SARPE/Braces at 35

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Carno
Posts: 46
Joined: Mon Feb 24, 2020 11:47 am

SARPE/Braces at 35

#1 Post by Carno »

Figured I'd start a journal of sorts to log my progress in my teeth straightening saga. First time having any sort of orthodontic work, but the time is right, so I'm finally getting started. Talked to an ortho nearby who recommended me to an oral surgeon for SARPE. After working with the surgeon, we finally got a surgery date on the books: March 16 2020. Before surgery I had to get the expander put in, and so this morning I went to the ortho's office where they installed the expander.

Total time at the ortho's office this morning was 15 minutes, so putting it in was very fast. My ortho was out of town this week, so it was actually a dental assistant who put it in. She showed me what the expander looked like, then laid me back and put the expander in to check the fit. I was fine, so she took it out and then put some sort of prep stuff on my molars where the expander was placed. Once that stuff was on she dried my teeth with air and then put some dental glue (or whatever it is) on the expander and then placed it in my mouth. Once it was set and everything looked okay she put two bunches of gauze between my upper and lower teeth and had me bite down on that for a few minutes until the glue was set. Once that was done I got the key from her and was on my way.

First impressions of the expander in my mouth weren't horrible, but it is fairly annoying having it in the roof of my mouth. There's enough of a gap between the top of the expander and the roof of my mouth that I can fit the tip of my tongue through. Having it on my teeth and in my mouth isn't too bad, and I only have slight difficulty with pronunciation. The most difficult words to say properly start with 'g' and 'u'. Other than that, fairly easy to talk normally. The biggest thing, and something I wasn't expecting was the amount of saliva.

So. Much. Saliva.

My mouth keeps producing it, so I have no choice but to try to swallow it or spit periodically. Speaking of spitting... not easy to do at all. I didn't realize before, but my tongue not being able to get to the roof of my mouth really inhibits my ability to spit or swallow completely. There's always some amount of spit left over in the roof of my mouth/around the expander, so I can never fully empty my mouth out.I pretty much have been drinking only water since if I drink anything else there's some amount of it left in my mouth after swallowing, so I have to swish some water around in my mouth to get it out, so I figured I'd just stick to water.

Eating has been fairly annoying, mostly because part of the expander that fits on my molars has a part that sticks out outside two of my molars. This metal part collides with a molar on my lower jaw, so I can't fully close my teeth together. This makes chewing food fairly annoying, since it feels super weird to have my jaws stop moving together before I feel like they should. Also, I don't want to damage my lower molar, so I keep it gentle with the chewing. Not being able to fully chew the food because my teeth don't close all the way is also annoying. The food also tends to congregate in the roof of my mouth, in the gap between my expander and the roof of my mouth. So, I have to constantly push the food out of that gap with my tongue. Overall it's not hard to eat, just tedious.

No issues brushing my teeth or using mouthwash, but I did have to rinse multiple times to feel like I got everything out of my mouth when I was done.

Overall not a bad start, but I will be counting down the days until I can get this expander out. Surgeon said it'll stay in for 6 weeks after surgery, so probably about 45 days total for me. I have surgery early on the morning of the 16th, so that'll be the next thing!

Carno
Posts: 46
Joined: Mon Feb 24, 2020 11:47 am

Re: SARPE/Braces at 35

#2 Post by Carno »

Had my Lefort 1 osteotomy yesterday morning. Was the first surgery scheduled for the day, so was in pretty early, and had the surgery itself about 8am. After waking up, was slightly groggy but woke up fairly quickly. Took a percocet and drank some apple juice, then slowly got ready to leave the surgery center. Got home about 11am. No nausea issues, but was in a fair amount of pain for the first little while after waking up. After taking the percocet I was fine, just really sore all over my lower face. My lower jaw was and still is pretty sore, I guess from having my mouth held open for the surgery.

Slept on and off most of the day yesterday, but was able to move around and do stuff on my own. Felt better by the evening, and was alternating the pain pills and ibuprofen. Took my last pain pill this morning after waking up, then have been on just 600mg of ibuprofen every 4 hours. Feel a LOT better today, but my lower jaw is still pretty sore and I still have trouble closing my jaw all the way. But, not painful, just sore. Throughout the day my upper jaw has been feeling better as well. My upper lip is pretty much back to full feeling, but my teeth don't have any feeling yet. Brushing them this morning was interesting.

The most noticeable feeling I have today is pressure in the roof of my mouth from the expander, and swelling behind my upper lip from the surgery. My face isn't too tender to touch (yesterday my cheeks and nose were pretty tender), so that's good. One big plus from the surgery is that I immediately noticed an improvement in my ability to breath through my nose. I've broken my nose three times and have a deviated septum, so always had trouble breathing through my nose. But, much more open now, which is nice.

Also speaking of my nose, had nosebleeds on and off all day yesterday, but only one today. Was able to take a shower and brush my teeth with no difficulty, and even went on some errands this evening.

This biggest hiccup is this COVID-19 thing. I'm supposed to begin turning the expander next Monday, but I'm not sure if my oral surgeon is going to close his office. My orthodontist said he was closing his office through the end of the month, but I wasn't supposed to get my braces put on until the first week of April anyway. But, I have a feeling that he won't be reopening for the forseeable future. So, I'm not sure what will happen with my expander as far as turning it (the surgeon kept the key after expanding it during the surgery). Not sure if I can just leave my expander where it is for the next few weeks, or if my jaw will start to heal together where it's at. Hopefully I will be able to get the key for the expander so that I can turn it at home while all of the virus scare is going on. I'm off work for the next 4 weeks anyway, and have plenty of supplies at home, so I'm pretty much self quarantining anyway.

Anyway, hopefully tomorrow brings less tenderness of my upper jaw and some reduced swelling.

Carno
Posts: 46
Joined: Mon Feb 24, 2020 11:47 am

Re: SARPE/Braces at 35

#3 Post by Carno »

Three days post op. Swelling in my cheeks hasn't gone down much at all, but my lower jaw is much less sore, and I am more easily able to close my jaws together. Not it much pain at all, just tightness in my cheeks and jaw mainly.

Ate some ravioli and cake today for lunch. Would have been able to eat soft foods yesterday, but my jaw was tired so I didn't feel like chewing. Recovery is going better than I expected, but it will be nice when the swelling goes down!

SinkFullOfDinner
Posts: 273
Joined: Mon May 23, 2016 2:25 pm

Re: SARPE/Braces at 35

#4 Post by SinkFullOfDinner »

Carno wrote:
Thu Mar 19, 2020 9:53 am
Three days post op..Ate some ravioli and cake today for lunch.
Your impaired-eating menu sounds better than my everyday menu, making jaw surgery almost sound appealing. Unless, of course, you puréed the ravioli and cake and then ate it through a squeeze tube, in which case jaw surgery sounds exactly as I imagined it!

Seriously though, so happy to hear the recovery is going so smoothly!

Carno
Posts: 46
Joined: Mon Feb 24, 2020 11:47 am

Re: SARPE/Braces at 35

#5 Post by Carno »

SinkFullOfDinner wrote:
Thu Mar 19, 2020 12:37 pm
Carno wrote:
Thu Mar 19, 2020 9:53 am
Three days post op..Ate some ravioli and cake today for lunch.
Your impaired-eating menu sounds better than my everyday menu, making jaw surgery almost sound appealing. Unless, of course, you puréed the ravioli and cake and then ate it through a squeeze tube, in which case jaw surgery sounds exactly as I imagined it!

Seriously though, so happy to hear the recovery is going so smoothly!
Thank you! I feel pretty relieved that it's been going so well. I did not puree the ravioli or cake, was able to kind of mush it up in my mouth hah. Haven't had to blend anything yet, which is nice.

Carno
Posts: 46
Joined: Mon Feb 24, 2020 11:47 am

Re: SARPE/Braces at 35

#6 Post by Carno »

Seven days post-op. Went to see the oral surgeon for the first time since last Monday; he cranked the expander 12 times that day, and we turned it 3 times today, putting me about 2mm expanded between my two front teeth. He said I'll need about 13mm of expansion between my rear two molars, which will put me about 6-7mm of expansion in the front all told.

Swelling kind of peaked 4-5 days after surgery, and hasn't gone down by any noticeable amount thus far. My face and jaw are far less tight and sore though, which is good. The areas immediately on either side of my nostrils are still fairly sensitive, due to the sinuses there, I assume. I have only been taking ibuprofen since the second day, and these last two days I've only been taking about 1800mg per day. Usually 3 every 6 hours or so. I haven't taken any yet today, but after turning the expander 3 times, I definitely feel some tightness on the outside of my upper jaw, near my ears. Turning the expander was interesting, I expected a little more... feeling, but all I felt was a little more pressure and that's about it. Now I am feeling that tightness on my outer jaw though.

One interesting development is that my orthodontist is closed until May 8th... So while I will keep seeing my oral surgeon once a week for the next two weeks, I won't be getting braces put on for the foreseeable future. He told me that my teeth will begin to shift on their own and the gap will close by itself though, which is nice to hear. He told me about one patient who didn't get braces put on for about 6 months after the surgery, and his teeth had shifted on their own and there was no gap whatsoever, so I'm hoping it will be the same for me (minus the 6 month wait). Makes me feel better about the ortho being closed due to the coronavirus fear though.

EDIT: One thing I haven't mentioned is that I'm able to breath much easier through my nose now. I noticed it right after I woke up from surgery, and 7 days later I'm still able to breath easier. I used to sleep with my mouth open, now I'm able to sleep with my mouth closed, which is good!

Carno
Posts: 46
Joined: Mon Feb 24, 2020 11:47 am

Re: SARPE/Braces at 35

#7 Post by Carno »

Had my two week check up today. A good amount of the swelling is finally gone, but there's still a little bit that I can notice. Someone who just met me probably wouldn't notice it though.

I've turned the expander enough to create 7.25mm of space, and I've got another week of turning it, which will put me at 11mm of expansion. I didn't know this before, but the expansion is great in the rear of the jaw than in the front, so my gap isn't quite at 7.25mm. Right now it's about 4.5-5mm across, so I'm guessing ill have about 6-7mm of a gap when I'm done expanding.

My oral surgeon said again today that my teeth will start to shift on their own, and that he wouldn't be surprised if the gap were completely closed by the time I'm able to get braces put on. I have my doubts about this, but hope it's true. With the coronavirus thing going on, I don't think I'll be able to get braces until June or July.

Still eating soft foods, but have stopped taking ibuprofen at all. Wishing I could eat firmer foods, but my jaw is definitely still sensitive, and I wouldn't be able to eat anything firm anyway. Hopefully not more than 2 more weeks of the softer food, but at least I'm not on a liquid diet anymore.

Carno
Posts: 46
Joined: Mon Feb 24, 2020 11:47 am

Re: SARPE/Braces at 35

#8 Post by Carno »

Two weeks and two days. I've noticed that the right side of my jaw has definitely moved more than the left side. My surgeon commented on it as well, but told me that he would be able to rotate my jaw during the second surgery, to fix this. This didn't make any sense to me, as if they are not lined up laterally, rotating the upper jaw would maybe align my two front teeth to the front of my mouth, but would screw up the alignment of the rest of my teeth.

He also mentioned that the orthodontist would be able to fix some alignment issues, but with respect to that comment he just meant my molars. They're not perfectly in a row, as the middle ones on both sides are closer to each other than the ones next to them. Looks like they both need to be pulled outward about a millimeter in order to line them up with their neighbors.

Seems like rotating my upper jaw in order to get my two front teeth to the center of my face would be a stupid idea, when the optimal solution would be to shift my jaw laterally 1 to 2 millimeters. Either way, nothing I can do about it right now. I won't be able to get braces on for months, but have about another week left of expanding. Hopefully it doesn't get much worse. Only thing I can think of is to sleep on my right side, hopefully putting pressure on that side of my face will push things back the other way (doubtful that will work though).

TCCZ
Posts: 38
Joined: Sun Dec 01, 2019 10:10 am

Re: SARPE/Braces at 35

#9 Post by TCCZ »

Glad your recovery is going nicely. I smiled when you mentioned the saliva and mushing your food, good times.

Carno
Posts: 46
Joined: Mon Feb 24, 2020 11:47 am

Re: SARPE/Braces at 35

#10 Post by Carno »

TCCZ wrote:
Tue Apr 07, 2020 2:27 pm
Glad your recovery is going nicely. I smiled when you mentioned the saliva and mushing your food, good times.
Thank you! Haha, yeah it's been an adventure in eating!

Carno
Posts: 46
Joined: Mon Feb 24, 2020 11:47 am

Re: SARPE/Braces at 35

#11 Post by Carno »

Had my three week check up with my oral surgeon on Tuesday, which was 3 days ago. Turned the expander 46 times, for a total of 11.5mm of expansion. All told it created a gap of about 8mm between my two front teeth. My right side definitely expanded more than my left, but after talking with both my surgeon and orthodontist, they assured me that braces would be able to shift the left side further out where it needs to be, as well as shift the right side of my maxilla down, as it seems to have raised while expanding.

My surgeon actually talked to my orthodontist after my appointment, and then my ortho called to set up an appointment for Thursday. I assumed it was just a progress check, but when I arrived the ortho told me that he was going to put braces on right then, so that was a surprise. They added metal braces to all of my lower teeth, and ceramic ones to most of my upper teeth. I have another appointment in two weeks where they will add a few more brackets that will allow them to attach rubber bands, to pull the left side of my jaw out further, so that it's in a better position.

My maxilla is definitely still sore, as it still hurts to eat firm foods, and just pushing on it with my tongue is uncomfortable. So, hopefully the rubber bands work, as right now my maxilla is not symmetrical at all. My left side teeth on top and bottom line up exactly on each other, whereas my right side has a couple mm gap between the upper and lower, and my right side is wider than my lower left side, as it should be. It isn't super comfortable to eat, since only my left side teeth touch, but I can't really use my molars to chew food, since only the tops of my teeth touch each other, they don't fit into each other like they should. I have to admit I'm skeptical about the rubber bands moving my maxilla around enough to arrange everything correctly, but my orthodontist and his dental assistant assured me that it's common and would totally work out. So, I'm hopeful that they're right!

The downside of the braces is that it hurts to eat again, so I'm back on very soft foods. There's also a spring on my lower braces that has torn up my lower lip, which is fun.

Carno
Posts: 46
Joined: Mon Feb 24, 2020 11:47 am

Re: SARPE/Braces at 35

#12 Post by Carno »

Four and a half weeks since my surgery, and almost a week in braces. Had a bracket pop off one of my lateral incisors last week, so had to go in yesterday to get it put back on. While I was there, they put another power chain between my two front teeth. The initial one had 4 lengths, this time they only used 3. My gap has shrunk down from about 8mm to about 5mm, but that's because one of my teeth moved more than the other. I now have a gap of about 2mm between my left front tooth and my left lateral incisor, whereas my right front tooth has only shifted about half a mm. My left front tooth also kinda bends toward the other, instead of pointing straight down.

Appearance-wise, this is worse than having the huge gap, but I have only had my braces on for less than a week, so I can't complain too much. Hopefully my right front tooth gets with the program and starts to march toward the center like my left one did.

Carno
Posts: 46
Joined: Mon Feb 24, 2020 11:47 am

Re: SARPE/Braces at 35

#13 Post by Carno »

Well, haven't made any updates here in a while, but I figured I'd add some progress pics. I was seeing the orthodontist every 2-3 weeks for a few months, but have now gone to every 5 weeks. I've also been seeing the oral surgeon at about the same frequency as well.

This first photo is from the morning of the surgery.
IMG_2210.jpg
This next photo is 3 and a half weeks later, the day I got the braces put on.
IMG_1142.jpg
And this photo is from just a few days ago, almost exactly 5 months after I had the braces put on.
IMG_2190.jpg
Obviously lots of progress in that time. Here's the timeline for everything that went down:
Mid-March - expander appliance put in
+3 days - SARPE procedure
+7 days - started expanding the appliance
+22 days - stop expanding
+24 days - braces on
+112 days - appliance removed
+166 days - the latest photo.

The biggest problem that I encountered was that the appliance didn't expand my jaw equally. It pushed one side out further than the other. The surgeon assured me that it will be easily fixed during the second surgery. I need to have double jaw surgery to move my maxilla out further, and pull my mandible back, since I have an underbite. There is a chance that I won't need anything done to my mandible, but we'll see. Hoping that I only need to have surgery on my maxilla to shift it over laterally about 1mm, and move it forward slightly. Overall I'm very happy that I went through with all of this, and can't wait to see the final result!
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SinkFullOfDinner
Posts: 273
Joined: Mon May 23, 2016 2:25 pm

Re: SARPE/Braces at 35

#14 Post by SinkFullOfDinner »

Wow. Just....wow! The amount of change in only five months is unbelievable. Who wouldn't be thrilled with that kind of progress? Continued good luck the rest of the way.

HarryGray
Posts: 8
Joined: Wed Jul 29, 2020 3:02 am

Re: SARPE/Braces at 35

#15 Post by HarryGray »

Look forward to hearing about the rest of your journey, Carno :)

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