1 year post-op!

Hi everyone,
Exactly one year and a day ago I was in the operating room having my face broken apart and put back together again.  Everything jaw-wise is great.  Right after my braces were taken off my jaw was clicking like crazy and I was wearing my retainers 24 hrs a day.  After a few months, I switched to wearing them only at night which I still do now.  It took a little while for my teeth to "settle" for the small gaps to close in the back.  Some of my contacts are still a little loose but I'm not too upset about it. My front tooth is temporized right now and I'm working on getting the final crown I attached a picture of what it looks like underneath, snagletooth!!

Annoyances:
-In terms of numbness I have about 60% feeling on my right chin and lip and probably 90% on the left side. The day after my surgery I was completely numb on my right chin and left cheek, so I have come a long way! I'm not expecting that I will have any additional feeling return but I am pretty used to how things are now.

-I cannot breathe as well as I used to on the right side of my nose. When completely clear, air goes through it but it feels like something is blocking half the air.
Here are some recent pictures:

braces free!

3rd week post-op visit

Hi everyone,
Just a quick post.   This past Wednesday I had my 3 wk post-op visit.  Doctors were happy with everything.  They tested my numbness which is about the same.  I still have swelling even though it's kind of uneven ("no one swells evenly" lol).  They did not put me in any guiding elastics.  My surgeon told me I can start chewing my food, yay!  Anything that is really soft and can be cut with the side of a fork I'm allowed to eat.  I left before they could take any more of my stitches out but ended up stopping back there on Friday to get them out.  The inside of my mouth is so much happier without those things in there!  Some were getting really long and stringy-yuck.

The other big thing they did was give me stretching exercises.  The exercises consist of stacking enough tongue depressors and putting them between my posterior teeth unilaterally so that I open all the way comfortably.  Then I take two more tongue depressors and wedge them into the stack one at a time until I'm open a little more (this is uncomfortable, ouchy).  Then I stay like that for 5 minutes.  I do this 4 times a day and it is really helping!  Being the dorky dental student that I am, I've been measuring how much I can open each morning and I've been noticing an increase of about 1mm a day (I'm up to 22mm!).  I've only added 1 tongue depressor to the stack so far but I can tell it's going in a little easier now so I can probably add another one tomorrow.

Other then during the exercises I have no pain, just numbness and tingling.

Laura

ps- wish me luck; I'm taking part II of my national board exam next week!  The exam is two days long and very scary! I've been studying for over a month so I hope I pass!

I'm happy Starbucks happy hour is only 2 hours away, caffeine!

unhappy I have to take this test, boo.

I sneezed

first time since before surgery.  my face didn't blow up.

on another note, I'm full time back at school and doing just fine with it.  It takes a little extra effort to eat a good breakfast and bring snacks/food for lunch but there is actually a good amount of food I can buy to eat (yogurt, soup, pasta, etc.)  

Its kinda funny to be back because I have to go to or through the oral surgery clinic a lot and I see my surgeons all the time haha.  3 week post op appointment is tomorrow.

still puffy, its going to take awhile for all of this residual swelling to go down.  

teefs

Look! I can purse my lips now!  couldn't do that very well a week ago.

p.s.- good luck lindsay on your surgery tomorrow! I'll be thinking of you.

yummy no chew food

I just ate by far the most delicious meal that I've had since getting my bands off:  Cheesy refried beans with guacamole on top! YUM!

I'd love suggestions on other yummy stuff!  I havent tried anything crazy like blending up a hamburger yet, but who knows how long I'll survive before doing that.  Anyone have favorite foods from before they could chew??

I've been striving for some variety in the food since eating blended soups gets so boring after awhile.  The refried beans were so easy.  I mashed up an avocado with a couple tablespoons of olive oil, lime juice, minced up cilantro, salt and pepper then let that sit and get happy in the fridge while I heated a can of traditional refried beans on the stove with salsa to soften them up a bit.  Once the beans were hot, plop the guac on top and there you go!  deliciousness on your plate.

Some other foods I've been eating:
breakfast foods

• scrambled eggs 
• oatmeal blended with milk to make it smaller
• juice 
• COFFEE MILKSHAKE!  This is so delicious- cooled down coffee, coffee ice cubes, vanilla ice cream and whole milk.  omg so good!

lunch/dinner

• soups
• overcooked mac 'n' cheese in fun shapes-  I ate this last night and struggled with it a bit but still managed to eat half the box (kind of a small serving for an adult).  I thought the shapes were good because they weren't very hard to mash on the top of my mouth with my tongue.

other

• fruit smoothies made with greek yogurt (lots of protein)
• applesauce (I got the kids' size gogo squeez packets)  for a quick snack
• ensure :(  even though its not that good for you it is just such an easy go-to food that I drink them when I need something quick
• fruit/vegetable juice from my juicer.  (Trying to sneak in some more nutrients)
• started taking multivitamin

on another random note:  I haven't sneezed or blown my nose since surgery.  Every time I feel like I need to sneeze I quick grab my saline nose spray and that makes it go away

here are some new pictures:

swelling is down, but definitely still have chubby cheeks

side profile, see all the swelling in my cheeks/ under my mandible?

top teeth are over the bottom!

second post-op appt, no more splint, no more bands!

Hi there!
Here is a video update about today:

I've slowly been returning to school doing random little things that couldn't wait.  I saw a patient yesterday while I was still banded shut and it went pretty well. I just said if you can't understand me I'll repeat myself or I'll write it down but we didn't really have any problems communicating.  My energy level is definitely returning.

At today's appointment they took the bands off and removed the splint.  I was nervous to open my mouth at first! It was so nice to finally brush my teeth.  Then they took out some of the stiches inside my mouth, I was really thankful that some of those areas were numb bc those stiches hurt coming out in the other areas that had feeling!  ouch.

day 8 updates- tequila sunrise and blenders

 Hi everyone,  Just thought I'd do a quick update with pictures, food info, and updates about pain.

Things that I've been eating recently that are good:
Greek yogurt thinned down with juice
soups blended with the immersion blender and strained
delicious homemade potato soup my mom made with milk and butter added! (strained)
boathouse farms drink (see picture below) + odwalla juice
ensure

About pain, I'm in very little pain, usually only when I wake up. I've been sleeping for 8 hrs a night which is wonderful, but the pain meds wear off by then.  I've only really been taking liquid ibuprofen for pain 400mg every 4-6hrs (two tabs worth) and that seems to nip it in the bud. A few times i've combined 400mg ibuprofen with 1/2 dose of percocet and some water to get it into the syringe and I call it my own tequila sunrise! lol

I have alot of numbness still and partial numbness in a lot of areas.  I get a lot of tingling sensations in my face, especially my chin, that feel like when your arm falls asleep and it regains feeling and it's almost like a squeezing sensation.

day 6

day 6

Day 7

Day 7

Day 8, mirror image from my webcam

Day 8

so many ways to blend/stain stuff

this is the best blender, wayy cheaper than a vitamix!

this drink tastes like a starbucks frappucino but has tons of added protein, and the  bottle with 4 servings costs less than a small frappucino!

video update, post-op day 6

Video update.  I think I said it all, good luck understanding me!

I just had my first post-op appointment today.  Surgeons took a peek around and said everything was healing fine.  Interestingly enough, they said even though the swelling is more on the right on the outside of my face, the inside of my mouth is swollen more on the left.

I'm just going to try straining everything from now on because I know I'm not getting enough calories.  Its hard with a liquid diet to get enough nutrition!

They also said that I'll be de-banded next week!  can't wait for that day.

Thank you everyone again for the tips about eating and everything else, they've really been helpful and encouraging.

life at post-op day 4

My life over the past couple days has been a cycle of taking medications on a schedule, eating and drinking as much as possible, and napping when possible.  It's kind of tiring to constantly be focusing on all of this but at least I know that I can take the time off of school and not worry about studying yet.

Today was definitely the best day so far, so I'm hoping everyday is going to get better from here on out.  I have a few new best friends:
liquid percocet
liquid ibuprofen
vasoline
eating syringes
straws

Eating is a tricky thing.  My mouth is banded shut with a splint (a retainer like thing) between the teeth.  When I eat this makes my teeth act like a sieve when anything that's not liquid tries to go through. I can drink water from a straw, it just goes slower then with the syringe. Here're some examples:
Good to eat:
a boost for breakfast and ensure for dessert (go to 56s)
milk
juice
broth
ensure
tomato soup
yogurt watered down with juice

not good to eat:
corn meal mush watered down
cream of wheat watered down
these things are too particulate and get clogged up in my braces

Before I forget I'd like to thank everyone that has been sending me their thoughts and prayers.  All of the moral support is really helpful.  I'd also like to say thank you to my mom's friends and my friends that have sent cards and supportive messages.  When you think things are tough, it really is nice to know that someone is there for you keeping you in mind.

Here are some pictures of each day since day 0, you can really see how much the swelling is going down!  I'll update more about the hospital experience later but everything was great, I love my team of doctors they are the best.

day 0. in recovery that afternoon

day 1. the hospital suction was my best friend

day 2, ready to go home later

day 3, my roommates travel neck pillow was a lifesaver

day 4, today.  my right side is actually more swollen than the left, the picture is just deceiving.  

this picture was from the beginning of the day, i'm even more yellow now

recovering at home

I'm currently at home recovering from jaw surgery.  Everything went as well as it possibly could have during the surgery and in the hospital recovering.  My top teeth are in front of my bottom teeth!!  Trying to keep my eye on the big picture here.

I'm sticking to the liquid percocet every 4 hours because I can feel the achy-ness/ pain starting to come back at the end of that time period.  Right now everything is revolving around getting enough liquids, taking medicines at the right time and trying to get rest.  Last night was difficult.  I find that if i'm sitting not moving around for long (like when you're sleeping haha) my nose will start to get stuffy and breathing gets more difficult.  more on that subject later.

Maybe I'll post a picture later, I seriously look like little miss piggy right now!

T -3 days and THANK YOU

Only 3 more days until the big day!  I'm really excited to get everything over and done with.

I wanted to say thank you to everyone who has written blogs like these and who has helped me out with a bunch of questions.  We all know that you go a little crazy before a surgery like this figuring out all the things you'll need for recovery not knowing what to expect.  For a lot of us, being a patient in the hospital will be a first time experience also which is nerve-racking.

So THANK YOU Jamie, Nikki, Nichole, Tara, Amanda, Catherine, Terra, Max, Amy, Gordon, Dani, Shane, Bracedmom and all the others that i've forgotten.  Your support and disclosure has been so helpful this far and I feel so much more prepared for what is to come.  Even though everyone is different and there is still so much unknown about what will happen I would probably be much more of a nervous wreck right now if it wasn't for you guys. :)

To anyone reading my blog for the first time please check out the links to these other people's great blogs on the right hand side of the screen.

a few last pre-op pictures:

need advice

Surgery is next week!  That snuck up quick. April 12th has been looming somewhere in the future and now its practically here.

The question I have for you fellow bloggers that have had surgery already and are recovering is;  How long did you need someone to take care of you?

My mom who works from home and lives far away (far enough a plane ticket is necessary) is coming to Boston to help support me through the recovery process.  I know at first I'm really going to need someone to help me take meds and eat and be in the hospital with me.  I'm guessing I'd need her to be here at least until the first post-op appointment?  It is scheduled for 6 days after.  That is already 10 days away from work for her.  As of now she's got her ticket here but no return ticket so I'm trying to think ahead to when she can get back home.

Any advice? suggestions?

pre-op...check!

15 days til surgery!  I seriously can't believe that it is so soon.  I'm excited to get everything over with already!

I had my pre-op appointment today with two residents and my oral surgeon.  They were great! "A-team" lol.  We did all of the typical stuff- pictures, x-rays, measurements, facebow, and impressions (not so fun with all those surgical hooks for the alginate to get stuck in).  The residents did everything and answered all of my questions.

these were some of my most important questions:
diet?: anything you can get through a blender and in your mouth
splint?: yes, 2 weeks at least.
medications?: liquid
how long banded shut?: 2 weeks at least, up to 6 wks.

The oral surgeon came in after, did a few measurements for herself and discussed the cephalometric analysis with the residents to come up with a tentative plan about movements they will do in the surgery.  It was kind of funny because we (3rd year students) just had our final oral surgery exam yesterday which had questions from her lectures on craniofacial deformities on it!  lol, talk about the educated patient!  I already new that I will definitely require double jaw surgery because if they were to just move my lower jaw back I would not have enough space left for my airway.  They have a tentative plan of how much to move each jaw but need to confirm it after they do the mock surgery on the models.

They said they'd probably want to have another appointment closer to the surgery (which is only 2 weeks away!!!!!!) to confirm everything after they do the model surgery.  One of the other things my Mom was concerned about was what she needs to do while she's taking care of me in terms of when to give meds, what signs to watch out for, etc. My oral surgeon was so nice, she said we can just set up another quick appointment with the her for when my Mom is in town right beforehand so she can meet the oral surgeon and ask herself.

The rest of the day wasn't so fun.  I had a meeting with anesthesia to have blood drawn and meet with the nurse about anesthesia stuff.  Then I had to go donate blood to myself :(.  I've volunteer donated blood many times in the past and this was not one of the best times.  ouchy.  Let's just leave it at that.

Anyhooo, that's all in the past now.  I have my last appointment with my orthodontist on Thursday.

check out my new GRILL

I had my second to last pre-surgical ortho appointment last week.  We put on 20 or so surgical hooks.  These are the hooks that the oral surgeon will use to wire my mouth shut when they do the surgery.  The orthodontist says the more hooks the better because they can break and the surgeons are always asking for more.  The orthodontist wants to have one more appointment before surgery just to check on the hooks and change the ties?

any votes on what color I should get before the surgery?  I was thinking just plain silver so they wont show stains- silver is just so boring though!!

35 days til surgery.  I can't wait.  I'm so excited to be 6 or so months down the road and be able to BITE into things and actually bite through them.  Like sandwiches, pizza, cookies- any and everything you bite into with your front teeth?  I'm so excited to be able to incise correctly and not tear, rip, or pull food to be able to get it in my mouth and eat!!

I'm officially on a no restrictions diet to try and gain some weight before the surgery- any pointers?  Ive just been trying to up the calories with every meal.  

Pre-op appointments are set for the end of this month, I'll be sure to update the blog afterwards.

Here are some pics-

My new grill! lol this is me slightly opened

luckily, it doesn't look too different from normal braces with my regular smile

right profile, jaw relaxed?

left profile

I wish my teeth were cleaner for these pics- sorry!

I've got so many sweet surgical hooks now!

there was only one area the hook wouldn't fit onto the wire because it has a bend

so class III!

Profile, biting down. I can't wait to have cheekbones!

Brushing your teeth with braces

Not too much new going on with my braces, I'm getting the surgical hooks put on on Monday.  I'm sure those are going to feel just great on my lips and cheeks :/

Now about the title of this post... We're adults and we generally think we know how to brush our teeth but when you have braces on your teeth, brushing is very different than without braces.  Braces automatically puts you in a high risk category for cavities because it is really difficult to keep your teeth clean.  Our teeth are naturally shaped so that food can get flushed away from the teeth.  With braces there are a million more areas for plaque to get trapped and bacteria to wreak havoc on our teeth and gums.

Below a very embarrassing photo of my teeth before I knew about proper brushing techniques.  The picture was taken right before I had a cleaning.  We put a dye on our patients teeth before their cleaning to show were plaque and calculus is built up.  On a person without braces, usually the plaque is built up along the gum line and in the areas between the teeth.  When we put the dye on my teeth, the plaque was built up directly beneath the wire.  That's when I realized just how important it is to use a proxabrush in addition to a regular toothbrush and floss.

you can see with this dye on my teeth that all of the plaque is built up right beneath where the wire normally is.

Adding the use of a proxabrush immensely helps with getting your teeth clean.  Also if there are spaces between any of your teeth you can use it not only around the brackets but also between the teeth to help get them clean.  The last thing you want after putting so much time and effort into having straight teeth is to end up with cavities or gum recession because you neglected your teeth while the braces were on.  This video explains how to use the proxabrush better than I can in words.

Here is another video about brushing with braces- because the technique is different than normal brushing.

and for flossing....  I've tried to use superfloss, but it takes SOOO long.  Now, I've been using "ortho flossers"  which are like floss picks but with a thin edge so they can fit under the wire.  The brand I absolutely LOVE are called platypus orthodontic flossers

They are seriously amazing.  I've found other brands that are similar at the drugstores and dental isle at the grocery.  They are soo much faster than using superfloss.  When I was just searching around on the web I found something called the flossFish.  It also looks really great and easy to use.  I'm definitely going to get some to try out!

good to go!

Its official!  My surgery date is still good, my insurance is cleared, and all my pre-op appointments are set.

All I need to do is get my surgery hooks and I'm all set. Hooray!

T- less than two months to go  :) :)

Happy Valentine's day to my teeth!

Hi Everyone,
Long time, no update!  That's really because there hasn't been much going on with my teeth lately, that is until my latest appointment!  So let's see, two appointments ago, My orthodontist finally got the last wire into my upper brackets.  It's a very large rectangular wire that is the biggest size that will fit into the brackets I have.  My orthodontist hasn't been moving any of my teeth, mostly keeping them where they are and just trying to expand my upper arch as much as possible.  If I needed any more expansion I would've had to have a SARPE (surgically assisted rapid palatal expansion), but luckily (probably because I had palatal expanders as a kid) my arch was just wide enough and they decided to make-up for the last few millimeters just by moving the teeth within the bone and not the bone itself.  Anyways,  when we got that last wire in I could feel when I flossed that most of my contacts of my upper teeth opened up probably because the teeth were moving that last little bit outwards.  yay!

Fast forward to my last appointment,  we had two appointments in one day, the first one to take the wires off and make some alginate impressions and the second one to put the wires back on after looking at the models.  I was so happy to have the wire off for a few hours!  I think I flossed 3 times, flossing is so much easier without those wires on!  Also,  my friend was able to give me a cleaning during the time off,  let me tell you it is so much easier to clean someones teeth who has braces once their wire is off.  Anyways, I returned to the ortho clinic with the cleanest teeth of anyone with braces and my models were good!  They basically told me that as far as they were concerned I am ready for surgery :D.  I'm going to drop by my surgeon's office tomorrow (its so convenient to have my dentist, orthodontist, surgeon, and the clinic I work in all in the same building)  to see if they need to see me before they have the pre-op appointment.  I also need to see if there are any updates about my insurance pre-approval coming in, and if my surgery date is still in the book.  Technically, when we originally picked the date for surgery last year the 2012 book didn't physically exist yet, so it was pencilled in at the end of 2011 lol.  So, unless their office majorly dropped the ball on that one,  I should be scheduled for surgery in exactly 2 months!

valentine's day colors!  

more updates to come...

good news!

My insurance and hospital decided to make nice so now I don't need to find a new oral surgeon! yay!  They signed a new 3 yr contract so I don't need to go anywhere new.  I love my oral surgeon, I couldn't imagine going to anyone else.  The other thing I love is that the medical center is connected to my school and literally it only takes me 5 minutes to get to from home, most of the time I'm already there anyways.

yayyyyyyy

pictures & update

Hi everyone,

Things are pretty much the same braces-wise.  The end of the year really snuck up on me!  Only two weeks left until school will be closed for 2 weeks, those two weeks are really jammed with patients though! I had an ortho appointment on monday and I'm in the .17 x .25 wire on the bottom still (which is the surgery wire).  That thing is really stiff!  He also tried to get me in to the .17x.25 on the top (right now i'm still in .16x.22's) but I wasn't ready yet.  He tried so hard to push that thing in! I thought my tooth was going to be extracted with how much pressure was on it.  But of course that would never happen I was just overly sensitive about the pressure.  So hopefully at our next appointment in the new year we'll be able to get into that wire so we're another step closer to being ready for surgery.  

Other than that my biggest worry lately is about a letter I got from my PCP (at the same medical center associated with my dental school and my OS).  The letter basically said that as of January 2012 the medical center is no longer going to be in-network for my medical insurance if the insurance company (BCBS) doesn't start paying them more money.  That throws a big wrench in my plans bc if the medical center isn't in-network anymore I'll have to go find a new oral surgeon at a hospital that accepts BCBS. bahhhhh.  There isn't anything I can do about it now until the date comes around and we see if they actually do drop it.  I really like my oral surgeon, she is the best and I feel comfortable around her.  Starting that whole relationship over with someone else would suck!

Here are some pictures from the whole process so far.  

So this is my bite "before"  My teeth really aren't out of line,  and the few that aren't in the correct position are the ones that we're still trying to correct now.  Notice the second molars on the bottom how they're turned in towards my tongue.  The third molars have since been extracted

This is my "before" pan.  You can see that I still have my lower 3rd molars that have since been extracted.  I really missed them at first!  they were in occlusion with my upper second molars and I would use them to chew, and once they were gone I was chewing onto the gum where they used to be. 

Here is my "before" lateral ceph.  This one really shows the severe discrepancy of my jaws to each other.  Its not just a problem with my teeth that cause my underbite, its a skeletal discrepancy between my upper and lower jaw.

This is where I was a month and a half ago.  My smile looks so awkward like this, I've never smiled biting down before!  Notice that heavy wire on the bottom.

And so it begins! (or began, I guess)

Hello everyone,
My name is Laura and I'm writing this blog like many others have because I'd like to write down my story as I go through braces, jaw surgery, and whatever else is on the other side of it all.  I've never written a blog before but because so many others' blogs are helpful to me,  I thought this may blog may be helpful to other people as well. As you can probably deduce from the title,  I am currently a dental student and I'm a little more than half way through dental school.

Here I am "brushing" my teeth with the candy toothbrush off our cake at a school party.  Yes, we have dental themed cakes.  be jealous. lol

A little more about my teeth:
I have a class III malocclusion with about 8 mm of negative overjet.  Also, I am in a posterior crossbite on all of my back teeth. (Basically, I'm in a crossbite everywhere).  I had palate expanders and braces a couple times as a kid and when I got them taken off at 13 1/2 years old I was technically in a Class I occlusion (where your top teeth fit over your bottom).  When you're 13 you are still growing and since your jaw bones grow at the same rate as your long bones, and since I was still growing taller, my jaw was still growing as well.  Over the next couple years I gradually went back to having a underbite.  Since the problem is a skeletal discrepancy, orthodontic therapy alone was unlikely to succeed.  The reason I had my braces off early was to take care of a traumatized central incisor that needed root canal therapy.  Since that was the reason I had them off I never considered jaw surgery that my orthodontist and dentist talked about since I thought that I couldn't have braces again.  (Also the thought of major surgery was way to scary!).

When I started dental school I realized I was wrong about not being able to have braces (you can have them even on non-vital teeth) and I started considering my options.  I have never been happy about my profile and since it is my job as a dental student to fix peoples teeth everyday, I constantly think about my own teeth.  It's like owning a car dealership and driving a broken down ford.  Sure, not all dentists have perfect teeth but I'd like to have pretty white teeth and a "normal" bite.

To make a very long story short, I have decided to correct my bite.  I currently have braces and am almost ready for surgery.  I had my lower 3rd molars removed (I used to use them to bite) because that is the area where my oral surgeon will split my jaw to move it back.  I had my upper third molars out in high school. I tentatively have a surgery date on April 12, 2012 and I cant wait!  My orthodontist is trying to expand my upper arch as much as possible before surgery so hopefully only a one piece Lefort will be needed instead of a two piece.  I do not need a SARPE(surgically assisted rapid palatal expansion).   I hope that having a correct bite will prevent me from having any periodontal and worse TMJ problems down the line.

Here are some of my pre-braces pictures  (I have nicer ones from the orthodontist, I just need to get them uploaded)

I've never smiled while biting down.  This is my fake-out smile, open the jaw so it doesn't look as protruded.

Another side profile opening so the prognathic jaw doesn't look so bad.

That's all for now I suppose, I need to go get ready for an exam and cleaning for my patient! Oh, the life of a dental student.

Laura :)