Even though I knew this part of treatment was coming for a long time, I was still dreading it. I talked in my last post about my extremely loose front teeth when they were out of the arch wires at my last appointment. This has been an ongoing issues since my first surgery when I found out that my roots were disappearing on my teeth without any word from my treating ortho or surgeon about it. They just let it happen and like everything else, turned the other way. When it finally got brought up, they told me it was just hints of some root blunting and nothing to worry about. Well, here it was some severe resorption going on and not just hints of blunting, which really wouldn't have been a big deal. Bad enough resorption where great care should have been given as to how my teeth were being moved, and instead my first ortho was super wildly yanking them all over the place to try and compensate for how messed up I came out of surgery. So, like everything else in my treatment, I took it upon myself to get with a prosthodontist and start monitoring the root health of my teeth. He's been wonderful. He's also super honest, and has told me from the start that the prognosis on my upper front teeth was not good at all. So, I proceeded with my second round of ortho (because I was in that much face and jaw pain that I didn't have a choice and had to risk more damage and possibly losing these teeth by going through ortho again) and knew we would be revisiting the state of these teeth. Well.... we're finally at a place to do that. So, lets break today's appointment in to the good, the bad, and the ugly.
The good: I've got about 6 months of braces left. That is what my ortho said when he called my prosthodontist to talk. So, yay for that. But then it's a huge boo, because that was literally the only good out of this appointment.
The bad: The resorption is bad. Really bad. He didn't even take new PA's (which I am surprised at, because I think I am due for them soon anyway), which means he probably just talked to my ortho and heard from him how loose those teeth were. My ortho had a face on him like, pure shock, where he had never seen teeth that loose before. I am not too worried about not having the PA's today because today was just a rough meeting to start to pow wow on what we want to do. We've got 6 months to stew on all of this. My prosthodontist is actually going to try to get back together with my ortho and surgeon to talk about everything and decide best course of action for us. The other bad is the beginning of what is going to be an endless money pit. I had nothing done today. No xrays, no nothing. Just to sit and talk with my doc for 15 minutes, that was $125. This is just the beginning of all of this. I've been trying to stash away what I can to cover what's coming, but just thinking about the numbers makes me sick. Luckily my first orthodontist refunded me back the $8300 I spent for treatment with him, but that totally just turned around and went to my next ortho. So $8300 for braces, and we're sitting at $6000 for surgery (including the cost of the copay for my surgeon and cost of picking up the extra medical for him. Surgery costs will probably go up since I haven't gotten the hospital bill yet), and all the restorative work is going to be in the $10,000-$15,000 range if I had to guess. So I'm looking to be up around $30,000 for my mouth the last 3.5 years when this is all said and done. No wonder my savings account keeps going down instead of up the last few years! Ugh!
The Ugly: The teeth are goners. My 4 main upper front teeth (the 4 teeth in between the K9's, teeth 7-10). We were hoping teeth 8-10 could maybe stick around for another 5-10 or maybe even 15 years, but they seem less optimistic now. Actually, my prosthodontist today said something like "actually, I can pretty much be 100% certain if you try to keep these teeth, it's only going to be a couple years. Maybe 2-3." So, they sound pretty damn sure at this point. So, what are my options? Do we rip them all out and go straight for the gold as soon as my braces are off? Do a wait and see approach? Do 4 implants on all of them, or go for an implant on each lateral incisor and bridge the two main incisors in between? The prosth is leaning towards the outer implants with the bridge. I am super hesitant on this, as I've done some research that says that is not good for bone. I'm young, and that is an awful lot of years for bone to shrink away and it ends up looking like dog crap later. But he says it would be worse to do 4 implants next to each other, because you end up losing gum/tissue when they are right next to each other and that ends up looking like crap later. So, sounds like I am damned if I do and damned if I don't. I definitely trust his opinion though, and I really want to hear what my surgeon has to say about this. He does implants all the time, and last I talked to him he was down with 1.) me keeping the teeth as long as I could to preserve bone, and 2.) I think he was also thinking implants for the same reason I was, but I'd have to ask him again because I am not 100% sure on that since it wasn't a point blank question and more of just a sum of some things he's said over time. I definitely for sure trust his opinion too. I wish I was seeing him sooner than in 3.5 weeks because my mind is going to be spinning wondering what he thinks. All of them are going to talk about this, and if I had to guess, they'll tap in to their study groups and get the other docs opinions too. So, there will be lots of eyes on my planning again, which is really fantastic.
So, I have really mixed emotions over today. This is not necessarily new news. They've slowly been prepping me to hear that this wasn't going to work out. They've been honest with me from the start on the prognosis of these teeth, but I guess in the back of my mind I had a secret hope that we could make do with teeth 8-10 for a good long while and take care of them later. I am not worried at all about 1 implant, but the thought of losing all 4 upper front teeth at once is completely devastating for some reason. I originally embarked on all of this work so I could save my teeth, and here I ended up losing at least 4, and possibly more (my bottom incisors actually don't look great on xray to me, but my team has not said anything about them....yet) because of it. So, in terms of tooth health, I was better to begin with when they told me I wouldn't be! Ha! Funny how life works sometimes. Despite this not being new news, I managed to still get a little rocked by this today. I think the prosth was waiting for me to lose my shit in his chair, but as always, I remain composed. I know at an appointment when he first told me I was going to lose these teeth, he said he was surprised I wasn't more emotional. Like, maybe he thought I didn't get it or it didn't sink in what he was telling me. Nope. I am just usually not a crier, especially in public places in front of strangers. So, I did what I normally do in these situations...... I lost my shit in my car instead. I got in my car and had to pull over and just have 10 minutes to let it go. It's teeth. Why is it such a big deal? Well, it's something so permanent to each of us. Something to integral to our health and well being. It's quite a big deal, actually. Think about it-- have you ever had a nightmare about losing teeth or getting teeth pulled? There are even definitions in dream books about this because the dream is that common. I also think another reason I am so upset is because this was something that was probably preventable. I am not 100% sure, but I am pretty sure that my first orthodontist was a huge cause of this. Could I genetically be prone to resorption? Yes. But that guy moved my teeth SO hard and SO fast. Ridiculously hard and fast. I had to eat vicodin through my whole round of treatment with him, and my second round of ortho I haven't needed so much as an advil. I am not sure, but I think if you look at my xrays, they show that the amount of resorption I have is not typical of somebody experiencing normal resorption from normal orthodontic movement. It's definitely trauma induced. And once it started, that was it. No matter how gentle and slow my second ortho is (and he has been amazingly gentle, slow, and attentive to my roots), the damage was already done and going. So, just the force of being in even the lightest wire is going to keep the damage coming no matter what we do. So, that is the deck of cards I have been dealt here. And on the tangible side with all of this, it sucks that I am again left paying for damage somebody else did to me. When I am all done with this, I'll probably have spent $30,000 to fix what my original surgeon and orthodontist have done to me. All the while, they just get to keep on keepin on.
So, last tid bits and on to a different topic(s)--- I sent letters to both my first ortho and surgeon. I let them know how I feel about everything that has happened to me, let them know that their treatment for me was not only wrong, but down right immoral, and I updated them with some records to show them what good work and at least the standard of care looks like. They might not even read it. Who knows, but at least I feel like I've said my final word and can hopefully get some closure from it. It's probably the closest thing I'll get to closure there. Otherwise, my bite is still looking great! Actually, it's starting to feel really good. My bicuspid on the left is no longer tooth tip to tooth tip and everything is now seated in their new little homes in their grooves. I wouldn't be surprised if I am officially class I all the way around now. At least it looks/feels like it to me! Still getting used to it, even two months in to this now. It will definitely take much longer to feel normal again. Like last time, it didn't happen over night, so I am in no rush. Pain wise I am doing pretty good. I think the worst of it for me is in the morning after clenching at night, my upper jaw across the osteotomy site is sore and around the plates and screws are puffy/sore. I remember this happening a long while last time too. I'm still puffy in the same spots. My numbness has gotten a smidge better on my lip/chin. I feel like I can definitely feel my lip more, and I am getting some bad shocks and zingers this week. One yesterday was REALLY painful and lasted for a good couple of minutes where I was out loud saying to myself, "wtf?!" I've also hit the super sensitive phase where my gums/teeth are sensitive. I think this is the feeling coming back in the gums. I hate brushing with my electric tooth brush right now, but it has to be done. I think this lasted 1-2 months last time. Ugh, no bueno for that. And last but not least in other news.... I got a hair cut! I made the big chop back to a pixie cut (see pics below). Hard not having a mop to hide my puffy face behind, but oh well. I started losing hair again bad like I did after the last surgery, so I am not dealing with it again. Off it went!! I am still not sure I am in love with it, but it will be fun to have while my hair goes through this weird shock and shed cycle again!
The good: I've got about 6 months of braces left. That is what my ortho said when he called my prosthodontist to talk. So, yay for that. But then it's a huge boo, because that was literally the only good out of this appointment.
The bad: The resorption is bad. Really bad. He didn't even take new PA's (which I am surprised at, because I think I am due for them soon anyway), which means he probably just talked to my ortho and heard from him how loose those teeth were. My ortho had a face on him like, pure shock, where he had never seen teeth that loose before. I am not too worried about not having the PA's today because today was just a rough meeting to start to pow wow on what we want to do. We've got 6 months to stew on all of this. My prosthodontist is actually going to try to get back together with my ortho and surgeon to talk about everything and decide best course of action for us. The other bad is the beginning of what is going to be an endless money pit. I had nothing done today. No xrays, no nothing. Just to sit and talk with my doc for 15 minutes, that was $125. This is just the beginning of all of this. I've been trying to stash away what I can to cover what's coming, but just thinking about the numbers makes me sick. Luckily my first orthodontist refunded me back the $8300 I spent for treatment with him, but that totally just turned around and went to my next ortho. So $8300 for braces, and we're sitting at $6000 for surgery (including the cost of the copay for my surgeon and cost of picking up the extra medical for him. Surgery costs will probably go up since I haven't gotten the hospital bill yet), and all the restorative work is going to be in the $10,000-$15,000 range if I had to guess. So I'm looking to be up around $30,000 for my mouth the last 3.5 years when this is all said and done. No wonder my savings account keeps going down instead of up the last few years! Ugh!
The Ugly: The teeth are goners. My 4 main upper front teeth (the 4 teeth in between the K9's, teeth 7-10). We were hoping teeth 8-10 could maybe stick around for another 5-10 or maybe even 15 years, but they seem less optimistic now. Actually, my prosthodontist today said something like "actually, I can pretty much be 100% certain if you try to keep these teeth, it's only going to be a couple years. Maybe 2-3." So, they sound pretty damn sure at this point. So, what are my options? Do we rip them all out and go straight for the gold as soon as my braces are off? Do a wait and see approach? Do 4 implants on all of them, or go for an implant on each lateral incisor and bridge the two main incisors in between? The prosth is leaning towards the outer implants with the bridge. I am super hesitant on this, as I've done some research that says that is not good for bone. I'm young, and that is an awful lot of years for bone to shrink away and it ends up looking like dog crap later. But he says it would be worse to do 4 implants next to each other, because you end up losing gum/tissue when they are right next to each other and that ends up looking like crap later. So, sounds like I am damned if I do and damned if I don't. I definitely trust his opinion though, and I really want to hear what my surgeon has to say about this. He does implants all the time, and last I talked to him he was down with 1.) me keeping the teeth as long as I could to preserve bone, and 2.) I think he was also thinking implants for the same reason I was, but I'd have to ask him again because I am not 100% sure on that since it wasn't a point blank question and more of just a sum of some things he's said over time. I definitely for sure trust his opinion too. I wish I was seeing him sooner than in 3.5 weeks because my mind is going to be spinning wondering what he thinks. All of them are going to talk about this, and if I had to guess, they'll tap in to their study groups and get the other docs opinions too. So, there will be lots of eyes on my planning again, which is really fantastic.
So, I have really mixed emotions over today. This is not necessarily new news. They've slowly been prepping me to hear that this wasn't going to work out. They've been honest with me from the start on the prognosis of these teeth, but I guess in the back of my mind I had a secret hope that we could make do with teeth 8-10 for a good long while and take care of them later. I am not worried at all about 1 implant, but the thought of losing all 4 upper front teeth at once is completely devastating for some reason. I originally embarked on all of this work so I could save my teeth, and here I ended up losing at least 4, and possibly more (my bottom incisors actually don't look great on xray to me, but my team has not said anything about them....yet) because of it. So, in terms of tooth health, I was better to begin with when they told me I wouldn't be! Ha! Funny how life works sometimes. Despite this not being new news, I managed to still get a little rocked by this today. I think the prosth was waiting for me to lose my shit in his chair, but as always, I remain composed. I know at an appointment when he first told me I was going to lose these teeth, he said he was surprised I wasn't more emotional. Like, maybe he thought I didn't get it or it didn't sink in what he was telling me. Nope. I am just usually not a crier, especially in public places in front of strangers. So, I did what I normally do in these situations...... I lost my shit in my car instead. I got in my car and had to pull over and just have 10 minutes to let it go. It's teeth. Why is it such a big deal? Well, it's something so permanent to each of us. Something to integral to our health and well being. It's quite a big deal, actually. Think about it-- have you ever had a nightmare about losing teeth or getting teeth pulled? There are even definitions in dream books about this because the dream is that common. I also think another reason I am so upset is because this was something that was probably preventable. I am not 100% sure, but I am pretty sure that my first orthodontist was a huge cause of this. Could I genetically be prone to resorption? Yes. But that guy moved my teeth SO hard and SO fast. Ridiculously hard and fast. I had to eat vicodin through my whole round of treatment with him, and my second round of ortho I haven't needed so much as an advil. I am not sure, but I think if you look at my xrays, they show that the amount of resorption I have is not typical of somebody experiencing normal resorption from normal orthodontic movement. It's definitely trauma induced. And once it started, that was it. No matter how gentle and slow my second ortho is (and he has been amazingly gentle, slow, and attentive to my roots), the damage was already done and going. So, just the force of being in even the lightest wire is going to keep the damage coming no matter what we do. So, that is the deck of cards I have been dealt here. And on the tangible side with all of this, it sucks that I am again left paying for damage somebody else did to me. When I am all done with this, I'll probably have spent $30,000 to fix what my original surgeon and orthodontist have done to me. All the while, they just get to keep on keepin on.
So, last tid bits and on to a different topic(s)--- I sent letters to both my first ortho and surgeon. I let them know how I feel about everything that has happened to me, let them know that their treatment for me was not only wrong, but down right immoral, and I updated them with some records to show them what good work and at least the standard of care looks like. They might not even read it. Who knows, but at least I feel like I've said my final word and can hopefully get some closure from it. It's probably the closest thing I'll get to closure there. Otherwise, my bite is still looking great! Actually, it's starting to feel really good. My bicuspid on the left is no longer tooth tip to tooth tip and everything is now seated in their new little homes in their grooves. I wouldn't be surprised if I am officially class I all the way around now. At least it looks/feels like it to me! Still getting used to it, even two months in to this now. It will definitely take much longer to feel normal again. Like last time, it didn't happen over night, so I am in no rush. Pain wise I am doing pretty good. I think the worst of it for me is in the morning after clenching at night, my upper jaw across the osteotomy site is sore and around the plates and screws are puffy/sore. I remember this happening a long while last time too. I'm still puffy in the same spots. My numbness has gotten a smidge better on my lip/chin. I feel like I can definitely feel my lip more, and I am getting some bad shocks and zingers this week. One yesterday was REALLY painful and lasted for a good couple of minutes where I was out loud saying to myself, "wtf?!" I've also hit the super sensitive phase where my gums/teeth are sensitive. I think this is the feeling coming back in the gums. I hate brushing with my electric tooth brush right now, but it has to be done. I think this lasted 1-2 months last time. Ugh, no bueno for that. And last but not least in other news.... I got a hair cut! I made the big chop back to a pixie cut (see pics below). Hard not having a mop to hide my puffy face behind, but oh well. I started losing hair again bad like I did after the last surgery, so I am not dealing with it again. Off it went!! I am still not sure I am in love with it, but it will be fun to have while my hair goes through this weird shock and shed cycle again!
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