Tuesday 25 December 2012

Orthodontic treatment - the first step on a long journey

I suppose my collision course with Orthodontics started back in May 2005 with a freak accident but its taken until 2012 to get this far.  I'm probably not a typical case for braces as I don't care enough about my teeth's appearance to have treatment and yet here I am.

My teeth have never been that bad.  My top arch, whilst not perfect (in a Hollywood sense) is better than many peoples with balanced, reasonably straight teeth.  My bottom arch has always been crowded and the teeth crooked but it didn't bother me at all.

When I was growing up, in the 70's and 80's, the only kids wearing braces were the ones with truly terrible teeth and as such were quite rare and mercilessly teased at school by those whose natural good looks made them feel superior.  Short, tubby and bespectacled from age 5 but with reasonable teeth I fitted into neither group.

Anyhow, I'd accepted my dental lot years ago and didn't spare it a thought.  In May 2005 I took part in a charity mountain biking event in the Mendips called "Clic 24" in aid of Clic Sargent, a charity which supports the families of children with cancer.  It is fair to say that it wasn't a charity close to my heart (although I have taken part in other fundraising events for them since) with my interest being in the mountain biking more than the fund raising.  I did however easily exceed the minimum fund raising target for entry.  If something is worth doing its worth doing well.

As part of a team of four I had three much fitter and capable companions.  The aim is to complete as many laps of a 10 mile cross country course as possible in 24 hours.  Considering the athletic prowess of my friends I suggested I go fourth in our relay team with the aim of potentially doing fewer laps and holding the others up less.  In true gentleman fashion they agreed without argument "if I felt that was fair" but we've been friends long enough to know that they had been thinking along the same lines.

Three laps down and it was my turn to go.  The course was close to my home in Bristol so I had trained on it and knew it quite well.  It would obviously be a different challenge with all the other bikers there as well but I wasn't fazed.  From here on I only have one memory.  I passed a young lady on the first climb and offered her some encouragement as she pushed her bike up the rather steep incline.  Next thing I remember clearly is the day they released me from hospital, I had to prove I could get up a flight of stairs unaided before they would discharge me.  That was four days later.

On a downhill section of the course I'd come off.  An eye witness said that the front wheel seemed to buckle under me and I flew over the handlebars landing face down on some rocky ground.  I was still not moving when that witness made it to me although by the time the Air Ambulance had arrived I was screaming loudly, apparently.


Four days on a neuro ward in Frenchay, I'd smashed my face quite well, stitches in my eyebrow, fractured right orbital, and I'd stripped the flesh and skin off a large portion of my right knee.  Despite this it was the serious cerebral contusion that had kept me in hospital.

I was in quite a lot of pain, that much I remember from my first days at home, and my teeth were quite painful.  My jaws also weren't parallel meaning I couldn't get my teeth together.  Despite it being the case at several follow up out patient appointments the maxfax consultant put it down to bruising and assured me it would be fine.

The bruising persisted and the situation didn't improve so I asked my dentist to refer me to the Dental Hospital which he did.  By this time I was getting some discomfort in my jaw joint due to the misalignment.  After several visits the consultants at the Dental Hospital concluded that my jaw was misaligned and the three potential treatments were
  1. Break my jaw again and try to get it to heal closer to the correct position.  They told me that the margin of error was greater than my current misalignment though.
  2. Grind down my teeth where they were meeting until all my teeth met.
  3. Do nothing and hope it fixed itself.
Being more than a little phobic about hospitals at the best of times and  getting no reassurance that options 1 or 2 would work I opted for 3.

Over the next few years it did settle down and I vowed to just get on with life putting it down as one of those things.  As time went by my lower teeth got more crooked and started overlapping, one in particular was heading backward significantly and they began resembling old tombstones.  My top teeth were also starting to move but it still didn't bother me that much.  I was getting more pain and discomfort from my jaw joint but accepted that there was nothing that could be done.

In January 2011 chance had me starting a job with Darren and Lynne Hills, the owners of a number of orthodontic practices.  They were growing, incorporating and becoming more corporate and in need of an FD.

At first I thought that it might be a bit like Ugly Betty of the Dental world and I'd stand out because everyone else would have perfect teeth but I was relieved when it was nothing like that.  It was probably another 18 months or so before fate get me another gentle prod, although not directly.

My wife had a routine trip to the dentist and he had no nurse that day so she couldn't have her usual scale and polish.  We have a hygienist who works part time with us so I suggested that she pop in and see her for a quick clean up.

Apparently its not quite as simple as that and my wife had to have a quick appointment with Darren first to "prescribe" the scale and polish.  My wife is terrified of dentists but Darren put her at ease and even managed to broach the subject of treatment.  Rachel has always been unhappy with her teeth but didn't agree to anything.

It took several months for Rachel to decide that she'd have treatment and partly due to her fear of dentists and partly out of an interest to see what our company actually did I accompanied her to her initial appointments.  Whilst she was out of the room having x-rays and photos Darren and I naturally started talking about whether I would ever have treatment.  I outlined my history as above, not caring that greatly the aesthetics but concerned a little about discomfort and functionality going forwards.  To my surprise Darren said he could do something about that.

After a proper consultation Darren said that he would ideally like to extract 4 teeth, 2 top 2 bottom, to make room for the required movement.  He couldn't tell from my x-rays but in his opinion I probably broke my bottom jaw in 1 or 2 places as well as by cheekbone / eye socket  and that would explain the problem with my teeth.

I was very reluctant to have any teeth out since I was quite proud to still have 32 but eventually we compromised and agreed on losing the lower 4's on each side, the first premolars.

With Christmas approaching and little time for multiple appointments with different dentists Darren agreed to do the extractions at the same time as the initial bond up.  Rachel thought I was mad but my theory was to get it all out of the way at the same time.

Prior to bond up I had a thorough clean with the practice hygienist.  It was the most thorough clean I'd ever had and felt like I ought to be noticeably lighter after all the scraping and polishing!



The day finally came, 21 December.  Darren bonded the brackets first and then extracted the two teeth.  The anaesthetic numbed the whole bottom jaw and I didn't feel a thing.  It took a matter of seconds for each tooth.

Wires went on once the bleeding had stopped.  014 Niti for the first period.  I could immediately feel the pulling on my teeth even though the anaesthetic hadn't worn off yet.  After a couple of hours feeling was almost back in my face and it was surprisingly pain free.




Over the next few days my teeth became progressively more uncomfortable, best described a bruised gums, only sore when eating.  After every meal I had to have salt mouthwashes to help the healing of the extraction holes.  Whether due to the salt washes, the shape of my mouth or the location of my teeth I've not had to use wax so far as the brackets are not rubbing.  Occasionally I feel them but nothing too serious.

I think I've had it quite easy so far but it still feels like the first steps on  a very long journey which I'm hoping will go quicker once I can eat without thinking about it.

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