Sunday, November 30, 2008

One week after

It has been a week of patience and trials... I was trying to hide my new add-ons from my colleagues but let's face it, such thing you can't hide no matter how self conscious you are. My trip had a different purpose but well, if I was there why not go for a 2nd opinion where they have excellent medical care? After all in February 2007 I had done my LASIK eye surgery in Medellín, Colombia as well.

My lips are toughened up against the wires and brackets so that is not painful anymore. I feel my teeth moving every day, new spaces being developed, some closing. Chewing is no longer a painful experience.

However, eating remains a challenge. Due to the crown thing I was advised to chew on the other side so I can only hope that molar holds on to all that stress (it has a big filling). No more sandwiches (good bye Burger King and Kentucky's Friend Chicken!), no more platanitos (delicious snack made of plaintain), no more hard cookies, no more chewing gum. Basically I am down to reengineering what I eat, nowadays mostly soft food and use fork and knife to cut down the sandwiches to manageable pieces I can place on my mouth in the right place.

Good thing about braces is you tend to stop eating junk food and bad snacks such as sugary chocolates! simply because the last thing you want is a cavity or have to run to the toilet to clean your hardware yet again. I have made it a point to clean up the hardware after lunch, then just drink tea, eat (soft) dinner and do the floss-brush-mouthwash ritual before going to bed so that everything looks and remains clean. Ah, nothing like the feeling of clean hardware on your mouth LOL. It is only beaten by the feeling of a mouth without hardware add-ons!.

I have already lost nearly 4 kilos already, I hope this trend does not continue as I have to get strong for the surgery one year from now.

As if that was not enough I am freaking out about the prospects of having this surgery! I normally sleep on my side or belly down which is a definite no-no after such surgery. I don't have a special bed where I can sleep in a propped-up position.

See: Jaw Surgery Pre/Post-op care

Friday 21 November 2008 Got braces

Oh my! getting braces at age 45 :-( "because I am worth it" as it goes in the commercial LOL. Not to mention that the prospect of surgery is still scary as I have never in my life had surgery of any kind (I must be lucky).

So, this was the day and I was full of anticipation because this meant that my eating habits will change today :-( me who loves all sorts of food (and the ocassional junk food), things soft and hard to chew. The picture on the left shows how it looked before my teeth were sent to jail for the coming years. Nice restorations on the upper teeth, he? Thanks Dr.!. The lower ones will be done when I am done with braces.

And so it came to be that my mouth was going to be the host of some extra hardware, some of which may or may not be aesthetically pleasing but the end results -and the sacrifice- are well worth it.

My fiancée was there with me, watching every step of the procedure as the orthodontist carefully glued all Damon self-ligating braces to my teeth. The two crowns had to be sanded prior to the gluing otherwise it may not stick very well. Then the tubes at the back. It was a long procedure and I had forgotten to go to the loo to empty my bladder so I had to hold on...

Finally the wires were installed and snapped. These are self ligating braces that do not need rubbers or other "manual" adjustments. They kind of get activated with heat so every day I drink a few cups of hot tea and swish it all around. This was all necessary because I will be abroad most of the time so we needed as little adjustments/visits as possible. He is already experienced in such cases and I had only but excellent references.

So... after what seemed like an endless life of work at my mouth I was offered a mirror to see my new set of "tooth jewelry" LOL.

Oh my! there they are :( It was funny how all that hardware felt on my mouth. With an overbite and extra hardware my lips looked puffed up to the point the office manager (a week later) asked me what was wrong with my mouth until I could not get away hiding it anymore.

That Friday and Saturday were hum, a trial to my patience and a snapshot of what was to come. As gentle as the whole installation was my whole mouth was painful, I had a headache. It felt as if my entire band of teeth were on the move. Those first days my lips where very sore trying to get used to those pinching things (yes I got some wax too!) but now the lips have toughened up and it does not bother me anymore. But those first days with all the talking and laughing it really became very very sore! I had to take some pain medication.

Even worse this first week (two days ago was my 7 day anniversary) chewing anything -no matter how soft- was a real trial!!! When a plate of delicious food was placed before me it felt like a challenge, to chew it all, slowly and carefully feeling the pain. Pfew, luckily there was Dolex and cold water to soothe the pain as well as a loving woman.

My first post-braces flossing session took me 45 minutes!!! something I did before in around 5-10 minutes. Brushing is also a challenge, specially around the crowns where the glue is not as powerful.

A second opinion and some extras

By now it was already November 2008 and I had a reconstructed semi-incisive (the one behind) and two crowns. I thought that by now with all these extra hindrances on my mouth and my 45 years of age I was just not worth the expense. Nevertheless I did not feel good with my smile.

It just so happned that I was visiting my fiancée in Colombia who was also aware of my "reserved" smile. She has a great hearth and wants everybody to feel good about him/herself. She had previously mentioned about a good friend of hers that was orthodontist that we did not get the chance to visit before.

So, one day in November she took me to his clinic under rather special circumstances. He interviewed me and told me what he could do. If I decided to go for the braces then it had to be decided that same night because I was only staying for 10 days... In the meantime he did a great job at restoring my 4 upper teeth to their initial glory so that they looked square and not worn out and misshapen. He also explained that most likely I would need the orthognathic surgery :-( and gave me a complete run up.
His colleague also did me a root planning (kind of an in-depth cleaning) in preparation for orthodontic braces, have to start with clean gums, roots and mouth.

Well, that night my lovely fiancée and I sat down to examine the facts and the decision was rather quick. I/we go for it...

Next day we went to the imaging lab to have some 10 xrays of my teeth plus one of those 360 degree photos. All of that for a mere €37 !!! A few days later I had to go again for a craneal scan with 3D imagery, the making of the model of my mouth (and an extra one for him), digital photos for posterity (before and after documentation), etc. All of that for around €120. Much less than what I had to pay for in The Netherlands and I must say I got a much better treatment, more personal attention. In The Netherlands it was more like "you need this surgery, this is how your mouth functions and your 15 minutes are up!".

Back to the orthodontist again to bring all the material he needed, some he had already received. He explained to me that the only way to get it done was with orthognathic surgery, I would need some 9mm enlargement (ugh!). He went to great lengths and explaining everything very clearly (something I never got in The Netherlands!). My fiancée watched the gory details of the surgery (I didn't want to see it).

The picture above shows some of my overbite. It does not seem dramatic but I was shocked when I saw the forward inclination of my front teeth which had gotten worse over the years. Here you can also appreciate that the 4 upper front teeth had been restored to their original shape, I am very glad with that job as well.

The initial scary verdict: Surgery!

OK, so it wasn't until 2004/2005 that I finally decided it was time to do something about it. I was tired of being ashamed of my smile (everybody has the right to smile right, pun intended). Besides, by then my kiwer front teeth were already worn out (at the top) nearly to the core.

The two upper front teeth had spread wider apart as well as sideways. causing them to wear out (really!) unevenly to the point they started looking more like an incipient triangle rather than having a squarish shape. I did not want to become a vampire, or even less stab my lower lips!

Some molars where also a bit worn out. Add to that the greater possibilities for cavities and I HATE visiting the dentist unless it is for cleaning and absolutely necessary work. Mainly due to "extreme angst" created by a bad dentist I had in The Netherlands that did a root canal on my with little anesthetic. So, how do you undergo orthodontic treatment with an extreme angst for the dentist? hum, you tell me but the neither prospect was good.

So, I found an orthodontist here in NL, he took digital photos, made XRays of my whole mouth and a 360 degree craneal scan, made a model of my mouth (out of some sort of plastic) and handed me an account for nearly €500 !!!

The day finally came when I had to visit my orthodontist for the veredict. I was happy with sufficient functional improvement as I was not looking for a mouth overhaul.

He and his colleague showed me the model, the photos, etc. and explained to me I needed orthognathic surgery. Ortho what? yeah that! in layman's language he told me they needed to saw off my lower jaw because it had not grown sufficiently. That it was the only way to have any improvement. It was all or nothing.

I started doing some research about orthognathic surgery because I was supposed to go to an informational evening at the hospital where they did this kind of surgery. Well, after spending all that money I chickened out and did not show up.

Background info - Before the braces

I always knew my teeth needed fixing but well that never happened (and I do not blame anybody). As an adult I failed to give it enough importance.

I remember when I was in my mid 20's I went to my dentist to have some filling done and he called his colleage "Hey come and take a look at this overbite!". Wow, I felt like a circus item! then he went around explaining all the problems I would get if I did not do anything about it. And I didn't...

And things started to happen... My jaw articulations started cracking whenever I ate, sometimes to the displeasure of my dining mates who thought I did it on purpose (helloooo!!!). My molars but mostly my front teeth started getting very worn out due to the misaligned bite. I sometimes had such pains in my jaw articulations that I just did not feel like eating, overstressed muscles on my neck (you would be amazed).

So, in my late 30's (2001)I visited an orthodontist in California to have some very quick evaluation. He told me that yes, I needed braces and that it would require some extra work. But it was a bad time, I was leaving the US back to The Netherlands so it was only as a reference.

I wouldn't do much about it for years, not that I did not want it just that it wasn't a priority and I thought I was too old for braces, old enough to NOT warrant having any more fixing done on my body parts.