Ann, age 56, of Arkansas
Ann had her AOO/Wilckodontics procedure done in September 2004. I
asked her several questions about her experience. Here are our
questions and answers:
did you pay for this procedure? Was any of it covered by your
insurance? Did you have to pay up front, or on a payment plan?
The AOO was
$4000. The braces were $5750. They cost--I can't recall
exactly--about $550 more than regular because of the
additional adjustments every 2 weeks (some more often, as
needed). The periodontal cost for the initial consultation was
$90 and digital x-rays $85. Two cleanings to be done towards
the end of my 6 months at $170 each. I don't have dental
insurance. I paid upfront, but could have worked out a payment
plan with the doctor.
sort of doctor did your procedure?
I used a
periodontist, working in close conjunction with the
orthodontist, who referred me. Together they decided on how to
proceed after I had decided to do it. They were wonderful,
compassionate men, calling, emailing, sending flowers the
you have to do to prepare for it?
get a good night's sleep (yeah, right), arrive with clean
teeth, have a driver.
get your braces on beforehand? If so, how long before?
were put on 2 days before, but the doctors. decided to leave
the wires off to possibly speed up the stitching, not having
to work the thread behind the wires. The brackets were very
uncomfortable without the wires-- more biting -- and the time
wasn't that much less, so they have returned to putting the
total braces on before surgery.
type of anesthesia was involved?
a Valium for the night before, and one for the morning of the
surgery, then many shots of Novocain to completely numb the
gums. The bottom took 45 minutes to go numb, the top 15, but
the top had to have another shot near the end when I noticed
some mild sensation. The shots, especially in the top, were
painful but not for long. The surgery was then totally
did the procedure take?
thing, counting going numb and resting afterward, took a
little over three and a half hours. The bottom was done, then
we had a short rest, then the top was done. He cut and pulled
the gums back, then used an electric tool to scratch the bone
surface all around the teeth, then put in a bone grafting
powder, then pulled the gums down and put a stitch between
stitches looked like a mouth full of dental wax. I think the
perio said they were Teflon. They had to be removed after 2
weeks, which only hurt some when the technician pressed the
little pointed scissors into the gums to cut them. Pulling
them out didn't hurt.
you feel immediately afterward? One day later? A few days
exhausted immediately afterward and thrilled it was finished
and hadn't hurt. I kept my eyes shut the whole time, praying,
and when the dr. asked if I wanted to know what he was doing,
I said, "No."
day I felt fantastic, thinking, "This is a piece of
cake!" But the second day, my lower face rapidly began to
swell right up into my sinuses. This swelling lasted 9 days,
but I saw the dr. twice in that time and he reassured me it
wasn't excessive and the gums were healthy, all looked fine;
the second time I went, though, he realized I was having more
pain than usual and told me to finish the narcotic pain pills
he had given me for the first few days; I had only taken 3,
not having real pain then. Stupid me, he said take them the
first couple of days if needed, then switch to Tylenol, so
that's what I did, but the Tylenol did no good.
biggest part of the throbbing jaw was the elevations on the
back teeth to open my bite installed when the braces were put
on to keep me from hitting the bottom brackets with my top
teeth and let crossbites move. From the surgery, my gums felt
raw and the roof of my mouth felt sore.
day of swelling, I held a cold pack to my face constantly; the
days I was swelled after that, I held a hot pack to my face
constantly. I slept (some) in the recliner so I could manage
the packs and to be more upright to help the swelling. The
swelling felt tight and stiff and affected my talking. I was
on liquid food since the stitches filled my mouth, between
every tooth. I could not brush/floss, but was given a
prescription for a mouthwash to use after each eating that
stained my teeth brownish a little. It didn't taste too bad;
the stains have cleaned off since I began brushing.
did it hurt? Can you compare the pain to anything else that
other people would be familiar with?
the rawness and soreness of the gums from the surgery were
something I could handle had I not had the throbbing of the
jaw teeth. The swelling didn't hurt, it was just tight,
tiring, and uncomfortable. Mine lasting 9 days is very
unusual, I understand.
swelling was involved? How much bleeding? Any bruising?
no bleeding and no bruising.
after the stitches were out, I had the wires put in. Two days
later I called the ortho because all my front top and bottom
teeth were so smashed together that I was sure they would
damage each other, and there were embrasures between those
teeth, apparently from the roots widening when their tops were
smashed together! That is how fast they were moving! He said
basically it often has to get worse before it gets better and
did no adjusting. My first adjustment was the next week (2
weeks after the wires went in) and he put on some springs to
make room for 2 crossbites. Pressing on the brackets to
open/close them had me in tears.
When were you able to go back to work/school afterward?
am retired, so I was able to crash. I don't believe I could
have gone back to work comfortably until after the stitches
were out; I was too grossed out.
about eating -- did you have to avoid certain foods? Were you
able to chew somewhat normally? Or, were you on a soft or
liquid diet for a while?
I was on a
liquid diet until the stitches came out, and because of those
darn jaw teeth elevations, I am still on liquids or
soft-cooked foods I can mince enough to swallow without
chewing. I have no chewing surface! Plus my teeth are too sore
to chew on, I am pretty sure! I have lost 6 pounds in 6 weeks.
did seem to agree that my teeth are more sore with the surgery
because they are all somewhat loose and all moving at the same
time. The brochure for Wilkodontics said adjustments were less
painful with the "softened" bone, but that is not
true. The 3 other people I have talked to (who had AOO) --
even those finished in a few months and into retainers before
their 6 month movement was finished -- had sore teeth and had
to eat soft food for 6 months.
take any pain medication afterward? If so, was it a narcotic
or a Tylenol-type?
I took 3 of
the narcotic pain pills initially, then went on Tylenol, as
directed by the doctor, but the pain of the jaws throbbing put
me back on the narcotics for 3 more days/4 nights. Once they
stopped throbbing, I was pain-free, just swollen and tired of
sort of braces do you have?
I have full
metal braces, self-ligating. They don't look exactly like the
pictures of the Damon braces, though.
How long will your total treatment take?
treatment is estimated at 12 months (compared to 24 without
the surgery) but all the people who are finished have done it
faster than the estimated time. I am older; I have quite a few
things to correct, I doubt I am faster, but I wish I would be!
So far, how are the results?
almost 4 weeks in braces, I can only see the front and bottom
teeth are smashed together. I can feel a lot of tingles,
vibrations, occasional soreness, different widths between
teeth for flossing. At my second adjustment, the clinician and
doctor, comparing all my photos and x-rays, tell me my teeth
are moving amazingly. Oddly, I can't really see it. But I can
believe it from how they feel: like huge foreign objects.
Would you recommend this to others? Why or why not?
decided not to do the surgery if my periodontal exam was good.
But it wasn't: I had 4 pockets that needed to be eliminated
and I have a narrow arch that could use more bone to widen.
After learning those things, I went for the surgery since the
pocket elimination surgery is basically the same as AOO, just
less so. I am expecting to be thrilled when my teeth begin to
go into place, but right now they are SO very sore from all of
them moving and responding to the braces.
said he hopes to have most of the straightening done in the 6
months that the teeth are easily moveable. After 6 months, the
bone grafting powder finishes joining the regular bone and the
teeth solidify in the gums and any movement then is like
regular ortho. work.
Right now I
cannot advise anyone whether to do the surgery: it was a big
deal and expensive and I have no way to compare the results
yet or the pain with normal braces. When I am out of braces in
a year instead of 2 or more, then I will probably say it was
your orthodontic problem that lead to this?
I have 3
crossbites on top, crowded bottom front teeth, and the bottom
side teeth are leaning in.
Are there any other comments or suggestions you want to add
about the AOO procedure that we haven't in these questions?
There are a
lot of medications. I had the Valium and Novocain for the
surgery. I had a week of steroid pills to help with the
swelling and a week of antibiotics to ward off infection (my
gum grafting powder did not include antibiotics; safer in case
there is a reaction to the med.) I had the narcotic pain pills
and 3 anti-nausea suppositories in case the pain pills made me
nauseous. (I used them, just in case, at first.) I had the
medicated mouthwash to use during the stitches.