Questions for follow up with surgeon (so far)

Hope everyone had a Merry Christmas and wonderful holiday season with family and friends!!!

Surgery is now 3 months away for me. Can't believe how quickly it's coming up, getting nervous and excited! Will be glad when it is here and done to get on with things.

Here are some of the questions I have for my follow up appointment with the surgeon at the end of January. Some have been borrowed from other blogs (thanks!). At my initial consult last year he thought just lower surgery would be necessary and genioplasty could also be done if desired. I have had more extractions since my initial appointment which I think has improved my tooth to gum ratio (less gummy. Anyways, here are my question so far:

What do you recommend? Do you think my teeth (gaps) will be ready by March 28th?
How much overjet do I have now(measurement)?  
Asymmetry?
What is the most the mandible can be advanced (and that you have done)? 
How much movement (and what kind) do you expect?  
Will BSSO be sufficient to correct bite?
Does amount of movement increase risk of permanent numbness?  Age?
Discuss hardware used to stabilize. 
Is there anything about my jaw discrepancy that can't be corrected, or can only partially be corrected?  Previously mentioned open bite...front/back?
Can these things be corrected orthodontically?
Can I expect a perfect bite post-op/post-braces?
Any incisions to face or intraoral only?
About how long will the surgery take?
Will it be you or a resident performing the surgery?
Will I be banded or wired shut?  (previously said not wired) For how long?  
Splint? Surgical hooks?
Swellling...Ice good or bad? Manual lymphatic drainage (massage)?
What changes can I expect in my face?  Do you have software that can show me potential profile and front view pictures?
How will surgery effect lip competence?
How will surgery effect mouth breathing?
Does genioplasty increase chance of permanent numbness with increased traction on the nerve?  Opinion re: need for genioplasty?
Can I expect to be free of jaw related headaches after?  Jaw clenching?
What are my chances of relapse? What causes relapse?
Supply list?
Diet info? Vitamins (Calcium, D, B)? Protein powders?
Postoperative meds? Antibiotics?
Chronic nasal inflammation...post-nasal drip, swelling, breathing, prior injury to nose
Preoperative physical? When?
Should I stay in the city overnight? Inpatient? Day surgery and I live two hours away in another city.
Sleep positions postop?
When is first follow up office visit? Timing of other visits to plan for travel/work. 
Time off work?
Bleeding
Any long term risks? Hardware...
Cosmetic suggestions re: bonding canines post-braces, who to see?

Yikes, that's a lot of questions but I'm sure he's used to it.

If anyone has ideas for other questions to ask feel free to comment. Thanks!

Closing the gap...and making a new one

Hey there bloggers...sorry this post is a bit delayed.  We've been working on a renovation project so access to my PC for uploading pics has been limited.

I had another adjustment done in early December and my upper extraction gap is slowly closing. I now have a new one developing between my front teeth as everything shifts over; which I know is necessary but still annoying. Can't wait until they are all closed up! I have had the same arch wires for the last couple adjustments, just replacing the power chains so nothing too exciting to report.

I got a double chain on the lower arch between my central incisors. Bottom teeth were super sore when getting the power chains on..OUCH! They seem to feel a bit loose at times and wiggle/click a bit, hope this isn't bad, I forgot to ask at my appointment. I go back in a month so will have to try to remember to ask then.

I also got a message from my surgeon's office the other day to call back and schedule another pre-surgical consult since I haven't seen him since last February and my braces weren't even on yet at that time. I'm getting a bit nervous about the surgery but excited to have a normal bite when all is said and done. It will be nice to come up with an official surgical plan. At my first appointment he thought we could like just do the BSSO mandibular advancement and possibly genioplasty instead of having to have maxillary surgery as well. My surgical consult is booked for January 30, 2012.  Hope things will progress enough in terms of the gaps closing so that I am surgery ready come March...

Here are some new pics:

       UPPERS

Dec 2011 compared to Aug 2011

   SMILE

Dec 2011 compared to Aug 2011

 Midline is definitely improving

(seems slow to me but a lot has to move)

 LOWERS

Dec 2011

6th Adjustment

I had my 6th adjustment today, 4 weeks from the last one. There has not been a lot of movement since last months appointment. My ortho joked that I should stop drinking milk...lol! I got my upper power chain replaced with a wide chain instead of having an extra loop in the gap so hopefully that should create some more movement. The gap is still about 4-5mm.

My lower teeth are extra sore tonight, there is a new power chain on all the lowers. Tylenol and Advil are my friends tonight!!! It even hurt to chew rice at supper...

Here are the new pics:

 I love the new rounded arch shapes, you can see more teeth when I smile :D

Upper midline seems to be shifting slowly

             Here are a few of my overbite and profile:
(You can see why this cannot be corrected without surgery)

Bite closed from the side, uppers and lowers very far apart

 Bite closed, view from below, YIKES

Relaxed profile, can't believe I'm posting this one!! 

I know my fellow bloggers are sympathetic...

'Til next time :)  Now for some more drugs then off to bed...

6 months (and a bit) later...

I can't believe six months has gone by already! Sorry about the lack of posts for awhile.  I've been busy with work, family, dogs and life in general.  Things are moving along nicely with my braces, still waiting for my lateral gap to close. I got a power chain added to the left side of my uppers to start closing it more quickly, more sore now :(  I have decided I like the silver powerchains as they stain less than the clear or whilte ones.  At my last appointment my ortho agreed to grind the hooks off the upper right canine bracket which has made my lip happier, but also gave me a strange rash, maybe the little bits of ceramic were irritating.  And hooray my lisp that showed up after the upper extractions seems to have resolved!!!  Glad that was only temporary, it was very frustrating especially at work, made me even more self conscious of my new toothless look. 


I can't believe how quickly my bottom "straggler" has moved into place.  I am noticing that my overbite is definitely getting worse and I was warned that they need to make it worse for now and the BSSO surgery will correct it, still annoying and starting to give me some TMJ pain.

 Here are some new pictures from Sept 2011: Six months in braces...

The deed is done!

My upper lateral incisors are officially gone...extractions were yesterday. I would have posted sooner but they looked kind of icky plus I had a sick and cranky kiddo. I will say I'm not a fan of the gap however my family, friends and coworkers have been really supportive which has made the transition easier. I know it's only temporary and will look the best in the long term!  The canines will still need to be reshaped and bonded after braces are removed and after I have my teeth whitenened...

On a more exciting note, my lonely unwired bottom tooth has now been connected and is on the move literally has moved since yesterday (ouch but YAY!!!). My lowers are more sore than the extraction sites! I also have a bit of a lisp now but think this will improve with time once I adjust to the extra space for my tongue now that the especially wonky upper tooth is gone.

Here are the latest pics:

Upper arch with extractions

 

Before braces photo for comparison

Lower arch, gap on right closed, left side smaller, all teeth strapped in...yipee!!!

Before braces photo for comparison

Smile with "the gap", excited to be able to correct my upper midline!

Decision made...

So I made my big decision and have decided to go with extracting both laterals. I'm not excited about the process but know the end result will be worth it! It's funny to me that I debated more about this than the jaw surgery. Now I'm waiting for my dentist to get back from vacation so I can hurry up and get it over with. They removed the spring on my upper arch and the space where the lateral is now seems to be getting smaller again which is good, less of a gap to close :)

As an aside, I was a little frustrated at my last appt with my OD. I know he's busy and sees a lot of patients but he often asks the same questions or does not remember important things about me. I asked him if i chose extractions how the upper teeth would move (would the front teeth move back or back teeth move forward?) and he went into answering about how the only way to correct my bite was for me to have jaw surgery...HELLO my surgery is booked for next March!!! I was really quite shocked, told him my surgery was booked already, if it happens again I will call him out on it but in the moment I didn't really know how to handle it. I just needed to rant about this, feels better already!

Anyways, that's all for now. My next post will likely be after my extractions once I get my appointments coordinated.

Need to make a BIG decision...opinions please!

Here's a quick update and then I'll share my dilemma with you...So I went in for my 2nd adjustment yesterday and things are progressing very well. I got new power chains on the bottom to close gaps (love the silver color), a new spring to make room for the unwired lower tooth and reshaped point off one upper canine.

Left

Right

Now, about my BIG DECISION...please share your opinion and be completely honest...

So I have been trying to decide about having my upper canines reshaped like laterals (since one lateral for sure has to be extracted). I mentioned to Dr. W that I am not happy with how gummy the spot over my lateral looks when I smile, I'm a type A and would really prefer symmetry...Here are some photos to give you a better idea:

Smile pre-braces

Recent casual photo, the gummy area is obvious

Front view

Upper arch

Sooooo my options are:

Option 1. Have the 2nd lateral extracted, best way to get symmetry and correct midline of central incisors. Best aesthetic end result as per the OD. sounds great right?.....BUT I'm so scared to have this tooth extracted as the gap will be HUGE for quite awhile and very visible. He didn't say exactly how long but I would guess a few months based on my other extraction gaps. Don't really want to look like a hillbilly, lol...I'm in a professional line of work too (health care) so I feel how I look matters. I realize this would only be temporary but once the tooth is gone I can't change my mind! The OD seemed very pleased I was considering this option. I asked about a fake temporary tooth (I think it`s called a pontic) but he said this wasn't an option :(

Option 2. Keep the 2nd lateral, have a procedure to cut away gum tissue (to make tooth appear taller) but won't quite resolve the gummy issue due to tooth height discrepancy. Uppers will remain asymmetrical and midline cannot be completely corrected.

I have until next Thursday to decide as he didn't want me to make a snap decision. But he needs to know so he can stop making room for the lateral if the teeth will need to be moved in the other direction...If it were you, what do you think you would do???

10 week update

So I'm officially in my thirties now and had a great birthday with my family and U2! Bono sang happy birthday on MY birthday, how awesome is that?!? I got to enjoy some yummy Thai food too, I would have loved a steak but not that brave yet...lol!

My first adjustment went well :)

I got thicker wires on both arches, a spring on the top to make room for one lateral and my first power chain on the bottom right. The spring looks kind of awful, so much for ceramics with a giant spring on there, but it's only temporary.

My lovely spring!!!  Canine next to central incisor...

if reshaped will it look like a lateral?

The power chain has only been on for 1 1/2 weeks and the gap is closing quickly, making room for the unwired tooth on the bottom.

          Right side first day with power chain

      Right side gap closing

I'm happy that they cut the left lower wire off before my gold crown as the brackets don't stick to the crown and the wire kept popping out of the bracket at the very back when I was eating (I could get it back in myself but it hurt)

       Left side gap to be closed later, shorter wire

   

 Also, I found out my cousin and my grandmother had congenitally missing lateral incisors.  My grandma had dentures for as long as I can remember, but my cousin had a canine conversion done for the missing lateral incisors on the top.  Her teeth actually look pretty good, so its making me consider that option more seriously, will have to discuss further with my OD at my next appointment. I can visualize it better now that my one canine is directly next to my central incisor on the right side and having seen someone else's in person. I think some filing/restoration or a cap to improve the shape of the canines will be necessary and whitening after braces are eventually off, which I was planning to do anyways. Why spend all this money on a great smile and not brighten it up a bit too!

10 week photos...

I'm so happy with how my teeth are progressing and can't believe I waited so long to take the plunge. 

To anyone out there who's not sure, I can honestly say I have no regrets so far

and would do it again in a heartbeat :)

First adjustment tomorrow!

I can't believe it's been two months with braces already, seems like it's gone by rather quickly. I'm definitely getting used to them and sometimes forget they're there (when I'm not eating of course). My teeth have been sore but nothing unbearable. I remember reading a story about someone's first week of braces and she said it was worse than labour pains...not sure what great drugs she had but this pain is a 2-3/10 for me not a 10!!

I'm excited to be seeing some changes already, YAY!! Mostly the front lower teeth from what I can tell. I did have to go back around 4 weeks to get two wires cut that were really poking my cheeks. I'm hoping my OD will add in the unwired lower tooth tomorrow.  We'll see what he thinks about the upper arch and...the plan.  I have a feeling he'll still be leaning towards two more extractions and possible canine substitution for my lateral incisors.

Here are a few comparison shots...



4 weeks



                                                             
                                                            8 weeks

I'm really happy with how quickly they are moving!

 

4 weeks

                                                                 8 weeks

The arch seems to be getting wider/rounder overall and the gap between my central incisor and canine on the left side of the picture has gotten smaller (blocking out the lateral incisor completely)

A few things I've learned so far:

- I never knew it could take sooooo long to floss! Seriously, people without braces have no excuse for not flossing.
- Others are not as aware of braces as you think. I also changed my hair so that's the first thing most people were noticing.
- Braces are a great weight loss plan! I definitely don't snack as much because I don't want to go clean my teeth again, plus when I do snack it's usually healthier, chips are too hard to chew an most other junk food is off limits though my ice cream intake has increased a little :) I do miss raw veggies
- Don't take pictures of your teeth without lipstick or lipgloss.

Excited for my appointment tomorrow and hoping I'm not too sore after as my big 3-0 birthday is coming up and would like to eat something tasty!

How to keep an orthodontist busy...

OK so this is a HUGE step for me posting pictures of my teeth for the whole world to see...I don't even normally smile with my mouth open.  My case is definitely a difficult one as you will see below.

BEFORE PICTURES: I've requested my ODs pictures but don't have them yet.

Here is a toothy smile, definitely a rare occurance in photographs.  As you can see my midline is off quite a bit.

Here's a shot of my uppers.  One tooth is totally blocked and he wants to maybe pull this one but then I'll be asymmetrical forever so I'm still on the fence.  We (especially me) decided to wait and see how things start moving before making a final extraction decision.

Lowers after extractions of both first premolars.

Panoramic x-ray. All four wisdom teeth were extracted previously.

Lateralcephalic x-ray.  Class II mallocclusion (overbite), recommended jaw surgery is the only way to correct this due to severity.

Braces on!!!

Smile with braces.



So there you have it....I can't wait to start seeing some results and can feel things loosening/shifting around already and it's only day 2 of braces!!!  Eating is interesting especially since they have added glue bumps to my back molars to prevent biting on brackets (and apparently biting in general...lol) so soft foods it is for awhile until I figure out how to chew again.  Thats all for now.

The adventure begins...

March 28, 2011:  Today is the first day of my adventures in braces and blogging :)

A bit about myself: I am a 29 year old mom from Canada who has always wished I had a fabulous smile. Like many others my family could not afford orthodontic treatment when I was younger. I have decided to finally take the plunge and invest in my teeth and my self-esteem. My teeth are very severely crowded and will keep my orthodontist busy for awhile... I also have a class II malocclusion with recessed chin and weak profile.

I initially saw my orthodontist a couple years ago but chickened out emotionally and financially. I decided to go for it now that I have better insurance and booked again in Nov/10. I was daunted when he discussed my options which involved extractions and orthognathic jaw surgery as well. After seeing the maxillofacial surgeon in Feb/11 he recommended BSSO surgery to advance my lower jaw and possible genioplasty for my recessed chin. I am definitely nervous about this but have been researching and reading others' blogs which I found helpful in making my decision to go ahead with all of the recommended treatments.

I had my two lower bicuspids extracted last week (still have to wait to see which uppers if any need to be extracted) and my braces went on today!! Ceramic uppers and metal lowers. So far they're aching a bit and feel foreign in my mouth, to be expected I guess...Eating my mushy mac n' cheese for dinner was an adventure in itself!

I'll post some pictures of my teeth soon. Hopefully this blog can be helpful to others and document my journey through my treatment. I'm really excited for the end results and having a great smile after 18-24 months.