Hello from snowy Virginia!

Hello from snowy Virginia!

Sorry I haven't written in a few months. My orthodontist decided not to change my wires in December which has actually lead to a wonderful 15- weeks of no changes to my mouth. Well any relative changes... I have noticed that my teeth have gotten straighter on the bottom and I am starting to get some gaps between a few teeth on the top.   Not hillbilly gaps yet, but I believe I will get there before this stage is done!

The headaches are starting to return a bit, I never thought for a minute I would miss that chunk of plastic splint, but I guess I didn't appreciate it enough until I had my first 3-day migraine in a year.  Too bad it wasn't a permanent fix!

But truly the best part in the last 15 months has been these past 3 weeks, my teeth have really dialed down on the soreness and I have been able to chew many more foods that have been challenging for the past year.  My front teeth still do not touch (and I don't expect them too until after the surgery) so there is no biting into a sandwich, but I've really been able to chew again with my back right teeth.  I've even been able to eat lettuce/salads and pizza this week!  Unfortunately its back to the orthodontist in another week, so I plan to eat everything under the sun in case the teeth sensitivity flare up again.  But I'm hopeful that maybe it was just so awful because it was the initial 6 months of braces and that the rest of this year will be a cakewalk...well that is until THE surgery.

2nd wire change for braces

5 November 2013

I just had my second wire change for my braces yesterday. And wow am I hurting today!  I know I was sore after the last one, but it still caught me off guard today.  I forget what gauge wire I am up to, but I was told that I am at a "medium level, the level at which they do most of the work."  And being the obsessive planner that I am, I asked again (like every time)...so how far out from surgery am I looking?  He told me that it is now looking like next fall at the earliest :(  which is fine, I believe in my orthodontist, I trust his outcomes, but I want this process over with! and he had told me upfront that it will likely be 1.5 years with braces before the surgery, but I did have the pipe-dream that I could graduate in May and get the surgery over with before I started a new job.

Anyways, my suggestions for the pain of a braces adjustment?  Take your pain medications regularly and on time. Ice packs. Take the day off after your get them adjusted (if possible! I say this as I head back to class). Definitely brush with Sensodyne toothpaste. And use your blender!  Your teeth are going to hurt so bad that you don't want them to come in contact with each other at all = no chew foods.

1st meeting with surgeon

September 23

Yesterday I had my first consultation with my maxillofacial surgeon.  I know its early out!  I just got my braces on 2 months ago and I was told to expect at least 1 -1.5 years before my teeth/bite/mouth are ready for surgery.  BUT... I just needed to talk to him.  All the website, journal articles, and blog research has only left me with more questions about what exactly will be happening to me personally and what I can expect as my prognosis.  I also really feel that its important to encourage my healthcare providers to act as a team.  To further that, I feel like if I'm on everyone's radar (or just somewhere in their patient files) they are going to watch out for me and something I may need is less likely to slip through the cracks.

So I met with the surgeon who actually put on gloves and looked at my mouth and my bite.  He then sat down and reviewed my x-rays with me.  And wow was that a shocker!  I knew I had a dental malocclusion and I thought that I had understood why this malocclusion led to my TMJ dysfunction. But what a difference an educated discussion made on my understanding!

Turns out I will need double jaw surgery.

There are typically 4 reasons someone needs this surgery (a part from trauma) and I've got 3 of the 4!  I've got the overbite, the overjet/open bite, and the asymmetry....wheee!  The only one I am missing is the underbite, which would be awfully hard to have at the same time as an overbite. The Dr gave me a brochure that looks like its from the 1980's "Your Orthognathic Surgery" I'll have to upload some pages next chance I get.  Essentially:
1. Serious Operation with all inherent risks
2. Inpatient hospital stay ~ 2-3 nights
3. I'll be out of work for 2-3 weeks
4. Liquid -> soft food diet for several months
5. My face/profile will change

Apparently I am still rather upset about the double jaw surgery, because I am really struggling and find myself reluctant to write tonight.  But I have about 1 year to a 1.5 years before the orthodontics will have done their work and my teeth will be where they should be for the surgery, so that should be plenty of time to come to terms with everything. 

1st Adjustment of Braces

9/20/2013

Well I went back to the orthodontist for my first adjustment of my braces yesterday.  They applied 1 gauge higher tensile strength wire on my top teeth and 2 gauges higher on my bottom teeth.  Here is a website I found that explains the importance of the wire: All About Arch Wires.  It was sore yesterday after the adjustment, but really the pain started when I woke up this morning.  It feels like my whole lower jaw is swollen, to the point where I feel like it should be obvious to everyone I meet. Of course I cannot see a difference in a mirror so there is no way that anyone else can tell, but I just want to wrap my whole face in ice and stop pretending that I am a normal person today... but that won't pay the bills!

Did I mention that they placed some composite material on my molars with the braces application in July? If not...they had placed a little composite material on my molars so that with my night grinding (bruxism) I would grind away the composite and not my tooth enamel (one of the reasons most people with TMJ disorders wear night guards). Well apparently I had managed to wear it away significantly (grad school= increase stress = more night grinding) so they added a lot more composite to my molars.  I know this sounds great in theory, but the composite material is all that can touch now, so its like have 2 pencil points that prop my teeth apart and my mouth open. Which brings me back to eating, one of my favorite hobbies and something I can no long do :(  Can you imagine trying to chew food with a pen tip? So needless to say I am really bummed to be back on a liquid/no chew diet.  Looks like I'm headed to the grocery store to stock back up on yogurt, mashed potatoes, protein powder, and pureed soups.

Now after I've complained enough, I did get some good news from the Orthodontist!  I asked if it still looked like we were on track to schedule my jaw surgery next fall (2014).  My reason for asking is that I graduate in May and I would really like to give my new employer a heads up that I will need to take some time off for the surgery.  And Dr R said that every mouth is different . . .*usual spiel*. . . BUT that there was a chance I could be ready for surgery in the Summer or even maybe May!  Which means surgery sooner, braces off sooner, new pain-free life sooner!!! My response was that if it was possible for him to crank on my teeth harder now I would take more pain today to get it all over quicker...unfortunately it doesn't work that way. But I left his office feeling a renewed sense of hope and optimism for my future life!

Here's an (unattractive) but upward view of my teeth as closed as they can get... which is to say not at all :(

Feeling Much Better!

September 17
So I have been feeling MUCH better with my braces.  I still have a couple really sore teeth that ache when I try to bite into something hard like a cracker (or push on them with my fingers), but overall the last week has been so much better.    I go in for my first re-tightening with the orthodontist in two days and I am not looking forward to it.  I guess I should make a batch of jello and mashed potatoes in anticipation. . . Did I mention how nice its been to eat anything but mashed potatoes?  SO  NICE!

Phase II: Braces

July 25, 2013
I had braces for both the upper and lower teeth placed on by a technician.  Everything I read online told me to expect about an hour for each application so I was planning for the process to be absolutely miserable.  I took 800mg of ibuprofen before I went in and braced mentally for another ordeal.  Surprisingly though, the application went very quickly and very smoothly. I was in and out in about an hour and that included the counselling time including what I cannot eat.  I'll post some of the list below for anyone else who is curious (or so that you know everything to eat before you get them on!) But truthfully the list did not impact me much as my jaw (and now teeth alignment) really didn't let me eat most of these foods even before the braces!

My webcam is a little grainy, but you can see that the top ceramic brackets really are a little more inconspicuous. I'll post a better pic of top and bottom brackets later for comparison.

Braces Contraband:

• Taffy, Toffee, Caramels
• Tostitos, Doritos, Tortilla Chips
• Corn on the Cob
• Apples (without cutting them up)
• Gum (which is HORRIBLE for TMJD anyways!)
• Hard Candies (they can get stuck and break a bracket)

Day 2 of Braces I was miserable. My jaw ached, my teeth ached and when my teeth touched together I got an electric-like pain that made me want to scream. I was taking 800mg of ibuprofen every 4 hours (not recommended if you want to preserve your GI tract)
Here is my post from Facebook:  "I REALLY want to take some pliers and rip these braces off of my teeth...grrr!"  

Day 3 of Braces: same as above . . . and now the brackets are ripping up the inside of my mouth. I've got so many sores lining my mouth even though I now have all the brackets coated in wax. As a note on the wax, the orthodontist told me to "try not to use the wax to allow your mouth to toughen up"  HA!

2 weeks of Braces:  FINALLY doing a bit better with the braces. I started attempting soft foods yesterday and have weaned off the 800mg of Motrin. Thanks everyone for the support it was a surprisingly rough start to a 2.5 year process!

CT Scan results

After I decided to go forward with the braces, I received my CT scan radiology report in the mail.

To sum it up I have degenerative joint disease (DJD) in both of my TMJs. With the Right TMJ showing increased signs of flattening and sclerosis. Also the right side of my mandible is shorter than the other!

Here is my scans:

This is what a normal TMJ should look like at my age :

And I thought this was a neat reproduction of the mandibular asymmetry that they put in my report:

The radiology report essentially confirmed that I made the right decision to proceed with getting the jaw corrected.  I was not expecting the DJD and especially not expecting the right TMJ to look that bad at 30 years old, I can only imagine how bad it will be in another 20 years if I don't take care of it now.