Braces, jaw surgery...Part II

Three months ago, I visited a TMJ specialist to get a new occlusal splint for my TMJ problem and was shocked by his recommendations.
Yesterday, Taciturn and I visited a new orthodontist who proposes a little surgery, not a huge amount that can only be done by one person like the other guy did. He told us what his tentative plan would be, but we were reassured by his words that he wanted to present my case to his partners (the other guy was in solo practice) and discuss me before he came up with a definitive plan. He said he wanted to use the brain power that was available to him.

The other thing that actually made us feel better in an odd way was that this new orthodontist offered no guarantees. The first guy was kind of cocky in that way. And I always wonder in this day and age about folks in solo practice. Do they not play well with others?

Dr. E agreed with the first guy that my bite is extremely complicated. He looked closely at the mouth model from my pre-treatment in 1982 to see how my mouth originally was before I had braces the first time at age 25, and noted some things in my original bite that made me a set up for TMJ.

In other words, I am one of those people who should have had braces, headgear, the whole shibang when I was ten. But, since in those days my family barely had money for food to eat let alone anything else, I didn't. In fact, my first visit to a dentist took place at age 12.

So parents, when the dentist says maybe you should think about braces for your young children and you can afford it, go for it. Try to help them avoid what I've gone through for over twenty-five years. Better to do this when the bones are still forming than when they are set. This is why I have to have facial surgery. What must be accomplished through surgery now could have been done with headgear as a child.

Again, preventative care simply is better overall in terms of human misery, as well as cheaper. See all of my posts on SCHIP.

Before I get off on that particular soapbox again, we plan to use Dr. E and his partners. They will make my treatment models in a couple of weeks, and present a detailed plan to us on Good Friday of all days (gotta take appointments when they are available). And we'll go from there!

Braces, jaw surgery, and baseball

The medical visit I made yesterday that shocked me somewhat was to a TMJ specialist. I have worn an occlusal splint for over 20 years; if I leave it out for any length of time (> 1 hour) I get a headache; if I break it so I cannot wear it (has happened twice), my jaw locks shut. Once I had to get good drugs so my jaw could be manipulated back into place, the other I had an arthrogram to inject dye into the joint space, which pushed the joint back so I could open my mouth.

Believe me when I say that this splint is more important to me than my husband. The one thing that strikes terror into my heart is the idea of breaking my splint.

So, I went yesterday to get a new splint; the present one is 5 years old. The person I saw said to forget the splint by itself; I should go back into braces (I had them in the early 80's in an attempt to fix this issue, and actually made it worse), and also have both my upper and lower jaw broken and reformed in tandem with the orthodontics. That is called orthognathic surgery. That is not news to me, I've had that mentioned to me on occasion over the years. This is the first time I've had it presented in such a forceful way. I mentioned that no one in Washington DC that I saw would give me a new splint or touch the present one. He said I have one of the complex problems he has seen, so most would not want to tackle my case as it is not cut and dry.

Anyway, he said there was only ONE oral surgeon in the US he would send me to, a guy in Santa Barbara, CA. Problem is, our insurance absolutely will not pay for this guy. Taciturn, who is very knowledgable about insurance, practicality and feasibility of treatment issues, etc due to his USAF work, says that unless we can prove that one person only can do this, no go. So, what we have decided to do is seek another opinion.

When I first worked in the ICU and did after hours recovery, I used to care for orthognathic patients. It was a pretty barbaric procedure back in the day. It is much refined now, and I must admit that the idea of not having to worry about my splint is really attractive. I have a call into my PA to get a second opinion authorized. This will be an interesting journey.

On a different tack, I am going to visit my childhood friend BB who lives in Cooperstown NY, home of the Baseball Hall of Fame. The plane leaves in the am and I'll be gone for a week. The trip is with frequent flyer miles, so it will cost only $10. Sweet. I'll try to blog some from there when I can!