Folk Ballad and the Case of the Open Bite

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Folk Ballad
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#16 Post by Folk Ballad »

So I shot off an email to my treatment coordinator yesterday about my awful experience. I'd thought about phoning, but it's easier for me to get my thoughts in order through writing than talking. (It's also not as likely that I'll be misunderstood.)
I basically outlined that I didn't like being treated as a kid, I just wanted to know what was going on with my treatment, etc.
I was expecting to be called back by the treatment coordinator, but at 9:30 this morning, low and behold, McAvoy himself was on the other line. Luckily, I managed to wake up (as I'd been sleeping) and stumble around, successfully finding the phone and answering. What wasn't so lucky was that I wasn't fully awake when speaking to him, my voice was still croaky from sleeping, and I just really wasn't as on the ball as I would have liked.
What I managed to get out of the conversation was that he was very sorry about what had happened and that my top second molars are to be extracted, the upper wisdom teeth moved into their place, but I would be allowed to keep my bottom second molars. (The wisdom teeth on the bottom, however, would be getting the boot.) Now, why this is, I'm still not sure I completely understand. My upper second molars have fillings was the reason given to me, but so do my lower second molars, yet they're allowed to stay. If I'd been a functioning human when he'd called, I might have asked for elaboration. I'm sure it all makes perfect sense to him. I'll probably wait until my next appointment (end of July) and ask him for a more thorough explanation then as my initial fears/nerves have been quelled and now I'm mostly just curious.
When I asked him how I'll be able to chew without having any of my teeth touching, McAvoy said that my bite will shift so that my first molars are touching instead. I'm not entirely sure how that'll happen, so maybe that'll be another thing I'll ask for further explanation of.
So, for now, the extraction drama has eased. Thanks for the advice, guys. It really helped encourage me to protest not being told what was going on.

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OhNicole
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#17 Post by OhNicole »

Don't you just hate those early phone calls? I always feel so silly because at first I'm indignant that somehow has actually dared wake me up with a phone call, especially if it's one I should be coherent for, and then I realize that most normal people are up at a decent hour and I just sound like a slug that sleeps all day :oops:

Anyways, I'm glad you worked up the courage to ask some questions and get the answers you needed!
~Nikki~
23 year old brace face and proud of it!

My story is well under way! Follow along in my thread.
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Folk Ballad
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#18 Post by Folk Ballad »

McAvoy also sounded a bit croaky (apparently he's been feeling a little under the weather), so I imagine our phone conversation sounded like a conversation between two frogs set in a bayou backdrop. :lol:

And about those answers... The questions McAvoy answered have only raised more. But now that I've bothered him once, I feel a little more bolder about doing it again... Heh.

Speaking of the extraction drama...
I thought it'd be interesting to hear an outsider's perspective on McAvoy's master plan, so I accompanied my mother to her dentist appointment.

I'll be honest, I love my dentist to pieces. He's easy going, friendly, open, and always manages to put me at ease. (Even when I was facing the daunting aspect of having 6 fillings - the first time I'd ever needed one, let alone half a dozen - his power of turning a scary dental procedure into something relatively unscary and manageable was something to admire.) Although he's more on the expensive side as dentists go, ultimately it's worth it, because he makes the experience of having to go to the dentist not some great, miserable unknown.

I thought up some questions I thought he could answer such as "Have you heard of this second molar/wisdom teeth switcheroo being done before?" and "Are my fillings really that bad that they warrant having the entire tooth replaced?"
Unlike McAvoy, I don't feel at all intimidated about asking questions of him and in return, he doesn't seem at all bothered by answering them thoroughly.

My dentist's views on my extraction dilemma makes me a lot more unsure about the whole thing. To sum it up, he said he was very surprised by 'fillings' being the reason given to me about my second molars needing to be extracted. While he studied my panoramic x-ray, he told me that my second molars were healthy, that there was only one filling in each and said fillings were only on the surface. He also mentioned that having teeth replaced by wisdom teeth were definitely an exception to the rule and, from what he's seen over his career, were only used in extreme cases. Why it would be done with mine, when my teeth are quite healthy, baffled him. (Welcome to the club.) The roots of wisdom teeth compared to the other variety of molar differ significantly, with the wisdom teeth roots being more pointed and the other molar teeth branching out. Worst case scenario was that if I do indeed have my second molars replaced with my wisdom teeth, far, far down the line in my life, those second molar imposters may need to come out due to weakened roots. (Though he did assure me that wisdom teeth could function just as well in the stead of second molars and this worst case scenario was a big, elephantine if.)

He also gave me a little pep talk about making sure to get all the answers out of my orthodontist, not hesitating to ask questions, etc. He's right of course, and it was tremendously thoughtful of him to want to bolster my confidence (which he did). He apologized for not being able to answer my questions very well, and although he repeatedly reminded me that he's (obviously) not an orthodontist, it was really helpful to get a second opinion. I want to be able to properly weigh the pros and cons of having my teeth yanked before I sign a consent form and don't want my ultimate decision to be guided by my inate fear of having teeth pulled or not having all my facts straight.

I have my very first consultation with one of two oral surgeons I'm considering tomorrow, so I'll also bring up the subject of my second molars with him to see what he has to say. After that, I'll call up Dr. McAvoy, ask him a final round of extraction questions, and then make a final decision.

(Phew. I really didn't think that braces would be this complicated! It's only the third month of this ordeal and I'm already bogged down with decisions.)

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Folk Ballad
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#19 Post by Folk Ballad »

I've met my oral surgeon and he has pretty much all the qualities I'd want in a medical professional: a straight-forward style, patience, a sense of humor, and a strong handshake (very important). It turns out he doesn't much like the idea of extracting my second molars either. In his words, trying to replace my lovely second molars with my diabolical wisdom teeth is a crapshoot, and I really don't have too many chips that I can risk gambling. At this point, it's basically settled in my mind that I'm not going to agree to the yanking of my second molars.
Hopefully together my oral surgeon and I shall vanquish McAvoy's wild and crazy scheme once and for all.

First of all, the oral surgery consult.
My whole mouth reconstruction process is like opening one crackerjack box after another. There's always some unexpected surprise being sprung on me. While my oral surgeon (who I'm just going to call Dr. Optimus Prime -makes for a nice change of pace.) was very against giving my second molars the boot, it turns out he wants to widen my palate either surgically or through whatever means McAvoy can come up with.
Now if it's surgery, that apparently ups the ante to *two* surgeries instead of one. The palate surgery before the end of this summer and the grand finale surgery at the start of next summer. Why they couldn't be combined into one surgery ala the Wonder Twins, I'm not entirely sure.
If we can go the orthodontic route (which I'm rooting for), I can avoid paying for a second surgery with money I don't have, force McAvoy to put a little more work into my mouth, and I won't have to deal a lot of extra mess and hassle.

Of course, with The Mouth nothing is ever easy. My upper brace day is tomorrow, but if I do end up needing to widen my palate surgically, those top braces are going to need to come off for the time being. If McAvoy can work orthodontic magic on my feisty palate instead, then top braces could probably possibly maybe be put on (according to my treatment coordinator).
Problem? Optimus Prime never managed to get into contact with McAvoy, because McAvoy decided now would be a good time to have a little R&R. McAvoy's first day back is tomorrow - brace day. You do the math.

The upside to my ever unfolding mouth drama is that I'm so worried about getting McAvoy and Optimus Prime to reach some sort of treatment agreement or at least, you know, speak on the telephone, that I don't really have any energy remaining to worry about the braces in and of themselves.

Tomorrow shall be an interesting day indeed.
Last edited by Folk Ballad on Fri Aug 01, 2008 1:50 pm, edited 1 time in total.

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OhNicole
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#20 Post by OhNicole »

Ooooh, you've nicknamed your oral surgeon Optimus Prime? This is getting good!
~Nikki~
23 year old brace face and proud of it!

My story is well under way! Follow along in my thread.
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Folk Ballad
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#21 Post by Folk Ballad »

Thanks chica. ^^

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(Apologies for the crap that is my skill at taking close-ups of The Mouth.)

Brace day part the second has come and gone, and I now officially have a matching set of braces top and bottom. I went with 'jade' ligs this time (though they're more of an evergreen color, if you ask me) and I've already realized the huge problem that comes with having colored ligs: you can't match them with your outfit 100% of the time. Braces are easy to rock when they match your outfit, but when your outfit clashes with your lig colors - no bueno.
Maybe I've been watching too much What Not To Wear.

Everytime I go into McAvoy's office, I get to practice my eavesdropping because there's always some other patient in the I AM A SHITHEAD SPAMMER. PLEASE REPORT ME TO THE ADMIN! with me being tortured not far away. This time not only did I get to hear about some kid's problem with his biteplate (it makes him feel self-conscious), but out of the corner of my eye I also watched a boy get fitted for high-pull headgear and I heard mention of the possibility of wiring it in (though it's horrible to say, he made me feel a hundred times better about my own situation. thanks fellow unfortunate!).

It's already turning out to be a McAvoy vs. Optimus Prime cage match.
Optimus Prime wants me to have two surgeries, McAvoy wants me to have one surgery that's a sort of combination of the two Optimus Prime suggested. McAvoy thinks Optimus Prime is a nincompoop who's going to screw my mouth up royally. (How The Mouth could get any worse, I don't know.) Optimus Prime thinks McAvoy is loco for wanting to pull my second molars and replace them with wisdom teeth.
And on and on the drama goes. It sort of reminds me of one those "It's me or the dog." type of arguments. If I don't do the treatment Optimus Prime wants, he's walking. If I don't do the treatment McAvoy wants, *he's* walking. So really, it's either one or the other and I think what it's going to come down to is that I'll need to find a new surgeon. As much as I like Optimus Prime, unless he bends to McAvoy's iron will, I'm going to have to cut him loose. McAvoy is sitting on a lot more of my money than Optimus Prime is *and* McAvoy has already been toying with my mouth for over two months now. Optimus Prime has barely gotten SPAM SPAM SPAMMING.
I'm still holding out for them to settle their differences like grown ups, but I'm not going to get my hopes up too high.

The extraction drama has become more of a subplot compared to this new, more major drama. But I did invite McAvoy to argue in favor of extracting the second molars one last time and by the way he made it sound, there are no possibilities of complications when trying to convince the wisdom teeth to get over their stage fright and upstage the second molars. He also assured me that he does so all the time with his patients. Optimus Prime and my dentist gave a far more balanced view of the pros and cons either way, and so, I've officially decided to side with them. Sorry McAvoy, if you're taking away my surgeon, I'm taking away your precious wisdom teeth.

As far as The Mouth's progress goes, I really haven't been able to see very many changes amongst the lower teeth beyond a small gap forming on the left side of my right canine. Waiting and watching for the braces to do something *anything* is about as rewarding as watching grass gros. I think I'm still of the mindset that I'll wake up one morning, look in the mirror, and my lower teeth will all be perfectly straight and orderly like little soldiers.

The aftermath of getting upper braces was surprisingly different than the lower braces. When it came to the lower braces, I thought I would pass out from how much it hurt when I chewed and I went through wax like it was going out of style. But with the upper braces there's been a lot more emotional pain, rather than physical. (Not wanting to smile, feeling really self-conscious and unattractive, etc.) There was a whole lot of moping, retail therapy, and vegetating in front of the television for a couple of days. (Very melodramatic, I know. I can practically see you shaking your head in disgust. There's just something about having braces that makes me more in touch with my inner preteen, I suppose.)
I'm mostly over the paralyzing confidence crisis now, though I can't say I don't miss my pre-braces smile. I have the inkling that I'll be completely back to my usual, good-humored ways just in time to go back to college, where I'll have to deal with explaining why I got braces over the summer again and again (which will consequently make me feel self-conscious about them once more). Oh, mouth. Look what you're doing to me.

My next visit with McAvoy is set for the 13th of August in which I'll be getting my suresmile scan done. (I'm actually really looking forward to this. The Mouth can't wait to see a 3d image of itself on the computer - it's such a primadonna.) Between then and now I'll be sorting out the whole surgeon debacle. Hopefully things will turn out all right.
I never thought fixing this open bite of mine would be so gosh dang complicated. :/

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GiovanntiLawing
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#22 Post by GiovanntiLawing »

Beautiful smile!....even with braces HAHAH

Good luck with your journey!
Giovannti. 26 years old with braces..

http://bracesandthecity.blogspot.com/

2nd Time w/Braces
Metal-First time 10 years ago
Ceramic-(Second time) Top Arch Installed 7/9/2008, Bottom Arch Installed 9/10/2008

Next Adjustment 11/25/2008

Word of advice: WEAR YOUR RETAINERS!!

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OhNicole
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#23 Post by OhNicole »

Hang in there, eventually your uppers and lowers will behave like peas in a pod (and hopefully so will your ortho and surgeon will too, even if they have to duke it out first :?)
~Nikki~
23 year old brace face and proud of it!

My story is well under way! Follow along in my thread.
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Clo
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#24 Post by Clo »

Hi,

holidays came and finally I am able to do some reading here on the forums. And
wow, did I miss something. What a horrible experience you have there. But it is
compensated by such a lovely way of writing. You wrote you never thought fixing
this open bite of yours would be so gosh dang complicated. I know all about this.

Look at this probably familiar to you post of mine :

viewtopic.php?t=25109&start=0

I am so lucky to have an open bite too. Only difference, mine was created mainly
by a mistreatment given to me so generously by my first ortho, some years ago.
It is now more than 2 years that a second ortho and now a third one are trying
to get it closed again. Yes, open bites are indeed so complicated, I witnessed. I do
now know that a surgery is indeed about the only good option to deal with this.
When I started reading your posts here, I saw all was good and about following
the path I know was right.

Until this extraction story came into the spotlights. I admit, it made my eyebrows
curve into 2 gigantic question marks. Indeed, your open bite, like mine, has this
openness that gets bigger towards the front. When one extracts the last teeth,
the contact area moves forward and the bite closes more. That is why they did
propose to me to extract my third molars. But I am not an easy patient, and I
refused. Because -a- there was no open bite before my treatment started and -b-
it is obvious that when these are extracted that I'll only gain one mm or so. And
then, what about the rest, I asked. Will you extract my second molars to gain
again a bit, and then my first molars to gain some more, until I have only front
teeth left, and then ... of course ... no open bite anymore. Hmm, I am deviating
I fear. What I wanted to tell is that I can understand the extraction of the back
molars. But frankly, after reading your posts twice, I still do not get it why on
earth extracting the second molars and moving the third ones in their place. Of
course I am no orthodontist, only some experienced patient, but I think this is
making complicated things more complicated. I even wonder why this extraction
is needed if you have jaw surgery which will involve impaction of the back of the
upper jaw. But the worst thing you are experiencing is this difference of opinion
between your ortho and the surgeon. That is just not right. Although you really
are dealing with this in an absolutely fabulous way, knowing you are only 19. They
should respect you a lot more and work out a good plan on their own. It looks like
you are a lot more adult and mature than they are.

Anyway, I am anxious to read how this goes on. Oh, I almost forgot. You indeed
have such lovely teeth. They look absolutely gorgeous. Now the only thing to do
is giving you a bite. Best of luck !

PS. I still did not start my own blog here because my story goes on for more
than 4 years now, which is even longer than this forum exists. But I post from
time to time in the Metal Mouth Forum. Another episode is to be expected soon
as Thursday I'll get a system called Rapid Molar Intrusion to try to close my bite
orthodontically.

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