Bracing For Impact
A twenty-something's journey with braces
Thursday, April 9, 2009
I expected a quick visit, and it was. The biggest surprise was...Dr. D again! I swear I thought he retired. Anyway, the tech told him to "check for deband" and he spent a few long moments poking around my mouth and looking at stuff, and all the while I've got my fingers crossed and I'm hoping for the magic words. Finally he commented about the tiny triangular space between my front teeth and I explained it had always been there, I was used to it, didn't mind it, etc.
Dr. D: "Well, technically braces CAN correct that."
Me: "I really don't mind it."
Dr. D: "And we're on a deadline."
Dr. D (to tech): "All right, well, give her new chains and take impressions for the bonded lingual, and she can come back in 1-2 weeks for deband."
Me (internally): "w00t!!!!!!"
So she took my old powerchains off and then got the tray ready for my impression. It wasn't the same two-toned playdough they used on me way back when - this was some kind of powder mixed with water into a putty. I was seriously worried it was plaster, but it was gummy and tasted faintly/pleasantly of mint, and set up fairly quickly. Bits of it got stuck under my lower archwire - not a problem, since they only need the back surfaces to be perfect for fitting - and I had to go brush it out.
The tech told me my permanent (lingual) bonded retainer would be a braided wire shaped to fit the back of my teeth, and anchored with spots of the same bonding cement that holds my current brackets to the front of my teeth. It will run from lower canine to lower canine, across 6 teeth total. Sounds pretty low profile. I'm prepared for it to irritate my tongue for a bit, and trap food, but I'm used to living with braces now so I don't think it will be a huge deal. I already own a waterpick, and (before the advent of the powerchains) I'd gotten pretty good at flossing around braces with no extra contraptions, so only having to mess with 6 should be cake.
Here are some pics from today:
My current smile.
Upper arch...now that it's rounded out, there aren't many other changes to note.
Lower arch...again, mostly the same. You can *kinda* tell the gap in my lower incisors has closed, but that's more obvious in the next pic...
This shows the detailing. The red line approximates the bends in my upper archwire, which are hidden behind the powerchain. Supposed to intrude the left lateral (on the right in this pic), extrude the right central, and really extrude the right lateral. My smile does look more even now that the bends have been working, and Dr. F will finish the job by shaping the edges of my teeth at deband.
Also, the gap in my lower incisors has FINALLY closed, as shown.
Funny story: I have the completely un-serious superstitious habit of making a wish when the clasp of my necklace reaches the pendant. Today it happened on my way into the appointment, and I thought a moment before wishing to "get my braces off in three weeks," hoping it wouldn't be 4 or more, or worse - needing another check before setting the date. Color me surprised when Dr. D said "1-2 weeks" and I fairly skipped up to the receptionist to schedule my freedom.
She had me all set for 2 weeks out, on a Wednesday, and told me it would take about an hour. "Even with bonding my lingual retainer?" I asked... She frowned, went and asked, and came back with the answer that they didn't have a long enough appointment slot for all that, which would actually take more like an hour and a half. First they'll bond my permanent retainer, then they'll remove my braces, then Dr. F will shape my teeth, and then they'll take impressions for my vacu-formed (aka clear, Essix-type) retainers. Lots going on that day.
After some pecking on the computer she found a slot for me: on Thursday, April 30th...one day before Dr. F's target date of May 1, and EXACTLY 3 WEEKS from today. Heh - be careful what you wish for!
But no matter what - I'm thrilled. April 30th will be MY LAST DAY IN BRACES. w00t!!!
(I will probably keep blogging, at least for a bit: life with retainers, follow-up appointments, etc. So stay tuned.)
Sunday, April 5, 2009
I'd made good progress and the gap in my lower arch had finally closed, so Dr. F said he would make the bends in my archwire to start detailing, putting me in Phase IV at last! He also said something I had to ask him to repeat to make sure I heard correctly: "Next appointment, check for deband!" which translates to "At your next appointment, if the detailing is doing what it should and it looks like another few weeks will be all that's needed, we will schedule your debanding date."
He said his target date was May 1st (!) - about a month earlier than I strictly NEED them off, but that gives him some leeway in case anything takes longer than expected. So at my next appointment we should know for sure, but he expects to give me a date at that time. WOOHOOO!!! My freedom is so close I can almost taste it.
The detailing he did was pretty simple - just a couple bends around my right central incisor to "extrude" (bring it down) a bit so he can smooth it off even with the left one.
Only I misheard him, and thought he was extruding my "short" right lateral incisor. A few days later I called in a panic, visions of delaying my deband dancing through my head. They brought me back in for him to look at and I felt very foolish when he explained that's what he'd meant all along. BUT I did talk to him about my lateral incisors being different lengths and how that made it look (to me) tilted, so he decided to put a few more bends in to extrude the short right one a bit, and intrude the longer left one. My upper archwire is a .019 x .025 TMA. At the next appointment he'll smooth off the edges of my teeth to make them look straight and even.
I left happy, especially because I also taked to them about retainers and got the news that since I wanted a permanent bonded retainer on my lowers - which they only agreed to if I SWORE to floss regularly - I'd get the clear plastic "Essix" retainers for both arches, instead of the plastic-and-wire Hawley on the bottom. They'll take impressions for the bonded retainer at my next appointment, so they can have it ready to bond before my braces come off on deband day. I can't believe it's this close!
I don't have pics this time, but I'll likely post them after the next adjustment; I expect they won't change much. Coming up soon on April 9th.
Both the hygenist and dentist commented on how well I had been keeping everything clean. No redness, bleeding, or signs of gingivitis (a problem of mine even before the braces)! I admitted to not flossing often since getting the powerchains on - it's almost impossible - but said my "best" routine was to waterpick, then brush with my Oral-B Triumph electric toothbrush, then rinse with Crest Pro-Health (spearmint flavor), and use an interdental brush to get all the "stringys" left behind after the mouthwash. That seemed to meet with their approval.
New wires at the orthos, and finally the light at the end of the tunnel became visible. They moved me into Phase III with Stainless Steel .019 x .025 on top and .016 x .025 on the bottom. Both powerchains remained, and I was told they likely would stay until the end of my treatment. I resigned myself to it; I have a goal after all. Plus the gap on the bottom was still there. The good news was they put the lower powerchain around my back brackets instead of the hook, so the food-trap triangle was gone.
Some pics for your viewing pleasure:
Braced smile, 13 months in. Everything's starting to look rounded out and even, though the upper arch looks a little off-level due to my lateral incisors being different lengths.
Teeth "bared" to show my lowers. Notice there is STILL a gap down there, though by this point it does look smaller. You can also see both of my powerchains in this pic. Notice the lower powerchain is BELOW the archwire. That's something to do with needing more expansion or not, but by this point it didn't really matter for my case, and at the end of this appointment they put it back on over top of the archwire. Actually made it easier to clean.
Appointments down to 3-week separation now; next one scheduled for March 19th.
Same wires, same drill as before. I DID get to brush and floss with powerchain and wires off, my usual habit, and in so doing noticed a fair bit of separation - not quite enough to call "gaps" - between my upper teeth. Worried the Big Gap would open again, I winced and asked - ASKED! - for the upper powerchain back. Dr. F smiled a little smugly and agreed. I had them top and bottom now.
The tech did something a little different when she put the lower chain on - instead of encircling the back bracket with the loop, as had been done before, she hooked it over the elastics hook on the bracket. That formed a little triangle between the wire, the bracket/hook, and the powerchain. (I found out later that this was the WORST situation for gomming up food chunks. I was always poking at it with my tongue, trying to dislodge something. Bleh.)
On a more positive note, my (new) upper powerchain didn't go all the way from back molar to back molar; they only ran it to my premolars. Which made it ever so slightly EASIER to clean. Lose some, win some, I guess.
When I was done, I bounced back and forth between my ortho and my dentist's office, setting up the big day of both my next adjustment AND my semi-annual cleaning, February 26th - a scant 3 weeks away.
My braced smile. Notice there is no gap between my central upper incisors; it closed pretty quickly with the powerchain on.
Upper arch - nice and rounded at last!
Lower arch - SO much better than it ever had been.
Some nice side-by side comparisons. All that progress in not quite a year...
The gap in my upper arch was gone, but this rather noticeable separation had developed on the lower. I knew what was in store...
My last adjustment of 2008 was pretty straightforward. I saw Dr. F again, and he left in the wires from the previous time. Still .018 x .025 on top and .017 x .025 (reverse curve) on the bottom. As I had suspected - and actually hoped - they put a powerchain on my lower arch to close the new gap. I asked, and was dubiously granted, freedom from my upper powerchain for the reason that the big gap had closed, and I was fond of the small triangle left between my front teeth. To close it completely would eliminate a lifetime's worth of sucking air through it when I was nervous or concentrating on something. *g*
I also talked with Dr. F about my accelerated schedule, an agreement I'd actually come to with Dr. D before he retired. Dr. F could make no promises - and I couldn't expect him to - but said he'd try to have me out by May. I told him I'd rather be in a little bit of pain, if necessary, and move things quicker.
From this point, the pace of adjustments was to pick up. My next was scheduled for February 4th, just over a month away.
Saturday, April 4, 2009
So. I had my next adjustment on November 20th, exactly 1 week before Thanksgiving here in the States. No coincidence: I wanted any possible tenderness to have worn off before the Big Dinner. (Or in our case, the Big Three Dinners - several sides of the family to visit!)
The adjustment went well, and I learned to my surprise that Dr. D - whom I had been seeing and whom I had finally gotten used to/developed a rapport with - was retiring in the immediate future and I would henceforward be seeing Dr. F again. Fine by me; I liked Dr. F from the get-go.
I got two new wires this time - big ones. A .018 x .025 (I think) on top and a reverse-curve (to open up my bite the last little bit, or so I was told) .017 x.025 on the bottom. Both the next step up in Phase II.
I also got that wonderful invention: a powerchain.
I had developed a Letterman-esqe gap between my front central incisors since my last adjustment, and this went way beyond the little triangle I was used to sucking air through. (Forgot to take pics this time, sorry!) I wanted it closed as much as they did, so I didn't protest the addition.
My ortho's office only uses silver powerchains, which I didn't mind, but which DID make my braces all that more noticable, completely covering my tiny looking half-clear upper brackets with opacity. Ah, well. I'm used to seeing braces in my mouth by now, and completely unself-conscious about it.
The bigger issue I had with the powerchains was cleanliness. Let me tell you now - say what you will about friction and speed and pain (or lack thereof) - all selling points of the system - but Damons are worth it to me for how easy they are to keep clean. The powerchain caught every last piece of gunk and plaque that I had been spoiled by not having to deal with previously. A little extra waterpicking and interdental brushing took care of the problem, but within a week my gap had closed and I was ready to have the thing off. Too bad my next appointment wasn't until New Years Eve...
Friday, October 3, 2008
It’s now been a week since my last adjustment, and things are finally back to normal. The tech wasn’t kidding when she said that would be a hard “jump” – within 24 hours my teeth HURT. I had trouble biting/chewing soft cheese pizza Thursday night. This is the first adjustment that has made me feel like I did when I first got the braces on.
I probably spent 3 days reverted back to my post-B-day routine of soft foods cut up with a knife and fork. But since then things have improved, and I’m back to eating pretty much normally, including some stuff – like nuts and crunchy things – I probably shouldn’t. (Shhhhh…I am very careful when I do that, I should point out.)
And I’m also getting used to having an actual BITE again, instead of two touch-points (the turbos). Even though my teeth meet now, it doesn’t feel like they’re quite *perfectly* lined up. But I imagine as I continue in braces that will improve, and I read on another braces blog [link] about a “bite adjustment” that involved shaving the points of the teeth down to improve alignment. I think that would really help me. We’ll see if I still need it in a few months.I do wonder… There are no brackets on my very back teeth (second molars). My impression going into this was that they eventually be bonded and added into the “chain” so to speak. But no one’s said anything about that lately, and as my arches round out and things line up, they are starting to look obviously off-kilter. Am I ever going to get those bonded?
Thursday, September 25, 2008
So…I never made it back around to update on my 3rd adjustment in July. My internet access has been extremely restricted since the beginning of the summer, and my previously linked-in life was dropped off on the side of the information superhighway and left to forlornly thumb for rides from the few evening hours I get on my computer (after the toddler goes to bed) when I’m not writing the novel, and/or the odd wifi network I can patch into on my iPod Touch. But I digress.There wasn’t much to report on in July. I did finally get a new wire on the bottom, to match the .018 on my top arch. But that was about it. Turbos stayed on; elastic hook stayed on (despite me not wearing elastics anymore). The only real interesting bit was that I had to go back the next week, because the ortho (Dr. D again) forgot to crimp my wire stops on the bottom and the whole archwire was sliding sideways to really jab the back of my cheeks. Fun times.
But! In the 2 months since then I’ve seen a lot of progress. My lower arch finally leveled and evened out. And my back molars were starting to touch. So I went into today’s appointment with high hopes.
Alas, even though I called yesterday and asked specifically to see him, Dr. F was nowhere to be found today. I saw Dr. D once more, but he’s still pretty cool and the adjustment went so well (even allowing for a few hiccups) I wasn’t much fussed about it.
I took the time yesterday to write up a list of what I wanted to happen:
1. Turbos off
2. New wires (top and bottom)
3. Hook off
Imagine my joy and surprise to get all three of my wishes granted! Dr. D took a look and said I’d definitely get new wires, then agreed to reduce my turbos bit by bit and see if I could get away with not having them. When I asked about the hook, he looked closely at my bite and told the tech to take it off as well.
I asked for and got the chance to floss wire-free and then 2 new archwires – more on that in a bit – and 1 removed hook later, Dr. D took the grinder to my turbos. (Which, I should add, have worn the points off my lower canines – see pic below.) He’d ask me to close every once in a while and at length he decided to take them off completely. Woohoo!
My new wires are the rectangular .014 x .025 listed as the “workhorse of Phase II” on the Damon archwire sequencing page. I’m glad to finally be out of Phase I and into the major mechanics.
The tech warned me that most people thought this jump was the hardest, and I’m starting to see why. My teeth have been sensitive all day, even with the pre-emptive ibuprofen I took right after the adjustment. I can FINALLY actually chew with my back teeth again, now the turbos are off, but they’re so tender I’m still not quite back to normal yet. Hopefully in a few days.
I spent several minutes checking my teeth and wires for anything amiss before I left, scheduled my next appointment for November 20th (the week before Thanksgiving here in the US) and got all the way back across town to my office before I realized something was snagging the inside of my lower lip. “It’s almost like one of my doors is still open…” I thought, and pulled the mirror out of my handy-dandy DentaKit.
Yeah. It was.
No amount of careful pushing and pinching on my part would close it, and I was terrified I would pop the bracket if I tried any harder, so BACK in my car and BACK across town to the ortho’s office and they took me right back to close it. It took 2 techs and quite a bit of pushing on my poor, loose, sensitive teeth before the darn thing finally closed. I thanked the ladies and decided to stop by the restroom on my way out.
While I was washing my hands, I decided to really look over everything again before I left the building. And guess what? I found not one but TWO other open doors. I really think that because of the new thick wire, they didn’t quite get all the way closed and then came open in the car between the ortho’s office and mine. So BACK into the office I went, and the poor tech apologized all over herself and got them both closed and I got back to work just in time to get a few things done before lunch.
Moral of the story(s): check for poky wires and open doors before you leave the ortho’s office! Every time!
Here are some more progress pics. I’ve come quite a ways in 9 months!
Upper arch - no turbos or elastics! Happy day!
Lower arch. Wow...just wow.
My current smile, with my own, actual, honest-to-God bite.
Compare to the pics in this post and see the difference!
So…8 more weeks until my next adjustment and (presumably) next set of wires. I need to find time to talk to one of the orthos about timing…I realized that I have both an oral board exam (big hairy deal in my profession) and my 10-year high school reunion in/around late May of next year. As much as I like the Damons and don’t mind them day-to-day, I’d really rather not be in braces for either of those events. So I want to explore the possibility of moving to Invisalign for the last few months if it looks like I won’t be out in time. Though Dr. D has said I was progressing really well and might get done early. *crossing fingers* I guess we’ll see.
Saturday, July 12, 2008
It's a "word cloud" created for this blog. I dunno, I thought it was cute.
Next week is my "big" adjustment/cleaning day. It's next Thursday, the 17th. First to ortho for wires out, then next door to dentist for semi-annual cleaning, then back to ortho for 6-month adjustment. Please, please, please, let them finally put a new archwire on the bottom. Turbos off would be nice, too, but I'm not holding my breath on that one.
I'll try to post an update shortly thereafter, but a lot depends on the rest of my schedule.
Those of you who left comments, I *will* respond, probably in next week's post. Life has been hectic lately!
ETA: I just looked again at the pics from my last appointment, and there has been progress on the bottom! Oh, I hope they change that archwire...
Wednesday, June 18, 2008
But last Monday, the 9th, I was in my ortho's office for yet another "emergency" adjustment. This time it was because my left central incisor was biting down on the bracket below it:
(Yeah, *major* leveling to be done on the bottom there...)
Truth be told, I was only slightly worried about the contact. But it seemed like a valid excuse for me to get them to address my bigger concern: the turbo.
I've gotten used to the turbo, but my lower arch is still offset to the right and I was becoming increasingly convinced that it was the downward/outward pressure of the turbo in that area that was keeping it pushed out a bit.
Of course, there's no turbo on the side that was now in contact, so I figured they'd at least add another one on the left side (yay, symmetry!) if not remove the previous and put one on the left instead.
Sure enough, the tech told me the new protocol was to place *2* turbos - one on each side. (Wish they'd thought of that a month ago!) I saw yet another ortho in the office - this time Dr. T - who recommended they place another buildup of BluGloo on my left upper canine instead of a turbo:
I'm actually okay with this. I did raise my concerns about the asymmetry in my lower arch and the turbo's contribution. Dr. T assured me this would correct very quickly as soon as the turbo was removed. "When will that be?" ... "When your back molars touch without your top teeth hitting the lower brackets."
Hmmm. At this rate, not looking to get the props off by my next adjustment (July 17th - also cleaning day). Bummer.
In a twist of good timing, a commenter (*waves to commenter*) asked me how I felt about turbos vs. the buildups. Here's my take:
If given a choice, I'd choose the buildups. They don't prop my bite open quite as far (so fewer chewing issues), they're smoother and generally less intrusive. The downside: more stress and sensitivity on those teeth, kinda like wearing high heeled shoes - all that force concentrated on a small area. But that goes away after a while.
HOWEVER, I'm really okay with the turbo now. It did take a bit of getting used to, mainly because scraping my bottom teeth on it felt like fingernails on a chalkboard (in my mouth) but once my body got used to it being there it effectively "went away". I haven't had any problems with tongue irritation or lisps, though I did lick it compulsively for the first few days. My biggest beef is the deformation it's causing in my arches, but Dr. T seemed confident that was merely transient.
Hope this helps. It's kinda cool to know actual people are out there reading this, even if most of my hits are still for the Aquafresh White Trays review.
Until next month...