I'd really been wanting to improve my bite and teeth for a while, but hadn't wanted to get braces. My teeth were starting to shift more, and I was concerned about this continuing. I'd done some research and it looked like there were a lot of removable type of appliances out there and maybe I'd even qualify for Invisalign. With having to wear masks during COVID, this seemed like a good time to pursue treatment.
Just to get an opinion, I made an appointment with an orthodontist.
The day of the appointment arrived. I considered not going but thought, what do I have to lose. It's just a consultation.
I arrived at the office with my mask on. They got me checked in and took me back. They told me to remove my mask and they would start with x-rays and photos. Afterwards, Dr. K came over.
Dr K: Hello Anna. We're glad you chose our office for your orthodontic concerns. What made you decide to seek orthodontic treatment?
Me: Well, I've wanted to fix my teeth for sometime now. I have quite a bit of crowding and my teeth are starting to shift even more, especially lately. I'm concerned my teeth are going to keep shifting. I would really love to have a wide, full look to my mouth. I was hoping I could get some sort of removable appliance or retainer or maybe Invisalign.
Dr K: Ok, let's take a look and see what's going on.
She looked at the x-rays and photos, then asked me to open my mouth while she prodded around with a metal tool.
Dr. K: Bite down. Open. Bite down. Open
Ok, now swallow. Again. And again.
She felt my jaw as I opened and closed.
Dr. K: Does that hurt?
Me: It's tender.
Dr. K: Do you have any jaw pain?
Me: Sometimes, if I open really far and sometimes when I wake up in the morning.
Dr. K: You grind your teeth at night but you also are developing TMJ issues. It's due to your jaws not being in proper alignment. Have you ever had orthodontic treatment?
Me: No.
Dr. K: So you have a couple of issues going on. Did you suck your thumb when you were a kid?
I nod.
Dr. K: I can tell because you have what we call an open bite and this caused your teeth to be narrow as your palate is more narrow and high. This also caused your lower jaw to not develop as much as your upper jaw. This can cause pain. The other issue is that you have a pretty severe tongue thrust. When you swallow, your tongue pushes forward against your front teeth, causing them to push out. It looks like it often puts pressure on your teeth at rest too. I also notice it's hard for you to keep your lips closed so you do a lot of breathing through your mouth.
Unfortunately you're not a candidate for Invisalign and we need to do more work than is possible with a retainer or removable appliance.
I usually don't recommend extractions but you have such severe crowding on your upper palate that it's more than an expander can handle. I recommend extraction of your two upper premolars.
I'd also like to start by installing a tongue crib appliance on your upper palate along with a lip bumper on your lower teeth. The tongue crib will address your tongue thrust and the lip bumper will help create more space. I'd also like to begin with partial braces to start guiding your teeth. After the extractions, you're also going to need to wear headgear to hold back your molars.
They took impressions. They then placed spacers between my molars to prepare for the appliances and braces.
Dr. K: The appliances will be ready next week, so let's get you back then.
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My dentist was busy and couldn't get my extractions scheduled until two more weeks.
I return for my next orthodontic appointment, a little nervous, but feeling ready to get started.
Dr. K: Hello, Anna, how are you.
Me: I'm doing fine. Thanks.
Dr. K: We're going to have you sit over here today.
She motioned to a different area of the office. I walk over and sit in the chair. The assistant places a paper bib around my neck and lowers the chair. Dr. K walks over with a tray, though I didn't get a good look at it. Dr. K places a lip spreader and tongue retractor. She removes the spacers. She takes a piece of metal and I feel pressure on my back molars. She adjusts it. Takes a tool and bends something. She uses a light that flashes. She takes another piece of metal and I feel pressure on my back molars. She adjust it. Then the light flashes again.
Dr. K: I've installed the tongue crib and lip bumper. Now I am going to place four upper brackets on your front teeth. You said your extractions will be next week. I'm going to go ahead and place the wire on your braces as well. Your dentist can remove the wire and then afterwards you can come back in for a new wire and your headgear.
I felt pressure as the wire was placed.
Dr. K: ok, all done.
She removed the lip spreader and tongue restraint.
My tongue hit something in my mouth and my mouth felt full. I pointed to my mouth, as I started to drool and struggled to swallow. I tried to speak, but couldn't. I couldn't get my lower lip to close around the lip bumper and my lip sticks out.
Me: I ca thpea
Dr. K: It will take a while to adjust to the appliances, but swallowing and speaking will improve. Your lip will eventually close around the lip bumper. Keep trying to close them for now and your teeth will shift. I can recommend a speech therapist to help you with adjusting to the appliances and addressing your tongue thrust.
I nod.
I thought at least thank goodness I can wear a mask. Without even looking at my teeth, I put on my mask and head out of the office. I stop at the reception desk to schedule my next appointment. Dr. K walks over.
Dr. K: What day are your extractions?
I look at a calendar and point.
Dr. K: Ok, can you come in the following Friday?
I nod.
Dr. K: Great. And the speech therapist I recommend is named Rachel. Here's her number. She will likely do a consult over the phone first and then go from there. Tell her I recommended her. I send quite a few of my patients there. She's great at working with orthodontic patients. And remember, practice speaking and your speaking will improve. See you later.
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At least wearing a mask, it all felt easier to hide than if I'd not had a mask. No one could see I was wearing braces.
I emailed Rachel when I got home. She responded quickly and asked me to call when I was able. I tried to practice speaking aloud, but it was useless. I was struggling to speak and even to swallow. I was even struggling to keep my lower lip closed around my lip bumper.
I called the number.
Receptionist: Hi, Better Speech Therapy, this is Amanda, how can I help you?
I pause.
Me: Hello, I'm callin o thpea o Rathel abou thpeeth thewapy.
R: I'm sorry, I don't think I caught all of that, but you said you wanted to speak to Rachel?
Me: Yeah
R: Are you currently a patient?
Me: No
R: Are you interested in a consultation?
Me: Yeah
R: Great, can I get your name?
Me: Anna Thmithon
R: Anna and what was the last part?
Me: Thmithon
R: Can you spell that?
Me: Th - m - i -t - ath - o - n
R: Smithson?
Me: Yeah
R: Great. Is this a good number to reach you at?
Me: Yeah
R: Rachel will call you a little later. Thanks for calling and we'll be in touch.
Rachel called a little later.
R: Hello, Anna?
Me: Yeah
R: This is Rachel with Better Speech Therapy. How are you today?
Me: I'm ok
R: Great. So I understand you've started orthodontic treatment and are trying to adjust to some new appliances and address a tongue thrust. Is that right?
Me: Yeah
R: So I know it can be super uncomfortable and difficult to talk with new orthodontic appliances. I work with some of Dr. K's patients and am used to working with orthodontic patients. The biggest thing is to practice speaking. So I'd like to go ahead and start with that practice by having you tell me a little about what's going on. When did you get the appliances?
Me: Toay
R: Wow, so they are really new. It can take some time to adjust. Can you tell me a little more about the appliances and concerns you have?
Me: I have an upper tongue cwib an a lip bumper on the boam. I altho have parthel bwathes on my fwont top tee bu tha dothent affect my thpeeth. I'm gettin two tee pull neth wee an then am gettin headgew.
R: I'd like to have you come in next week to get started. We have our patients wear face shields during treatment so we can look at your mouth and see what's going on. Go ahead and wear a mask when you first come and we'll give you a shield. Will that work?
Me: Yeah
R: Great, what about Thursday at 2.
Me: Yeah, thath goo
R: Great, I'll see you then. I'm going to send you some exercises to practice with reading out loud for you to get started on. The more you practice, the better you're speech will improve. See you then.
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The day for the extractions came. I had gone to Dr. Larry my dentist since I was a kid and he knew my family. I arrived at the office. They knew me and checked me in without my having to say anything. I thought how with a mask, I didn't look any different. A few min later, the assistant came and got me.
A: Hello, Anna, how are you?
Me: Ok
A: Good. You can put your coat and bag here. We're going to have you take your mask off and we're going to put this nosepiece on to administer the laughing gas. It will help you relax. Dr. Larry is finishing up with someone else and will be in a little while. I'll go ahead and get you started. Is your family doing ok?
I nod.
A: Good
