Wednesday, November 2, 2011

A big deal

I have a loooooooong history of orthodontia.

Let me give you a looooooooong explanation of this looooooooong history.  I was born with a class III malocclusion.  A malocclusion is a misalignment of teeth and/or incorrect relation between the teeth of the two dental arches. A Class III malocclusion, also known as a mesiocclusion, is when the lower front teeth are more prominent than the upper front teeth. In this case the patient very often has a large mandible or a short maxillary bone.   I had a short maxillary bone (upper jaw).

When I was in third grade I got my first of two rapid palate expanders.  I had the second one in sixth grade.  A rapid palate expander is a device used to widen the upper jaw so that the bottom and upper teeth will fit together better.  It looks like this:


Basically my mom would put a small key into the middle and turn it twice a day.  The expander (literally)  ripped my musculature and bone apart to expand my palate.  And I had two of these torture devices. 

I also had braces put on in sixth grade.  They came off in ninth grade.

The result of all of this orthodontia as a child was that I had really pretty, straight teeth and still horribly misaligned jaws.

My maxilla (upper jaw) was so misaligned with my mandible (lower jaw) that my midlines (the middle point of my teeth) were off by 4 millimeters.

The result of this was that my teeth were wearing out at an extreme rate because the wrong teeth hit the wrong teeth whenever I chewed.  I was told that my teeth probably wouldn't last past my 50's if I didn't do something about it.  I also had extreme muscle pain in my temples, neck and back.  My jaws were so misaligned that adjacent muscles (in my neck and back) had to "help out" when I was talking and chewing. 

I found out about all of this when I was in graduate school.  Not an ideal time to start another round of orthodontia.  I put it off and put it off.

Then one day, my first year out of graduate school, I yawned at work and my mouth got stuck open.  I could not close it.  It hurt.  A lot.  I had to use my hands to push my mouth closed.

By this point I had gotten 8 separate opinions- from 6 orthodontists and 2 oral surgeons.  They all, independently of each other, recommended the same thing: another round of braces and oral surgery.

So, when I was 25, I did it.  I became an adult with braces.  They cost a bundle.  When I was 26 I had a  Le Fort I Osteotomy to finally fix the relationship of my jaws. A Le Fort I Osteotomy involves separating the maxilla and the palate from the skull above the roots of the upper teeth through an incision inside the upper lip.  My surgeon moved my maxilla forward by 4 millimeters and rotated it forward slightly.  Then my maxilla was fixed in its new position with 4 titanium plates and 17 screws.

This is my face: 
That surgery is truly the most hideous thing that has ever, ever, ever happened to me.  I cannot even use words to describe how painful it was.  It took 3 weeks before I stopped considering jumping off a cliff, 6 weeks before I ate any solids and 10 weeks before I felt close to what I had felt before. 

My sinuses were cut open and the bones that make up my eye sockets were moved so I felt pain throughout my entire face.  I was sensitive to light.  I had to sleep sitting up for weeks because there was so much swelling that my air way was compromised if I layed down.  I still (5 years later) do not have full sensory function in my upper gums because all of those nerves were severed.

  I used to have nightmares that something went wrong and I was told I had to have the surgery again.  I would wake up all sweaty and crying.

Now that you know all of that you can imagine how I felt when I was told, when Spencer was 3, that he also has a Class III malocclusion.

I was crushed.

Can you imagine, knowing what I know and going through what I have gone through, thinking about your baby going through all of that?

I cried.  Many times.

That's why, when Spencer was 3, I took him to my orthodontist, whom I trust more than just about anybody.   They tried to take x-rays.  Fail.  They tried to take pictures.  Epic fail.  The Dr. was able to see him bite though, and he confirmed the malocclusion.  He told us to come back when Spencer was 4 and that we'd start treatment when he was 5.  He also said that my misalignment was "severe" and Spencer's, at this point, is "moderate" but has the potential to be severe if we don't do something about it.

We went in for another appointment 2 weeks ago.  This time they didn't even attempt x-rays, but they got all the pictures they needed.  Spencer was such a trooper.  The pictures involve all sorts of lip spreading contraptions and mirrors in the mouth, so they are not comfortable.

Once they took all the pictures we had our consultation.  Spencer got to play with models of teeth while we waited.

These are some of the pictures they took.  You can see how his bottom teeth come out further than his top teeth.
Here's the plan:

The Dr. still wants to start treatment next year when Spencer turns 5.  He does not use rapid palate expansion like I had as a kid.  Rather he uses slow fixed palate expansion with a facial mask.  It is less painful and works better.  A win-win.  This combination will slowly stretch Spencer's maxilla while he is growing to fix the relationship of his jaws.

Basically, Spencer will have an expander placed in his mouth and will wear the mask at night while he sleeps.  He does not have to wear it during the day, meaning he does not have to wear it in public.  Total treatment time is 9-12 months.  There is no guarantee that he won't have to have braces to align his teeth in the future (it's pretty likely, actually, that he will), but this will fix his jaw.

This is what the mask looks like:
Another good thing:  Our insurance should pay for half of it and it's actually not nearly as expensive as what I had anticipated (or what I paid for my treatment).

I did decide after this latest appointment that there is no way we can start allergy shots when Spencer turns 5 like his allergist wants.  I just can't do that to him.  We'll just have to wait until he is 6 and all done with this mask.

Good decision?

5 comments:

Megan said...

I too had the palate expander & it sucked. My poor mother - can you imagine what it must have been like for them to have to turn that key & inflict all that pain on us? I'm glad you don't have to do that with Spencer. I'm also glad you didn't end up jumping off a cliff!

Karen said...

Sounds like quite a relief! I am sure Spencer will be a trooper throughout the whole process, however long it takes.

Krista said...

I think that's the right decision. Ugh, all this drama is not making me want to be a parent - it's such a hard job!

Megan said...

So glad there is a better option for him. Totally the right choice to wait on allergy shots.

Landon Heath said...

How’s Spencer doing? It’s been a year since you posted this, so I’m assuming he has already started his treatment. The good thing about Malocclusion is that it’s easier to treat when growth isn’t complete. This could mean that there’s a good chance that he won’t have to undergo surgery, but I think he would still have to wear braces. Nonetheless, I know Spencer’s a strong kid, and I know he can get through his condition. :)