It's here!  The almost final step in my treatment plan!  I say almost because it's actually not the final restorations.  I'd love for it to be, but we know the final restorations will be the implant/bridge segment we have to do later when these teeth finally do start presenting as loose as they should given how awful they look on scans.  We'll cross that bridge when we get to it in the probably not super distant future.  But for the mean time (however long that time ends up being-- who knows!), I am doing veneers on the front teeth.  I always knew this was going to be a part of my treatment plan. I trashed these front teeth a few times over the years, and then my first ortho trashed them even more.  So, I knew this was coming, but now I have mixed emotions over it.  Over the years I had these teeth ground down and bonded to cover up an overlap I had on the front teeth, and old fillings that stuck out in my two front incisors, and in general just a bad patchwork bonding job was done on them more than once.  I wish I could rewind time and yell at my 24 year old self that let my family dentist grind my teeth down and put cheap bonding over them, but I can't change what I did.  I wish I would have just waited to get my teeth fixed properly with ortho and all, but the damage is done, and now I am paying to fix it.  Again, I knew this was coming, but what makes it a tough expense now is I have been faced with the situation of knowing this is a temporary fix that will lead me to an even more expensive final restoration with the implant/bridge segment.  So this $7200 (yes....that is what these 4 veneers cost me yesterday.  Ugh.) is to make my teeth pretty for possibly as little as just a couple years.  We hope for the best and maybe this will end up being a 10 year thing for me before I have to start implant work, but my docs aren't super optimistic.  

So, mixed emotions spending this much money on something that is 1.) So vain and superficial, and 2.) temporary in the grand scheme of things.  And now I am doing this after I just took a new job and got hit with an almost 50% pay cut.  Super ouch!  BUT..... I owe this to myself after everything I've been through to get to this point.  Could you see that patchwork bonding in pics and from far away?  No.  Could I see it?  Could my dental professionals see it?  Could my husband see it and friends up close see it?  Yes.  For sure.  Plus the bonding kept chipping off, turning different colors and getting worse, and the places where it was little slivers/chips, I was shredding floss on like a mo-fo.  So, there was some functional issues here too.  I am looking forward to not shredding floss anymore (and having an easier time flossing with smooth lateral tooth surfaces), and I am looking forward to having properly sized teeth.  One of the issues through treatment is my first ortho adjusted the size of my teeth and screwed them all up.  So both of my incisors were different sizes, both laterals were different sizes.  It looked goofy.  I am glad to get these guys the right size/shape finally. And I am glad to not have to look at my first ortho's hack job anymore.  It was a constant reminder every day looking at what he did to me.  I don't deserve to be reminded of that every day.  So, hopefully this will help me move on there.

My prosth asked me if I was at all surprised about how things went yesterday-- the whole process of prepping these teeth and getting my temp veneers on.  I told him I wasn't.  It wasn't that far off from other work I've had done, esp the bonding on those teeth.  It was very similar in a sense where they prepped the surface of the teeth (although didn't take off nearly as much natural tooth surface), wrap the cords and stuff around the teeth to push the gums up, cure things, etc.  I was in the chair for about 3 hours.  Worst part of the whole thing was the needle to get numbed up.  Needles up top/front are always more ouchie, but he stuck me right in fresh scar tissue from my plate removal, and that was SUPER ouchy.  Like, I had a few tears sneak out from the corner of my eyes and Dr. Lew totally caught me and handed me a tissue.  I hate being a baby, but I wasn't expecting this ouchie at all.  Normally it's no big thing taking the novicane shot, but damn this one was one of the worst ones I've ever had.  The rest of it was just discomfort in my back from laying down in the chair so long, and then my jaw joints from being cranked open for 3 hours.  A few good tidbits during all the work in this appointment:  1.) No decay.  I think my prosth was ready to find some decay under all the old bonding and fillings in my front teeth and he said they looked great.  2.) Both my prosth and the chair side assistant gushed over how amazing my gum tissue is.  Like, multiple times remarked about it.  This makes me VERY happy.  I've worked hard to get to a place where I take really great care of myself now.  I started this journey with severe periodentisis with 5-8mm pockets around teeth.  It feels really good to be in a place now where I get compliments along the lines of "these are some of the best gums we see in here!"  And on the same token Dr. Lew quipped that even my retainer is kept so clean, like it basically looked brand new.  Yep, I work hard on that too, so I'll take it :)

So, 3 hours and $7,200 later, I have temps in and my actual veneers are on order with a lab and I'll go back April 18th to hopefully get them seated for good.  If they are not perfect and to Dr. Lew's high standards (which I am thankful for!), he'll send them back and get them right before he permanently cements them.   Dr. Lew was also able to adjust my retainer for me in his lab, so it fits the temps he put on and he saved me an hour trip over to see my ortho to do that.  Super awesome of him!  Speaking of Dr. Lew, he also mentioned to me that the CA Dental Board did contact them to initiate their records request for my case, so it sounds like the dental board is moving forward with an investigation, which is great news.  From what I gather, they typically won't even take this step to get records and start investigating if they don't think there is something there worth looking at.  They'll totally close a case before it even began in that sense.  So, this is really great news.  I think I am finally feeling better pushing forward with this.  The few bits I have gotten to talk with my team about have been pleasant.  They have given me as warm a response as I think I can get here, so I am moving forward with the belief that they are on my side and they don't think I am a bad person for doing this.  I really hope not, because this dental board investigation train has now left the station and it's out of my hands.

Here are a few shots I had fun doing fb updates with in the chair yesterday.  I have no shame.  :)

I decided to make a blog post about this issue because recently I've chatted with a few patients who are having issues with this:  Records.  They're yours.  All yours.  ALL of them.   YOURS.  Each state varies in terms of the circumstances around timing of when records are to be given to you  upon request, but by law they have to be given to you.  Your doctor(s) can not hold them hostage for whatever reason.  More than one time now I've caught an orthodontist saying something like, "We can't release records until final payment," or, "We will only release them if you sign a document releasing all liability for us and gagging you from talking about your care with us from this moment forward."  You do not have to sign anything except for a records release form.  You can even put one together yourself here from the American Association of Orthodontics.  This is the only form  you legally need if they ask you to sign anything.  If you get something that looks like it's speaking legal-ise and demands anything from you in exchange for the records, then run for the hills.  

So what happens if you're in this situation?  I can speak from my personal experience and the experience of a few patients I've helped.  I had put in a verbal request for records with my orthodontist a month or two before leaving his office. I never was able to get my full records, and for various reasons, I really wanted them.  I also wanted my new orthodontist to have them in case there was anything to help give them an idea of where things were and then plan my new treatment from there.  I told my new ortho that I was having trouble obtaining my full records.  They filled out this AAO form, faxed it to my old ortho, and then I was eventually able to get "full" records.  I say "full" records because it wasn't full at all.  A lot was missing (like, anything regarding my surgical planning, notes, times/dates of when my ortho/surgeon talked, etc, etc) and I was told they just don't keep things like that.  And in case anybody reading this is wondering, yes, that is illegal too.  Doctors follow a certain medical care standard of what is kept and what isn't kept, and almost everything gets kept.  Some things are required to be kept longer than others, but most things get kept. Especially important treatment notes on a major surgery and said planning and discussion for it.  I kept the AAO form, the date/time I faxed it, the date/time I got my records finally in my hands.  This has become especially useful now, 2.5 years later, when the CA Dental Board is investigating my first set of doctors and they can possibly see fines and dings on their records for not meeting the standard of care set forth when it comes to dealing with records.  

I was fortunate that my orthodontist did not try to hold my records hostage from me in exchange for anything.  Instead they just held them for me for.... I don't know what... but at least I finally got what I could.  At the time I was consulting with a lawyer about everything, and he was the one to give me a heads up that more than likely my ortho was going to try to slip in a note releasing all liability in exchange for my records and I was to not sign it.  Luckily I didn't run in to that at all, which looking back on it now, is VERY surprising.  Not only that, but my ortho called me within minutes of them getting an official transfer notice from my new ortho and they offered up a full 100% refund of my $8300 treatment cost with their office.  Again, I got incredibly lucky there.  

So, do not let your doctor bully you.  Your records are legally yours.  They HAVE to give them to you.  If you feel like you are being done over on your records, look up information for your states licensing board and file a complaint with them.  More than likely it's illegal.  In CA you have X days to give a patient their records after request.  If a complaint is filed and it's found you were past the timely date of records release, you can be fined X dollars per day for every day you were late.  Don't let them get away with it.  A good doctor will have no reason to want to cover their tracks and hold your records.  Do NOT be gagged!!  Do not sign anything that will release liability and gag you from talking.  That is bullshit.  Don't let it happen.  Look out for numero uno here.  Don't worry about hurting the feelings of the nice lady working at the front desk in the office if you have to call and talk to her about this.  She understands.  It's just business.  Stay polite, yet be firm.  Like everything else in this process, sometimes we need to be advocates for ourselves.  Unfortunately this is one of those instances.  Keep good notes on everything.  Dates/times of your requests and copies of all exchanges and faxes.  It may help you later down the line.  Keeping detailed notes and keeping good records has for sure  helped me in more ways than one through this journey!