03 January 2016: ….2016?!

I have no idea how over two years have passed since my last post. I am so sorry. To be honest, very little happened in that time with my teeth. I had regular adjustments but nothing more exciting for quite some time.

Why the radio silence?

I can explain my absence though, I promise. Shortly after my last post in December 2013, we found out that we were expecting our first baby. Cue excitement, warm, fuzzy feelings and a flurry of activity to try and find a new house and secure a mortgage. We did all of that and managed to completely redecorate, fit all new carpets, secure the garden and move in just 7 days before our little boy was born. He is now 14 months old (!) and our world. He’s just brilliant and we are only just starting to find our feet with parenting (do you ever really find your feet…?).

Back to Jaw Surgery

They were unable to do much during the pregnancy, for obvious reasons, and so things just trickled on with my usual adjustments. After the birth, we got back on track and in August 2015, 22 months after my braces were fitted, I was told that I was surgery ready.

Yes, surgery ready! I know, how did that happen. It has flown by!

I had a great appointment with my orthodontist in August;  she took some final moulds, fitted me for my surgical wafer and fitted my tie-ins. Tie-ins, it turns out, are metal ligatures around each bracket, replacing the usual rubber bands. They rubbed to begin with and I got through plenty of wax but after another appointment, some snipping of sharps bits, they settled really quickly. I was then told I would just need to come back to meet with my surgeon and have my surgical hooks fitted. Excited, I attended my next appointment in September, ready to meet with my surgeon. I had a pre-op assessment, bloods taken, full medical check-up and then….I was told my surgeon was off sick. She had been off just a couple of weeks and would be back within a fortnight. I would get my surgery date when she returned.

To cut a long story short, she remained off work and is expected back this week. I have had to have a further pre-op assessment as they only last 3 months and have met with another surgeon who has agreed to take my case on in her absence.

What now?

I have a date! I am finally scheduled to have my surgery (with both surgeons) on Tuesday 9th February 2016. I had hoped to have it before Christmas but I’m relieved to have a date.

My orthodontic work has gone really well, closing my overbite from 14mm to 7mm and closing all of the unsightly gaps.  I am so pleased with the progress and can’t wait to have my surgery. There is a question mark over whether I will have a genioplasty at the same time but we’ll see on the day. I am in two minds about whether I need it or not but I won’t go in to all that here.

I am having my surgical hooks fitted on Wednesday 6th January, in just 3 days time.

True to form, here are some recent photos of my teeth. They aren’t great and I struggled to get a decent one of the overbite but I hope you can see the difference. My last post from December 2013 has the best before pics.

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That’s it for now. A catch up in a nutshell. I hope you’re all well and I will update again after my hooks are fitted. N x

11 Dec 2013: First adjustment – all I want for Christmas is a ….rotation wedge!

Photo on 14-12-2013 at 15.22

Ah, the photos on a braces and/or jaw surgery blog are always so attractive!

My word these past two months have gone quickly – the week before getting my braces was excruciatingly slow but now look…it’s almost Christmas! The past few weeks have been really busy for us so I’m really sorry for radio silence – especially to Aidan (thank you, it’s brilliant!) and those of you who have left comments. I promise I will reply very soon!

So…braces. I’m still struggling a bit but getting more and more used to them. The main issue is still the tenderness. I mentioned it in my last post and it’s still the only pain I have (apart from food getting stuck in them, which is driving me nuts!). If my teeth aren’t closed/touching/being used, they’re absolutely fine – not a hint of any ache. It’s the biting and chewing that’s a bit tricky. That said, I still see lots of movement, which is incredible and I can’t believe the changes already – every bit of ache has already been worth it.

So I had my first adjustment on Wednesday. I was only with the ortho for about 10 minutes. I met someone on Sunday who is just 4 weeks post-double jaw surgery and he had said that the pain from brace adjustments was worse than from double jaw surgery – excellent, here we go!

First of all, she cut the sharp wire which had worked it’s way out of the back right bracket and shuffled the wire around a bit. There was no wire change this time. Instead, she just changed the ligatures and placed a ‘quick lig’ on two teeth. When I got home and had a look, rather than elastic bands, she had put pieces of wire around the bracket and twisted it tight. I also became the proud owner of a ‘rotation wedge’ – something I had never heard of in all my reading/googling/chatting! This sits next to the bracket and looks a bit like this (on my incisor)…

Photo on 14-12-2013 at 15.24

And does this…

rotation wedge

I won’t lie – it really hurt having it fitted! My front teeth were still a little tender anyway so when this baby was wedged in there (literally) it hurt….a lot. Like when I had them fitted though, the first day was painful and I had some painkillers to hand but soon after, normal business resumed.

This is what’s happened in my mouth so far:

Bottom

(day 1 in October vs today)

Blue Bands

Photo on 14-12-2013 at 15.23

Top

(I have never been brave enough to post a photo of my gappy, pre-braces top teeth)

Photo on 05-03-2013 at 18.03 #3

Photo on 14-12-2013 at 15.24 #2

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Photo on 14-12-2013 at 15.24

Next appointment is 22 January – I genuinely opted for 6 weeks rather than 4 because after 4 weeks this time, my teeth were still too sore to think about going back in the chair. A wimp I know but we’ll get there eventually.

I hope you’re all well and looking forward to Christmas!

05 Nov 2013: First two weeks in braces

My first two weeks with braces have flown by! My teeth are definitely still adjusting and there have been a couple of things I hadn’t quite planned for but the movement in my bottom teeth has already really surprised me.

I have started to relax a little bit about the appearance as well – they’re on and they’re staying for quite some time so we might as well all get used to them.

Photo on 02-11-2013 at 19.17

In terms of pain, there have definitely been two different types:

1) The ulcers/cuts/rubbing/catching of the wires and metal bands. Having my brackets fitted a week earlier helped this enormously because I had already experienced all of these nasties during that first week. That said though, the metal bands and wires have presented their own issues. Obviously, as your teeth move, the wire begins to poke out and can be really painful at the back of your mouth. Normal ortho wax usually helps this but I struggled at times to get the wax to the back – there isn’t a lot of room back there (despite only ever having had one wisdom tooth!). My tongue has also caught on the metal bands on the back teeth a few times over the last few days and that hurts! I haven’t really had a good look but it feels as if the edge of the ring has folded over (I think this happened when they were fitted but it has got worse) and so there’s a little lip. I think that’s what’s catching – the metal is quite soft though, so I have managed to bend it back.

2) Next up, and this has been the real pain, is tender teeth! This was something I definitely wasn’t prepared for. I knew about the metal bits, about the ulcers and the food getting stuck (that’s annoying!) and I knew that it would be painful when they were fitted but I did not expect this feeling. The first day or two I had pretty chronic tooth ache, which even paracetamol and ibuprofen together couldn’t stop. Then when that wore off, this tenderness really set in.

I have struggled to describe this to people but until the last couple of days, I haven’t been able to put any pressure on my teeth at all. Even to close my mouth and rest them gently against each other has been too painful. There has definitely been no biting or chewing since I’ve had the braces fitted. To bite something felt like my teeth would come away with whatever I was trying to bite, they felt really loose! It feels like a slow acting shooting pain that moves up each and every tooth and into the gum. It stops almost as soon as the pressure is lifted but it is a really uncomfortable feeling. Brushing has been another issue – no electric tooth brush was going near these babies for a while. Oh god, just thinking about that makes my bones tingle. At the moment, two weeks in, they are all still tender but I can finally chew soft food on the back teeth.

BUT…..

With all the pain and grumbling aside, I am really surprised at how much my bottom teeth have moved in such a short space of time (apologies for poor quality photos).

Day 0  |  Day 9  |  Day 14

Teeth 2 Weeks

Not much else to report (apart from baby pink bands are already discolouring so won’t be having those again) – hopefully, the tenderness will stop within the next week or so.

N x

Update – 23 Oct 2013: Let’s get cracking…

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They’re on, let’s do this!

Full post later but metal bands, wires and ligatures make me a full set of braces up!

Update:

Well, 7 appointments in 4 weeks (hospital x 3, dentist x 2, hygienist x 2) and I finally have my braces on. It still feels a bit surreal to think that my journey (don’t worry, I hate that word too!) was finally underway.

Appointment

Today’s appointment was quite straight forward – I arrived at 9 am and was the only person in the waiting room (oh good, I might be able to actually hear the children’s animated DVD this time!) so I was called in pretty much straight away (but I was watching that!).

My orthodontist asked how the past week had been (with brackets and spacer bands in place) and before I could answer her, she had crinkled her face as if she already knew what I was going say. I think my first week was as expected really – multiple, awkwardly placed ulcers (including under my tongue!), what felt like mouthfuls of wax and the odd cut here and there. Not to mention the dull ache on my bottom teeth, which I’m guessing was from the bands working their magic (I have large gaps on the top already so there was no extra crowding and so no ache) and awkward experience of learning to eat with these enormous (they felt enormous!) brackets.

As I laid back (zzzzzzzz……..oh no, hold on!) she began to take the spacer bands out one by one. Then came the metal bands that go around each of the back teeth (essentially, for anchoring the wire). This took some time whilst she tried various sizes on each tooth to get the correct fit. They were then glued in place one by one and I soon noticed the feel of metal on the inside of my teeth that rubbed against my tongue. Sigh – more metal.

Finally, the wires were fitted and very pale baby pink ligatures placed around each bracket, securing the oh so tight wire in place. This was the only painful bit of the morning because for a short time, the wire was poking out at each end and my orthodontist had difficulty cutting a couple of the ends, which meant she had to really push against my jaw bone to get the tool in far enough (I know this is bound to happen more as my teeth start to move into position).

Go on, how do they feel?!

My immediate reaction was that it was so much easier to get my lips and tongue around the brackets now that the wires were on – the wire provides a sort of buffer so that they aren’t so abrasive. I also much prefer how they look now – without sounding too obvious, they look like proper braces now whereas before, people would spend longer trying to figure out if I had braces or something different because they weren’t used to seeing just the brackets.

That said, I’m really pleased my orthodontist fitted them in this order and not how I had expected (spacer bands on week and brackets + wires the next) because my god do my teeth HURT. I have had three lots of paracetamol (and Ibuprofen at one point) to dull the ache but they’re still super sore and super sensitive to touch (not to hot/cold as such but to touch – even a drink of water passing over them is really sore at the moment). Fortunately though, my mouth has adjusted to the brackets over the past week and I hardly notice those any more so I don’t have that pain to worry about as well.

How wonky??

Looking at the photos has made me realise how off-centre my mid-line is – I had never noticed at all before.

Teeth

One of these days I will pluck up the courage to post side profiles that actually show my teeth and how crooked they are. Not just yet though.

14 Oct 2013: Brackets and spacer bands anyone?

As you’ve probably guessed, I got some of my hardware fitted on Monday.

Ugh – what a head(mouth)ache these things are! Why on earth, when all my friends who have ever had braces complained about ulcers, cuts, aches, wax, enormous pieces of metal in their mouth (…did I mention cuts?), did I not equate that with what I would experience when I got my own braces?!

Sigh.

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Photo on 17-10-2013 at 19.37

Appointment

After the hiccup with my last appointment and confusion over the timings of my brace-fitting appointments, I called the department on Friday to confirm things and to see if they could give me any more info on what would be happening – they couldn’t. But the orthodontic nurse I spoke to assumed that because I hadn’t had anything fitted yet, I would just get the blue spacer bands at Monday’s appointment (20 mins) and then brackets and arch wire the following week (40 min appointment). On the back of that and my initial doubt, I managed to completely persuade myself that I would just get spacer bands on Monday. So much so that, despite being told they would fit the brackets, it came as a surprise!

My ortho fitted the spacer bands (separators) in less than a minute. I have one on each side at the bottom and two on each side at the top.

These went in really easily and although it was a squeeze to get them in, they really didn’t hurt going in at all. I had read lots about them being painful and really irritating but to be honest, they haven’t been too bad at all. Yes, I can feel them but no, I don’t feel like I have meat stuck between my teeth. Yes, my teeth have ached a bit when I put any pressure on them, but no, it hasn’t been bad at all.

To be honest, I think that was probably because as soon as the bands were in (and as I was about to sit up, ready to go home), they started preparing my teeth for the brackets. Within twenty minutes of walking in to the room, I was walking out again with a mouth full of metal!

I won’t go in to detail (yawn) – but this is how they fit braces.

First 3 days with brackets on

These past 3 days have been pretty difficult. The ulcers have been the worst bit but I’ve found wax invaluable! I sleep with it on to allow my mouth time to recover and only really take it out to eat. Tonight (Thursday) is the first time I’ve been able to eat solids without causing more cuts and without having had wax to hand. Up until now I either haven’t been fussed about eating because of the pain/hassle or have had nothing but soup. I’m still struggling to bite properly (ha, bite properly…what do I know about biting properly?!) because the brackets either catch on my top lip or knock a bottom tooth and there’s the paranoia about having my entire meal wrapped around them!

It is getting much easier each day so I’m sure that by the time I have the wire and bands added next Wednesday, I’ll have it sorted – god I hope so!

Dental Geek

From what I can tell, this seems to happen to most people going through braces and/or jaw surgery – I’ve become an actual teeth geek.

Since my ortho asked me to see my dentist (twice) and hygienist (twice) before having braces on, I’ve had to move all my dental gubbins to the other bathroom and now have a second makeup bag for it all. I’ve even become a Waterpik’er (I wasn’t even a flosser really, let alone a Waterpik’er), which I love!

So……wires and bands next Wednesday and then we’re off. I’ll be a fully fledged orthodontic/orthognathic patient and I cannot wait for this process to start properly.

Update – 24 Sept 2013: first appointment since joining the waiting list

Predictable?

Well, my appointment on Tuesday didn’t quite go as planned but thankfully, there won’t be any big delays. The only real issue was with the booking (or not) of my 30 minute appointment. Long story short, they hadn’t updated my appointment on the system but as I still couldn’t make the original one (the next day), they were very apologetic and said that I could still be seen. It meant a longer wait but I  was just glad I didn’t have the delay of being sent away and waiting for a new appointment (plus I got to sit and watch kids films and people watch without feeling too guilty!).

Appointment

When I did eventually get to see my orthodontist, I was only in there for about 10 minutes. She asked if I had any thoughts or questions (which I didn’t because everyone else’s blogs have been fab) and then ran me through the consent form and risks involved in having braces – never very fun listening….root shortening, discolouring, gum recession/overgrowth.

She told me that she would like me to have a dental checkup and hygienist appointment before they fit the braces, but provided they don’t need to do any work, we’re good to go – braces as soon as possible! Needless to say, as soon as I left the hospital I called my dentist to rearrange the appointments I already had scheduled (hygienist in December!) and was over the moon to be able to get them both booked for next week.

The Plan

Soooo, that means my two brace fitting appointments (1 week apart) start on Monday 14 October 2013 and I cannot wait! Now, my orthodontist did tell me what they’ll do at each appointment and I even asked to clarify but I’m still not sure I’ve got it right so this will probably change. At the moment, this is what I think will be happening:

Appointment 1 (20 minutes) – separators and brackets fitted.

Appointment 2 (40 minutes) – archwire fitted.

From everything I have read, this is what surprised me. I had assumed I would have separators fitted and then brackets and archwire the following week (especially given the timings of the appointments – surely fitting the brackets will take more like 40 minutes?). I have however, found a paper that says the orthodontist could choose to fit them in this order and so maybe I didn’t get it wrong – oh well, it will be a nice surprise….won’t it?

Has anyone else had them fitted like this?

 

Musings: Getting Jaw Surgery on the NHS

A few people have asked me recently about how I got to have this treatment on the NHS, the braces I will have and my experience so far. It seems that fewer and fewer people are being found eligible and there are still only a handful of UK based cases blogged about, so I thought I would write a quick summary of how I got to where I am.

Just to be clear – I am not due to start any treatment, orthodontic or otherwise, until my next appointment (24 September) so I can only comment on my (limited) experience so far.

Dentist

In the Spring of 2011, I went to see my high street dentist for a regular NHS check up. I hadn’t been for far too long and so we had a good catch up. After my check up, he asked how I was and I mentioned my worries about my overbite, crooked teeth and worsening jaw problems (chronic locking, constant aching, regular clicking and inability to open wide enough to bite in to sandwiches etc). He told me what several dentists (and JR orthodontists) had told me when I was in my late teens – that it was likely my overbite couldn’t be corrected by braces alone and that surgery might be necessary. He referred me to a high street orthodontist (as opposed to a hospital orthodontic department) for an assessment and that appointment was just a few weeks later.

Orthodontist

At the orthodontists, I had the only slightly worrying appointment of this whole experience. They had two senior orthos look at me and neither of which seemed particularly professional. They seemed shocked at my jaw and as if they had little or no experience of over bites whatsoever – their inexperience really unnerved me. Nonetheless, they talked me through the options:

1) Have braces (metal, clear or Invisalign) privately for 2-3 years. This may close gaps, but wouldn’t deal with my overbite and would cost in the region of £2000 per arch.
2) Have metal braces on the NHS. Again, this wouldn’t solve the issue of my overbite or TMJ issues.
3) Be referred to the hospital for further assessment.

They sent me away with glossy brochures and price lists and I did give the braces serious thought but really, it was the TMJ and overbite that were my biggest problems so it was a no-brainer.

Department of Oral & Maxillofacial Surgery, Orthodontics and Restorative Dentistry, John Radcliffe Hospital

Within weeks I had my first appointment in the Orthodontic and Oral Surgery Department at the John Radcliffe Hospital in Oxford. To begin with, I went ahead with an arthroscopy to my left TMJ and I’ve written about that separately here.

At my one and only post-op appointment with my consultant, he made sure I was given another appointment in the orthodontic clinic to discuss the possibility of orthognathic surgery to correct my overbite. At that stage, we nearly dropped the ball and between us, we failed to rearrange one of my appointments. BUT, I managed stayed in the system and within a few months of my next appointment (and with a few appointments in between) I was put on the waiting list for orthodontics and double jaw surgery.

HOWEVER…

When I discussed the possibility of jaw surgery with my orthodontist at the hospital (back in 2012), I was told that I was lucky because there had been a meeting just a couple of weeks beforehand in which they had decided to continue to consider whether or not this sort of treatment would still be available on the NHS – I was advised not to take too long thinking about whether I wanted to go ahead or not.

Oh, but you’ll have clear braces won’t you?

No.

Not unless I want to pay in the region of £3,500-£4,000 for the orthodontics and £6,000 for the surgery. That’s right, under our great National Health Service, the option to contribute towards payment of your treatment, and therefore save them money, is non-existent. You either have it all completely free (and wear the NHS issue metal braces) or pay for the lot privately. I asked the questions, mulled it over, asked a couple more questions and learnt that paying privately would get me exactly the same appointments, exactly the same medical team, exactly the same waiting times, exactly the same treatment….but clear braces. Thanks. But no thanks.

I’ll be honest though – I thought about it. Of course I did. But I’m nearly 30 and married. For better or worse. Although I am happy with my decision (seriously, £10,000 for clear braces?!) it has been quite difficult to persuade others and I have no doubt there will be more to persuade once they’re on but that’s just something I will have to deal with.

Not to mention the fact that metal braces are more effective than clear braces. But that’s by the by isn’t it?

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