Treatment Recess! Braces are off for a little while

An adult’s life isn’t easy and between one thing and the other time slips away. As I mentioned I was originally following treatment in Colombia and it was going fine but then I moved abroad and was not able to visit my orthodontist, the last thing he did was –something I shall regret for the rest of my life- do premolar extractions on my upper jaw, that was in 2010 (see one of my previous posts).

In my new home country I kind of tried with two (2) orthodontists but I was not truly happy with the alternatives or options given. One of them even quoting $3,000 as if I was starting from zero and was really way out of a reasonable amount ($1,500 is regular).

Time flew, last time I think beginning of last year the upper brackets where getting painful so I had them removed. The orthodontist (that had not begun treatment) was reluctant to also remove the lower ones so I left it there. Was another reason why I chose not to proceed with them. I spent all this time worrying about those lower ones, what to do, which options I had and lately VERY worried a cavity may had developed under the lower front teeth.

And today, six years, eleven months and three weeks (almost 7 years!!!) something wonderful has happened. I chose another orthodontist and I had my lower (what was left) brackets and wire removed and again a profilaxis.

Thanks God all went well and I had been worrying too much for no reason. The teeth were okay, it was not painful to have the brackets removed and my teeth didn’t chip or come lose as I was fearing!.

This picture shows my current state of affairs, my teeth are still not aligned and the premolar extraction has not closed much in the past 4 years due to stop in treatment.

In (1) on my upper teeth you can observed that despite the fact I had not had braces above for nearly a year or so, they are still together. Remember a few years ago I had a painful surgery there to remove the frenum and pull the two upper front teeth together and align them vertically (each was pointing to their respective sides). In (2) on the lower front tooth I have an issue where my root has gotten exposed. Perhaps partly for having braces for so long.

The picture on the right was also taken today but from straight ahead instead of from below (to appreciate misalignment).

In this one it is easier to see the few aesthetic reconstructions that were done to the front upper teeth that had lost some of their shape due to a bad bite. Additionally one can observe the issue with the exposed root that has not been addressed and to its left the small white thing is a periodontal implant that was done to protect the root of the other tooth (cost me $400). Hopefully one day I can have my root covered again.

What’s Next?

To begin with, I must have yet another panoramic X-Ray done so that my new (and final) orthodontist can determine what the treatment plan is.

At this moment he suggested not applying any braces to my lower teeth since they are already aligned –although some separation in between them has resulted from treatment- that comes as a relief, they have suffered much already.

He proposes wearing braces on the upper teeth for a year at a cost of $610 without having screws installed on my gums, that comes much cheaper than the $3,000 quoted by my former candidate and much less pain. Ah yes, instead of going for Damon braces again this price will be with Transparent (ceramic I think) braces.

Now, he says the gap of the extractions –again, I regret having them done- will not be closed because it he does it then my profile will change and my nose will drop down a bit and since I have no plans on having jaw surgery or genioplasty as suggested by former orthodontist, it seems okay. It appears the idea is to close part of the gap to make it more aesthetical, align them better to the lower teeth and prevent that the gap causes two of the lower teeth to raise and fall due to the lack of an upper constraint.

All in all I am optimistic again, I am confident of my new choice of orthodontist, I feel like a new man for a while now that I have no braces and my teeth are all smooth and without gadgets.

Waterpik W-360 – Product Review

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.

Power Cleaning on 3rd revision

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!.

Time for some orthodontic wax :(

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.

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.

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.