Episode 71.
As Sarah watched Dr. Parker install first an upper facebow and then a lower facebow in Julia's mouth, she felt overwhelming guilt. At that moment, the one thing she wanted to do was take back what had happened. She knew that wasn't possible, so she racked her brain as to how she could somehow make this up to Julia. She drew a blank.
After Dr. Parker was done fitting the facebows she explained "so Julia, until the fracture in your jaw heals, your active orthodontic treatment is on pause. We can't exactly be moving teeth around. Instead, I want to stabilize everything. That is the reason for this new headgear. It will help stabilize your occlusion while you heal. Much like your halo is doing for your spine, this headgear is intended only to hold your jaws immobile. I will use very light forces, so you should not feel any discomfort from the headgear. I do want you to wear it full time until your jaw heals. The one exception is you can remove the facebows for hygiene; once in the morning and once in the evening. Other than that, you should have them in and attached to your Interlandi cap. Because of the rear pins of your brace putting it on will be a little more complicated than it would be normally. How often do you wash your hair now?"
Julia responded "oncsh a week, ish hard with the halo and shoulder shpica."
Dr. Parker nodded and continued "then in that case, please wear the cap all the time except when you wash your hair. So, let me show you what I mean." Looking over at Peter she asked "Peter, would you mind being my model? Would you please go ahead and slip your facebow in? And please hand me your straps so I can show Julia what she will need to do."
After having slipped his facebow in and being directed to sit in a stool beside Julia, Dr. Parker said "so, because of your rear pins, you can't just slip the cap on. Instead, you will need to unfasten the top strap, like this". She slid the straps that went over the top of the head out from the flat plastic buckle on top. She continued "you will need to attach the cap around the back of your head and neck. It would be best if someone helps you. Like this." Looking at Sarah she asked "Sarah, would you please hold the cap in place on Peter's head while I attach the elastics." Sarah held the cap while Dr. Parker explained "for you Julia, I am only going to use one elastic on each facebow on each side. Again, we are not trying to move anything, just keep it in place. Like this." Once she had the elastics in place she said to Sarah "you can let go. The elastics will hold the cap in place. Like they do your facemask. Which I might note, you are not wearing." Sarah took the hint and left the trio for a moment. When she returned, she was wearing her facemask. Once she returned Dr. Parker continued "and so, this is where it gets just a little different for you Julia. Once you have everything on, you will need to thread the straps that go over the top of your head back together." As she did this she said "you just want it snug, do not over tighten it. You should just be able to get a finger under it without discomfort. But you also don't want it to be loose. Like this." She placed her hand on the back of Peter's head and bent it down, so that Julia could see the top of his head. She continued "since you are only washing your hair once a week, you will only need to do it a total of 5 or 6 times; or the number of weeks it takes your jaw to heal." Looking at Peter she said "Peter, since you have your headgear on, would it not be a good idea to go ahead and add two more additional elastics like your treatment calls for? Every minute of wear helps." Without needing a mirror, Peter quickly attached two more elastics. Dr. Parker said "good boy. Now, let me go ahead and get Julia strapped in. I will also mark your top straps with a sharpie marker so you know how much to tighten the top strap."
As Cassie held Julia's cap around the back of your head, Dr. Parker quickly attached her elastics. As she looked at the scene, the feeling of guilt returned to Sarah. There before her were Dr. Parker and Cassie both wearing pink facemasks, as she herself was. Dr. Parker also had her hot pink headgear strap on, which was like a flashing beacon on top of her head. In the chair was poor Julia, being fitted with double Interlandi headgear, and beside her still sitting was her husband wearing his own Interlandi headgear. And she knew back in the treatment coordinator's office Dr. Higgins and Izzy were finalizing the details of their own treatments, which also involved headgear. It all seemed so ridiculous, and extreme. And Sarah felt it was all her fault.
Back in the treatment coordinator's office, Pam had finalized all of the financial details with Dr. Higgins. Ever since she had introduced herself and began explaining everything, Pam couldn't help but notice that Dr. Higgins was focused on her mouth. Once Pam was finished explaining everything and had them sign all the necessary documents she asked "so, any questions?"
Dr. Higgins responded "I do. Dr. Parker said you also wear an FR appliance. Are you wearing it? She said it was intrusive. But I don't see anything. Is it really not visible?"
Pam gave an exaggerated smile and then replied "no, I am not wearing it now. When meeting with new patients, I take it out. Only because it does impact my speech a little. And I don't want there to be any miscommunication. Plus, it can be a little intimidating to new patients. I do have these fancy, shiny molar bands all the time though." She pulled her cheek back on one side, showing molars bands, each with a hook welded on them, on her upper and lower molars. She continued "now, when we meet again, I will have it in. And be wearing my facemask. It is hard to cheat when you work for your orthodontist." After a quick laugh she asked "would you like to see it?"
Nervously Dr. Higgins said "I guess since I am committed to this, the paperwork is all signed, I can't back out now. Sure, let's see what is in store for me."
As Pam pulled open a desk drawer she responded "really, you will get acclimated to it. I won't say used to it, but acclimated." Pulling out a large pink plastic flip top box she opened it. From it she removed the largest orthodontic appliance Dr. Higgins had ever seen. It was a mass of silver wires, purple colored acrylic, and something that looked like a fence in the middle of the appliance. Pam held it up and explained "so, this is it. You see the large pads on the side that rest between my teeth and cheeks. And you might notice the Fair Oaks Orthodontics logo on them. We can add all kinds of neat designs on them. There is certainly enough room. And these two smaller pads here in front rest below my front lower teeth, between my lips and gums. These two wires are inside my teeth, running along my upper and lower palate, the lower one in front of my tongue. And speaking of tongue, this jail cell here in the middle is to hold my tongue back. It is really what impedes my speech the most. And finally, I have this upper wire that runs along the outside of my top teeth, like a hawley retainer. Here, let me demonstrate."
Dr. Higgins was shocked. She was shocked that the appliance was so large. So large she wondered how Pam even got it in her mouth. She was also shocked that anyone could tolerate wearing it.
Dr. Higgins watched as Pam opened her mouth and somehow maneuvered the appliance in. Once in her mouth, Pam seated it in place. With the appliance in, Dr. Higgins noticed her lower lip and both her cheeks puffed out. It looked like she had a mouth full of something. Which she did. Once the appliance was in place, Pam gave an open mouthed smile. The large acrylic pads were visible in the corners of her mouth with a shiny wire running across the front of her top teeth. Then Pam spoke, and Dr. Higgins felt sick to her stomach.
Pam said "sho, thish eh my appliansch. Ash ya can hear, it doesh affect speech shome. With the tongue guard training my tongue, it ish hard to shay shome wordsh. Ssh is one. Among othersh. But everyone can shtill undershtand me for the mosht part. The firstht few weeksh are the hardest. You really will need to practish shpeaking as musch ash you can. Now, here is my fashmask." From the open drawer she removed a white plastic and metal mask. It did not look like the facemasks which Sarah, Cassie, and Dr. Parker wore. Instead, it looked like it had a pad for the forehead, and then there were two pads below that on either side. She was confused until Pam said "sho, thish is my facemashk. It is ish a Grummonsh style facemashk. My job ish speaking, and I find the chin pad of the Petit shtyle to be cumbersome. Sho here at the officsh I wear thish. Let me show you." She held the mask up to her face, a pad resting on her forehead and one on each cheek, and deftly attached elastics to the hooks on her upper molars. She then connected them to the facemask. But she was not done. She then attached two more elastics to the hooks on her lower molars and also attached them to the facemask. Smiling at Dr. Higgins she said "voila, and now we have headgear!"
Dr. Higgins was as white as a ghost. Pam noticed this and said "really, it isn't THAT bad. You will get used to it. And it looks like you don't have to wear the facemashk all the time. Sho that will make it even eashier. Trust me, you will see. I think that wrapsh it up. Letsh get you two back out to the treatment area sho we can get you two some spacersh. This really ish an exciting day. Smile! It is the first day of your new smile. And life with a better, healthier bite. You will see."
Sarah noticed Pam enter the treatment area. She couldn't help but notice the facemask she was wearing. Behind her followed Dr. Higgins and Izzy. They were quite the contrast. Izzy was smiling wide, practically beaming. Dr. Higgins on the other hand looked so sad, like she had just suffered a devastating loss of some type. As Pam approached she announced "Dr. Parker, your two new patientsh are ready to begin treatment." Pam turned to face Izzy and Dr. Higgins and said "congratulationsh you two! And it wash shuch a pleashure to meet with you. I look sho forward to working with you as you proceed on your journey." With that said she departed.
Dr. Parker said "perfect timing. I am just finishing up here. Dr. Higgins, Izzy, why don't you get seated." Before they could however, Maria led a girl who appeared to be around 10 years old in followed by her mother. As the little girl passed, she took in the group before her. Her eyes got big and she turned to face her mother, who's eyes were also huge. Neither said anything, but Sarah could tell they were horrified. And she couldn't blame them. After passing, Cassie and Dr. Parker once again helped Julia up and into a chair along the wall. Sarah and Peter followed. Sarah took the seat directly beside Julia, on the opposite side of her casted arm, and wrapped her arm around her. She softly said "I am so sorry dear."
Julia said "ish ok, who will even notish thish headgear with everything elsh going on."
Sarah squeezed her and said "I don't know how, but I am going to make this up to you one way or another."
