With this ring, I thee bled!

Ok, so grammatically the title of this post is pretty rubbish, but hey - I'm trying to be funny!

I went back to the orthodontist on Tuesday - just 24 hours after having my spacers put in.  The spacers were removed and the rings (which will eventually be connected to the SARME / expander device) were sized for my upper molars and front upper teeth.  I think I had become complacent about pain as the spacers did not hurt or cause any discomfort - but I can tell you, having the rings fitted soon kicked me back to reality!

The process of sizing the rings involves sliding various different metal rings up over the teeth in question (quite roughly I might add) in order to find ones which are the perfect fit around the tooth - not too tight and not too loose.  The rings hit my gums a number of times and I could feel the edges of them against the inside of my cheeks as well as against my tongue.  This caused some discomfort but luckily the whole process only took 20 minutes or so.

Once the metal rings were fitted I had some impressions made and the rings were removed - phew!  The impressions will be sent to the lab to have the device built and this will be 'installed' on 4th March. Oh happy day!

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.

The spacers are in!

It's all finally happening!  I had an orthodontist appointment today and got the spacers put in ready for the expansion device which should go in about a week from now.  The spacers are simply little plastic discs that are placed in between teeth to create a larger space in between them.

I had four spacers placed in total (two on each side of my upper jaw) and I have to say they are not as uncomfortable as I was led to believe.  My orthodontist had warned me to take some painkillers as he said there would be soreness and I did take a couple of painkillers over twelve hours ago, but I have felt no pain whatsoever.

While its not the most attractive pose, here you can see one of the blue spacers in my upper jaw - they're kinda cute :)

I'll be back in to see the orthodontist tomorrow to have the final impressions made for the expansion device. Three weeks and counting!

Countdown to SARME surgery

It's a brand new year and I'm excited about the challenges that lay ahead - 2013 is certainly going to be a big year of change for me.

Even though I started out on this journey over a year ago (information gathering, getting restorative dental work), my first medical procedure is now a lot closer than I realised.  Of course I have known the date of this surgery for a few months now, but it was always easy to say "the surgery is next year".  Well it's now next year and less than two months away!

I'm booked into Randwick Day Surgery on Monday 11th March at 9am for my SARME surgery and extraction of four teeth.  The surgery will be performed by my Maxillofacial Surgeon, Dr Peter Tsakiris and as the name suggests this will simply be a day surgery.

I mentioned the SARME in my first post and also posted a YouTube video, but here is some further information as to what the surgery involves:

• A week prior to the procedure my orthodontist will fit a widening device in my mouth just like in the video, allowing me time to become accustomed to it and learn how to speak with it in.   The device pushes against the inside of the upper jaw (a little like a vice) allowing it to move once the procedure has been completed.  
• The day surgery will involve incisions through my palette basically splitting it in half - of course they will remove the separation device while performing the incisions.  I am also going to have four teeth removed which will assist with the orthodontics later.
• The device will then be placed back into my mouth (while still under anaesthetic) and they will insert the key and perform some of the widening as part of the surgical procedure.
• They cannot widen the jaw by the desired amount all at once, so for 3-4 months after surgery I will regularly insert the key into the device myself widening my jaw further.
• The device will then be removed by my orthodontist and they will allow my mouth a month or so to settle and heal.
• I will then move onto the second stage which will be braces.

So now I'm getting a little nervous!  Not so much for the anaesthetic or even what they are doing, but just in regards to the rehabilitation, post surgery pain and how I will look afterwards.  My surgeon assures me that the healing time is very quick (only about a week) and the pain is minimal - but I still find that hard to comprehend considering what the surgery involves.  In terms of how I will look, I will be waking up with a lovely gap in between my front teeth.  Of course this gap will grow so I'm bound to look as attractive as a camel.  I feel like getting a neon sign made up now stating 'yes I am having dental work' to save the myriad of questions, stares and comments that are bound to result from this!

Oh well, I just need to keep thinking of the final result after braces and jaw realignment, even though it is still 18 months or so away.

X-rays, photographs and projected outcomes

I thought I would now share with you some of the x-rays, photographs and projected outcomes in the report from my Maxillofacial Surgeon - Dr Peter Tsakiris.  I've had the report and images for a month or two, but it has taken me a little while to find the courage to upload them because the images really highlight the extent of my jaw abnormalities.  However this blog would not achieve it's purpose if I didn't share them, so here you go.  You can click on any of the images to view a larger version.

In the first x-ray (front view) you can see how my jaw has grown down too far covering my lower teeth.  The x-ray also shows that my upper jaw sits at an angle.  The side x-ray shows the extent of my overbite (upper jaw being further forward than the lower) but also the overjet of my upper teeth (the angle at which they are protruding outwards).

Current view of jaw from front

Current view of jaw from side

My last post talked about my SARME surgery which is the very first stage due to take place in a couple of months.  This surgical procedure will see my palette split in half to allow the expander device to widen my upper jaw.  A few teeth will also be removed during this procedure.  The below images show the expected changes in my jaw after this first stage.  As I stated before, this is actually the least invasive of all the surgical procedures.

First stage projections - SARME

The next set of images show the final expected outcome after stages two and three.  Stage two will involve wearing braces for a period of 8-9 months, and stage three will be the main double jaw surgery which will see me in hospital for a week.

As you can see my jaw will not only be wider, but also more square with the upper jaw being lifted up a further 2mm.  This will be quite a dramatic change as the length (and shape) of my face will completely change.  This is achieved by the removal of different parts of the bone in the upper jaw taking it both up and backwards, while the bottom jaw will be split and extended further forward using implants.  I will also have a genioplasty which involves an osteotomy of a piece of the chin bone, which will then be slid forward or backwards depending on the shape of my face.

Final projected outcomes - front view

While it's quite difficult to see - the final images show the expected changes from the side profile.  Again, click on any of the images to see a larger version.

Final projected outcomes - side view

These images are only projected outcomes and the treatment plan will evolve as I move through this journey, depending on movements made by orthodontics and other factors.

Well that's it for this post - if you have any questions please feel free to send me a message or leave a comment.  Next update soon!

So what is a SARME?

For those of you wondering exactly how the first stage of surgery works (mentioned in my last post), here is a YouTube video showing an example of the SARME (Surgically Assisted Rapid Maxillary Expansion).  My teeth are not crowded like the example in the video, but you still get to see how the jaw is expanded.

Disclaimer: I am not the female in the video...

The journey begins

What is this blog about?  Well, it is an honest account about my face and how I am planning to change it.

I have been unhappy with my smile for a very long time due to having an extremely prominent overbite (13mm), an overjet of my upper teeth, a narrow upper jaw and a gummy smile.  In fact this unhappiness has been with me since I was a very young child and teased for my looks.  I was called everything from 'buck-teeth' to 'goofy' and this has stayed with me throughout my life.  And so I thought rather than wallow in shoulda-woulda-couldas any more, I would do something about it.

If you are reading this blog, chances are you are doing so because we are kindred spirits, you are a family member/friend of mine or you were randomly redirected here while watching videos of cute kittens on YouTube.  Whatever your reason for reading this, I will attempt and explain what some of the issues with my jaw mean:

• Overbite - the official definition of overbite is 'a malocclusion of the teeth in which the front upper incisor and canine teeth project over the lower'.  That's a mouthful in itself (pardon the pun) but in layman's terms - my upper jaw is set much further forward than my lower and the jaws do not meet correctly.
• Overjet - not only is my upper jaw set much more forward than my lower, my upper teeth have also grown out at an angle instead of vertically.  Thank you Mother Nature.
• Narrow jaw - it is simply that, narrow.  When I smile my teeth do not go across the width of my smile as my jaw is too narrow.  Instead you see gaps (aka the Grand Canyon) in each side of my mouth between my jaw and the sides of my mouth.
• Gummy smile - not only did my upper jaw grow much further forward than my lower, it also grew down too much meaning that I show too much gum-line below my upper lip.

It all adds up for a smile that is pretty out of whack, or 'unharmonised' as my Maxillofacial Surgeon much more eloquently puts it.

So finally after years of wishing I had done something about this, I decided to start the ball rolling on my way to facial harmony.  Now this journey actually started about a year ago, but before I could think about moving towards a better face I needed some major restorative dental work.

You see, I had a pretty bad addiction when I was younger.  I was addicted to Coke.  Now before you start calling me a 'crack whore' (I should be so lucky), I am of course talking about Coca-Cola.  I couldn't get enough of the stuff!  Now as a much more mature person I hardly touch sugary drinks, but the damage was done.  Three fillings, two root canals and multiple cleans later, not to mention three teeth that will need to be extracted (ok so it could have been worse) and I am finally on my way.

So why am I starting this blog now?  Well after a move from the west coast of Australia to the east, I have found a great dentist, orthodontist and Maxillofacial Surgeon.  My treatment plan has been put in place, and I signed my first lot of paperwork today!  This treatment plan will be in three main stages (with the first stage in March 2013) and will consist of:

1. SARME (Surgically Assisted Rapid Maxillary Expansion) otherwise known as SARPE where the 'P' stands for 'palatal' instead of 'maxillary'.  This is a surgical procedure where I am put under general anaesthetic, an incision is made through my upper palette (yes it's split in half) and my jaw is widened.  I'll write more about this closer the time, but in the grand scheme of things this is the easiest stage of my treatment plan!
2. Orthodontics - Oh the joy of having braces.  I will have upper and lower braces fitted around 6 months after the SARME surgery which will bring my teeth in and close the gap between my front teeth that the SARME will create, as well as realign some other teeth.
3. Bi-maxillary surgery - this is by far the most major part of the plan and is double jaw surgery where both jaws are broken, various bits of jaw bone are removed, my lower jaw is extended forward and my upper jaw set back.  This surgery will be undertaken around 9 months after the braces go on.  Again, more about this later.

Still reading?  I'm impressed!  Well hopefully by now you are intrigued, impressed, interested or even infatuated.  Let's be honest though, even if you are totally bored and wanting to gouge your eyes out with safety teaspoons (is there such a thing?) to avoid reading any further, I still appreciate you looking.  Can anyone say attention whore? 

Of course you may have gathered by now that I love to talk, or type, or both - but my first blog post is now coming to an end.  

On a serious note, this will be a life changing journey for me (and my bank balance) and I am writing this blog to educate and entertain.  I hope you will follow me on my journey, and feel free to subscribe using the button within the 'Followers' section on the right hand side of the page.  Or simply comment, share and do whatever else with me that you will.

Ciao