Debraced!

On July 3, I was debraced!  This marks the end of my jaw surgery treatment plan.

First, I had a permanent retainer installed on my lower arch.  The retainer is just a thin piece of wire that is cemented to the back of my front 6 teeth – from canine to canine.  I had an option of getting a removable retainer instead, but I know myself and after a couple months I will inevitably get lazy and stop wearing my retainer like I’m supposed to.  A permanent one solves this problem with the only drawback that I have to brush a little more carefully and have to use floss threaders for those front 6 teeth.  After more than 2 years of having to floss thread all of my teeth, I think I can handle just 6.

Getting the retainer put in was pretty time consuming – it took probably 30+ minutes.  But after it was UV bonded in, it was time for the main event – getting those braces off!

The debracing process was easy, but not quite painless.  One of the techs used a special pliers-like tool and basically “crunched” off every one of my brackets.  I say crunch because that’s what it sounded *and* felt like.  The whole process took … oh … 20 seconds or so.  My tech didn’t even both taking off the arch-wire first.  This part was incredibly easy and was no more uncomfortable than any other tune-up where they are adding hooks or power chains or what-not.

I couldn’t help but rub my tongue all over my teeth.  It felt great!  … and kind of gritty.  There was still a bit of glue residue left over.  And when I looked in the mirror my teeth looked kind of chalky and gross.  Ugh I was ridiculously obsessed with brushing and flossing my first year with braces, but ever since my surgery I’ve gotten kind of lazy.  And that first glance in the mirror kind of looked like it.

My ortho came over a few minutes later to make sure everything was ok and then proceeded to polish my teeth.  Remember when I said the debracing process was “not quite painless”?  Apparently “polishing” teeth involves using what looks like a dental dremel to essentially sand off the top layer of your teeth.  It’s loud, sprays a fine white powder of glue and tooth dust all over your mouth, and worst of all, hurts like crazy.  Now after all this work – gum grafts, fillings, extractions, braces, surgery – I feel like I have a pretty high tolerance for dental pain but this was probably the most discomfort I felt orally through this whole journey.

I’m pretty sure my eyes watered a bit and I wanted to cry out, but after about 5-10 minutes of sanding my teeth it was all over.  I brushed my teeth, and looked in the mirror – my teeth were now ridiculously smooth & shiny – they even looked whiter! – compared to when I first had my braces off.  So all that pain was actually worth it – kind of.

Next, I had impressions made for my upper retainer, which is going to be made out of clear plastic.  I will get that on Friday.  The last thing was final records – basically taking the same photos I took when I had my first official appointment with my ortho.

I’ve worn braces since April 2010 and had really gotten used to them, so it feels kind of weird not having them on now.  But at the same time, it feels really, really good to finally have them off.

Photos and some deeper reflections to come soon.

Day 105 (3 Months)

It’s been a while since I’ve last updated my recovery, but as my recovery progressed, the surgery and the aftermath have kind of faded from my attention.  But it’s been about 3 1/2 months now so I thought I’d put down to words how I’ve been doing.

Life has completely returned to normal.  At this point I feel as normal as pre-surgery.  I don’t notice any more swelling, I don’t have any weakness in my jaw or face, and I feel well and healthy.  Life is good.  For those currently post-op wondering how long it takes to feel “normal” again, it happened to me somewhere between 45 and 60 days.  But it’s not like one day I woke up and I declared “I am fully recovered!”  After the 6-week mark, I stopped noticing day-by-day improvements.  As one week rolled into the next, the swelling went down bit-by-bit, my bone felt firmer bit-by-bit, and chewing became easier bit-by-bit.

So today, post-op day 105, I do feel normal and recovered.  But that’s not to say everything is normal or recovered.  While I was very lucky to wake up with full feeling in my chin and lower lip, the right side of my chin still has a little degraded sensation.  It doesn’t feel numb or anything serious, it just feels a little … off.  But I’ve gotten used to it and it won’t bother me if doesn’t ever feel fully normal.

My upper gums are still numb, although feeling is returning very slowly.  At my final doctor’s visit, my surgeon told me that feeling is lost because of the way my upper jaw was segmented.  It’s usually the last thing to heal, but I should expect full feeling in my gums again.  It’s getting there.  Feeling returned first to the back of my gums around my molars, and it’s been slowly progressing forward around my arch towards my front teeth.  The gum around my front teeth and canines are still straight-up numb, but I don’t even notice unless I’m brushing my teeth or flossing.  Then I have to be  careful not to brush too hard or floss too deep and hurting my gums.  Feeling is also returning to my palette, but unevenly.  The right side of my palette feels pretty normal, but the left has a really weird sensation when I touch it with my tongue.  It’s hard to describe but it gives this hollow feeling to my palette and upper jaw.

I can open my jaw about 3 1/2 finger widths now.  It’s still not quite as good as my 4-finger pre-surgery range of motion, but it’s big enough where I can eat any heaping sandwich or burger I want.  Biting into things with my front teeth still feels a little weird, but that might be related to my upper jaw numbness.  I still avoid certain really hard foods like nuts and apples, but that’s more from pain from braces & rubber bands than from the surgery.

Other than that, I am just wearing rubber bands to correct my bite and waiting for these braces to come off.  If anything this whole journey has taught me, it’s patience.  You can’t rush your braces treatment and you can’t rush your recovery.  The best way is to just accept that moving teeth and healing bone take time.  And once I did that and stopped obsessing over the swelling, or loose-feeling bone, or whether my teeth moved overnight, life became much more pleasant and less stressful.

Some before & after pictures, before to the left and after to the right:

    

    

    

    

    

    

 

Day 47

    

I am about 6 1/2 weeks post-op, and had my fourth post-op appointment with my surgeon today.  It went by really quick.  He took a quick look inside my mouth and seemed quite pleased with how my recovery was coming along.

My surgeon also removed the two TADS mini-screws I had in my upper gums, above my molars on both sides.  I originally had three mini-screws in my upper gums, two on either side and one in the middle.  My splint was securely wired to them to prevent my upper teeth from extruding during the first couple weeks of recovery.  At my last post-op appointment when I had my splint removed, my surgeon took out the middle mini-screw, but left the other two “just in case” my ortho wanted to use them for any movement.  But at this appointment, he decided that my ortho probably wouldn’t need them and decided to take them out.

It was a quick process.  His resident applied some topical anesthetic to both sites and let it sit for a few minutes.  Then he simply took a pair of foreceps and literally unscrewed the mini-screws from my gum.  I didn’t think I’d feel anything, and I didn’t on the right side, but I definitely felt an “unscrewing” sensation as he worked the screw out of my left side.  It wasn’t quite painful, just a really odd sensation.  I felt like a piece of wood getting worked on by a carpenter.

But after that, my surgeon declared my surgery a success and sent me on my way.  Although I still don’t feel 100% normal, I am done with the surgery phase.  The next time I see him will be after I get my braces off, for final records and photos.

He also gave me approval to eat whatever I wanted to.  Finally, I get to go out, eat some steak, chomp on some almonds, and start biting through apples!  Except not at all.  While my chewing has come a long ways, I am still uncomfortable chewing for real.  I tried eating a small lettuce salad a few days ago, but I couldn’t really chew hard enough to cut up the lettuce.  It was a mixture of pain from my braces & elastics and my jaw still not feeling fully stable.  I’ve made a ton of progress and I’m getting more comfortable eating solider foods, but I am no where close to eating normally yet.

Feeling is sloooowly coming back to my upper gums.  When I first came out of surgery, they were dead numb.  Brushing felt extremely weird.  Slowly over the past few weeks sensation has been subtely returning.  I didn’t even realize I was getting feeling back until I was flossing about a week ago and I was completley surprised … “Did I just feel something??”  My surgeon said I should expect to get 100% feeling back in my gums and palette, which was good to hear since I had already mentally prepared myself to be numb forever.

I am still wearing my elastics everyday, but it’s starting to make my molars sore all the time.  It’s kind of annoying since I thought it would only be sore for the first couple days, like getting a new archwire.  But I’ve been wearing them for two weeks and they are still very sore.  On top of that, they keep on popping off while I’ve been eating.  I think I’ve accidentally swallowed maybe 5 rubber bands in the past week.  Now they’re going to be stuck in my stomach for the next 7 years.  At least that’s what my parents told me about swallowing gum, so maybe it’s the same with rubberbands, hah.

My swelling is mostly gone, but the last bit is still lingering.  Although all my friends say that I’m completely back to normal, I still feel kind of swollen.  But it goes away a bit every single day, and I don’t notice it anymore for it to bother me.

Day 40

5 1/2 weeks post-op:

    

Day 32

    

Got my splint out this morning!  Everything went smoothly and it went by super quick – I was in and out of my surgeon’s office within 20 minutes.

The cursed thing:

         

What’s so great about getting my splint out?
– I can talk normally again – no more muffled or mumbled talking
– It’s no longer irritating my saliva glands, which means I’m not drooling everywhere all the time
– I can brush my upper teeth
– I don’t get half of my last meal trapped in it anymore
– My mouth no longer looks like it came out of a Saw movie. No splint, fewer wires, and no more mini-screw

There are some downsides though:
– I can touch the front part of palette and all my upper gums now, and sadly it’s all completely numb.  No feeling.  Nada.  Zilch.
– My teeth aren’t touching properly – I have an open bite in the front and an open bite in the back.  My molars are a few millimeters apart, and I have a big enough overbite that my front teeth are hitting the brackets on my lower teeth.
– I had two other mini-screws in my mouth that I didn’t even know about.  My surgeon said he’s leaving them in “Just in case your orthodontist needs them.”  Great.

I had my first post-surgery orthodontist appointment within an hour and a half of getting out of the surgeon’s office.  I got a new, full arch wire for my uppers.  I also have to wear some pretty heavy-duty elastics in a box configuration across my molars, it’s supposed to extrude my molars and close my bite in the back.  My ortho will take care of the open bite in the front later.

So I’ve been wearing these elastics for a few hours now and already my molars are super sore.  Sore to the point where I can’t really chew anything.  So between too-sore-to-chew molars and my bite that’s too-open-to-chew in the front, I can’t really chew period anymore.  So back to the liquid diet again for the next week or so, or until the soreness goes away.

My swelling is pretty much not noticeable to my friends or co-workers anymore, but it’s definitely apparent to people in the dental field.  My surgeon mentioned that I still have a bit of residual swelling left when I saw him.  And then at my ortho appointment, my ortho aide said she would wait until my next appointment to take my official after-surgery pictures because I was still kind of puffy.  So it’s not all in my head!  I really am still swollen. But it’s only been 32 days so far, and each day is getting better and better.

Day 31

Sorry about not updating as often – as I returned to my daily routine writing kind of fell by the wayside.  At this point the day-to-day changes are not very noticeable, but I will still post for any new developments and for all my post-op appointments.

    

Today is my 1 month surgery anniversary!  Time has really flown by and my recovery continues.  Tomorrow is a very special day for me because tomorrow morning I am going in to see my surgeon for the third post-op appointment, and I will be getting my splint out!  No more trapped food and no more slurred & mumbled talking.

I have a pretty tight schedule tomorrow.  I am going to see my surgeon tomorrow morning at 9:30 in Hollywood, then have to dash down to Manhattan Beach to see my orthodontist at 11:15.  While that might sound like a lot of time, LA traffic can get really ridiculous and it will take anywhere from 40 minutes to an hour and a half to make the trip.  But my surgeon made it clear it was very important to see my orthodontist the same day my splint is removed, and this was the only way I could schedule it.  My upper jaw was segmented into three pieces and widened significantly, and the splint helps to hold the pieces in place.  Once the splint is removed, I need to have a thick arch wire placed in as soon as possible to keep the shape of my upper arch, otherwise there is a chance of relapse and my upper jaw might shrink back – ruining the results of the surgery.  I do *not* want that.

Also a few days ago the wire connecting the mini-screw I have in my gums down to my arch wire broke.  I’m not sure exactly how it happened, but my guess is that I was brushing too hard and after four weeks it finally broke.  Food was always getting stuck behind the wire and I always had to brush pretty vigorously around it to get the junk out.  Plus, my upper gums are still completely numb, so I can’t quite tell how hard I am brushing.  That or I am just way too strong, able to break metal wires with a soft-bristled toothbrush, heh.

The swelling continues to go down and I am slowly getting used to my new face.  Mentally I’m in a much better place now – I’m starting to view the facial changes more positively and am starting to move from “What did I do?? This was a complete mistake!” to “The changes are improvements, they were worth it, and I am happy with the outcome.”  I’m still not completely happy, but each day I’m liking the outcome a little more and feeling less regretful.  As the swelling continues to go down and I get more used to my changed look, I think I will continue to feel better about the results.

Lastly, my upper jaw has a clicking or crackling feeling occasionally on the right side where the jaw was segmented (between my right outer incisor and my right canine).  I feel it at random times.  I will feel a twinge there when I’m chewing on something, sometimes if I yawn, even sometimes when I swallow.  Each of these movements places some type of pressure on my upper jaw, so I’m not really surprised by the feeling.  But it’s making me super paranoid that my upper jaw is not healing properly and is stil loose and mobile.  I’ve read a few accounts that this is a sympton of the bone not knitting together – but that’s only after several months.  It’s only been 1 month for me so maybe it’s still supposed to be kind of loose – after all bone takes some 6 weeks to start firming up.  But to calm my anxiety I will definitely be asking my surgeon about it tomorrow.

In the meanwhile, I’m trying to be a little more careful about what I eat.  I’ve been being kind of aggressive with my soft-chew, eating firmer foods, but I will probably dial that back a bit to be safe about those funny twinge feelings in my upper jaw.  I also need to be a little more conservative about going back to normal physical activities.  I was surfing yesterday, caught a shoulder high wave which then closed out behind me and pushed me off my board … and then I proceeded to fall into the water face first.  You’d think that water is a soft and forgiving surface, but my lower jaw felt really funky for several minutes afterwards.  I really need to stop being dumb and doing any risky activity that might jeopardize my healing.  After the hell of the surgery and week 1, I am not about to mess it up by being too aggressive trying to return to normal activities.  That will come, I can wait the extra few weeks.

Day 26

Just a picture update: