Chapter Eighty:
Saturday morning Dr. Miller woke up and rolled over gently, hoping not to wake Megan. He saw that he had not. He just lay there a minute watching her, thinking how beautiful she was. And how lucky he was.
He got out of bed and made his way to their bathroom. There, he removed his facemask and brushed his teeth. He then took his waterflosser and rinsed his mouth out. After he got out of the shower, he wrapped a towel around himself and went back into the bedroom. He saw Megan was still sleeping. He stood over her, again watching her slumber. He thought again how beautiful she was, even with no makeup on. He reached down and gently shook her. As she woke he said "good morning kitten." She pulled her eye mask up, revealing her eyes. She smiled at him and through her clenched jaw said "goo morning sir."
As Megan got ready for the day, Brad helped their boys get ready. He and Megan were going into the office that morning. It wasn't his scheduled day, but he had a few things he wanted to do. He wanted to bring Megan along to train her on how to help fill in for Becky. Plus he had an idea on how to improve her treatment. He had just gotten their oldest settled at the table with a bowl of cereal when he heard the doorbell ring. That must be Mom he thought, she was going to pick the boys up and watch them.
When he opened the door, his Mom said "oh Brad honey, is that new?"
He knew she must be talking about the facemask he was wearing. It was the first time she had seen him in it. He smiled and said "yes, I had some shifting occur. And with Dr. Andi now a part of the practice, I figured there was no time like the present to address it."
His mother said "oh honey, I know how much you hated your facemask when your Dad made you wear one." She thought a moment and said "I hated mine too."
Brad looked at his mom's teeth and said "Mom, have you considered letting me take a look at your teeth?"
His mom laughed and said "oh honey, I'm too old now. Plus I don't think I could handle it again. You know I loved your father with all my heart, god bless his soul. I still love him. And I miss him every day. But I certainly don't miss my braces. And springs. And expanders. And bite plate. And most of all the different headgears he had me wear. Honey, you know your father kept me in treatment for 16 years. I am done with braces forever. I'd rather get dentures than braces again. But I am so proud of you for doing it again."
Brad let it go. He said "I understand. Please come in. I know the boys have missed their Grammy."
As they parked in front of the office, Brad noticed Dr. Andi and Maggie's vehicles were already there. Walking towards his office, he ran into Andi. She said "good morning Brad! And Megan, you look good this morning! To what do we owe the honor?"
Brad smiled and said "I am spying on you." He laughed and continued "no, really, I have an idea I want to try with Megan's appliances. Plus, I want to teach Megan all about how scheduling and reception work. Becky is going to have a tough time for the next month, I plan to give her all the support I can."
Andi said "oh no, what is wrong with Becky?"
Brad realized that Andi was not aware of what had happened. He spent five minutes explaining everything. As he described everything, Andi's eyes had gotten wider and wider.
Once he was done, she exclaimed "oh that poor girl. We have to do everything we can. A bodycast? In the summer in Texas? I can't even imagine." Again she said "oh that poor girl."
Dr. Brad said "it will be tough. But she has people that care about her. Anyway, what do you have on tap this morning?"
Andi said "well, it is a light day. Or it was. We only had two patients scheduled this morning, a 9 and a 9:30. Just routine adjustments, they will be quick. So, I text Dr. Tim yesterday and let him know we had plenty of openings after 10 this morning if he wanted to come in. I told him any of his staff that wanted to come were welcome too. He text me back yesterday afternoon that he would love to. And his hygienist Sharon will be joining him. They are supposed to be here at 10. I don't know why, but I am really excited about possibly starting treatment on other dental professionals. I think because they understand and appreciate it more than the average patient. Plus, think about what good advertising it will be if we have a pediatric dentist and his staff in treatment. I bet we will get a ton of referrals from them."
Brad scratched his chin and said "you know, I bet you are right. I wonder if it would be worth it if we offered complimentary treatment for all dental professionals in the area? It would increase our workload. But I bet it would lead to a ton more referral business." He thought a moment before he answered his own question "Nah, we are already busy enough."
Dr. Andi said "well, we could always bring on a third orthodontist. I have a girlfriend who was, well is, a year behind me in school. She will be entering the field this summer. She is looking for a job now. We could bring her on. And as a newly minted ortho, she would be willing to work her way up. Like I am doing. I bet she would be willing to start for a lot less than a more established ortho. Maybe you would like her to come in and interview?"
Brad wasn't looking to expand anymore. But he wanted to at least be polite and keep Andi happy. He responded "sure, tell her to come on by when it is convenient for her." He then joked and said "but you know if she does, she will have to start treatment too." He laughed to show he was only joking.
He thought the look on Andi's face was serious when she responded "oh, she knows. I already told her that."
Dr. Brad asked "really? You told her that? What was her response?"
Andi said "yes, I did. I absolutely told her she would have to consider it. And she is all for it. She told me that my appliances are amazing." She laughed and said "us ortho girls are weird aren't we? I mean, who would want to wear this?" as she pointed to her Miller headgear.
Megan interjected "I would love to be able to wear my Miller headgear again. Instead of this halo."
Brad said "honey, it won't be for too much longer. And I have an idea on how to shorten your treatment time even more. Let me show you how reception and scheduling work. And then I will show you what I have in mind."
At 10:12, Brad entered the treatment area with Megan. He could see Dr. Andi was bent over a reclined man. Dr. Brad realized that must be Dr. Tim. He had never met him, but even from two chairs over Brad could see he had a narrow upper palate. In a chair along the wall sat a trim, pretty blond who appeared to be in her mid to late thirties. She was not paying Brad or Megan any attention, instead her focus was on Tim and Andi. Brad thought that must be Tim's hygienist Sharon.
Brad got Megan seated and explained "honey, I am not going to recline you. I just want to replace your springs. But, I am not going to replace them with springs. No, the linkages, for lack of a better word, that Dr. Olivia has on her halo gave me an idea. Why couldn't I use something similar, but obviously smaller, in place of your springs? Something I could attach from the hooks in your mouth to your protraction module that could be turned, tightening them and placing a precise amount of force on your maxilla. That way we could exert more force resulting in faster movement, thus reducing treatment time. And your time in your dreaded halo. First, let me get your springs off." Once he had them off, he said "hang on". As he got up, he noticed that Dr. Tim and Maggie were gone. He knew they were probably doing imaging. In the chair was the pretty blond hygienist, reclined back with a lip retractor holding her mouth open. To Brad's trained eye he saw she too had a narrow palate. But unlike Tim who had a Class III underbite, she suffered from a severe class II overbite. He quickly dismissed the thought, that was Andi's concern. They were her patients, not his.
Returning to Megan's side, he proudly held up his latest invention. He said "see honey, look". He rotated the rod counterclockwise and it expanded in length. He then asked her to hold one end of it while he held the other. With his free hand he picked up the same torx style driver used to lock the scopes on a Miller appliance. He inserted it into a recess in the middle of the divided rod. He made one complete clockwise rotation on the device. As he did, it screwed together and became slightly shorter. He beamed as he said "see, one complete turn equals a quarter of a millimeter. Kitten, I am going to install these between your appliance and module. We will be able to control the force much better. And exert even more force than your springs. Plus, because this is smooth, it should not irritate your lips like the springs did." Megan noticed how excited her husband looked. She was not. To her, more force meant more pain. The fact that he had already had her take a dose of ibuprofen was also a bad sign she thought.
Brad held the rod up to Megan's mouth and roughly estimated how long it should be. He unscrewed both rods to the length he thought they should be and then placed the eyes of each over the hooks in Megan's mouth. They hung from her mouth like broken shock absorbers under a car. He gently placed his hand on one and held it up to her protraction module. He made three turns on it and said to himself "perfect." He placed it over one of the outside hooks on her protraction module. He repeated the process with the other one. He said proudly "kitten, this is going to work so well. I just know it. And I won't need to crimp them in place because their is no flex on these. Once I tighten them, they will be permanent unless they are loosened with the tool." Megan saw how excited he was. She was happy for him. And more than willing to be his guinea pig.
He said "ok babe, let me tighten them and remove the slack." He made four turns to snug them up. He felt them to confirm that had equal force. He looked into Megan's face and said "ok kitten, I am going to make some turns." She took a deep breath. As he made the first complete turn, she could feel the pressure in her mouth. He made a corresponding turn to the other rod. The pressure increased. He asked her "how is that, do you feel it, is it manageable?"
She said "yesh sir. I can feel it, but it is manageable."
He smiled and said "good kitten. One more." On the second set of turns Megan squirmed a little in the chair. He noticed and said "you are doing good." He made one more set of turns. Halfway through, she let out an involuntary whimper. He patted her arm and said "that is good for now dear. How are you? Are you in pain?"
Megan said "yes sir, I am."
Brad said "that means it is working. But if it is too much, I can turn them back a turn."
Megan stuck her tongue out and ran them along the rods. The pressure in her face was enormous. But, in a way she liked it despite the pain. Plus, she didn't want to disappoint her husband. She said "I will manage".
He hugged her and whispered in her ear "you are such a good kitten. I think since you are being such a good girl, and mom has the boys, I will let you out to play this afternoon." He released her and straightened up. Becoming professional once again, he said "I really do think this will cut your time in the halo down tremendously. Let's go take some imaging. I want to have a baseline to compare before and after."
He had to wait a few minutes for Maggie to finish taking x-rays and cbct scans for Dr. Tim's hygienist Sharon. As she walked by he gave her a big smile and said "hi, good morning! You are in excellent hands!" She didn't smile back. Here only response was to look at him. She looked to be in shock.
After completing the imaging, Brad and Megan returned to the treatment room. As they walked in, hand in hand, Brad said "kitten, we are about done. I know your mouth is sore. I need to get you home and nurse you back to health. But first, let's meet Dr. Tim."
As they approached Tim, who was sitting in a chair along the wall adjacent to the treatment chair now occupied by Sharon, Brad saw that Tim was holding up a mirror. He had his mouth open peering into the mirror. Brad could see the blue spacers in Tim's mouth. In the chair, Brad could see that Andi was installing spacers in Sharon's mouth as well.
Brad walked up with a big smile on his face and exclaimed "starting treatment is SO exciting! We love it here. We love it here so much, we all are doing it. Hello, I am Dr. Brad Miller. This is my amazing wife Megan. And you must be Dr. Tim!"
Tim put the mirror down and looked up. Tim said "yes, I am." He stuck out his hand.
After making introductions, Dr. Brad asked "so, what was Dr. Andi's assessment?"
Tim replied "for me, a narrow upper and lower palate, a crossbite, and a mild class III underbite. My airway is also constricted. For Sharon there, a narrow upper palate, crowding and tipping of the lowers, protruding canines, and a severe class II overjet caused by her tongue thrust. She too has a constricted airway."
Brad smiled and said "it really is an epidemic. I am glad you both came in. You will be so glad you did. So, how is Dr. Andi going to fix everything?"
Tim said "both of us are getting Miller appliances. Sharon's will have a tongue crib and rake integrated into it. I will get Miller headgear set up for simple protraction. Sharon's will be a bit different. Instead of using a standard headgear to retract her upper jaw and constrict her airway more, like most orthos would do, Andi is going to set up her up with a facebow on top to hold her maxilla in place and use springs on her mandible, in conjunction with her scopes, to pull her lower jaw forward to the desired occlusion. Both of us are looking at roughly two years I think."
Brad smiled and said "the time will fly by. And again, you will be so glad you did it." He looked over at Sharon and noticed the look on her face. He didn't think she would agree with him at the moment. Dr. Brad said "the spacers may make you a little sore, alternate with acetaminophen and ibuprofen. Speaking of sore, my Megan here had an adjustment just now and is a little sore herself. It was a pleasure to meet you and I look forward to watching your journey."
As he watched Dr. Brad and Megan depart, Tim wondered if he would be able to wear his headgear in the office as confidently as Brad appeared to. He reminded himself he was lucky, Andi had told him he would only need to wear his for 16 hours a day. She added that he probably would not need it for the entire duration of his treatment. He looked at Sharon. He wondered how she would manage wearing hers 24 hours a day for the duration of her treatment.