Treatment resumed... State of affairs

My treatment had no progress for 2 years (my fault) but I finally made the decision to continue it and finalize it. For that I have a new orthodontist (local) but I had to go also to get my upper brackets & powerchain removed.

I wanted it so because a couple of months ago I bit a piece of bacon that had a bone (I didn't know) and that stroke the wire. It caused the wire to misadjust and it was changing my bite. As a result I was getting some pains in my teeth and jaw.

So the orthodontist temporarily removed them, as it turned out I also had 2 loose brackets. The pain is now gone.

So, I had a new set of Panoramic and Cephalo-something XRays done ($40) to reassess my current situation. Also had my teeth cleaned ($30) which as usual was a bit painful but it is over with. For a week already I have been enjoying a partial sense of freedom, no brackets on my upper teeth!!! it feels wonderful! it feels so smooth! it is sooooo easy to clean and brush! it is just amazing!!!!

But that won't last long, as I mentioned it was only a temporary measure. I am resuming treatment this week ($900 downpayment) because:

• My upper teeth are not yet properly aligned with the bottom teeth (see photo)
• The space left by the premolar (2) extractions needs to be closed.
• My periodontist needs my lower teeth to also be pulled back a little bit so that I can have yet another gum implant to cover the root of one of my front lower teeth which is very much exposed (can see on the photo as well).

So, I think that in the next appointment they will probably be removing the lower brackets, clean up the left over glue and make a model of my mouth to play with. Then as part of the new treatment the orthodontist will do something I hoped would never happen: I will have two (2) micro screws installed between the two molars behind the premolars so that it serves as anchor to pull the front teeth back without moving the back molars forwards. The purpose is that I would end up with with Class 1 bite instead of a Class 2.

Micro screws? yes, horrible!!! a couple of years ago I saw videos of it on YouTube and considered myself lucky that was not part of my treatment. WRONG!!!! well, probably because I opted NOT to have orthognatic surgery. BTW this orthodontist says I don't need that, that I could have a good bite without the trauma of such surgery.

I will also get a whole new set of brackets installed, my old Damon system is going down the toilet because they don't use that here. So now I will have to deal with rubbers and the like. The treatment is going to cost me $3,000 (three thousand!!!) so there goes some of the things I wanted to have because now the orthodontic budget had to be expanded :-(

I haven't been the luckiest guy with orthodontics I must say....

• Several of the orthodontists I saw said I needed orthognatic surgery.
• According to Damon system information premolar extractions are almost never required. Well, wrong! I had to have two removed two years ago. I was not happy about that.
• I needed some surgery on my mouth to remove some gum that was separating my upper two front teeth. Very painful but at least now my teeth are together and kind of straight,
• I blew up some of my gum at the root of my lower front tooth, needing periodontic treatment ($400) and awaiting another to cover the exposed root.
• So far 5 loose brackets. 
• Now the micro screws!

As for the screws, for what I read they do that so that the pulling is done from within the mouth instead of using the external headgear. Yes, headgear looks ridiculous and annoying to wear in public but dental treatment is traumatic to me, quite frankly I would rather be ashamed of having to wear a headgear than have to go through the trauma, pain and extra care needed by having two micro screws perforating my gum and jaw.

Back to the chair of torment

The two year pause in my orthodontic treatment has come to an end. As I indicated in my previous post I have some periodontal issues aggravated by the orthodontic treatment that need to be addressed.

Also, being in a new relationship for about a year I became motivated again to give an end (a happy one we hope) to my orthodontic treatment. I am really tired of wearing braces. It has been nearly 2 years since my premolars where extracted without any movement on upper teeth (lower are aligned already) and gosh, I think about 6 years since I got the brackets installed (01 April 2006), way too long!!!

I finally got in the mood and courage to resume treatment and visited my orthodontist. As usual the news weren't good, well, I have no cavities which is good news :-)

Basically, I have to get all X-Rays done again to check the state of affairs, not good for my thyroid glands... They are going to remove all my brackets (Damon) because they don't use that system and don't like it much for rotations :-(

So I will get a whole new set of tiny brackets and together with the micro implants and the retention stuff it comes down to another $3,000 !!! gosh! why wasn't I born with a perfect smile? I wish I could spend all that money into something else!

The expense is not the only bad news either... In order to pull the upper teeth that are in front of the premolar gaps backwards to align with my lower teeth, they will install two micro implants on my upper jaw between the root of two molars. These micro implants (micro screws) on each side of my upper jaw will be used to pull the teeth back without moving the molars in the back to the front so that the premolar gap is closed entirely by the teeth in front of the extracted premolars. Hopefully I will not have a class-2 byte.

More bad news... the treatment will last another 21 months!!! I'm going to go crazy, more than 5 years on brackets, when will I get to brush my teeth like everybody does? I hope all of this expense and pain is worth it, I want to keep all the teeth I currently have and once and for all feel confident about my smile.

Periodontal treatment...

Sorry it has been a long time since my last update. It has been nearly two years since I had my upper premolars extracted in Colombia. I became very demotivated due to the change from single jaw to double jaw surgery. I didn't know whether to abort the whole treatment or what and complicated with the breakup with my then (Colombian) girlfriend.

After extraction I briefly explored surgery in Panama but I didn't like what I heard, double jaw surgery and not even that pain and torment would close up the space left by the extraction of my two premolars! I felt as if my sane premolars had been amputated. I simply stopped caring.

Now nearly two (2) years after I have decided to resume orthodontic treatment. I am simply tired of braces and apparently the only way is to go back to the chair of torment again. I simply want to have those gaps closed.

Unfortunately this past 8 months I had a problem with the root of my lower front tooth getting exposed. The gums where very thin there and a pizza crust caused an injury that was made worse by brushing. Then I am told that orthodontic treatment ALSO causes gum recession!

Back in June of this year (2012) I had a small (1+ hour) surgery to have a gum implant to prevent further recession of my gums below my lower front teeth. I didn't have pain during the surgery, not even anxiety (I was given a pill for that) but right after it the burning sensation & pain began. Thanks God there was strong pain killer for post-op. But the next few weeks were a bit of a torment.

A week later I had the stitches removed, then a follow up a month afterwards and all was well. Except the implant was not to cover the exposed the root but to prevent further recession.

A few weeks ago I had another visit to the dentist & periodontist to seek covering the exposed root. However, he told me that for that the lower front teeth need some repositioning for that treatment to be successful and was advised to resume orthodontic treatment so that they could coordinate between them to have treatment completed and also treat my periodontic complication.

Unsure and pissed off.

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

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!

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!

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 :(