Another picture while I'm at it

I can't juggle loads of pictures in one post. It's a nightmare, as you can probably tell from the last post!

Just thought I'd add one more of my bottom arch too, for comparison

I'm waiting for a gap to close right now on my upper arch on the left. I'll try and get a picture of the gap and post it. It's moved quite a lot now I have springs on, however the rest of my teeth need to move as well in order to 'redistribute the space', as my ortho would say, because the gap closing at one side is creating another gap from next tooth on at the other side! Honestly....

Picture updates (yikes)

Now I’ve caught up as much as I can with what’s gone before, might as well post some new updates as to the progression of my teeth now. I haven't taken many pictures, and they're only off my phone so sorry if they aren't totally clear, but I think you can see the differences at least.
Here are my teeth now, compared to how they started:

(taken end of 07 before treatment)

During the expansion starting from mid November 07.

The one of the right shows how narrow my upper palate was to start with.

My arch as of 22nd July, 2009. Hope you can see around a 10mm difference!!!

Now my teeth and palate are as they should be, this has made my underbite more prominent and worsened my open bite and cross bite. This is just how it goes, because obviously before my upper jaw wasn't big enough so obviously that lessens the true extent of the problem. Once your teeth are finally perfectly alligned- that's when you are ready to correct the true problem! Eating is a problem, but you just have to get on with it. And if anyone ever queries me undergoing the surgeries I would just say why don't you try trying to eat with a bite like this! lol :

Open bite above,

underbite below

That's all for now :D

Thanks, and apologies for the odd text wraps around the pics. I'll get used to it eventually!

We Need to Talk About Our Feelings

I’ve been putting off writing this because I always worry I will sound like I need to get over myself, but after a discussion I had on the Metal Mouth Message Board : (http://www.archwired.com/phpbb2/index.php- which is great) with someone I felt obliged to say how I feel about the whole issue of whether this is cosmetic vs. necessity. Basically their point was how is having your jaw/s altered in order to ‘better your appearance’ any different than having your hair straightened because you don’t like your curly hair. They said it was difficult to say, but I totally disagree!
Okay, there is no denying that a malocclusion is going to give you some, well, mal side-effects. By this I’m talking about self-esteem issues, confidence and overall self-perception. I’m not going to talk too much about my personal issues, but let’s just say I do have problems with all of the above.
But the main thing that I think it is important for everyone to know though, is that in terms of vanity, in most of our cases any opinion of our appearance and hope that it might be improved is just a by-product of the underlying fact that an abnormal jaw is just that; an abnormality.

Obviously this is going to have numerous adverse effects on many things- both externally (appearance wise) and internally (about the function of our bites and trouble breathing). I would say it would be a very minor malocclusion for a person to only have a problem with the way they look and no other issues relating to their bite, breathing or TMJ (joint and ear pain). In that case it can be viewed as just a cosmetic thing due to vanity. However in the majority of cases where the problem is bad enough, I think any issues we have about our appearance are totally justified. It’s not about seeking perfection, but seeking normality. If it ain’t broke then don’t fix it; but if it is, then do.

Next important thing to consider is that if it is true that the majority of us considering having or actually are having oral surgery will have a problem bad enough, then problems with appearance and functionality will be interlinked, not separate . By that I mean if you have one you will most likely have the other. The main difference between us all then, is simply how we deal with them. For some of us, the problem with appearance manifests itself into low confidence, little self-esteem and a generally bad self-perception. And it’s not easy to just undo these feelings. For others, this isn’t such a huge downer and it doesn’t affect their character. Could I be presumptuous and say that those of us having the treatment during their teens feel this the worst? Not just because we’re moaning teenagers with so many ‘issues’ (!) but because this means that for most of us it has been a case of knowing we need the surgery from a young age, but having to wait until we have stopped growing to have it done. The older ones among us have led their lives without the thought of jaw surgery on their minds, and without necessarily having to wait for it, but choosing to go through with it in their own time later in life, so the effects of their malocclusions have remained rather dormant in their minds, rather than manifesting like in our minds. Is that a fair assumption?

- This is sounding a bit like a bloody thesis, so I hope I’m not boring anyone, lol. I just think it’s important to think about, especially when people don’t understand what you’re trying to get through to them. Anyway...

Additionally we’ve all grown up with misaligned jaws –and consequently breathing issues and eating problems. So to us this is just natural. We have adapted our bites. You become habituated to it, and cope with it, and so is this going to be the main issue on our minds? Can the same be done about the way we feel about our appearance? The difference is that this is constant, as you can’t escape seeing yourself one way or another every day. So you focus on the way you look most of all. And so maybe people who think they are only having this done for cosmetic reasons fail to realise that they do have other issues because of their malocclusion, it’s just that they don’t register it. Either way what I’m saying is it’s hard to have one problem without the other; if you have a malocclusion chances are you’re going to have bad functionality as well as a problem with your appearance (among other things).

And at the end of the day it’s not vanity to want a ‘normal’ jaw. Everyone else has one, right?

Tips for SARME/SARPE Victims

Just thought I’d re-visit the SARME surgery again to write a few pointers about what to expect with the surgery, and importantly how to cope with the expander in your mouth.

First thing is this- the expander takes a while to get used to. Some people get their expander put in a week or even a few weeks before the actual surgery, however I got mine in the day before. Perhaps you could argue that having it for a while before the surgery helps you get used to it, but it’s better to have your diet messed up because of the surgery and not for a few weeks prior because of the expander, right? So I would say either way it doesn’t matter, but maybe you’ve lucked out by having it in for only a matter of hours before your surgery.

Anyway once I got the expander I was straight in to claim my bed at the hospital (why I couldn’t just go in on the morning of the surgery I don’t know) so I had a sandwich with me and tried to eat it right after the expander fitting. And I just couldn’t. It felt like I couldn’t chew, my tongue didn’t know where to go or what to do with this big hunk of plastic blocking its natural movement. So I thought great, I’m going to be starving all day and have to get soup or something at the hospital (I loathe soup- which incidentally doesn’t bode well for when I will be having the bimax surgery and I’ll be eating only food with a soup-type consistency). So, eating just feels so wrong and abnormal at first; this is because your tongue needs to get used to its new restricted area of movement.

Eating With the Expander After Surgery:
Always listen to what your surgeon tells you over anything else. If you aren’t allowed to chew, then don’t. That being said, my surgeon told me I could eat whatever so long as I felt I could. I didn’t push it, but after say day 2 I found I could eat pretty normally and didn’t just need soft foods. I wasn’t really in pain and my jaw felt stable, so it really wasn’t an issue. And if this is the case for you I don’t see why you can’t give eating your normal foods a go as soon as you can. Especially for those of us who are having second surgeries- let’s keep some of the liquid diet fun for that and not waste it on SARME :P

Keeping a Clean Mouth:
Food getting stuck in the expander was such a pain. Here are some basic ideas to help. It’s not always a nice picture, but if food gets stuck you need to un-stick it! :

• Swill your mouth with water at the end of everything you eat and during a meal if you feel a build-up of clog coming up. Swill fairly rapidly to blast the food out.
• Use a thicker type of interdental brush to push it through the gap between your palate and the expander to push out any clogs and to reach some of the trickier areas around the molars or other teeth
• Get a syringe or something along those lines (I’ve heard of waterpiks, however I don’t own one so perhaps this is similar), fill it with some water and have a squirt around. Then fill it with mouthwash and repeat to really keep your mouth fresh. My ortho gave me mine, so perhaps ask yours
• If you really hate getting things stuck in the expander keep clear of flaky fish or tinned fish like tuna, and things like beans. They are real buggers to get out because one can get lodged somewhere without you noticing and it gets wedged in so you can’t poke it out.

Talking with the Expander:
Sadly talking with an expander in is never 100%. Talking will certainly improve after a while as to what it was like when you first got it fitted, however I think you will find some words or sounds very difficult to properly enunciate. I had trouble with the k, q, and s sounds. You might come across other problems. You’ll get used to it after a while, but talking won’t be 100% normal until you have the expander removed.

Bridging the Gap:
Aah, the gap, it’s quite awesome really. Not really much you can do about it except embrace it. If people know what you’ve had done they won’t much care about your gap, and won’t really pay too much attention to it.
Things to do with your gap:

• Pretend to be Cletus from The Simpsons
• Use it to hold a straw when you have a drink
• Make a fake tooth out of dental wax and pretend to knock out your tooth to scare someone and/or pretend they have knocked out your tooth and get them to give you a gift as an apology
• Drop said fake tooth into a family members drink or dinner, wait for them to discover it and then say ‘Oh that’s where my tooth is, I thought I’d swallowed it when it came out. Sorry’

Well not really! You just need to live with it until it closes. Not much else!

Back to the Future

So back to now (I think, anyway- the films always confused me)- Back to the big one- the bimax. SARME was all well and good, and my teeth are looking good now, but I always saw that as just another stepping stone to the real thing.
In Jan or Feb this year, I had an appt with my ortho and she said we might be ready for surgery in around 6 months. Cue next appointment, which are approximately 8-10 weeks apart for me- she said the same thing. Cue 6 months later- she says the same thing. So what looked like a possible time for August became a possible time ‘in 6 months’ from...eternity. Now you see why I’m sometimes I might be a little despondent and forlorn! But last appointment she estimated (6 months again) for December, and on my next appt which was last Wednesday she again said December. So I’m tentatively going to hope for a December surgery. It’s pushing the boundaries of a 2009 surgery, but by God if it’s not I will be extremely disappointed. Even thinking about a possible set-back at this stage makes me quite teary-eyed I have to be honest. I hope I don’t seem melodramatic, but, you know....

Anyway to brighten things up for me a bit, the past week has been quite good. At the last appointment she put on some steel wires (I perhaps heard ‘no. 19’ size, but then I wouldn’t know what that means anyway) and said these were my final wires, and that at the next appointment which will be September 9th she will take new moulds of my teeth. I think this bodes well for a surgery date this year, at least! She was showing her assistant my old moulds and my bite as it is now and they both agreed that 1) my teeth look great now (why thank you) and 2) I will have fantastic results in the end (but when is the end?!?! ).
Next bit of good news needs me to go back in time again- at the start of all this my upper jaw was so crowded my canines sat above the arch (see pictures in the previous post). After SARME and a few months of braces my canines had moved back down into their right spots thereabouts, however my left canine did not fill the gap the was left for it after I had had two extractions (the 2 teeth next to the canines- are they lateral incisors?). My right one moved very quickly, but still, for close to a year in braces, the left one lay dormant. My ortho said she needed to ‘redistribute the space’ in order for the gap to close, but as of my last appointment she hadn’t done anything to start this process. So now she put on some springs on both sides of my mouth, and yesterday, oh yes- HALLELUJAH THE LITTLE BUGGER HAS MOVED. Only a teeny amount, but wow; amazing. Thank God for these horrible springs! So I hope this progress continues. My next appointment is scheduled in 10 weeks, so it has time to.

So happy days. Progress finally. Let’s keep it up.

The Turn of the Screw

My recovery was pretty normal I would say. I was very swollen, but could eat near to normally after only a couple of days so I never had the experience of having to have a fork-smash or liquid diet like some people do need to do with this surgery (and of course most definately is the case with the more intrusive Le Forts and BSSOs).

The problem for me was the anaesthesia, as I was pretty weak and out of it for at least a week. I felt back to normal after 2 weeks, however the next week I ended up with flu so that didn't help things. But I got on with it and it wasn't too big a deal. i was just happy I'd had the surgery at last.

Also my issue was with turning the expander. I simply could not turn it myself. Those who do manage to- you are fantastic and I bow to you. Really, it was impossible for me! So I got my mum to do it for me, but she was scared it would hurt me and in the end couldn't turn it completely correct. So we had to go get a masterclass from my ortho a few days later. After that she did it fine. All in all I expanded around 10mm, turning twice a day. The expansion hurt a couple of times, but only briefly. The only real pain I remember from it all was a few weeks afterwards in the middle of 2 consecutive nights where my entire gumline was just burning. Thankfully it only lasted 2 nights, but it always seems worse at night because if you can't sleep, you can't do anything except think about the pain.

I've found out some old pics pre-surgery and braces, that I have to say I'm pretty shocked at now! At my last appt my ortho showed me my old moulds too and I can't believe the difference. In terms of my teeth being straight, my only problem was with my upper jaw and my 'fangs'- otherwise I'm not really in this for perfect straight teeth (I am a Brit, you know...) because it doesn't bother me so long as they are healthy. But hey I'm not complaining about having straight teeth anyway! Maybe I will move to Hollywood when this is all over....


Anyway this is around the end of 2007:


As you can see, my fangs were pretty awful. My upper jaw was very small, and my lowers were also relatively crowded.
The below pic was taken a few months ago, and it's the only one I have currently, but you can see the difference quite clearly in my upper jaw:

The difference is seems so unreal to me, and it's actually great to look back now and think wow, that went quick, though in reality I've been braces for over a year now, so it's a good job there is such a huge difference! lol

Back to 2007...

So I knew I would need these surgeries for a long time, and finally at the end of 2007 I was 'ready' to get the expansion surgery. It was pretty much a rush job getting scheduled, and I with a few days to go before I had it done I still didn't know what hospital I was going to lol. Well we figured it out eventually...
The day before the surgery as the day I had to go claim my bed at the hospital. It seemed pretty pointless and weird having to stay overnight when I was perfectly fine and normal, but I suppose they wanted me there in good time (maybe this is a UK thing? because I know a lot of people in the US get SARME and then leave the same day). It was a pain though, because in the morning I had to go and get my expander fitted by my ortho at my local hospital where the clinic is, but my surgery was being conducted at a different hospital, so straight after I had the expander in we were off to the next one. Also what needs noting is that beforehand I had an appt to see if the expander would fit my mouth. It didn't.

Now the thing with my ortho is that she is very persistent and tenacious, so even though it didn't fit she was going to make it fit. The worst thing with appliance fittings- and which I'm sure those with braces will know- is that you have to bite down on a stick thingy yourself to push the appliance onto your molars securely- so not only was she forcing this thing into my mouth and causing me pain, but I had to inflict it on myself to try and push it in place. Maybe sadism is a require qualification in order to be a dentist/orthodontist? Anyway she finally decided the expander didn't was too small and I needed another mould taking, so I left in pain, slightly bleeding and dreading round 2 and the next expander. Thankfully next time the lab technicians or whoeer got the size right, and it fit perfectly.

The expander was horrible at first, and even a measly sandwiche thwarted my attempts to eat properly. At that point I was actually glad I would be staying at the hospital because I had an excuse not to eat their food (I actually ended up having pea soup, but it was really just warm water in a cup with a pea floating in it....good old NHS :D)! I wasn't nervous about the surgery in fact I was pretty excited, but it was boring waiting for tomorrow because I was in a ward alone. There was an old woman with me for a while, who only had about 8 fingers (though maybe she just had arthritis...my memory is distorted somewhat now!), who came in because her nose wouldn't stop bleeding. At one point her nose started bleeding uncontrollably again, and because she was fingerless or had lost the use of some of them, I pressed the buzzer thing to call a nurse to come. About 3 came and all gathered around me, but I swiftly told them I was fine (I was just some girl crashing in a hospital at this point, afterall- though to be fair the expander made me sound rather odd) and they went and saw to her. She was fine eventually and she could go home. The ambulance guy who came for her kindly asked me if I wanted something from the vending machine, but I told him I couldn't eat anything, but thanks. To him I was just some normal girl crashing in a hospital too, and he didn't know i had the expander in, so I hope he wasn't too hurt by my refusal, but he'll live.

So the next day I was looking forward to going down to surgery. That morning the ward filled up (it had 4 beds), and they all got their surgeries before me! I was like hello, I'm pretty sure I bagseyd first spot when I got here at 3:00pm yesterday! But hey, I'm not the selfish type. Turns out one of the women came from the same town as me, and I've seen her a few times afterwards round and about. Small world!

So finally it's my turn, and when I'm being wheeled down to surgery I finally start to get a little nervous. I remember the anaesthetist not being able to get the vein in my right hand (because I have 'delicate veins', apparantly) so I ended up with two bruised hands getting it right, but that wasn't exactly the most important thing on my mind. I drifted off, then suddenly it was over.

I wasn't in pain, but I the anaesthetic really did me in. It was probably the worst thing about it, really. I stayed for the night, then the next day I had to wait for my perscription which took pretty much the whole day. While I was waiting to go home I wasn't told whether my mum or dad had rung, or what was happening. They let me ring them but of course I could barely talk, and I started to cry (aaaww). Turns out they'd been ringing all day but the nurses said I couldn't go until I got my perscription. Eventually things were sorted out and they came and got me.

Next post: recovery and turning the expander

Toodles xXxXx

A Little Late on the Uptake...

I'm not new to the game, in fact I started my 'journey' in November 2007. But I've decided to start a blog now because I'm at the point where I need some motivation- and to keep motivated- as I wait for the big one (that is, the bixmaxillary osteotomy to correct my underbite, among other things). I think it's because I'm getting a bit down about the whole thing lately; I've felt like I'm just waiting endlessly but nothing is happening, and I want to have some form of activity related to the whole thing, even if it is just me blogging about how nothing is happening!

The thing is I've been told from about the age of 13 by my dentist that at some point when I've stopped growing I would need jaw surgery. So since then I've waited and waited until 2007, at 17 when I suppose I did eventually stop growing) when we got the ball rolling and I had SARME (surgically assisted rapid maxillary expansion, to widen my upper jaw). Now I'm waiting and waiting until my teeth decide they want to move and give me a break. It's a bugger

And so I suppose I have a lot to update! For now I'll just post from my ticker-

* It has been 19 months, 2 weeks, and 4 days since I had SARME
...and 13 months, 2 weeks, and 6 days since I was braced (upper and lower at the same time)

For my next trick, I'll time-travel next post to talk about when I had SARME, and all what's happened inbetween

Toodles, xXxXx