Hey gang,
Originally I wasn't going to post anything until closer to my consultation appointment with Dr. Levin as there was no new information of my own experience to report. But, this does not meant that I haven't been busy researching. I started a post close to the end of last month that I've been learning more and more information regarding the development of my own particular occlusion problem. I've learned that mandibular prognathism is not entirely genetic - well, not all of it, anyway.
The only problem with this new post is that it's so lengthy, I'm going to have to break it up into two seperate parts. I also am trying to make sure that the flow is there to make it fun to read and you're not falling asleep at your computer, as I'm sure you're doing now.
I'm aiming to put up the first part by Tuesday of next week, and possibly following that up the Tuesday after with the second half. If I'm lucky, I'll be finished with it by then.
Stay tuned.
Friday, February 26, 2010
Tuesday, February 16, 2010
Video Links
2 blogs in one day...such value for money, eh kids?
I decided to include some video links for you to watch so you can see just what it is that I may be having done here.
This first link demonstrates the sagittal split osteotomy. Most likely, this is what will be used to correct my underbite.
http://www.youtube.com/watch?v=w9sJArgbXpU&NR=1
This second link shows the bimaxillary osteotomy. This could also be done as my prognathism is rather severe. In fact, I've been having a hard time finding someone with a malocclusion as severe as mine in all the web searches I've been doing.
http://www.youtube.com/watch?v=SCaG6ZfXi1s&feature=related
This final link shows the LeFort I osteotomy. I have seen this technique used to correct underbites before with extremely esthetic results.
http://www.youtube.com/watch?v=FbP9DaSgINU&feature=related
I decided to include some video links for you to watch so you can see just what it is that I may be having done here.
This first link demonstrates the sagittal split osteotomy. Most likely, this is what will be used to correct my underbite.
http://www.youtube.com/watch?v=w9sJArgbXpU&NR=1
This second link shows the bimaxillary osteotomy. This could also be done as my prognathism is rather severe. In fact, I've been having a hard time finding someone with a malocclusion as severe as mine in all the web searches I've been doing.
http://www.youtube.com/watch?v=SCaG6ZfXi1s&feature=related
This final link shows the LeFort I osteotomy. I have seen this technique used to correct underbites before with extremely esthetic results.
http://www.youtube.com/watch?v=FbP9DaSgINU&feature=related
And Then, There Came An Answer...
As I stated last week, Dr. Archer wasn't exactly sure how to go about getting me the referral to Dr. Levin for my underbite. It's not that she's a bad physician - far from it, I trust her judgement and she's the one that got things started so I can breathe through my nose like humans do - it's just that she's never had to deal with anything like this before. I admit I do love giving people a challenge, and love them myself, but I didn't think it would have to get to this.
The last week has been possibly one of the most stressful in my life with all of the research on insurance coverage and what it is that each agency covers and for what to try to figure out if I could get coverage for this surgery. The only thing that I could find regarding this for my own insurance was that it covers the surgery to correct skeletal deformity. Okay, but to what limits? Trying to get any information other than that in the paperwork was a waste of time, and dealing with the phone operators was...you know, I really do wonder if they get paid by the call! It seemed like they were trying to get me off the phone with little help at all.
Regardless, I decided to wait the week out and see what would happen. Unfortunately, Monday was a federal holiday and I didn't receive any mail to find out any information. Also, I decided on Sunday that I would call and just make the appointment and pay out of pocket so I could find out for myself if this could be covered. Calling on Monday proved fruitless as the office was closed and all calls were going straight to voicemail. I hate voicemail to begin with, so I just decided I'd have to wait until Tuesday.
When today arrived, I woke early as I was scheduled to go to my mother's house to take her to her doctor for her appointment. As I was walking down the street at 6:45 a.m., she phoned me to tell me that she would not be going to the appointment (this is yet another drama I have to deal with) and that I should just go and enjoy my day. So, being that I was so far away from the apartment to walk back, I jumped the bus to Orange Coast College to have breakfast in the cafeteria and also get a large, hot chai tea from the coffee stand outside the Literature and Languages building. I walked back to Harbor Boulevard and caught the route 43 to 1313 S. Harbor Blvd. in Anaheim, CA.
Well, it seems that everyone came out for Fat Tuesday. Hey, kids...this isn't New Orleans - go THERE! The good thing was that I didn't have to wait until 10 a.m. for the park to open as it opened at 9 which meant no waiting around for another hour and 15 minutes. Head up to Main Street USA and wait for them to drop the rope and let us in, went to Space Mountain for a Fastpass, then caught a train to New Orleans Square to jump a ride on the Haunted Mansion. I thought for a second about what time it was, checked my cellphone and realized that it was after 9 a.m. so I figured that Dr. Levin's office must be open, so I called up the number.
When I called, a woman named Cheryl answered the phone and I told her I wanted to schedule an appointment. She asked me if I had insurance and responded, "Yes" and told her my insurance coverage. She asked me if I was referred and I told her that I was willing to pay out of pocket just so I could get some questions answered. I told her the situation about what happened with Dr. Archer's referral and I just wanted to get this thing scheduled. She asked me which medical group I belonged to, so I told her. She then asked, "Would you like me to check their website to see if you're pending approval?" I didn't even know about this, and asked her if she could and she responded positively. She told me to hold on, so I waited. After a few seconds that seemed like an eternity, she gave me an answer.
I've been approved for my referral!
I had to stop there at the entrance to the Mansion and move to the side of the line. This was not just because I didn't want to lose the reception on my phone but because I was getting so excited my eyes were tearing up. Cheryl looked up what she had for consultation appointments and I took the first available appointment. I disconnected and went into the Mansion. Once in my "Doom Buggy" and away from view of the general populace, I kind of lost it. At last, I now have a true sense of getting somewhere with something that has bothered me physically, psychologically and socially since I was a child. I am so hyped up, everything looks beautiful to me. I wanted to share this as soon as possible, so I sent off a text message to my friend, Loana, once I got off the ride. I then sent off a text to my sister to find out if she was working so I could deliver her the news myself; I sent an offline Yahoo! Instant Message to my friend, Evelyn; then another message to my cousin's wife Becky.
My appointment is March 16th, 2010 at 2 p.m. (3:16, as Loana pointed out, would have a new meaning for me today - I didn't even think of that! I almost cracked up on the bus after reading that text message.) According to the referral letter I received, this does not confirm eligibility. This will have to be done by Dr. Levin to show that this is surgery is medically necessary, I think. I'm sure I'll worry about it then, but this takes a gigantic load off my mind so I can just get on with my life.
Onward!
The last week has been possibly one of the most stressful in my life with all of the research on insurance coverage and what it is that each agency covers and for what to try to figure out if I could get coverage for this surgery. The only thing that I could find regarding this for my own insurance was that it covers the surgery to correct skeletal deformity. Okay, but to what limits? Trying to get any information other than that in the paperwork was a waste of time, and dealing with the phone operators was...you know, I really do wonder if they get paid by the call! It seemed like they were trying to get me off the phone with little help at all.
Regardless, I decided to wait the week out and see what would happen. Unfortunately, Monday was a federal holiday and I didn't receive any mail to find out any information. Also, I decided on Sunday that I would call and just make the appointment and pay out of pocket so I could find out for myself if this could be covered. Calling on Monday proved fruitless as the office was closed and all calls were going straight to voicemail. I hate voicemail to begin with, so I just decided I'd have to wait until Tuesday.
When today arrived, I woke early as I was scheduled to go to my mother's house to take her to her doctor for her appointment. As I was walking down the street at 6:45 a.m., she phoned me to tell me that she would not be going to the appointment (this is yet another drama I have to deal with) and that I should just go and enjoy my day. So, being that I was so far away from the apartment to walk back, I jumped the bus to Orange Coast College to have breakfast in the cafeteria and also get a large, hot chai tea from the coffee stand outside the Literature and Languages building. I walked back to Harbor Boulevard and caught the route 43 to 1313 S. Harbor Blvd. in Anaheim, CA.
Well, it seems that everyone came out for Fat Tuesday. Hey, kids...this isn't New Orleans - go THERE! The good thing was that I didn't have to wait until 10 a.m. for the park to open as it opened at 9 which meant no waiting around for another hour and 15 minutes. Head up to Main Street USA and wait for them to drop the rope and let us in, went to Space Mountain for a Fastpass, then caught a train to New Orleans Square to jump a ride on the Haunted Mansion. I thought for a second about what time it was, checked my cellphone and realized that it was after 9 a.m. so I figured that Dr. Levin's office must be open, so I called up the number.
When I called, a woman named Cheryl answered the phone and I told her I wanted to schedule an appointment. She asked me if I had insurance and responded, "Yes" and told her my insurance coverage. She asked me if I was referred and I told her that I was willing to pay out of pocket just so I could get some questions answered. I told her the situation about what happened with Dr. Archer's referral and I just wanted to get this thing scheduled. She asked me which medical group I belonged to, so I told her. She then asked, "Would you like me to check their website to see if you're pending approval?" I didn't even know about this, and asked her if she could and she responded positively. She told me to hold on, so I waited. After a few seconds that seemed like an eternity, she gave me an answer.
I've been approved for my referral!
I had to stop there at the entrance to the Mansion and move to the side of the line. This was not just because I didn't want to lose the reception on my phone but because I was getting so excited my eyes were tearing up. Cheryl looked up what she had for consultation appointments and I took the first available appointment. I disconnected and went into the Mansion. Once in my "Doom Buggy" and away from view of the general populace, I kind of lost it. At last, I now have a true sense of getting somewhere with something that has bothered me physically, psychologically and socially since I was a child. I am so hyped up, everything looks beautiful to me. I wanted to share this as soon as possible, so I sent off a text message to my friend, Loana, once I got off the ride. I then sent off a text to my sister to find out if she was working so I could deliver her the news myself; I sent an offline Yahoo! Instant Message to my friend, Evelyn; then another message to my cousin's wife Becky.
My appointment is March 16th, 2010 at 2 p.m. (3:16, as Loana pointed out, would have a new meaning for me today - I didn't even think of that! I almost cracked up on the bus after reading that text message.) According to the referral letter I received, this does not confirm eligibility. This will have to be done by Dr. Levin to show that this is surgery is medically necessary, I think. I'm sure I'll worry about it then, but this takes a gigantic load off my mind so I can just get on with my life.
Onward!
Tuesday, February 9, 2010
Bureaucracy
After sleeping in late this morning, I eventually got up, had breakfast, then went to the gym. I don't remember what time I left for the gym, but by the time I had finished with my workout, it was already 1:15 p.m. So, I left there, went home and showered and got dressed. I then walked to Dr. Rita Archer's office.
After waiting a few minutes, Rita came in and went over my general health and medications, including my pharmacy losing my prescription for my testosterone again. We also went over that I was due for blood work, so she gave me the form I needed to get that done. Then, we got to the heart of the matter.
I showed Dr. Archer my cephalometric x-ray and she asked how long I had been living with the underbite. It's been like that for so long, I couldn't figure out how long I've been dealing with it. I took a wild guess and said since about 8 years of age. We discussed if I'd been having other problems which could be caused by this, including snoring, sleep apnea, etc. I also advised her of the muscle pain that I've been having in the sides of my jaw, as well as the clicking and popping I have.
Part of the problem that Dr. Archer has about getting approval for this surgery is trying to figure out how to tell the insurance company of why they should approve it. She's working on my side for this, she's just at a loss to figure out which code she needs to use to submit. She knows that Dr. Levin will know what to tell them, but until then, I have to wait again. Her estimate is that it will be about a week and I'll get a letter saying "yes" or "no."
Fuck...
After waiting a few minutes, Rita came in and went over my general health and medications, including my pharmacy losing my prescription for my testosterone again. We also went over that I was due for blood work, so she gave me the form I needed to get that done. Then, we got to the heart of the matter.
I showed Dr. Archer my cephalometric x-ray and she asked how long I had been living with the underbite. It's been like that for so long, I couldn't figure out how long I've been dealing with it. I took a wild guess and said since about 8 years of age. We discussed if I'd been having other problems which could be caused by this, including snoring, sleep apnea, etc. I also advised her of the muscle pain that I've been having in the sides of my jaw, as well as the clicking and popping I have.Part of the problem that Dr. Archer has about getting approval for this surgery is trying to figure out how to tell the insurance company of why they should approve it. She's working on my side for this, she's just at a loss to figure out which code she needs to use to submit. She knows that Dr. Levin will know what to tell them, but until then, I have to wait again. Her estimate is that it will be about a week and I'll get a letter saying "yes" or "no."
Fuck...
Monday, February 8, 2010
Reaction
" Holy crap! You could eat a tomato through a tennis racket!!!" --Dave Clark
"Woooooooooooooooooooooooooooooooooooow!" --Laura Smart
"Looking at this is making my eyes water." --Jessica Marks
Well, now you can kind of see how messed up my underbite is by these reactions to my cephalometric x-rays by my co-workers if you haven't seen the pictures from my last post. (I'm still not entirely sure what the hell Dave is trying to say, but I think I'll get it eventually.) Laura's reaction was most telling. The fact that she could make the word "wow" last for nearly 5 seconds upon seeing it drives home just how freakishly abnormal this is.
There's still a few things I wish I could find out. First, how are underbites measured? Then, I could see if mine has progressed since I was 17 when I had it measured the first time. Also, what do the insurance companies consider as being severe enough to cover the financial portion for this surgery? I think this is beyond cosmetics and it's the one thing that's still bugging the crap out of me. If anything, I think it would be better to cover this thing regardless of the severity just for the psychological well-being of their customers.
Tomorrow, I have my appointment with Dr. Archer to get the referral to Dr. Levin. I'm glad that I have the x-rays with me. I'm sure it will save time explaining the whole situation with Dr. Archer. Until then, it's the waiting and the unanswered questions to deal with.
Next update is tomorrow afternoon.
"Woooooooooooooooooooooooooooooooooooow!" --Laura Smart
"Looking at this is making my eyes water." --Jessica Marks
Well, now you can kind of see how messed up my underbite is by these reactions to my cephalometric x-rays by my co-workers if you haven't seen the pictures from my last post. (I'm still not entirely sure what the hell Dave is trying to say, but I think I'll get it eventually.) Laura's reaction was most telling. The fact that she could make the word "wow" last for nearly 5 seconds upon seeing it drives home just how freakishly abnormal this is.
There's still a few things I wish I could find out. First, how are underbites measured? Then, I could see if mine has progressed since I was 17 when I had it measured the first time. Also, what do the insurance companies consider as being severe enough to cover the financial portion for this surgery? I think this is beyond cosmetics and it's the one thing that's still bugging the crap out of me. If anything, I think it would be better to cover this thing regardless of the severity just for the psychological well-being of their customers.
Tomorrow, I have my appointment with Dr. Archer to get the referral to Dr. Levin. I'm glad that I have the x-rays with me. I'm sure it will save time explaining the whole situation with Dr. Archer. Until then, it's the waiting and the unanswered questions to deal with.
Next update is tomorrow afternoon.
Thursday, February 4, 2010
"Ah, shit...here we go again!"
Well, I was going to add this to my previous post for today, but decided that if I was going to do this, it kind of deserved its own post.
Showed up early to Dr. Graham's office and chilled out in the waiting room for about 20 minutes. No problem as I'm still on vacation. Only thing on my plate was that I was meeting my sister for a shabu shabu dinner. While I'm waiting there, I see a cute, blonde dental assistant working in the operatory. I couldn't tell if she was staring at me or not. I don't know...I've never really felt used to being stared at by girls. Eventually, I go in and get taken into Dr. Graham's office which is on the opposite side of the wall in the waiting room where I was sitting.
A different assistant showed me into the room and laid out the booklets that I later took with me and also laid out the photos that I had taken on Monday. I also got to see the x-rays I had taken which were turned into glossy photos. I was invited by his assistant to read through the booklets while waiting for Dr. Graham, so I did.
This illustration was made from my cephalometric radiograph and gives the measurements that I have for my underbite. I have included it here so you can see just how severe my underbite is. The two molars shown are actually the front molars and the distance between the top and bottom first molars is about 3 millimeters, from what I'm guessing. Most severe underbites cephalometric radiographs that I've seen have the 2 first molars meeting each other midway. From what Dr. Graham says, when the oral maxillofacial surgeon sees this underbite, he's going to go apeshit. Okay, not his exact words, but you can see where this is going. The good thing is that the top teeth are close to being in the position that they're going to need to be, but they're going to have to tweek the bottom teeth - more on that in a few paragraphs.
Within a few minutes, Dr. Graham came in and we started discussing the treatment plan. As it turns out, tooth #6 is not actually located in the facial area of my gingiva (gums) as I'd thought. It turns out that it's located in the palate (roof) of my mouth. This does present a problem - he can save the tooth, but it will add an additional 2 years to my treatment to bring it forward and hook onto it with braces. It would also have to be glued to tooth #5 to make sure that it stayed there. Doing this would also cause a problem with trying to correct my midline which, as you'll see from the panorex radiograph below, is deviated a few millimeters to my right. If I want my midline corrected, I would have to have 4 teeth removed. Originally, I thought that I would have to have my canine teeth removed, but from what Dr. Graham is proposing, I would have 3 of my bicuspids removed - 1 from either quadrant of the mandibular teeth and 1 from the left quadrant of my maxillary teeth. Tooth #11 will be kept and either tooth #4 or #5 will be kept to use as its esthetic replacement.
The only other question that comes in at this point is just which surgeon in the area accepts the Blue Shield of California HMO plan. This is my main concern. Dr. Graham didn't know if the surgeon that he usually refers people to, Dr. Lee, accepts Blue Shield's HMO plan, and it looks like he doesn't. I was recommended to contact Blue Shield and also check with my general dentist to see if they had a list of any OMS's in the area that takes my insurance.
Show up at my regular dentist's office to see if they had any doctors that participated as contractors for my insurance and get told that I would have to go through my primary care provider, Dr. Rita Archer, to get a referral to an oral surgeon that's in my provider group. I tried to get in for an appointment for tomorrow, but Dr. Archer doesn't work on Fridays, it seems. So, I did what I could do and I'll be able to get in on Tuesday to talk with her about this and see if I can get prior approval. After that, I can then get the consult to the oral surgeon and discuss the treatment plan, including removing the teeth.
The good thing about all of this is that if I have the 4 teeth removed, it will lighten up the load of work that will have to be done prior to having my surgery. After removing the teeth, I'll be back in for impressions so they can get everything prepared to have the braces put on.
There is still an additional problem: my upper teeth come into place behind my lower teeth as you'll see from this x-ray. Not only does this result in an open bite up front, it also causes a problem with placing of the brackets for the braces. Most likely, I'll have to have the braces put on the lower arch prior to getting the upper arch put on to change the position of the teeth in the lower arch to make sure I'm not making my braces on the top loose when I bite down.
The good news for today is that from that point, Dr. Graham said that he estimates that I'll be ready for surgery by the end of the year! That works for me - let's get it moving! =)
P.S. Okay, if anyone is reading this in America and is looking to get this covered through their medical insurance/HMO - and medical insurance WILL cover this surgery if it is a medical necessity - check with your Primary Medical Care Provider FIRST! This will save you all kinds of time and running around from one dentist to another only to find out that you're not going to be covered.
Showed up early to Dr. Graham's office and chilled out in the waiting room for about 20 minutes. No problem as I'm still on vacation. Only thing on my plate was that I was meeting my sister for a shabu shabu dinner. While I'm waiting there, I see a cute, blonde dental assistant working in the operatory. I couldn't tell if she was staring at me or not. I don't know...I've never really felt used to being stared at by girls. Eventually, I go in and get taken into Dr. Graham's office which is on the opposite side of the wall in the waiting room where I was sitting.
A different assistant showed me into the room and laid out the booklets that I later took with me and also laid out the photos that I had taken on Monday. I also got to see the x-rays I had taken which were turned into glossy photos. I was invited by his assistant to read through the booklets while waiting for Dr. Graham, so I did.
This illustration was made from my cephalometric radiograph and gives the measurements that I have for my underbite. I have included it here so you can see just how severe my underbite is. The two molars shown are actually the front molars and the distance between the top and bottom first molars is about 3 millimeters, from what I'm guessing. Most severe underbites cephalometric radiographs that I've seen have the 2 first molars meeting each other midway. From what Dr. Graham says, when the oral maxillofacial surgeon sees this underbite, he's going to go apeshit. Okay, not his exact words, but you can see where this is going. The good thing is that the top teeth are close to being in the position that they're going to need to be, but they're going to have to tweek the bottom teeth - more on that in a few paragraphs.
Within a few minutes, Dr. Graham came in and we started discussing the treatment plan. As it turns out, tooth #6 is not actually located in the facial area of my gingiva (gums) as I'd thought. It turns out that it's located in the palate (roof) of my mouth. This does present a problem - he can save the tooth, but it will add an additional 2 years to my treatment to bring it forward and hook onto it with braces. It would also have to be glued to tooth #5 to make sure that it stayed there. Doing this would also cause a problem with trying to correct my midline which, as you'll see from the panorex radiograph below, is deviated a few millimeters to my right. If I want my midline corrected, I would have to have 4 teeth removed. Originally, I thought that I would have to have my canine teeth removed, but from what Dr. Graham is proposing, I would have 3 of my bicuspids removed - 1 from either quadrant of the mandibular teeth and 1 from the left quadrant of my maxillary teeth. Tooth #11 will be kept and either tooth #4 or #5 will be kept to use as its esthetic replacement.
The only other question that comes in at this point is just which surgeon in the area accepts the Blue Shield of California HMO plan. This is my main concern. Dr. Graham didn't know if the surgeon that he usually refers people to, Dr. Lee, accepts Blue Shield's HMO plan, and it looks like he doesn't. I was recommended to contact Blue Shield and also check with my general dentist to see if they had a list of any OMS's in the area that takes my insurance.
Show up at my regular dentist's office to see if they had any doctors that participated as contractors for my insurance and get told that I would have to go through my primary care provider, Dr. Rita Archer, to get a referral to an oral surgeon that's in my provider group. I tried to get in for an appointment for tomorrow, but Dr. Archer doesn't work on Fridays, it seems. So, I did what I could do and I'll be able to get in on Tuesday to talk with her about this and see if I can get prior approval. After that, I can then get the consult to the oral surgeon and discuss the treatment plan, including removing the teeth.
The good thing about all of this is that if I have the 4 teeth removed, it will lighten up the load of work that will have to be done prior to having my surgery. After removing the teeth, I'll be back in for impressions so they can get everything prepared to have the braces put on.
There is still an additional problem: my upper teeth come into place behind my lower teeth as you'll see from this x-ray. Not only does this result in an open bite up front, it also causes a problem with placing of the brackets for the braces. Most likely, I'll have to have the braces put on the lower arch prior to getting the upper arch put on to change the position of the teeth in the lower arch to make sure I'm not making my braces on the top loose when I bite down.
The good news for today is that from that point, Dr. Graham said that he estimates that I'll be ready for surgery by the end of the year! That works for me - let's get it moving! =)
P.S. Okay, if anyone is reading this in America and is looking to get this covered through their medical insurance/HMO - and medical insurance WILL cover this surgery if it is a medical necessity - check with your Primary Medical Care Provider FIRST! This will save you all kinds of time and running around from one dentist to another only to find out that you're not going to be covered.
Cart Before The Horse
I'm beginning to wonder if I'm getting ahead of myself while I'm sleeping. Last night, I had a dream that they were prepping me for surgery in the hospital. Maybe it's because today is my final consultation with the orthodontist where we discuss everything and get started in earnest on this whole endeavor. I AM being realistic about the timeline I'm looking at here, but you know what they say about the mind playing tricks. Stop that brain!
I reviewed my medical insurance yesterday. Seems they'll cover everything except the teeth portion as long as it's medically necessary. As I said in a previous blog, the masticatory muscles are still sore since having the septoplasty done last June. And, having seen my cephalometric radiographs, I don't think it will be too hard to convince them to approve this operation. With any luck, Dr. Graham will refer me to the surgeon today. I would like to know if I'll be having any teeth pulled prior to getting my braces or if I'll be able to keep them all.
I'm also really interested to find out what, if anything, they can do about tooth #6, my right maxillary canine tooth. That tooth never erupted and I can feel the tip of it just underneath my gums sitting at a nearly 45 degree angle over tooth #7, the right lateral incisor. Dr. Graham says this can be a tricky problem as to put it into place, you're forcing it into a position where there are already other teeth. I know this could delay things for a bit if they decide to extract all of the canines to make room for the other teeth when they put the braces on.
Well, 6 hours to go from the time of this writing, so I think I'll go find something to do until then. Check back later on this post.
I reviewed my medical insurance yesterday. Seems they'll cover everything except the teeth portion as long as it's medically necessary. As I said in a previous blog, the masticatory muscles are still sore since having the septoplasty done last June. And, having seen my cephalometric radiographs, I don't think it will be too hard to convince them to approve this operation. With any luck, Dr. Graham will refer me to the surgeon today. I would like to know if I'll be having any teeth pulled prior to getting my braces or if I'll be able to keep them all.
I'm also really interested to find out what, if anything, they can do about tooth #6, my right maxillary canine tooth. That tooth never erupted and I can feel the tip of it just underneath my gums sitting at a nearly 45 degree angle over tooth #7, the right lateral incisor. Dr. Graham says this can be a tricky problem as to put it into place, you're forcing it into a position where there are already other teeth. I know this could delay things for a bit if they decide to extract all of the canines to make room for the other teeth when they put the braces on.
Well, 6 hours to go from the time of this writing, so I think I'll go find something to do until then. Check back later on this post.
Monday, February 1, 2010
Restless
I had a hard time sleeping this morning. I can't say last night as I was up doing more research on this surgery and was practicing with Uprooted until 11 p.m. However, this didn't keep me from falling asleep.
The problem once I fell asleep was that I kept having dreams where I had already gotten my braces! I'd get so excited that I kept waking up! And, each time, I had to tell myself, "Dude, calm down. It's coming. Today is just an appointment for x-rays. The final consultation appointment is coming up on Thursday, be excited for that!"
I'll update this post with what happens in about an hour when I get home. I'm going to a dental x-ray clinic that's down the street from Dr. Graham's office and in the same parking lot as the local branch of my bank. I'm not entirely sure of what type of x-rays I'll be getting, but I'm pretty sure I'll be having a panorex (panoramic view) of my jaw done, as well as P.A. (periapical) x-rays so Dr. Graham can see the entire root structure of each tooth and what he'll have to deal with as far as me being a patient. Personally, I hope it's a full-mouth series of P.A. x-rays as this is going to cost me $140 out of my own pocket!
More to come when I return.
Okay, back and getting ready for school. Tonight's the first night of Intermediate Spanish.
Not only was this a full-mouth series like I thought, it was more. After I checked in, the technician brought me in to the room. I put my stuff that I had with me on a counter, then was sat in a chair.
The first thing that I did was I had my picture taken for a profile shot, then a head shot. I was then given plastic devices to hold my lips away from my teeth so that my bite could be photographed up close. He also took photos of my occlusal surfaces, which I could have done without. I wasn't too keen with having a 3" x 5" mirror placed in my mouth, but I dealt with it. After the photos were taken, I was taken to the other side of the 10' x 15' room. There, I had my panorex x-ray taken.
What this x-ray does is give a panoramic view of all of the teeth and the jaws and any work that's currently in place. While useful, this x-ray is not the most reliable as the image is distorted since the machines travels all the way around the head 270 degrees. I was used to dealing with this x-ray from my days in the Navy. Fortunately, everything at this lab is done digitally so I didn't have to wait 5-10 minutes for the film to be developed.
The next x-ray I had taken was a full profile of my head, or lateral cephalometric x-ray. The only thing I didn't like about this was the calipers placed in my ears to hold my head steady while the machine was working. If you've seen the film "Star Trek 2: The Wrath of Khan," you'll know what I'm talking about. This is only a minor complaint as I got to see this picture just after it was taken.
I've seen this same x-ray in web searches for underbite surgery for what's labeled "extreme underbite," and most of the ones I've seen are not as severe as mine. Most patients that I've seen this x-ray of have their 2nd mandibular molars overlapping about halfway with their 1st maxillary molars. I don't have this problem - my 2nd mandibular molars meet up directly with my 1st maxillary molars. My maxillary teeth could not even be seen on the scan as they're too far below the mandibular teeth. In comparison with some of the pictures that I've seen, I have to wonder if my underbite really has gotten worse with age. Hopefully, I'll find out soon.
After the cephalometric analysis was completed, I then had 2 occlusal x-rays taken. These take picutres of the actual biting surfaces of the teeth and show how the roots and other teeth match up. One is taken from the top and one from the bottom. After these shots, I then had a full P.A. series taken - all 14 of them. Fortunately, only one of them had to be retaken. I could feel the thing moving right when the technician walked away from me to take the picture.
My next appointment is coming on Thursday. This will be my final orthodontic consultation, then it's full speed ahead once I've paid 10% of the total cost for the orthodontic treatment which looks like it will be 20 months total - well, at least the payments will be for that length of time. Tune back in on Thursday evening after shabu shabu dinner with one of the siblings.
Ever onward...
The problem once I fell asleep was that I kept having dreams where I had already gotten my braces! I'd get so excited that I kept waking up! And, each time, I had to tell myself, "Dude, calm down. It's coming. Today is just an appointment for x-rays. The final consultation appointment is coming up on Thursday, be excited for that!"
I'll update this post with what happens in about an hour when I get home. I'm going to a dental x-ray clinic that's down the street from Dr. Graham's office and in the same parking lot as the local branch of my bank. I'm not entirely sure of what type of x-rays I'll be getting, but I'm pretty sure I'll be having a panorex (panoramic view) of my jaw done, as well as P.A. (periapical) x-rays so Dr. Graham can see the entire root structure of each tooth and what he'll have to deal with as far as me being a patient. Personally, I hope it's a full-mouth series of P.A. x-rays as this is going to cost me $140 out of my own pocket!
More to come when I return.
Okay, back and getting ready for school. Tonight's the first night of Intermediate Spanish.
Not only was this a full-mouth series like I thought, it was more. After I checked in, the technician brought me in to the room. I put my stuff that I had with me on a counter, then was sat in a chair.
The first thing that I did was I had my picture taken for a profile shot, then a head shot. I was then given plastic devices to hold my lips away from my teeth so that my bite could be photographed up close. He also took photos of my occlusal surfaces, which I could have done without. I wasn't too keen with having a 3" x 5" mirror placed in my mouth, but I dealt with it. After the photos were taken, I was taken to the other side of the 10' x 15' room. There, I had my panorex x-ray taken.
What this x-ray does is give a panoramic view of all of the teeth and the jaws and any work that's currently in place. While useful, this x-ray is not the most reliable as the image is distorted since the machines travels all the way around the head 270 degrees. I was used to dealing with this x-ray from my days in the Navy. Fortunately, everything at this lab is done digitally so I didn't have to wait 5-10 minutes for the film to be developed.
The next x-ray I had taken was a full profile of my head, or lateral cephalometric x-ray. The only thing I didn't like about this was the calipers placed in my ears to hold my head steady while the machine was working. If you've seen the film "Star Trek 2: The Wrath of Khan," you'll know what I'm talking about. This is only a minor complaint as I got to see this picture just after it was taken.
I've seen this same x-ray in web searches for underbite surgery for what's labeled "extreme underbite," and most of the ones I've seen are not as severe as mine. Most patients that I've seen this x-ray of have their 2nd mandibular molars overlapping about halfway with their 1st maxillary molars. I don't have this problem - my 2nd mandibular molars meet up directly with my 1st maxillary molars. My maxillary teeth could not even be seen on the scan as they're too far below the mandibular teeth. In comparison with some of the pictures that I've seen, I have to wonder if my underbite really has gotten worse with age. Hopefully, I'll find out soon.
After the cephalometric analysis was completed, I then had 2 occlusal x-rays taken. These take picutres of the actual biting surfaces of the teeth and show how the roots and other teeth match up. One is taken from the top and one from the bottom. After these shots, I then had a full P.A. series taken - all 14 of them. Fortunately, only one of them had to be retaken. I could feel the thing moving right when the technician walked away from me to take the picture.
My next appointment is coming on Thursday. This will be my final orthodontic consultation, then it's full speed ahead once I've paid 10% of the total cost for the orthodontic treatment which looks like it will be 20 months total - well, at least the payments will be for that length of time. Tune back in on Thursday evening after shabu shabu dinner with one of the siblings.
Ever onward...
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