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Author Topic: Story - treatment during COVID  (Read 2135 times)

Offline Rachels

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Story - treatment during COVID
« on: 16. February 2021, 02:43:05 AM »
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.

---

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.

----

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.

---

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














Offline Bracedup

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Re: Story - treatment during COVID
« Reply #1 on: 17. February 2021, 02:13:11 AM »
Off to a great start!

Offline caster72401

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Re: Story - treatment during COVID
« Reply #2 on: 17. February 2021, 15:12:26 PM »
Great start! Patiently waiting for more!

Offline Braceface2015

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Re: Story - treatment during COVID
« Reply #3 on: 18. February 2021, 19:52:37 PM »
I have updated TheArchive with the latest chapter.

It's off to a good start and I am looking forward to more of it.

Braceface2015
TheArchive2018

Offline Rachels

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Re: Story - treatment during COVID
« Reply #4 on: 22. February 2021, 00:48:41 AM »
I put my coat and bag down and take off my mask. I lay down on the chair as the assistant places the laughing gas nosepiece on my nose.

A: You're going to want to breathe in deeply through your nose. I'm going to start the laughing gas now. Dr. Larry will be in here soon. You're going to feel a little bit tingly in a few minutes.

In a few minutes, Dr. Larry walks in.

Dr. L: Anna, I'm sorry I'm late.

He walks over to me and sits down. He picks up the X-rays sent from the orthodontist's office and looks at them.

Dr. L: I got the x-rays from Dr. K and am up to date on your orthodontic treatment. Let me say it's wonderful you're taking such good care to preserve your teeth and jaw. I know this process is difficult. So this visit today is no fun, is it. Extractions sound scary but we'll go as easy as we can on you and this laughing gas should really help. We're going to be extracting your upper two premolars today. I'm going to start by taking a look and administering a numbing agent. Open up.

I open my mouth, aware of all the appliances.

Dr. L: Ok, I'm going to start with the numbing agent and then am going to remove the upper wire on your braces so I can better get to your premolars.

I have trouble swallowing with the tongue crib and start drooling. Dr. Larry puts a suction in my mouth to help with the saliva.

Dr. L taps my upper gum: Can you feel this?

Me: Yeah, a little.

Dr. L: are your hands and feet tingling?

Me: a little. I fewl it more in my hanth than in my fee.

Dr. L: How long have you had your appliances and braces?

Me: abou a wee

Dr. L: The tongue crib is making it a little difficult for me to position you for the extractions. I'm going to have you hold your head back a bit more. For the extractions, it helps me if you can keep your tongue positioned behind the wire cage of your crib.

I start to feel really sleepy. I'm aware of some pulling and pressure. Next thing I know, Dr. Larry is telling me I'm all done.

Dr. L: Keep biting on these cotton swabs. You did great. Keep an eye on things and if you have any problems, call the office.

--

I go home and look and am shocked to see the two holes where my teeth were.

A couple days later, I have an appointment with Dr. K to get the wire replaced on my braces.

Dr. K: how did the extractions go?

Me: I don wemembew muth abou it. Bu I'm having thum pain now.

Dr. K: that should improve in time. I know we'd just talked about putting in a new wire, but I really think we can go ahead and place your full upper braces. I see her retrieve a tray with some metal pieces on it. We'll also place your expanders today.

Me: Wait, what?

Dr. K: your upper and lower expanders.

Me: We din tal about that.

Dr. K: I have it here in your chart.

Me: I don wemembew.

Dr. K: Yes, these are essential as a next step in your treatment. The top one has a built-in tongue crib with it, so I'll replace your tongue crib with this piece.

She lays my chair back and I feel strong pressure as she places the expanders in my mouth. The light flashes. She then makes some adjustments and I feel more pressure. She places the brackets on the rest of my upper teeth and I feel pressure as the wire is placed. She removes the lip and tongue retractor. I feel shocked.

There is no room in the roof or bottom of my mouth. My tongue is held completely back, even more than with the first tongue crib. I immediately start drooling. Dr. K places a suction in my mouth.

Dr. K: Anna, these appliances aren't easy to adjust to. It takes a lot of patience and perseverance. I recommend you let Rachel know so you can address this more in speech therapy. Talking will be quite difficult at first, but with practice, it will improve. I hate to add more today, but it's essential that we also start you with headgear since we must hold your molars back from the extractions, and it will also help address your overbite.

She walked away and came back with a metal piece and some straps. She placed the metal piece in my mouth and placed a piece around my head with several straps and strips down my face. She adjusted the straps around my head and attached the facebow to the straps. I felt a lot of pressure when she connected them. My lips were open and Dr. K encouraged me to try to close them around the facebow.

I practiced taking it in and out a few times. She instructed me I was to wear it at least 14 hours a day, more if I could.

Dr. K then showed me how to activate my expanders. She activated them and I felt pain and tightness in my mouth.

Dr. K: I've activated your expanders. Everything will be tight for the next 24 hours, and it will be difficult to remove your headgear. Practice speaking and your speech will improve.

I left in a daze. I put my face mask back on and go to check out.

Receptionist: She wants you to come back in a month. Does Thursday the 14th work?

I nod

R: I can do 3:30 or 4:30

Me: thee- thiree worth

---

When I get home, I notice a lot of pain around the places of extraction. It starts hurting so bad that I call my dentist.

R: Hello, Dr. Larry's office

Me: Hi, I ha thum tee pull a few dayth o an I'm having a lo o pai.

R: I'm sorry, I didn't catch all of that. What's your name?

Me: Anna

R: Oh, yes, Anna. Why don't you come on over now so Dr. Larry can take a look.

I drive over wanting to take off my headgear. I try, but I can't get the facebow off. I consider taking off the headpiece but thought it would look more odd just wearing a facebow.

I arrive at the dentist and walk in. The receptionist sees me and tells me to come on back.

I put my stuff down and remove my mask.

Dr. Larry walks in. I feel embarrassed with my headgear and appliances.

Dr. Larry: So you're having pain at the sites of extraction?

I nod

Dr. Larry: What does it feel like?

Me: ith dee an twobbin

Dr. Larry: Let's take a look. Wow, you already have quite a few new appliances. I didn't realize you were getting expanders so soon. My son wore expanders for a year. It was tough to get used to at first but he adjusted.

Me: The ton cwi fewlth oo low. I can ge my ton awoun it o thpea or thwallow.

Dr. Larry: It is lower than your other one. Tongue cribs are meant to retrain your tongue and break habits. Most patients with cribs need to have them this low to be effective. It's something you will adjust to. Are you going to speech therapy to help adjust?

I nod.

Dr. Larry: Good.

Me: I wath altho thurpwithed abou the heagewer. I ha never theen thith ki beore. Ith tho big.

Dr Larry: There are many different kinds of headgear. The kind you have is best for holding back molars and correcting overjets.
Me: Dotor K thaid I would nee a win bock or herbth in a few month to brin my daw fowar.

Dr. Larry: I've had some patients with herbsts. It's also an adjustment but a very effective appliance. I imagine it will do a lot for your jaw pain.

Yes, I see that you are getting dry sockets. I will flush out the extraction sites and place medication and dressing. Would you be able to remove your headgear so I can better access the extraction areas.

Me: Well, I can wemove i becuth my ethpandeth were dus ativatet. Ith oo igh.

Dr. Larry: That's fine. We can work around it.









Offline Braceface2015

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Re: Story - treatment during COVID
« Reply #5 on: 24. February 2021, 14:21:57 PM »
I have added the latest chapter to TheArchive.

Offline Rachels

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Re: Story - treatment during COVID
« Reply #6 on: 15. March 2021, 03:35:06 AM »
Dr. Larry: I'm going to give you some laughing gas and some numbing medication while I flush your extraction sites.

I started getting sleepy.

Dr. Larry: Can you open a bit wider?

Before I knew it, Dr. Larry was telling me I was all done.

Dr. Larry: I've applied medication and dressing to the extraction sites. You'll need to come back in three days so I can look at it again. In the meantime, eat only liquids and do not use a straw.

I activated my expanders as directed, and it always hurt. I wasn't able to wear my headgear as instructed. I barely wore it at all. I'd wake up in the middle of the night with it off. And I didn't wear it during the day.

It came time for my next orthodontic appointment. I arrived and checked in.

The assistant called me back.

Dr. K: Anna, how has the first month with braces and expanders been?

Me: Im thill ajuthin. Ith thill har to thpea and ith uncomfortable.

Dr. K: That's unfortunately part of treatment, especially with tongue cribs and expanders. Have you been going to speech therapy?

I nod.

Dr. K: How has the headgear been going?

Me: Ith bee har to wear. I try to wear it a nigh but it keeth coming out when I thlee.

Dr. K: Are you making up the hours during the day?

Me: I've tried but can alwath get them all in.

Dr. K: Did you bring your headgear with you?

I reached into my bag and pulled it out. Dr. K took it out of the bag and inserted it into my bands.

Dr. K: It's really tight. And your teeth are moving at the sites of extraction. It's essential that you wear your headgear the directed time. You actually need to wear it more now to catch up the time that was missed. As we do expansion, you must have the headgear to keep your teeth in place and pull back your overjet. I'm going to adjust your headgear.

She adjusted it and replaced it. She placed the strap and it felt very tight. She then activated the expanders.

Dr. K: I'm going to add some elastics to help correct some of the tooth movement.

She placed hooks on my braces and then placed four elastics.

Dr. K: You need to wear these elastics all the time. I've placed a kind of hook that if you don't wear the elastics, the hook will poke you as a reminder. You also need to wear your headgear 16-18 hours a day. I'm going to tell Rachel so she can check with you at speech therapy how your headgear wearing is going. I'd like you to wear your headgear to speech therapy so you can adjust to speaking and wearing the headgear. I know this isn't easy, but this is essential for your treatment.

The elastics felt so tight, it was hard to open my mouth, making my speech worse, as my tongue was fully behind the tongue crib.

Dr. K: Do you have any questions?

Me: He elathith ar weweally tigh. I can open my mowth an my ton ith thuck behin he cwi.

Dr. K: You need to adjust to speaking with your tongue behind the crib. Your speech will improve with practice.

I put my mask on and left to check out.

Receptionist: I could schedule you back on Tuesday the 10th or Thursday the 12th.

Me: Tuethay

Receptionist: I have 3:30 or 4:30

Me: thee-thiree

Receptionist: Great, we'll see you then.

Dr. K walked back over: Remember, wear your headgear as directed.





Offline carking

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Re: Story - treatment during COVID
« Reply #7 on: 15. March 2021, 16:25:28 PM »
Nice job