Mid-December 2015
Not a great day.
Today was my second adjustment appointment since getting braces. And Janice's too, of course.
At the first adjustment, a month ago, they gave me new archwires, which are thicker and stronger (I guess each time you just get a slightly stronger wire, which, duh, obviously) and checked the expanders. Then they spent a lot of time on the headgear again, measuring the forces, taking the straps on and off. They took new X-rays and impressions, and they asked to see me again for a check-in two weeks after.
Janice, of course, was told her teeth are moving really well, and it's possible her entire treatment will come in under a year.
At the check-in appointment they had the new X-rays and the impressions and they again did a lot of looking at the headgear and those molars. Honestly, I really don't care if my molars move a bit. Who even sees them? But the faculty guy then talked to me – which seems to only be when they want to make sure I know this is very professional – and said it's about the bite relationship and that it's actually super important, even more than the aesthetic stuff that orthodontics provides.
"So at your next appointment we may reconfigure your extra-oral appliance in order to make sure we're on track," Dr. Amy told me.
So that was two weeks ago.
Today, first of all, Janice got elastics. Selfishly, I'm kind of happy about this as it makes her braces slightly more obvious, although they're sort of hidden further to the back of her mouth. And I also get the sense that elastics are a later stage thing, so somehow her progress is going crazily fast.
So I go in and they do the usual stuff first: remove the ligatures and the archwires, do a bunch of cleaning and poking around, adjusted something on both expanders, and then put in new archwires and new ligatures. I sat up to rinse.
"Oh yeah, you need my headgear now," I said, and picked up my handbag. I handed Dr. Amy the case with the facebow and the case with the straps.
"We told you about a reconfiguration last time," Amy said, putting them down on the counter. "So you're actually done with this facebow. We're going to try a similar one."
She went to another counter and came back with another facebow. It looked similar, but with the outer bow looping on either side just before the joining point with the inner bow. The ends of the outer bow had blue plastic stoppers on them.
"This is called a cushion-loop facebow," she said. "The wire loops around here, which helps to absorb some of the applied force. It lets us control the pressure more precisely."
"The problem we've been having with your headgear is that we haven't been able to control the direction of the force and the degree of the force as much as we'd like," Dr. Lorenzo said. "So this will help."
"OK," I said.
Then they lowered the chair, brought out a lip-spreader again and put it in. They both worked on the new facebow, adjusting it with what looked like pliers. After about ten minutes they showed it to faculty guy, who pulled on gloves and took it out and reinserted it a few times before telling them it was good. They took the lip-spreader out, raised the chair, and Dr. Amy gave me some lip-balm again.
Then they put the facebow back in.
"So we're also going to replace the straps you've been wearing with something that gives us more control," Dr. Amy said. She brought a clear plastic packet over and pulled out a small mass of blue straps. "This is called an Interlandi headgear. It's a single strap and it's easier to adjust the force exactly as we need it."
Dr. Amy arranged this thing over my head. It had a bunch of straps on top of my head that converged into a plastic piece at either temple. That plastic piece extended in front of my ears and then under them, back to near the corner of my jaw, where they were attached to a padded neckstrap. It felt like my combination headgear but much more elaborate. Dr. Amy and Dr. Lorenzo took a bunch of measurements and adjusted the straps, then removed everything, did something at the counter, and then put it back on. I could feel that it now fit more snugly.
"This appliance uses elastics to provide the force we need," Dr. Lorenzo said, holding up a small plastic bag of rubber bands. He and Dr. Amy then spent 10 more minutes connecting different sized (I assume?) elastics between the ends of the facebow and something on the plastic pieces in front of my ears. They used some measuring tool and wrote down various numbers, and then faculty guy again looked at everything and approved.
Dr. Amy handed me a mirror. I was used to seeing myself wearing headgear at this point. This was, in some ways, pretty much the same, but bulkier in every respect.
"There are two connecting pegs in the correct holes on each side of the headgear," Dr. Amy said. "You'll need to put everything on and then these elastics" – she handed me a baggie full of red elastics – "go from the top pegs to the facebow" – she connected two as I watched – "and these elastics" – she handed me another baggie of blue elastics – "go from the bottom pegs. When in doubt, B for blue, B for bottom."
I stared at myself in the mirror.
"Give it a try, Annika," Dr. Amy said.
I disconnected all the elastics and pulled the straps off my head. Then I reached into my mouth and slid out the facebow. Then I put it back in, pulled the straps over my head and neck, fiddled with the elastics and was wearing headgear again.
"Easy enough, right?" Dr. Lorenzo said. I nodded, reluctantly. "Ideally you should change these elastics every four hours, but if you sleep through it, it's not a huge deal."
"Annika, the other change we want to make is with wear time," Dr. Amy said. "We'd like you to wear this appliance 12 hours a day, preferably consecutive hours. Do you think that's possible?"
"I'll do my best," I said, for some reason. Why didn't I resist these things when they were happening? "Are we still on track for time?"
Dr. Amy and Dr. Lorenzo looked at each other. "It's still possible, but we've adjusted the expanders for now so that their progress is more moderate while we're resolving this anchorage challenge. So this might add a bit of time to the total treatment. It's still hard to say."
They asked me to make an appointment for a week later and for the day after I got back from Christmas break so they could check the headgear.
I got new cases for the new facebow and straps, a bunch of bags of red and blue elastics, and my old headgear ("if you want a souvenir," Dr. Amy said). I took everything off, thanked the orthodontists, and went out to meet Janice. I made two more appointments, plus one for later in January for my actual adjustment. Janice made a single adjustment appointment, same day as me.
So now I'm writing this at 10 pm the same day as that appointment, sitting at my desk in my room, wearing this thing called an Interlandi headgear, metal braces and two expanders. I've had the headgear on since 8 pm, and I will wear it till 8 am. There are four thick elastics that I can see out of the corner of my eye, two on each side.
I'm just not quite ready to hang out in the den with this. I can hear Janice out there joking with some friends about her elastics, her tiny little elastics. Oh well. Only twelve more months. Or more.
