SARPE and braces and jaw surgery oh my!

[jaime]

Hello!

While I have just joined this forum, my journey started a long time ago.

I'm 28 years old and knew since I was 12 or 13 that I needed braces. My dentist sent me for a consultation with an orthodontist back then; however, my parents couldn't afford it and the idea was quickly shelved.

I've had dental insurance through my job for 7 years but kept putting off getting braces since they are so expensive and the time never felt right. I've always hated my smile and knew I wanted to get braces, but couldn't imagine parting with so much money. Finally, last year my sister said she wanted to get braces. I decided the time would never feel right and decided to embark on the journey with her.

After 5 consultations, I heard varying opinions on my treatment. I ended up going with the orthodontist I'd seen when I was 12 (whom my sister also decided to go with). I also was referred for a consultation with a dental surgeon.

The problems:
-class II malocclusion
-severe crowding
-crossbite
-midline is way off
-anterior open bite
-lower jaw is too far back and tilted downward
-upper jaw is too far forward and tilted backward
-TMJ/jaw clicking/jaw pain

The plan:
-surgically assisted rapid palatal expansion, with the RPE appliance installed for 4-6 months
-transpalatal appliance put in after that, for remainder of treatment
-possible extractions (which I didn't end up needing, YAY)
-braces, not sure for how long, presumably 2+ years
-upper and lower jaw surgery with genioplasty

Journey so far:
-5 consultations: November 2013
-SARPE: December 19, 2013
-RPE removed, TPA put in: May 13, 2014
-Upper and lower braces: May 21, 2014
-Jaw surgery: ???? (2016?)


All of this is costing me $6100, plus a few other costs related to the surgeries. I live in Canada so the cost of the surgeries themselves are covered. My work contributes $2500 for the cost of braces, which I am very grateful for.

I'm now at the braces part of the plan, having had SARPE in December. I talked all about that in my blog which I will link at the end.

SARPE wasn't too bad although it's 5.5 months later and my upper incisors are still tender. I have only recently gotten the feeling back in my upper gums. It really sucked having the RPE appliance but the time (5 months) flew by and before I knew it, they were replacing it with the much more tolerable TPA.

I've been fortunate in that my friends and family have been very supportive, especially my boyfriend. I've found that people are super interested in hearing about the process, and like to tell me about their childhood adventures with an RPE and/or braces.

Admittedly, I'm not thrilled about having braces. Luckily I didn't have a hard time adjusting to them. My teeth only hurt for about a day, and I'm back to most foods now. My cheeks didn't really get cut up, and I only used wax for a couple days, and more as a preventative measure.

I have ceramic on my upper 6 front teeth, and traditional metal for the rest.

I go for a checkup with my surgeon later this month and hope that I'll find out more about the big surgery coming my way.

I plan to update this thread as I go along!

My blog, which has lots of photos: http://unexpectedlyjaime.blogspot.com

Thanks for reading!

[jaime]

[quote="jaime"]Hello!
My cheeks didn't really get cut up, and I only used **cannot mention** for a couple days, and more as a preventative measure.[/quote]

Oops, didn't know I couldn't mention certain products. I was talking about a popular brand of dental silicone, that people use as an alternative to wax.

[Kevinr144]

Your blog is very thorough! I hope you continue to update. Your teeth have already changed a lot.

Good job on the body progress as well...personally I think it's harder to stay in shape than dealing with braces.

[jaime]

Thanks, Kevin! I agree with you...losing weight is constant effort, but the braces do their job no matter what. Both take a longgggggggg time, though!

[parsleysage]

Awesome blog! I'm so glad you joined Archwired I have been trying to transition to a low-carb diet for awhile now. I have a lot of weight to lose. So far I mostly focus on meals that are naturally low-carb, but I have tried one "substitute" recipe which was cauliflower mac & cheese, and it was actually really good! It didn't taste much like pasta mac & cheese but it was delicious in its own right.

Anyway, you have quite a journey ahead of you as well and I'm glad you are sharing it with us!!

[jaime]

Let me know if you have any questions about low carb! There's a ton of stuff on Reddit, too. r/xxketo is great, I like it better than the larger r/keto sub.

[jaime]

Just got back from seeing my dental surgeon! He said everything looks great after my SARPE, which was 6 months ago today.

I asked about my upper teeth still being tender and was told it's normal.

My second surgery (upper + lower jaw surgery with genioplasty) is now tentatively set for June 11, 2015. I hope my summer isn't too messed up from surgery as it'll be my last summer of my 20s! Not that I planned to go hog wild but still...

Happy thing are progressing faster than predicted originally. Saturday is 1 month in braces and I plan to post some progress photos.

[jaime]

Had my first adjustment yesterday. New wire on top, same wire on the bottom. The assistant made some kind of DIY metal wire attachment thing that is now pushing my one funky tooth away from the one next to it. Said tooth was crowded out and has been slowly joining my other lower incisors. I'm guessing this little attachment will help bring it forward.

I went with clear ligs on top this time as opposed to pearlescent. I didn't feel like pearl stained that much but when I was looking at the ligs on the table after, they had turned to more of a golden colour. I went with light blue and light purple on the bottom as I wanted something summer-y.

Teeth are hurting again, more on my right side than left. Nowhere near as bad as day one with braces but still painful.

I have some random gaps here and there, the biggest one being between my front teeth because of the SARPE. Ortho said once I work my way up to stronger wires, they'll get me a powerchain if I need it. He said without a stronger wire, the powerchain can cause undesireable effects like overlapping of teeth.

It's pretty great that my ortho gives out free silicone wax (GG brand). I bought my first tube of it pre-braces and it was about $10. It runs out pretty quickly if you're using it so I was happy to score free stuff yesterday.

My next appointment was supposed to be anywhere from 4-6 weeks but it ended up being scheduled 7 weeks off because of conflicting schedules, ugh. I dislike when things have to move slower than I want them to!

[jaime]

Things are good with the braces, just thought I'd give a little update. I promise there will be photos soon.

SARPE was now 8+ months ago. I can still feel that the bone isn't 100% healed but my front incisors are very stable now. I have been able to bite into all sorts of foods now which feels AMAZING after 8 long months. Cutting up a cheeseburger just isn't the same. I know many people (including my sister) who get braces without any prior surgery but don't like to bite into things with the braces. For me, it's been driving me insane all year so if I can bite into something now, I will.

It is now pretty apparent how messed up my bite is. If I bite down naturally, only the right side touches. I am hoping elastics will help that. My second adjustment is in a week from now. It'll be interesting to see if I get anything new, e.g. powerchains or elastics.

My teeth are more or less straight now. I can't believe how different I already look. I used to always smile for photos with my mouth closed but now I look awkward when I do that, so I've been showing my teeth. It feels SO GOOD to look at a photo of yourself smiling and not think, "Yuck, my teeth."

Not much pain to report on, which is a welcome change. Braces and jaw surgery are a long and painful road, full of peaks and valleys. For anyone contemplating going through it, trust me when I say the peaks make the valleys so, so worth it. I only wish I had done this sooner.

That's all for now. Will probably post next week after my appointment.

[jaime]

Hello everyone!

I've had braces now for about 5.5 months! I can't believe I'm already 1/3 -- 1/4 of the way through treatment. Time really does fly!

Things are going pretty well still. It's been a mostly uninteresting journey for me since May. I will say that I am so tired of waking up with my lips and cheeks stuck to my braces, though.

Next month I have another appointment for my double jaw surgery + genioplasty. I have to say, I am SHOCKED at how much my overjet has reduced just from braces. I can see why now in my consultations, I was told that I would still have a decent result without surgery. Earlier this year, I could stick my pinky finger all the way in my mouth while biting down; that's how big my overjet was. Now my overjet is only a few milimetres. Every time I have an adjustment, the assistants remark on how quickly my teeth have moved.

I have gotten extremely lucky with the surgeon I picked for my surgery. The double jaw surgery and genioplasty is only going to cost me $800, plus whatever my meds cost after insurance (not much). I live in Canada so the surgery is covered by public health care, but other Canadians seem to pay heftier consultation fees, usually in the thousands. I really like my surgeon as well, he's very personable.

All 4 of my second molars have been bracketed and wired, so I am a full metal mouth now. I haven't been able to floss the very back teeth with regular floss, but I have some disposable flosser things meant for braces and they seem to do the trick. If anyone wants to know more about them, I can provide a link.

Anyway, here are some photos. These were taken October 7, the day after my most recent adjustment. My upper central incisors have already straightened out noticeably since these photos were taken. After the SARPE surgery, they closed in on an angle. My surgeon predicted it would take a long time to correct the torquing of those teeth and he was right; it took a little over 5 months.

The "before" photos were taken shortly after I got my braces on May 21. The "after" photos were taken October 7.

My apologies that the photos aren't the best quality. I will post more at a later date.

[Anna5]

Hello Jaime,

What an AMAZING progress you have made!!! I am so happy for you! And how great that your overjet has reduced so much already without surgery!
I hope you will have a good talk with your surgeon, and then see what is best for you: still having the surgery or skipping the surgery..... It is great that the surgery is not going to cost you much, but no surgery and getting great results as well is even better of course!
I think you teeth look great already! What would be the reasons to still go through surgery?
I wish you very good luck with your treatment, I hope your teeth keep moving this well!

Greetings from Anna

[jaime]

Hello Jaime,

What an AMAZING progress you have made!!! I am so happy for you! And how great that your overjet has reduced so much already without surgery!
I hope you will have a good talk with your surgeon, and then see what is best for you: still having the surgery or skipping the surgery..... It is great that the surgery is not going to cost you much, but no surgery and getting great results as well is even better of course!
I think you teeth look great already! What would be the reasons to still go through surgery?
I wish you very good luck with your treatment, I hope your teeth keep moving this well!

Greetings from Anna

Thanks, Anna! It's nice that you're still posting even though your braces are off!

I have a few problems necessitating surgery: open bite, lip incompetence, overjet (though it's been greatly reduced), and the angle of my upper jaw is off. Both my jaws are tipped so that only my molars touch when I bite. I've already had lots of problems with my molars because of it and have "excessive wear" on them according to various professional opinions.

[Anna5]

Hello Jaime,

I am sorry to hear that you still have all these problems with your teeth, but fortunately all your problems will be fixed with the surgery. And for now, you have made very great progress with the braces already! I wish you very good luck on your journey, I keep following your progress!

[Sadoozie]

Thanks for sharing your story, i will be going through exactly the same process and its very encouraging to hear from someone that has been there before. I just turned 30 a month ago and today was the first day of getting braces put on my bottom jaw while i wait for an appointment for SARPE surgery.

[jaime]

I saw my oral surgeon again today. He said everything looked good and when he played around with my jaw and bite, he said my bite was going to be really nice post-surgery.

I mentioned that I've been able to bite into things with my front teeth and he was quite surprised as he seemed to think it was still pretty soon post-SARPE for that. I had SARPE nearly a year ago (December 19, 2013).

I had a list of questions to ask and he was very patient and answered everything in great detail, showing me before-and-afters of other patients, using my x-rays and photos to show me, etc. I am pleased my ortho recommended this surgeon. He is the cheapest of any surgeon I've heard or read about too. Double jaw surgery plus the genioplasty is only $800. I lucked out.

I wanted to know specifically which surgeries I'm getting. My upper jaw is getting Le Fort 1 and lower is mandibular sagittal advancement. And of course, genioplasty on my chin but I knew that.

All in all, he seemed happy with my post-SARPE progress and how my teeth are coming along with the braces. I feel very fortunate to have no complications and so far with everything, I've been ahead of schedule. Healing faster than normal, teeth moving faster than normal, etc.

Is it weird I'm excited for surgery? Only 6 months away!