Danna inspected her teeth in the bathroom mirror. "Why does everyone always clean their teeth the most diligently right before they go to the dentist?" she wondered to herself. She had always had this random butterflies in the stomach feeling whenever she had to go the dentist. And it was very unwarranted. She had rarely had so much as a cavity and her family dentist, Dr. Cooper, had never been anything but wonderful to her every time she had an appointment but this time was different. The gap between her two front teeth had been gradually getting bigger and her incisors had gotten more and more flared over the last few months. "Dr. Cooper will know what to do." Danna told herself as she prepared to leave for her appointment. She was wearing jeans and sneakers and a faded white long sleeve t-shirt. She took one last quick look in the mirror before walking out the door.
She walked into the dental office, signed in and waited for her name to be called. After a few minutes, a hygienist came out and called Danna back. They made the standard small talk while the hygienist cleaned her teeth and asked her all the boiler plate questions. "Have you been flossing, brushing after every meal?? etc." Danna just smiled and nodded as we all do. Seemingly play catted, the hygienist told her the doctor would be in soon and made her exit. A couple of minutes later, Dr. Cooper entered the room. She was a rather tiny woman. Mid 50's with blonde hair, bangs in the front wearing a white lab coat and linen suit pants. She always had a positive disposition and a wonderful chair side manor.
"How are you?!" she exclaimed as she walked in and patted Danna on the shoulder. "Oh good! how are you?" Danna asked and they made the normal small talk while Dr. Cooper looked at Danna's chart and snapped on a set of gloves. "Any problems with your teeth?" Dr. Cooper asked after the usual pleasantries. "Not really any problems. I've just noticed that the gap between my two front teeth seems to be getting wider and my incisors look like they're sticking out more than they were before."
Dr. Cooper put her new x-ray on the computer monitor and inspected it closely. Then she asked Danna to open wide, inspecting her teeth, having her bite down and open her jaw several times. After a couple of minutes of this, she sat back and said "Yeah. It looks like your upper wisdom teeth are shifting which is making the rest of your upper teeth shift a little. The gap between your two front teeth isn't really getting bigger but your front left tooth is turning a little bit which is making it look like the gap is getting bigger."
"Oh. Is there anything you can do to fix it?" Danna asked, feeling the sweat form on her palms. "Not really." Dr. Cooper replied. "All I can really do is take a mold of your teeth and make a clear plastic retainer to make sure things don't get any worse. I'd like you to go see a colleague of mine, Dr. Brassard. He's really wonderful. He does cosmetic dentistry, bonding, orthodontics. He'll be able to help you much better than I can."
"Ok." Dana said. "Well, everything else looks great. Unless anything else comes up, I'll see you in six months." Dr. Cooper said cheerfully. "Afraid not!" Danna said smiling "The boys are due for their six month check up in 3 weeks!"
"Oh! well I'll tell the staff to get ready then!" Dr. Cooper said as they both laughed and said their goodbyes. She walked to the front desk and gave them her insurance card and the receptionist gave her Dr. Brassard's business card. Danna said thank you, stuck it in her purse and walked outside. She ignored the cold sweat feeling in her stomach as she drove home. She got there about 20 minutes before her sons' school bus dropped them off in front of her house. She entertained her 7 and 9 year old, made them snacks and did her regular routine until her husband Jim got home from work a couple hours later. Jim was a construction foreman. The hours were sometimes long but the pay was good and he had great benefits for the family. He grabbed the boys and wrestled with them for a minute before crossing the living room, putting his hand on the small of Danna's back and kissing her gently on the mouth.
"How was your day?" he said raising his eyebrows and smiling. "It was fine." She said with a wide grin, choosing not to tell him about her dental appointment or what Dr. Cooper had suggested. She wasn't sure she was going to call Dr. Brassard yet.
The next day, while the boys were at school and Jim was at the jobsite, Danna stared at Dr. Brassard's card wondering if she should call. She had braces when she was 11 and HATED them. Her orthodontist was a very old man, near retirement and wasn't exactly up on all the latest technology. He put Danna in upper braces for about 8 months to close all the gaps in her teeth. Then removed her braces while her teeth were still somewhat crooked and with some considerable gaps remaining. But Danna being so happy to be done with her braces made no protest about the subpar condition of her teeth. She was given a retainer which she wore for a few months then lost shortly there after when her family moved into a new house. "Oh well. What's done is done." she thought and didn't give it a second thought... until now.
"I'll just go in, meet him, hear what he has to say and if I don't like it, I'll just say no thank you. Simple as that." Danna thought as she dialed the number on the card. She said that Dr. Cooper had referred her and made an appointment for the following morning. She didn't tell Jim or anyone else about the appointment. Why would she? There was nothing to tell, right?
She flossed and brushed her teeth the next morning as one does before going to a dental appointment. She left her long, dark hair down and wore an off white silk blouse with black slacks and black leather flats. She arrived a few minutes early so she could fill out all the usual new patient paperwork. The office was on the third floor of a four story building. She walked in the door marked 'Dr. Robert Brassard- aesthetic dentistry and orthodontics' , gave her name to the receptionist and was given a clipboard with a few pages of information she needed to fill out as expected. She sat in the middle of a row of blue and black chairs and filled out the forms, A couple minutes after she'd finished, a nurse opened the door leading to the exam rooms and called her back.
The nurse introduced herself as Jenny and told Danna this was going to "just be a records appointment." She took pictures of Danna's profile and of her face straight on. Then she gave Danna cheek retractors and told her to hold them while she took several pictures of her teeth. Then she mixed up some kind of pink goop in a small, dark green bowl. She put the goop in a jaw shaped tray, then told Danna to open wide and stuck the tray in her mouth for about a minute. Then did the same thing on Danna's bottom teeth. Next, she took several x-rays and then had Danna follow her to small room in the back of the office and had her bite on a small tube and told her to keep perfectly still while she took a panoramic x-ray of Danna's skull. She then lead Danna back to the exam room and told her the doctor would be with her shortly. Danna looked at all the model teeth on the counter next to the exam chair. One had metal braces, one had ceramic braces, one had clear retainers, one had normal retainers with the metal bar on the front of the teeth,
Then, a tall, robust man wearing a white dress shirt and khakis walked in. "Hi Danna! I'm Robert Brassard." He said, shaking her hand. He was jovial with a very pleasant disposition. He had light brown hair with a touch of grey slicked back and curly on the ends. He had a good energy and an excellent chairside manor which made Danna much more comfortable.
"So, what are we doing today?" he asked. Danna pointed to her top teeth and replied "Oh, nothing much. I just noticed that the gap between my two front teeth seems to have gotten bigger and my incisors look like they're protruding more than they were before."
"Oh well that doesn't sound too serious. Let's take a look. Open please." he said as he snapped on some rubber gloves. He told Danna to open and bite down what felt like a couple thousand times. Jenny was standing close behind him with a clip board taking notes. He said several numbers after words like "crossbite" and "malocclusion". Then baked up and raised the exam chair Danna was sitting in. Then he started in. "Well, your teeth are shifting because your upper wisdom teeth are shifting. Unfortunately, they're still to deep into your jaw for us to remove them so we'll have to deal with this problem orthodontically."
Danna felt the butterflies flutter in her stomach and the sweat forming on her palms. "Oh, OK. What do you suggest?" She asked shyly. "Well, your bottom teeth are perfect so I don't want to do anything there but I'd like to out a permanent retainer behind your bottom teeth just to be on the safe side and to make sure nothing we do causes them to shift. This is a totally painless procedure, it only takes a few minutes and it's pretty much invisible. After a couple days of getting used to it, you won't even notice it's there."
This sounded more than expectable to Danna. "OK. Anything else?" She asked, nervous for what would come next. "I'd like to fit you with braces on your upper teeth as soon an possible." he said. "Oh... OK. is that all?" Danna asked nervously. Dr. Brassard continued "I don't want to put braces on your lower teeth if we can avoid it but we will need to put brackets called spurs on your lower incisors to hook your elastics to."
Now she was going to have braces AND elastics?! Time to start asking about a contingency plan. "Is there some kind of retainer I could wear that would give me similar results?" She asked. Dr. Brassard quickly replied "No. Afraid not. Retainers are really just used to keep the teeth straight after orthodontic treatment. They don't really do any of the straightening themselves." Strike one.
"What about Invisalign or something like that?" Danna asked. Dr. Brassard continued "Invisalign is great for straightening out misaligned teeth but your main problem is with your bite which Invisalign is not the best at combating and even if we did go that route, it would take much longer than braces and be much more expensive." Strike two. Then Dr. Brassard threw her the meanest curve ball of all.
"Plus, with Invisalign we wouldn't have anything to anchor your headgear to." HEADGEAR!!?? is what went through Danna's mind but it came out "Oh, headgear?"
"I know what you're thinking." he said "but it would only be worn at night of course and only for a few months. I almost never prescribe it to my adult patients but you 4 mm overbite which is considered severe and since you're an adult, your jaw bone has already completely formed so it's going to take quite a bit of force to correct it." Danna felt dizzy. Then he continued "In addition to fitting you with a permanent lower retainer today, I'd also like to put spacers on your upper molars so that we can fit your braces in a few days. Jenny. Can you see if we have a banding appointment available then?" he asked.
"We have 3:00 on Monday available." she said checking the computer on the counter in the exam room. "Is that ok Danna?" Dr. Brassard asked smiling. Danna wasn't sure what was happening. She simply said "Do you have anything earlier? My kids get home from school around 3:00."
"Sure!" said Jenny cheerfully. "How about Tuesday at 9 a.m.?" Danna stammered "Uhh… sure. That should be fine." It was like she was hypnotized. "Great!" said Dr. Brassard. "Jenny will get you set up with your spacers and your permanent retainer and we'll see you in a few days," He took off his gloves and shook Danna's hand and left the room. What had she just agreed to?! Before she had time to think about it, Jenny put on a mask and rubber gloves and laid the exam chair back. She began with the permanent retainer. She took a very small piece of wire and fit it behind Danna's bottom teeth. Then removed it and adjusted it. She did this several times. Then, when she had it the way she liked it, she took several threads of floss and ran them between Danna's bottom front teeth. Once she had the wire in position, she glued it into place and used a bright blue light to cure the glue. Then she removed all the floss and said "There we go! That wasn't so bad, was it?" Danna just shook her head not really knowing what else to do.
"Good!" said Jenny. "The spacers are much easier." She took a long piece of floss and tied a small, blue o-ring to the middle of it. Then she forced it in between the last and second to last molar on the right side of Danna's top teeth. Then repeated the process with her second and third to last molar and did the same thing on the left side. Then announced "There we go! You're all set. I already scheduled your appointment for Tuesday at 9:00. Just grab an appointment card from the front desk. Oh! and be careful with those spacers. No hard or sticky foods because that could make them come out. If one does come out, just call us and we'll replace it for you, OK?" she said smiling.
"Uh. Yeah. Sure." Danna replied getting up from the exam chair. "OK. Awesome! See you Tuesday!" Jenny said waving as she walked out of the room. Danna walked out the front to the reception desk and got her appointment card. By the time she got to her car, her head was spinning. "Is this really happening?" she thought.
