It's been too long - here's an update to my journey

A blog is a big commitment and sometimes it can be really easy to think 'I'll update it next week'.  I've been super busy with work, travelling quite a lot for both work and pleasure and I also moved to a new apartment.  Then I realised that almost a year has passed by since my last post.  I am still very much on my journey and the biggest step is yet to come, so I thought I would finally give an update and will commit to keeping this blog up to date.

So what has happened in the last year?  

To start with the expansion device had to stay in my mouth for a good 3-4 months after the braces were on so my jaw could stabilise.  It was a bit awkward having both in my mouth so you can imagine my joy when it was finally removed - I could touch the top of my mouth with my tongue again!

Since then it has been braces all the way - and my face has changed a lot.  I knew that it would take a while to close the huge gap that was between my front teeth - I just didn't realise it would take so long, but now I am really happy to say that the gap has almost closed.  In fact, there is only a 0.25mm gap right now thanks to orthodontic power chains.  You can see the result for yourself in the photo below - needless to say I am extremely happy with the result.  When I used to smile wide, there used to be huge gaps at each side of my upper jaw due to how extremely narrow it was.  Now my teeth are as wide as my smile.

When you look at yourself in the mirror every day you do not always notice the changes.  Looking at my upper jaw here though - it's amazing to see the changes.  And yes, it's another stupid pose!

I mentioned power chains - but what are they?

Well they are definitely not as scary as they sound.  At first when I heard about power chains I expected metal chains to be placed in my mouth and across the braces.  In reality, a power chain is just a plastic set of links similar to the o-rings that hold the brackets closed on your braces.  They go over the top of your regular o-rings and are quite tight, and that tension pulls the teeth together which in turn closes any gaps you may have.  There are different types of power chains and as the gaps get smaller, so do the links between each o-ring on the power chain.  In the image below, you would start with the power chains at the bottom of the image and slowly move to the ones at the top. 

Other results of the braces

Aside from the closing of the gap, the braces have also greatly reduced the over-jet of my front teeth. I didn't expect the result to be so dramatic because reducing the over-jet has in turn reduced the appearance of the overbite.  I still need double jaw surgery to fully correct everything, but I am well on my way to having a functional jaw.

This side profile shows the reduction of the over-jet

Of course the main function of braces is to straighten teeth and while my upper teeth were always nice and straight, my lower teeth were a mess.  I had a fang on each side of my lower jaw and these were not in line with the other teeth - but the braces soon worked their magic and straightened these teeth out.  In fact this only took a couple of months before there was a big change.

And that's it for now!  I will be posting a couple more updates soon on how to live with braces and the next steps in my treatment leading up to surgery.  Until then, thanks to everyone who has taken the time to read and comment - your support means a lot and your questions are always welcome. 

The braces are on!

Hello again bloggerland!

A major event occurred a few weeks ago - I finally got my braces fitted.  Of course I wanted to update my blog straight away, but life has been super busy since then. With a work trip to Melbourne, then my own trip to Melbourne and a busy schedule, I've hardly had enough time to think.  Forgive my tardiness, I will make up for it I promise :)  Long blog post - beware!

So on Monday 27th May I had an appointment with my orthodontist to first remove my palatal/maxillary expander (my torture device) and then have upper and lower ceramic braces fitted (my new torture devices).  Having the expansion device removed was quite an ordeal because the metal bands of the device are glued to the teeth, so there was lots of pulling and quite strenuous physical labour (on the orthodontists part) to remove it from the jaw.  I usually have quite a high threshold for pain, but I must admit I winced a couple of times during the removal.  Now as you know I'm not going to shy away from the gory details in this blog - the smell was awful!  I couldn't believe that something that smelled so bad could be in my mouth.  My orthodontist explained that food gets stuck around the expander and some of it is almost impossible to floss/clean, so the devices are usually smelly once they have been removed.  Lovely.

Now for the braces - and for all the fuss made by many people that I know who have had them, I have to say that getting them fitted was not uncomfortable or painful and I actually almost fell asleep at one point.  Hats off to the amazing orthodontic team at Sydney Smile Specialists.  While I'm here, I may as well give them a plug - if you are looking for an orthodontist in Sydney, I really don't think you could find a more professional, friendly and caring team of people.  You can view their Facebook page by clicking their name above.

The ceramic brackets that will be adhered to my teeth, made by 3M.

The first step in getting the braces on is for the teeth to be prepared.  This involves popping a plastic device into the mouth to stop the lips touching the teeth, giving the teeth a thorough clean and then gluing each bracket to the surface of each tooth.  The majority of the brackets are clear ceramic, while a couple towards the back of my mouth are metal.  Having the lips away from the teeth ensures they are completely dry otherwise the glue will not adhere.

Ready to get the braces on

Once the brackets are on the wires are threaded (kind of) through the brackets.  One wire for the upper jaw and one for the lower jaw.  O-rings are then placed around each bracket (a little uncomfortable) which close the opening of the bracket and hold the wire in place!  Phew!  The wires are very flexible, but also have a tendency to want to retain their shape.  It is these characterises that apply tension to the brackets and so the teeth, and eventually move them into the original shape of the wire.  My orthodontist advised that I have a 'super-cable' on the lower teeth which is a stronger type of wire to move misaligned teeth a little faster.  That's a nice way of saying my lower teeth need a lot of work!

The whole process including the removing of the expansion device and the fitting of the braces took around 1 hour and 30 mins, with the braces taking up about an hour.  Not bad at all really.  And once my braces were fitted I couldn't stop looking at myself in the mirror - I'm so happy to finally have them on.  I was given cleaning and care tips and was on my merry way.

Here I am with my braces on

And you know how I love these beautiful close up shots

Over the next 4-5 days a couple of my lower teeth did get very sore, but I was told this was to be expected.  I took painkillers, ate lots of yoghurt and other soft foods and after a few more days the pain was gone.  Happy days.

One week later I had to visit the orthodontist again because even though I had my expansion device removed, I had to get a new metal arch fitted in the roof of my mouth.  This one is called a Trans-Palatal Arch (TPA) and it is designed to keep the expansion of the jaw stable and to stop the molars moving back inwards.  Yes, it's another metal device in my mouth but much smaller than the expansion device - in fact I hardly notice it's there.

Now to the downside.  Eating.  It's not painful or sore - just very inconvenient.  My upper and lower front teeth have never met, but before the jaw expansion the majority of my side teeth did.  Due to the massive expansion I have now undergone, only a couple of my teeth meet on each side.  This along with the gap in the front teeth (yes I know it will eventually close) and food getting stuck all around my braces make eating rather tiresome.  It's not due to the braces - they are just another obstacle in the way of me doing some serious chow down.  Eventually the braces will rotate my lower teeth outwards to meet my upper teeth, and of course there will be the main surgery next year, so until then it's a waiting game.  And the result will be worth it.

And that's all for now!  Hopefully you are still reading and enjoyed this post.  Feel free to leave me a comment or ask away if you have any questions.

Before and after jaw widening

Throughout my whole SARME experience I have of course noticed my jaw getting wider.  This is mainly because of the gap that has formed between my front teeth.  However because I look at myself every day, I don't think I realised just how much wider my jaw actually is.  Last night I took a photograph of the roof of my mouth and compared this to the same photograph I took before the surgery/widening and I am truly amazed at the difference.  So here are the photographs side by side, so you can see the difference too!  When I look at these, I have no doubt that I am doing the right thing.

Enjoy the lovely nostril shots...

Pass that paper bag

It's been a strange few days.  Last weekend I suddenly became extremely self-conscious and aware of the stares I get in public due to the gap in between my front teeth, and a Facebook post where I vented my frustration prompted an interesting conversation with a very good friend.

Why am I worried about people staring at me, when I have this blog which is showing my jaw (and journey) for all to see?

I thought that was a very good question because my blog if anything, is quite explicit in the descriptions I give and the photographs I share.  To me, it comes down to control and context.  When I post an update to my blog I am putting my face right out there for all to see.  And while I have no control in who reads the blog, the reactions of people who read it are not displayed to me right away.  If someone is reading my blog, they know I am going through surgery and so for my readers, things are put into context.  This is quite different to what happens in public.

When I am out and about in public, people stare.  They can't help it but they just do.  I have had people stare so much that I turn around and they are still looking.  On one occasion the stares have led to all out laughing which was very obviously directed at me.  The issue is this - they do not know I am having jaw surgery, they do not know this is all part of a larger plan and they do not know that I haven't been in a fight and had my teeth knocked out (because after all, I am quite butch).  Of course I don't blame people for looking because unlike my blog there is no context, however after a while the stares make me uncomfortable.  Of course the laughing to me is another matter and just plain rude, and prompted my Facebook frustration.

So there is a bit of an insight into how I am feeling and why stares in public are very different to someone reading my blog!  It has definitely highlighted my coping (or lack of) mechanisms and this is something I will be working on.  On a more positive note, this situation has prompted me to contact my orthodontist who has said they can put some temporary composite (the same material fillings are made from) across my front teeth which will disguise the gap.  It won't look like a tooth, but I won't have a huge gaping hole either so in the short term I can get back to looking fairly normal.

Now all I need to do is wait until the upper braces are fitted and the gap starts to close...

SARME Surgery post-op day 33 - mind the gap!

It's been a few weeks since I posted to my blog, because to be honest nothing much has been happening apart from the gap getting bigger and bigger!  I've become quite self conscious (although not  enough to stop me from posting this) because the wider the gap has become, the more you notice the slant in my jaw.  This has led me to covering my mouth a great deal while out in public and I have become quite sensitive, even dare I say, high maintenance.  Of course I always knew that my jaw had grown downwards at a slant - the gap just exaggrates it greatly and I'm looking more and more like Cletus from The Simpsons.  The slant in my jaw will be fixed up though through a combination of the braces and my jaw re-alignment surgery next year.

The exciting news is that I went to see my orthodontist on Monday and they instructed me to stop turning the expander as the upper jaw has now been widened enough.  So that's a total of 25 days expanding twice a day, and I'm quite glad that stage is over.  While expanding never caused me any pain as such, I did feel a lot of pressure on my jaw after each expansion.  As each expansion was only 12 hours apart - the pressure was almost constant all day, every day.

Anyhow they do not call it a rapid maxillary expansion for nothing, and the photo's below show my expansion progress since my last blog post.

Post-op day eight (six days turning the device)

Post-op day twelve (ten days turning the device)

Post-op day 20 (18 days turning the device)

Post-op day 28 (26 days and the turning has stopped!)

In five weeks time I will be getting my lower braces on - I'm quite looking forward to that.  The upper braces will not be able to go on for a further four weeks though as my upper jaw needs time to heal in the new position.  This does mean the gap will remain for at least nine more weeks until the braces can start closing the gap, and the expansion device will need to remain in my mouth for that length of time, but at least things are moving along.  I still have virtually no feeling in my upper jaw or gums, but now the jaw has started healing the feeling should start to come back.  I have been advised though that it could be a number of months for the feeling to fully return.

Eating is still a chore and while I can eat semi-solid food, I still cannot eat anything too chewy or crunchy.  I've been making up for it with the soft foods though and have been eating so much yoghurt that I've put on a couple of kilos!

As a last note, I had a really strange dream last night (which was partly red wine fuelled) where my front teeth fell out and new ones instantly grew in their place.  I think this highlights the anxiety I have been feeling, but I'm still in good spirits.

Over and out.

SARME surgery post-op day seven - Look at my gap!

It has now been seven days since my SARME surgery and I'm glad to say that everything is going pretty well.

I went to see my Maxillofacial Surgeon for the first time since the procedure and he has commented that my gums are nice and pink and that I look like I am healing fast.  I still have no feeling in my upper teeth and my gums are completely numb, but he has said it can take months for the feeling to come back!  I mentioned to him my concern over one side of my jaw sitting slightly lower than the other, but he assures me this is normal and that it will be fixed up during both orthodontics and my bi-maxillary surgery next year.

I'm really surprised with how quick my upper jaw is widening.  I know I said before that it would widen by 0.25mm with each turn and yes I know it's called a 'rapid' maxillary expansion, but I didn't realise how quickly it would become a large gap.  After four days of turning the gap is extremely noticeable and I am able to do all sorts of tricks with my gap such as whistle or direct a stream of water through it.

Anyway that's all for now - enjoy the photos below and check out my sexy (not) gap!

I'm sexy and I know it

I can almost fit a straw through the middle

SARME surgery post-op day three - I've started turning!

Three days after my SARME surgery and I am still feeling no pain, however I have been extremely exhausted and sleeping loads.

Today I went for an appointment with my orthodontist to start the adjustments/turns on my expansion device.  I freaked out a little inside when he put the mini spanner into my mouth and shook (quite visibly) as he made the very first turn.  I was so convinced that it was going to hurt, but to my surprise it didn't.  My orthodontist gave me instructions on adjusting my expander and within five minutes I was finished.

The SARME surgery on Monday split the jaw bone which allows the upper jaw to move and now by turning the device I am making my upper jaw wider.  This is not a slow process (theres a reason they call it 'rapid' maxillary expansion) as my jaw is widening by 0.25mm with each turn.  After the first turn by the orthodontist I could already notice a gap (however this did not come out in the photo below) so it's reasonable to say that I will be looking like Cletus from The Simpsons in no time.  

That's all for now - just a quick post.  I will update more in the days to come.

The day of my SARME surgery

It's the day of my jaw widening surgery (SARME) so I thought I'd let you hear it from the horses mouth!

Maxillary expander update and three days until surgery!

My expander has been in for three days and I must say I'm getting used to it quicker than expected.  My speech is not half as bad as it was on Tuesday (I no longer sound like Joseph Merrick) and it's now only certain words and sounds that I have difficulty with.  Eating is still a challenge as food constantly gets stuck between the device and the roof of my mouth, but nothing that gargling water after every meal doesn't cure.

The strange thing is that since having my expander in my sense of smell seems to have heightened.  I did not expect this to happen and haven't read it in other peoples experiences so it came as a surprise, but I must say it's a rather pleasant surprise.  I seem to be picking up smells that transport me back in time to a place with fond memories - spices in an Indian market, the smell of damp English soil when camping as a child, the smell of the sea breeze on San Francisco Bay.  Call me crazy, but they do say that if certain senses are limited, the others compensate for them.

Aside from this it is only three days until my surgery and I am starting to get a little nervous.  However, I am in the care of an absolutely fantastic team who make me feel comfortable and I have every confidence in them.  Dr. Peter Tsakiris is my Oral and Maxillofacial Surgeon and will be performing the SARME surgery on Monday, Dr. Steve Stromotas is my Orthodontist (who also has an amazing, friendly and professional team of staff) and will be assisting me with the expansion device and later my braces, and my dentist Dr Kenneth Wong is keeping my dental health at top notch condition.  That's enough love for one thread!

So what am I doing this weekend?  Well apart from stocking up on mashed potato, soup, protein drinks and other soft meals I am going to make the most of my oral freedom <insert naughty pun here>.  I have some friends coming for dinner on Saturday evening (I love to entertain) and will be chilling out on Sunday and catching up with as many people as I can on the phone while I can still talk.

I'll be updating this blog pre and post surgery so watch this space!

The expander is in!

I finally got my expansion device in today in preparation for my SARME next week on Monday and for the first time I have started feeling nervous!  The expander only took 15-20 minutes to be installed and glued into place, and after a quick check by the orthodontist I'm ready to go.

Learning to speak with the expander in is a lot of fun as I suddenly have a very prominent lisp.  Add to that the constant swallowing from the excess saliva and it all adds up to a rather attractive package!  I haven't tried to eat anything yet but have been warned to stay away from any sticky foods - so goodbye chewing gum, sweets and caramel :(

While I'm feeling nervous I am also excited as it means things are now moving along.  I can't wait for my SARME surgery next Monday and will keep this blog updated of my progress.

For now here are some photos showing the expander in my mouth as well as some side pictures which show the metal rings of the expander attached to my teeth.  Not very attractive camera angles but what can you do?

When my palette is split in half this device will widen my jaw

The metal rings surround two teeth on each side of the upper jaw and are glued into place

Another attractive shot

How much will it all cost?

When I started enquiring about 'fixing' my jaw I first did a lot of research on pricing.  While the costs have worked out to a little more than I originally expected (well OK around 40% more), I still had a fair idea of what I was letting myself in for.

So for those of you out there who are looking into SARME/SARPE, orthodontics and bi-max surgery - here is the cost for each stage along with a breakdown of what fees make up the total.  All prices are in Australian dollars before any rebates from my private health fund or Medicare.

Stage 1 SARME = $6,250

Surgical fee = $3,000

Teeth removed x 5 = $550 (total)

Day surgery fees = $1,800

Anaesthetist fees = $900

Stage 2 Orthodontics = $10,800

Braces, adjustments and all appointment fees = $10,800 ($3750 initial deposit then $470 per month for 15 months).

While the orthodontics sound expensive this also includes consultations for two years after orthodontic work is completed.

Stage 3 Bi-maxillary (double jaw) surgery = $23,000 (approx.)

Pre-op surgical appointment = $1,500 (approx)
Surgical fees = $17,000

Hospital and anaesthetist fees including 1 night high dependency unit and five night stay total = $4,000 (approx.)

Other fees for x-rays, consults, veneers, cleaning and general dental = $3,000 (approx.)

Grand total for entire treatment = $40,000 (before any rebates)

Expensive?  Well yes it is - but remember these fees are before any health fund or Medicare rebates.  I can expect to receive about $8,000 in total from these rebates.  Then there are the tax refunds on top of that - the Australian government will give 20% back on all medical expenses over $2,200 in any tax year (after rebates from health funds and Medicare).  The cost of these procedures will be spread over two years, but I can still expect to receive another $5,000 or so back, which brings the grand total out of pocket to around $27,000 which is much more manageable.

If you are still reading but unsure of the prices I think its a matter of putting things into perspective.  Some people would not think twice about spending this much money on a brand new car.  Some people will easily spend $10K on an overseas holiday.  This is something that will last me for the rest of my life, so I definitely think it is a wise investment.

Well that's all for now - it's late here in Sydney and time for bed.  If you have any questions feel free to drop me a line or leave a comment.