubber tube between the device and the reservoir, something present in other units with larger reservoir but that might prove annoying.

A couple of days ago I went to use it after a couple of days and it quickly discharged half way. I found that strange and put it to charge. Let it 8 hours and when I went to turn it on it did nothing. I put it to charge another 12 because unfortunately this unit also lacks a charge indicator (red/green) how can something so basic be missing from an expensive device?

Well, after two consecutive charges I got the same result. The diagnostic appeared final, this unit, still relatively new and with not that many charge cycles on it, has become an expensive paper weight! or so I thought!. I was getting ready to dump it and decided to do some forensics, got my voltmeter and decided to check the charger/adapter and then I noticed it was 220V input and here we have 110V !!! no wonder, it was not getting enough voltage. But was it damaged? well, I checked the voltage and it said 4.3V (nominal 3.0V) so all was good. This time it charged properly as I had a low wattage 110V/220V step up/down converter.

The battery compartment is sealed and it cannot be replaced. Something to look for next time because once that NiCad gets Alzheimer (memory effect) my Waterpik truly becomes an expensive paper weight!

So in summary, while it works it serves its purpose with the pulsating water jet, especially if you choose the high power nozzle. Unfortunately the electrical design leaves some things to be desired and the reservoir is too small.

An open Damon bracket

2010-05-27T17:13:00.000-07:00

To begin with I have not had any more teeth movements since February, perhaps because I have not been drinking hot beverages now that I live in a tropical country.

My rubber powerchain is still yellow in spite of all the cleaning :( and on top of that I think the bracket that was replaced on my lower front tooth (ouch!) to allow it to rotate more has become open for quite a while. That would mean it is not doing its work.

Considering that I am abroad an no longer where my orthodontist has his practice (in another country) I think I will have to look for a local orthodontist specialized in Damon braces and have him/her close it and hopefully change the rubber chain for a new one.

Other than that no news except I am really tired of wearing braces and all the special care it needs. I want freedom!

Hating the transparent power chain

2010-02-01T22:02:00.000-08:00

Yes I hate it, I am very detailed in my mouth hygiene, brushing very often as well. It has been barely a week since the rubbery transparent power chain was (re)newed on my upper jaw and it already looks yellowy (disgusting!!!). The reason: I ate a Thai chicken with curry at Crepes & Waffles :(

I serioulsy thing the "transparent" power chain is counterproductive, you are better off with a strongly coloured one like red or blue, I don´t think those will get stained that easily. Anyway, just my experience.

Another painful experience :´(

2010-01-26T08:25:00.000-08:00

Today after 14 months and 5 days since getting braces I had my follow up at the orthodontist. This is what happened today on my early (8AM) visit (tooth numbering chart here):

First both archwires were removed and on the lower archwire a binding wire had to be removed as well because due to the position of my two lower central incisors it was not possible to completely pass the archwire. The removal of this binding caused some pain. Opening the locks of the demon brackets was not painful this time, on my previous appt. (June 2009) a few were painful,especially the two lower central incisors.

Second to that was the removal of two brackets, one from my upper jaw tooth #11 (left canine/cuspid) the bracket needed to be repositioned. The removal of both bracket and glue was not a big deal. However, on the lower jaw tooth #25 (lower left central incisor) after the bracket was removed (a bit painful) he had to remove the remaining glue and THAT was very very painful! I was wriggling in the chair and would not like to go through that ever again! I thought the tooth was going to break or come out. In the end he had to use the grinder/drill to remove the rest. Both brackets were installed again but in a new position to adjust the teeth once the archwires are placed.

The third task was to grind some of the side that lower central incisor (#25) so that there is space to move around with less pain. That was not a big deal luckily.

Fourth came the placing of the archwires. The upper one was placed and brackets closed (daemon self-fixation) the same was done on the lower one. Unfortunately again there was some problem passing the whole archwire into position due to the new position of the lower central incisor bracket :( again a binding wire was used and that caused some pain on the sore tooth.

Last thing was the placing of another rubber power chain (unfortunately transparent so after some time it will get stained and look ugly) on the upper jaw to replace the one I removed a week ago. This one however is not as tight so that we can see if teeth move back to much or what. It is supposed to last there for a couple of months until my next visit.

So yes, a painful visit, no wonder a few weeks ago I had a nightmare (more like a premotion) that one of my lower central incisors had come out! Other than that all is good, still with a sore tooth but ok.

A new follow up

2010-01-25T09:22:00.000-08:00

Just had my first follow up of the year after 6 months. Supposedly my lower wire was going to be changed and other things checked.

The outcome was the dental hygiene was very good (yeehaa!) and I had my teeth cleaned after the upper wire was temporarly loosened. All is looking good but surgery is not yet planned, but I may choose not to go for surgery.

He decided my lower archwire will remain as it is but some grinding will be done to let the brackets do the rest of the alignment. This will happen with the two front teeth of the lower jaw. The molar that has been bothering me (with crown) will probably be sanded down while we monitor what it is happening there.

On the upper jaw all is looking fantastic, all teeth aligned and retracted enough. Last week I removed myself the rubbery power chain that was supposed to have fallen off months ago. The teeth felt a bit painful (just faintly) for a few days because there was not chain traction.

Tomorrow the upper archwire will be replaced for another (I thought it was the last and thickest one). A new rubber power chain will be applied though I hope it is not transparent. Transparent is fine because in the beginning it is barely seen but as time passes it gets stained and in my opinion looks quite horrible! I hope he puts one with a color or something, better that than a horrible stained power chain.

He ordered a new panoramic XRay and a peri-something XRay of the molar with the crown that is bothering me every now and then. I had it done right away (paid about $14 for both!).

Other than that nothing else to report. I shall see tomorrow.

Not the crown! and other news

2009-12-11T19:44:00.000-08:00

Well, back in October I apparently slept clenching my teeth sooooo hard that when I woke up I had pain my my 2nd to last molar of the lower jaw. Both of those last 2 molars have crowns but only the last one has a root canal. The one experiencing the pain was the 2nd crown (luckily I only have two which is more than enough).

I thought it was fractured and only kept together by the crown. A couple of days of very uncomfortable pain. I had to take some pain killers and typical of Dutch medical care I had to wait a couple of weeks before I could be seen by a dentist. This one was specialized in "fearful patients" and endodonthics (root canal).

She looked at it and told me the pulp at the end of the root was not infected but irritated but so far no need for a root canal. I was supposed to have a follow up 4 weeks after prior to my trip but by then I was so busy that I had to cancel. The pain had gone away.

A few days ago (already abroad) I decided to bite some peanuts (not hard) on that side and since then the crowned molar is acting up. I don't think I will have time to visit my orthodontist any time soon so I will probably have to deal with it here.

As for the jaw surgery I am doubting whether I should proceed with it. Now I have a calcium and vitamin D deficiency caused so I wouldn't want my bones to be hammered and cut when I have a calcium deficiency. I just hope my teeth don't break when they remove the braces. Oh yes, I am also thinking of just having them removed and go on the rest of my life as I am so far.

An inspiring jaw surgery video

2009-09-18T23:47:00.001-07:00

To this date I had only seen jaw surgery videos that while they portraited the positive sides they also freaked me out big time!

Well while facebooking in the jaw surgery FB groups I was pointed out to this video. Really reassuring.

Post jaw surgery video

Now one of my remaining problems is that my insurance in the country where I will have the surgery sees it as a “precondition” and therefore opted for not covering this surgery!!! whereas my insurance abroad was willing to cover with a letter from the orthodontist but I don’t think they would cover this surgery abroad :(

So, no insurance coverage, no surgery for me that is decided. At this moment it depends on that plus the fact that I have already had 5 months of misery due to a back pain problem which I am just getting through.

Looking good so far!

2009-08-04T16:11:00.001-07:00

It has been about 1.5 months since my last visit to the orthodontist and I am still abroad. He told me the elastic power chain would fall off by itself (or I could cut it off myself) between 1 to 1.5 months since it was installed.

The power chain hasn’t fallen but it does not bother me at all, it keeps my teeth in better shape and they are transparent. Well, they have colored a bit (stain) due to the coffee but are mostly transparent.

By now the molar that was out of place in my lower jaw is now perfectly aligned. The new archwire on the lower jaw is still doing its work (I feel movement) and even that same day I was able to pass a flossing thread between the two lower front teeth, something I couldn’t do since nov. 2008! In other words the lower front teeth are rotating and realigning.

I also noticed that the archwire on my lower jaw is now straighter than before! previously it was arhed upward on the six (three on each side) lower frontal teeth. It isn’t totally straightened/leveled but getting there. These teeth also have to lower themselves so that they are not hidden behind my upper front teeth.

And this picture shows a historical animation (made by me) of the progress made on my (over)bite since the beginning on the various follow ups. The first frame (19 nov 2008) is just before the brackets but after the 4 upper front teeth had been “restored” to their initial grace by some aesthetic reconstruction because they were worn out due to the malocclusion.

PS. This silly blogger does not support animated GIFs, the file is transformed to show only the 1st frame. Shame on you blogspot!

Power chain and new archwires

2009-06-19T15:09:00.000-07:00

With renewed teeth and some happiness (I never feel happy to go to the dentist!) I went with my future wife to the clinic of Dr. Ibarra for the big appointment. In my previous visit a few days ago I had my teeth cleaned and a visual inspection of the progress.

By now the two brackets that were on my two crowns (back molars of lower jaw) had fallen over the past months. I live abroad so I could not visit him to have that taken care of.

The 2 fallen brackets posed no problem for the treatment because my lower jaw molars and teeth were almost totally aligned and with sufficient space. He chose to simply replace my lower archwire to a thicker wire (more force now) and cut the archwire so that the two crowns remained without brackets. Brackets don’t bond well with (porcelain) crowns even with more powerful glue as he had used.

The replacement of my lower archwire was very painful, pfew! stressful too! in the past months the two lower front teeth had rotated slightly, in fact for a few months I had not been able to pass floss between them due to their tightness. It was impossible to completely place the wire through the bracket so in the end to save my some pain he had to tie them. Looks as if it is through but well, saved me more discomfort.

My upper archwire was also replaced with a thicker one. This one is the last (and thickest) to be placed there while my lower jaw will still require a thicker one on the next follow up (December).

In order to close down the gap between the upper front teeth and align them Dr. Ibarra put on a “power chain” on my upper jaw. The “power chain” (see video below) is an elastic chain with loops that are put around each bracket to close space/gaps, they apply extra force. That first day was a bit uncomfortable but bearable and I noticed results that same day (the gap was closed!).

My power chain is transparent to make it discrete so for the purpose of this blog I am showing somebody else’s chains (in pink, see (a)). There is also a video of the application of a power chain (again another person).

Surgery Update: Meet your surgeon

2009-06-18T15:29:00.000-07:00

On this same appointment (3rd) Dr. Ibarra introduced me to the surgeon that will do my orthognathic surgery. She is a relatively young woman with a lot of experience in more difficult cases.

We discussed my situation for about an hour in which they explained everything to me and let me ask a lot of questions about my worries (I have never had “major” surgery).

The panoramic X-Rays taken a few days ago showed all my teeth and their roots perfectly vertically aligned and this was quite a change! I hope to get copies of that later. They also showed me the plaster mold and I could see my upper jaw has also widened to make more space and become rounder, quite a nice change too!

There have been a lot of retraction too and I feel and see that I no longer have to force my lower jaw way forward in order to have my teeth meet each other.

Because I live abroad and can’t come often they decided it was better not to perform extractions now because they wouldn’t be able to monitor it or perform maintenance on the archwires that my stick out when the gap closes.

Also, the original plan (nov. 2008) was that I would have surgery on my lower jaw to enlarge it. During my earlier research I learned that there are two big nerves in that area which cause a lot of numbness & tingling for months and it presents a risk. I was (am) very worried about it so I discussed it.

They also told me that now that she has evaluated my case there were several (4) alternatives and it has been chosen to do the following:

Perform the two extractions on the upper jaw during the orthognathic surgery.
Perform surgery on the upper jaw instead of the lower jaw. This would involve shortening (pulling back) my front side which would change the profile of my face. They would do the cuts on the gaps created by the extracted teeth (bicuspids).
Having done that they would then evaluate if that is enough. If not, then they would also perform surgery on the lower jaw to enlarge it. In this case the advancement will be shorter than the original assessment (9mm) and therefore involve less risks.

Naturally I was more worried to hear about surgery to my upper jaw, still worries me but I hope that the lower one can be left untouched.

My surgery has not yet been scheduled, that depends on the assessment made on the next follow up in December. However they estimate it could be around June 2010 (I don’t want to have that for my birthday!). If I was not abroad maybe even earlier!

Also, since I am scared about it Dr. Ibarra told me that even if I changed my mind and decide not to have the surgery the current results are still very good. In the meantime they will practice the surgery on the plaster (?) models they make of my mouth.

Power Cleaning on 3rd revision

2009-06-13T12:53:00.000-07:00

The day came on June 13th, 2009 when I was at the waiting room of Dr. O.A. Ibarra for my 3rd revision after having braces put on on November 2008.

In my previous visit (Jan. 2009) I was told that probably I would have two teeth removed from my upper jaw to make some space and that was to take place now and I was worried about it. Also because in April I suffered a new back injury which has kept me with uncomfortable pain and incapacitation for quite some time.

Today was only a quick follow up of about 30-45 minutes in which he ordered another panoramic X-ray of my mouth to get an updated view of the current state of affairs.

My teeth were cleaned thoroughly with some sort of bicabornate (baking soda) sand blasting technique. It was cool! it was painless! and my teeth looked slightly whiter too as they had suffered some extra coloration during the past months! Naturally I had a stingy feeling on my mouth for part of the day.

According to my orthodontist the previous minor surgery I had on my gum to remove the fraenum healed perfectly. My upper frontal teeth were almost together but for about 1 millimeter.

The lower molars were almost totally aligned (I have been amazed about this change after 45 years!) and believe it or not even my upper teeth feel pulled back. My bite feels different.

On my next visit a couple of days from now I will be examined by the surgeon that will do my orthognatic surgery and have some things installed by my orthodontist.

His other colleague (dentist) did a retouch of the aesthetic reconstruction of my upper frontal teeth (two) given that they have done quite a lot of rotation and alignment. Now they look even more beautiful like they had never been before!.

Lost another bracket, bands are coming :-(

2009-05-09T07:04:00.000-07:00

It was bound to happen, 5+ months into treatment the 2nd bracket came lose and I had to remove it from the wire before I swallowed it.

So my wisdom teeth do not exist since my early 20s, these are teeth 17 & 32 (lower) and 1 & 16 (upper). On right side of my lower jaw just before the missing wisdom tooth I have two molars who tragically had to be replaced by crows (teeth #30 & 31).

My orthodontist told me since the beginning that brackets don't bond very well on crowns due to the material of the crowns (ceramic) so I had to avoid eating on that side (and I did avoid it!). Well in spite of the fact that he used extra strong glue to place the brackets on those two crowns those are exactly the 2 brackets that have deserted, first the one on the back, then the next one.

Now I have this long piece of archwire there without brackets to hold them :( Since my visit won't be until the first week of June when I am in town again I have to hold it until then.

I did speak to him though and told me now that they have fallen he will then have to replace those with bands, ouch!!! I was hoping never to wear bands, now I will need two and on adjacent teeth (so forcing double space in between them). Not the kind of news I wanted to hear.

My extractions may not take place after all, he and the surgeon will reexamine me to determine progress and whether extractions are needed or not.

Anyway, brackets minus two... more pain in sight.

Time for some orthodontic wax :(

2009-05-03T05:32:00.001-07:00

Oh my, I remember when I got my braces 5+ months ago and could not stand all the sore spots on my lips and inner cheek thanks to the railroad tracks installed on my teeth.

Well luckily this doesn’t happen very often but for the past two weeks I have been pestered by an open sore spot on my lower lip (almost healed now) caused by one rebellious bracket.

And then the one that annoys me the most these days is on the linen of my inner cheek, right beside the bracket that is on my last upper right molar (no I don’t have wisdom teeth). For some reason there is something there that is hurting my cheek. It has something like a tit as if it was caused by a wire that pulls the cheek linen out and then dislodges itself.

I examined that bracket and there is no protruding wire so I guess it must be the bracket itself that is injuring my cheek and causing that much discomfort.

So, I had no other alternative than to pull out some orthodontic wax to cover the offending bracket at least until the inflammation goes away or I get to visit my orthodontist 10,000 kilometers away.

By the way in the link “Orthodontic Personal Care” on the right you can find the items I have found most helpful to cope with braces.

Lost a bracket :(

2009-03-09T11:51:00.000-07:00

One month ago I was in a company meeting and was enjoying the dinner with my colleagues. The food was delicious (Indonesian) and soft. When I got home I started playing with my tongue -that way all brace wearers know- and felt something odd in the back of my mouth near the last molar.

I was thinking "Oh my God! please NO, not another broken tooth!" and my world was falling apart because believe it or not I HATE having dental work that has potential for being painful. Yes, don't ask me how I got to wear braces, I am holding on so far.

Anyway, when I got to the bathroom I spit out that piece of something that felt metallic. That is why I thought it was a big chunk of filling (amalgam). Well, as it turned out it was a full bracket! Thanks God I did not swallow it!!!

As it turns out it was the bracket sitting on my last molar which happens to be a crown. My orthodontist warned me that even though he used a much stronger glue for those two brackets-on-crowns it was possible that they might fall off. I was told to only eat soft things on that side.

Well, now I have a fallen bracket on the right side (lower jaw) with a large wire sticking out. I have not cut it, don't have where to but it is not bothering me so far. Then on the last molar (a real one) on the other side of the lower jaw I have an orphan bracket that lost the wire. As you read before in this blog the ortho that helped me out cut it.

I am having more inconveniences with the orphan bracket that has no wire than with the wire that has no bracket. I have to wait until June when I get my next appointment abroad. That means my lower archwire will have to be replaced. That means having all my lower brackets opened up (I have Damon self-ligating brackets) and that is PAINFUL.

Oh well, one day two years from now I hope to be smiling without a bunch of electromagnethic antennas installed on my teeth.

2009-02-03T11:24:00.000-08:00

Counting up since the day eating ceased being something enjoyable...

Yes, even though I am scared of the upcoming surgery I can't wait to have these things taken off my mouth!. Since I have no specific date for the surgery (and even less for getting them removed) I can't count down to such joyous event.

The tools of the trade...

2009-01-30T16:38:00.000-08:00

Having reached my first two (2) months with braces I have found these things to be time savers and ameliorate the nasty things of wearing braces...

Using regular flossing which is time consuming with braces? struggling with the threader? well, get yourself the Super Floss from Oral B! it comes in a box with 50 of them, each having a built-in threader, a thick floss section for the brackets and a regular floss section for the flossing. A time saver! a bit expensive but well worth it!
Get the WaterPik! nothing like a jet of water to help cleaning those teeth and brackets!
A good mouth wash without alcohol. IF you are given a special mouth wash such as PerioGard for use after a periodontal treatment or oral surgery, use it only for no more than a week or it will stain your teeth! it happened to me because I thought I could just finish the bottle.
Get a pack of mini-brushes.

The purpose of it all

2009-01-30T16:20:00.000-08:00

Well some people criticize adults with braces as if one were to do it for fun. Let me tell you there is no fun to it. Also, those people either never wore them or never think there is a FUNCTIONAL purpose to all of that. In my case I view it this way:

Visual or Physical and Improvements:

Eliminate the growing gap between the two frontal teeth on the upper jaw. Requires fraenum surgery (see earlier post).
Terminate the movement of the frontal teeth towards outside and the sides which has been causing a lot of tear and wear. Requires the installation of braces and tooth restoration with resin.
Align the 5th tooth on the left side of the lower jaw which was nearly 40% pushed towards the inside (the tongue) by its two neighbours. Done by the braces.
Push the front teeth back and straighten them in general. This was getting worse over the years.
Fix the lower jaw which did not grow enough. Requires orthognathic surgery :(

Health Improvements:

Put an end to the nearly extreme wearing off of all the teeth. In particular the upper/lower frontal teeth were so worn out that it was reaching the core and losing shape. These need to be restored to their original grace.
Improve speech, the position of the upper two was so far out that it hinders the pronunciation of sounds that require the tongue to establish contact with the front teeth
Eliminate the problem with the jaw joints making cracking noises when moving (TMJ).
Eliminate over stressing neck and jaw muscles

Other improvements:

To finally gain confidence for smiling normally and without shame, what else?! I have not done that for as long as I can remember.