Thursday, March 5, 2009

The Braces are off!

First, I have to apologize for not posting for a couple months. It is amazing ... a few months after my orthognathic surgery, life does not revolve around my mouth anymore! It is true ... there is life after orthognathic surgery ... and it does not consume my every waking thought anymore (or while I'm sleeping for that matter)! So, unfortunately, I am quite sure I will leave out a few of the details in my brief recount of the last couple of months, but the meat of my blog I really do believe is during the 6 weeks post-op recovery period, anyway. I do apologize for all my spelling errors and typos during the first couple weeks after surgery, but I didn't want to go back and edit because I was reminded by the blurred vision, so my horrific writing is a true reflection of a part of my post-op recovery.

So, January was relatively uneventful orthodontically. I traveled quite a bit for work, so that made the month fly by. I had a couple of migraines, but not alcohol induced. They were most likely hormonal, given the timing. I guess I need to be more diligent about taking my magnesium again. On February 2nd, I had another orthodontist appointment. Got a powerchain all the way across the top, and no longer on the bottom. Elastics only on the right side at night. Here is a progress pic from that appointment:


The following day, I had an appointment with my OS. Everything looked good, except my ROM, which I expected. I was only at about 30 mm, and I don't think I've progressed much more since then. So, I am not released yet from his care until I get up to at least 40 mm. I have a follow-up appointment for May, at which time I hope to be to where I need! I will be working on it daily, as I am afraid that if I don't I will loose it. He doesn't want me to do tongue retractors or put anything physically in there, for fear I could damage my teeth. So, stretching exercises it will be.

At some point in February, I thought I had a piece of food stuck in between my tooth/band on my upper left side, so I started digging with a toothpick. Well, I don't have the feeling back in my upper gums, so little did I know that I was actually picking at my gums. I made a mess out of them, and with the band around the tooth, it didn't allow it to heal very well, so it is still a bit of a mess. Things should get better now, though.

One week before debanding, I had a DOUBLE power chain put on my upper teeth, one below the archwire and one over top of it. That was fun. While putting it on, one bracket popped off my upper right tooth. We got the bracket repositioned and back on, and wouldn't you know, the other bracket popped off the upper left tooth. Geez! The objective of this torturous dual powerchain configuration was to close the gaps next to my upper canines. Soon after the visit, the one on the left was closed. But the stubborn one on the right persisted, and I was incredulous that I would really get my braces off yesterday. So, skeptically, I went to my debanding appointment.

I am not going to sugar coat it. It was a painful experience. With the feeling starting to come back in my upper gums, everything is ultra-sensitive. I used to love brushing with my sonic care, and even that was not a pleasant experience any more. The vibration against the brackets is annoying. The wierdest part, when sanding off the glue, the feeling is criss-crossed along the gumline above my top front teeth. My bottom teeth didn't like the pressure when taking off the lower brackets, either. I felt bad for the hygienist. She was trying so hard to be gentle, but I felt like somewhat of a baby. I usually have a pretty good threshold for pain. But, I got through it, and I was willing to endure ANYTHING to get those babies off. Before getting the brackets off, she put a double power chain on the upper front teeth to close the remaining gap. It opened back up after taking off the chains, but the tooth is mobile, so the retainer will put it in its place.

I need to forewarn those who have bands on their back teeth. Although I felt I've kept very good hygiene throughout this process (except for the weeks post-op when I wasn't allowed to brush), there was a very disturbing stench when taking those bands off. Luckily, the hygienist wears a mask, otherwise I would have fully expected her to gag.

Since debanding, I do have to admit I have been obsessively narcissistic, looking in the mirror incessantly at my new shiny teeth and bite. "This isn't my mouth!" I exclaimed when I had my first look. The results, using the words of my orthodontist ... "Perfect".

So, now that I have completed the majority of this process, I feel that it is high time to give due credit to the amazing team of professionals that have gotten me to this point. I have added a list on the left side of this page that includes a hyperlink to my OS, OD, and dentist. I wouldn't have started on this journey if it wasn't for my dentist, Dr. Villwock, referring me to see an orthodontist. From there, Dr. Lin, my OD, took over and diagnosed me with vertical maxillary excess with mandibular AP hypoplasia. Dr. Lin referred me to Dr. Parmar, my OS, who is the most empathetic surgeon I could ever ask for! Combined, they have provided me with a result far superior to what I could have ever envisioned. I am so grateful for their expertise, patience, and professionalism. I wouldn't change a thing about any part of my treatment. I was and am truly blessed. And, I could never forget everyone at their offices who were always my biggest cheerleaders, along with my family, friends, and of course all of my fellow ortho bloggers! Cindy, Lisa, and Traci at Bellevue Family Dentistry have always been wonderful to me, and especially through this process! The countless number of techs at Orthodontic Specialists who worked on me and always had positive and encouraging things to say. And the receptionists at Bay Oral office who I got to know very well since I was there once a week for oh so many weeks post-op while waiting for that exposed plate to heal over. Sorry if this sounds like an Oscar acceptance speech, but I am forever grateful to everyone involved in this process, the results have been truly amazing. Now, when I place my hands on each TMJ and open my mouth, I no longer hear the cracking in the right joint and feel the popping out of the left joint. I can actually see my bottom teeth when my teeth are together, and at the same time I can feel the back of my upper teeth with my tongue! There are so many functional differences, not to mention the relief that I am not continuing to wear down my joints. The cosmetic improvements were a very positive side-effect. This was all so worth it.

So, I am sure you want to see pictures of my naked teeth! I'll start off with a picture of Dr. Lin and I, freshly de-braced!

Below are my before and after photos. The befores were taken in June, 2007, and afters in March, 2009. I now introduce you to my Class I bite!:

Front view, no smile. Notice the lack of lip incompetence! No more puckering of the chin when my lips cme together. Also, the nose has changed. I didn't think I wanted my nose to change from this surgery, but I definately think I like my new nose better!


Front view, smile. No more gummy smile! I no longer need to posture my jaw forward so I don't have a double chin!

Right profile. I have a chin! Nuff said. Also, look at the difference in the angle of my upper lip. Dramatic difference.

Front teeth, closed. My lower teeth are now visible ... no more deep bite!

Front teeth, slightly open. Dramatic difference in the crowding of the lowers.



Left and right occlusion. Check out that Class I relationship. No more overjet or overbite. Very swollen gums from lots of torture, but an extremely satisfied patient!!




Upper Arch. Check out how much it widened and rounded out.


Lower Arch, a picture is worth a thousand words.



For retention, I have a fixed lingual retainer on the bottom, and an essix retainer on the top. I am to wear the essix day and night for 3 months, until instructed otherwise. My gums are too swollen at this point to get floss in at my gumline on my lower teeth, so I need to allow the swelling to reduce and work on that with some oral pix. I plan to give my mouth a rest for a while, and next year I need to have one of my molars crowned due to a large filling, and will slowly get my metal fillings replaced by composite ones.

I will post again soon with some of my reflections on this whole process. I still follow all of your blogs, and look forward to your updates. Hopefully, my blog will serve to educate future orthognathic surgery patients as your blogs have educated me! In the process, it has been incredibly therapeutic and I have created a diary of my journey along the way.

20 comments:

Katherine (Kate) said...

Congratulations! Both on the debracing AND reaching the point where you don't think about it all the time. Toss up as to which is the biggest milestone :)

Thanks for the head-up on getting those molar bands off, will definitely be shoving vicks up my nose to ward off the smell, should that days ever come.

Amazing results, Stephanie, and cheers to you for the wonderful bite you've earned and can now show of with pride. Will be rooting for those stretching exercizes to pay off and ROM is finally and fully restored.

Woot-woot!

Katherine said...

I am thrilled, absolutely thrilled for you! Don't you love how smooth and glassy your teeth feel?

Your side by side photos really show the postive changes. Tonight, I was especially struck by how you still look like you, but an even healthier version of you. :) An you look very happy, too.

Thanks for posting your update. I will follow your progress on your ROM in detail.

Anonymous said...

You look absolutely radiant! Your smile and profile is gorgeous now! Congratulations!

Michelle said...

Stephanie! This is awesome news. I actually read your post over the weekend, and I've been happy for you ever since. You look amazing, like a zillion bucks! Congratulations for completing this orthognathic journey!

:0)
M

stephanie said...

I can't believe I didn't comment on this post already - I meant to say (thought I had already said) that you had such amazing results from braces/surgery! You look fantastic.

Also... I just posted another entry on my blog as I'm going through major issues... maybe you can help?

stephanie said...

Okay, now I posted it on my blog (my computer is weird lately)... I was wondering if you had to write a personal statement, and if you did, what did you say in it? I can't figure out what to say....

Cali Girl said...

Stephanie,

You look beautiful! I'm 3 1/2 weeks post op from upper/lower jaw surgery. How long did it take for all the swelling to go down on your nose and around your nose area? My nose has changed a little bit but it looks like it's still swollen or at least I'm hoping it's still swollen. What do you think?

ladyanjen said...

I have been at the mercy of orthodonture since I was about 8 years old- my permanent laterals came in essentially facing one another, requiring the use of the old fashioned quad-helix (the kind the ortho had to tighten weekly with a winch- no plastic, no plates, no key). Excepting a short stint around age 11 of just retainers, I wore full braces until I was 17 years old. Sometimes this treatment included headgear, sometimes cross-lateral elastics, always pain, always diligence regarding gums and tongue, a grim and dull diet (no gum, no soda, no fresh hard fruits or veggies- all this was before the days of meal supplements like Ensure), continuous visits. Once the things were finally removed I was elated, I couldn't believe I was finally going to graduate high school with clear and clean teeth for the first time I could remember.
I am now 32. Two weeks ago I tripped on the asphalt getting the mail and landed square on my chin, breaking it, the right condial joint bone in my jaw, necessitating 25 stitches from a plastic surgeon and the full wiring closed of my jaw. I realize I'm lucky in that it could have required invasive facial reconstruction, but so far my oral surgeon is proving really adept. I am happy to report that today I had the wires cut and my bite pronounced beautiful, and after another x-ray (my right bicuspid is broken in back but that's gonna have to wait till I can open my mouth all the way)... I am still in upper and lower bands and am using two elastics, over each canine, to help keep the jaw aligned and allow for flexibility and mobility in the joint. I am freaking out just a little bit because I cleaned my teeth again as soon as I got home and can't quite remember if the bands go over the canines or bicuspids, but it feels right over the canines. I've come quite far, I truly did not think I could endure the first few days, the pain was unbelievable but worse was the feeling and knowledge that I could not open my own teeth . . . and I'm sure it resurrected many dormant panics from those long years of braces.
I mention all of this in light of reading your entry because I first want to congratulate you enormously on not just surviving but thriving throughout what I know all too well to be a miserable procedure. I only wish some of this advice had been available when I was a kid- I still remember every horrible smell, the sound and feeling of those mallets pounding molar bands in place, the constant taste of blood from abraded lips. . . the entire practice has certainly come a long way.
I also write because while I'm not dealing with braces at the moment, what I am dealing with is honestly not that different, although necessary for a medically different reason than my crooked permanents and severe overbite. One of my biggest concerns throughout all of this is that I'll have MY face back- which is easy to doubt, between the broken bones and the gouged chin. You detail in some of your picture commentary the difference in your appearance (positively, and I'm really happy for you!)- it's a giant comfort to know that the changes I saw in my face were far from imaginary but absolutely related to the damage done in the nasty fall I took.
Enjoy your neat bite (especially the lower, that's fantastic work and I know how much it hurts as those teeth slowly align to a better position), smile and laugh a LOT, cherish the smooth teeth you've got with the brackets off . . . and if anyone has any advice/info about what happens post-wiring, well, I'd love to hear it.
Congratulations and thank you again for giving us all such a positive, detailed account of what is all too often a misunderstood, minimized, serious dental and medical procedure.
My Very Best,
A Fellow Survivor

June said...

Hi Stephanie. I'm new to this jaw surgery "club" and I don't know if you still read the comments, but I wanted to ask how you are doing? I have a very similar bite to yours (well, your previous bite) and I'm considering the surgery. Are you still happy with the results? Do you notice the plates and screws? Do you still have pain or weird feelings? Was it worth it? Thank you so much for your time. This has been such a difficult decision - one day I want to do and the next day I'm too scared to. June

Jaw Surgery Brandon said...

Wow, awesome before and afters, and lots of them!

I'm Brandon from the Jaw Surgery Blog.

I just wanted to congratulate you on a successful surgery, and it would be a great help to others and future patients that are going to be going through the same thing you did if you could share your story and experience.

I'd love to get as many people to share their story as possible in one organized place, so people just like us won't be as scared, and they too can have a successful surgery.

All you have to do is write a quick summary of how the process was for you, in as much or as little detail as you like. For example, you could include how you felt right before surgery, how you felt after, what the sensations were like, what you wish you had known before, or anything else you can think of that will make the process a little bit easier for someone else.

To help, just go here:

http://www.jawsurgeryblog.com/forums/topic/help-future-jaw-surgery-patients

If you have any questions at all or trouble posting your story, just let me know, and I'll be glad to help you help others!

Thanks again,
Brandon

Anonymous said...

i dont understand, what happened to you? i have to get my bottom jaw lengthened and im kind of scared about it. i mean, im only 12. so i was wondering if you could help me through this.
please and thankyou verymuch ,
lola

Olive Tree said...

Hi, it's a very great blog.
I could tell how much efforts you've taken on it.
Keep doing!

maybe said...

I'm appreciate your writing skill.Please keep on working hard.^^

Cleo said...

Do you still check this blog? I would love to ask a few question because I have the exact same problems you had. If so, please email ryanvaughnmurray@gmail.com

Thanks so much

Dennis Wooden said...

Stephanie, Congratulations for the successful surgery and de-bracing. Effective dental treatment can really change the life of the patient. My sister also underwent a similar surgery last year. Dentists (Germantown) usually advice such procedures to correct the bite of the patient. Fortunately, it was able to resolve my sister's teeth alignment problems. The dentist (Germantown, TN) had been thorough and he did a lot of assessments to know the type response needed for her case.

Great pictures by the way. Hope everything goes well.

Wilton Winrow said...

Hi Steph!

I was scheduled next week for a tooth extraction, because my wisdom tooth is really needs to be pulled out. I'm a bit nervous because someone told me that after the extraction, I'd feel pain. I trust my dentist (Miami Florida-based) that he will do a great job for it because my mom knows him since last year. While reading your blog, I've gained the strength to face this procedure.

Dr. Ordon plastic surgeon said...

You teeth look very fine now.Surgeries go on very well when you can spot the right surgeon who can take you through the highway which is not always easy for all.

Weekly Horoscope said...

Hi. I don't know if you continue reading the comments..But i would ask you one question. why doctors removed one of your titanium plates after surgery? Sorry, I didn't read all your blog posts and only watched that you got one of them removed.
I ask you this because I'm getting surgery this year and I'm a bit concerned because I don't like pretty much the idea of having LOT of plates and screw in my face for the rest of my life. So I would love knowing more about your plate removal causes and if the 39 srews and 7 plates annoy you in any sense or are just imperceptible.
Thank you and I hope you read this
Best of luck!

Grace said...

I think I had the same thing you did. Lefort 1 and BSSO, similar problems of extreme overbite, and none of my upper teeth mashed with my lower teeth, had trouble cutting food w/ my incisors and my molars were all super jagged b/c they never ground against the opposites.
I had my operation in April 2008, so I think 6 yrs to the day today! Braces off by Oct. 2008 and it's been so much better. I also had a plate removed June 2009, from my lower jaw, left side. Mostly b/c it was the one part that was painful (and pokey, b/c one of the screws seemed to have been pushed out a little bit).
I didn't document things nearly as well as others have, so I like to occasionally look at what others have done.

One thing about the "gummy smile." I didn't have a gummy smile at all before the operation, but somehow, now I do. I also noticed that the little flap of skin holding down the top of my upper lip/mouth to the top of my gums were cut during the operation, presumably for the Lefort 1. My mom asked me if I should get that reconstructed, and I just brushed it off as being overly sensitive about my looks...but have you heard of it? Does it bother you at all?

Lissa said...

Hiya Stephanie!!! You look awesome !
Please let me know if you still read this blog.... I have some questions for you. Thank you!