Tuesday, March 29, 2016

Pheealzabraces: A saga 25 years in the making.


    December, 1991: Our tale begins with a young student of technical theater studying at Temple University who spent his Summer and holiday breaks working first as a clerk/cashier at various Pennsylvania State Stores and later as a Casual Letter Carrier for his local suburban US Post Office.
   
    One morning, having gone out on an early mail collection run and mere blocks from the post office, young Phil decided that the travel mug of tea, which was in the letter tray and had tipped over while he was making a turn in his ancient postal jeep, was a higher priority than watching his path while in the middle of the turn. In the wink of an eye a parking meter was parallel with the ground, the front end of the jeep was wrapped around a telephone pole, and his face was forever changed due to its violent encounter with the steering wheel courtesy of the lack of a shoulder belt in the 1950’s era vehicle. Upon looking up in the rearview mirror and seeing his rearranged visage, including missing (actually merely displaced) teeth, panic ensued and he ran screaming back to the Post Office, where he burst into the sorting floor, shouted to all that could hear what had happened, and ran up stairs to the break/locker room to begin washing the blood off and surveying the damage.

    An ER and oral surgeon visit later, home, stitched and wired up, our hero was visited by several friends and convinced to venture out to see a movie. Not just any movie, but the latest offering from two rising young stars of the early 90s, Msrs, Depp and Rider (Edward Scissorhands). Not the best choice for someone who had just torn up his face and was still a bit loopy from the painkillers, it predictably ended with him balling his eyes out in the car after the viewing.

    Being young and healthy, recovery from the inflicted wounds was fairly quick and painless. the facial wounds healed with minimal scarring. The two teeth were reset, the bone healed, and root canals were subsequently performed on both of them.

    February, 2015: During a regular 6 month cleaning and checkup with my regular dentist, the hygenist noticed that the gums around the two dead teeth were bleeding at the slightest provocation. Some additional X-rays were taken and viewed immediately (computers are pretty amazing these days) and the dentist noted a “shadow” developing between the two teeth. We talked about a couple options, and I chose the Sonicare toothbrush and Waterpik ones. On the subsequent visit in August, things seemed to have settled down.

    February, 2016: The bleeding had returned, along with the shadow becoming more evident. The dentist introduced a new term to my vocabulary, “external resorption”. I was (understandably) concerned and intrigued.The process in question is one of the body secreting enzymes that essentially eat away at the tooth(teeth) from the outside. So the upshot of all this was that my body was done with the two dead teeth and was hastening their demise.

    March, 2016: I was referred to a dental specialist/periodontist, who confirmed the external resorption and broke the (not entirely unexpected) news that the two dead teeth were going to need to be extracted and replaced with an implant. Her biggest concern was that the resorption was occurring at the gum line and thus was affecting the bone as well. The subject of braces was raised. It was not the first time I had been asked about them. She (Lauren Brownfield, let’s introduce her, since she is a key player in current and future proceedings) wanted me to consider the option because of other problems with my teeth (which I always thought were in pretty good shape. Not perfect by any means, but better than some of the rickety grills I’ve seen on other people I’ve crossed paths with). Once the dead teeth were replaced with the implant, braces would be less effective due to the fact that the implant would not move like the other live teeth since it would be anchored into the jaw with a screw.

I went ahead and scheduled a consultation appointment with the Orthodontist she recommended (mainly because they work together on quite a few patients, I’ll get into that in a bit). He (Tom Hall, introduced for the same reason) identified several issues (cross bite, overbite and crowding in the lower front) that he said would only be more of an issue the longer I waited. I went ahead and got some scans done at his office as well as a dental imaging lab that same day. This was in addition to a 360 degree ct scan of my upper and lower jaw at Dr. Brownfield’s office the week before. Two days later at a follow up visit with Dr. Hall, I pretty much acquiesced to the fact that the braces were a necessity and began the discussion of which ones to go with and the financials and timeline/duration of the treatment. He also casually dropped the bomb of it probably being necessary to extract my wisdom teeth, which had all come in straight (a fact which I was probably a little too smugly proud of). When I inquired about why that might be necessary, he explained that they were actually evolutionarily obsolete, having developed through evolution to deal with all the dirt and rocks that were attached to the food we pulled out of the ground and ate immediately tens of thousands of years ago, and designed to be worn down significantly by this time in one’s life (I’m in my mid 40s, most of you know this already, and for those of you that don’t, hi, and which back then was ancient and close to the end of the line anyway) the upshot of which was that because they weren’t they were potentially impeding the fulcrum of my jaw’s motion. It seemed a logical explanation, but the one from Dr. Brownfield was a bit more sound.

    When I went to see her for the follow up that we had scheduled at the end of the first visit she concurred with Dr. Hall about the wisdom teeth, explaining that they would actually be an impediment to the other teeth moving as guided by the braces. We began to speak about the timeline of the extraction of said wisdom teeth as well as other surgery to prep the gums and bone for the braces, which she had initially mentioned during the first visit and which I had found intriguing.

    Essentially what she does (and is kind of a pioneer in, from what I understand) is make a series of incisions in the bone of the mandible (lower jaw) and maxilla (upper jaw) around all the teeth prior to the application of the braces. This stimulates bone reformation and gives the teeth more room to move where the braces are guiding them. Dr. Hall (rather cavalierly, imo) said that she could perform the extractions at the same time she did the prep surgery, but Dr. Brownfield was of a slightly different opinion, mainly because I have unusually deep roots, but also because extracting all four wisdom teeth AND performing the prep surgery would be a long time to have my jaw open all the way and might strain the hinges and muscles.

    So now I find myself a little over a week out from the first extraction surgery, wondering what it’s going to feel like running my tongue back along my jaw and only feeling three molars, wondering how much this is actually gonna hurt, wondering how annoying these Incognito braces are gong to be on the inside if my teeth, and wondering how crazy it’s gonna be to have a totally different smile