Wednesday, October 31, 2012
Second Consultation
Last Friday, I had the second consultation with the surgeon recommended by the ortho I've chosen. (the first one was just one in my medical network-ortho knows of the 1st dr. but said that he doesn't do the procedures very often-not a good omen in my book). Anyway, the 2nd dr. was fantastic! She was very personable, and took a long time to discuss things with me and my husband and to go over the many questions/issues I wanted to discuss. They do these surgeries weekly. The discussion was at least an hour, with records taking another 1/2 hour or so to complete. I have had xrays taken recently by 2 orthos, but they did the first set of molds. I was waiting to get them done with the ortho because they want alot of money up-front for that and I wanted to make sure I had insurance approval for surgery before getting started with that much monetary commitment. The 2nd surgeon's office will also be submitting the info for insurance pre-authorization, so I am anxiously awaiting news on that. She did definitely recommend that the bottom jaw be brought forward, she didn't really recommend upper jaw being impacted at all since in the natural position/talking I showed a normal amount of tooth and was only a little on the gummy side when smiling really big. If my upper jaw was moved up, then as I age, my skin would sag a bit and I would lose the aesthetics of showing the normal amount of tooth. Apparently women can get away with showing a little more gum and still be acceptable. So unless she can tell that my top jaw needs widening-once she studied the xrays and molds they took, then she would just recommend lower jaw surgery. She said that if she impacted the upper jaw 5 mm then only 3mm is visible in changes to appearance, but bottom jaw shows 100% of the movement made. Interesting! In anticipation of the insurance approval, I made an appointment with the ortho for more records to be completed in preparation for braces! Can't wait to hear from insurance-already approved surgery with 1st dr. but want to know for sure with the 2nd dr, if it's approved!! Fingers crossed!
Wednesday, October 24, 2012
Good News!
It's been a little over a week since my consultation with the first surgeon, and I haven't heard anything regarding insurance approval,etc. yet. I decided to contact the surgeon's office to see if they knew anything. The girl I spoke to stated that they sent in the request the day after my appointment and they heard from insurance the next day asking for more information and x-rays but haven't heard anything since then. I thought that I would call and check the status of the request and was told that it was APPROVED!!!! But only until Jan. 14th 2013. and only for outpatient so if it was for inpatient then they need to do a new request for that. Also, I know from reading others' blogs that everyone has to resubmit the insurance information for final approval right before surgery. That makes me a little nervous-what if they change their minds later? I don't even want to know if that happened to anyone else. About the short timeline, when I gave a brief explanation of the process, the lady said they could ask for extension of the approval. I guess I should look in to that a little more. I am sure the surgeon's office knows what to do about that, it is their job after all. I just like to have all the details to try and put my mind at ease and I want no surprises later on! I am really looking forward to the other consultation on Friday! I hope they can get everything approved through insurance too and then I can start the braces! It's still a little scary thinking of all this!
Thursday, October 18, 2012
The beginning
Where do I start? I will try to summarize what's been happening to get me to consider jaw surgery...
I have been living (unhappily) with my teeth/bite for a long time! I am 42, with 3 teens that are in various stages of their own orthodontic work:) we had put their needs first since they are in the rapid growth stage of their teen years and would benefit the most from treatment right now...anyway...
*had braces as a teen for 3 or 4 years for large overjet (measured recently at 10-10.5mm-yikes!)
*teeth shifted after braces, even before I got the retainer, used the retainer for years after
*have had 5 crowns placed, 11 teeth with composite bonding on the front surfaces to provide better cosmetic appearance due to poor enamel
*had to have a crown replaced recently that caused my bite to be off on the left side causing aches and pains in my jaw, especially when I first woke up in the morning (grinding or clenching possibly)
*had the crown ground down to adjust the bite after need for root canal was ruled out/jaw is feeling better
*decided to consult with orthodontist (again-last consult was 5 years ago!) to see what could be done with bite before continuing with more needed cosmetic dentistry
* new dentist replaced 2 large fillings, filled several cavities, sealed 4 molars, adjusted the thickness of some of the composite bonded teeth (in preparation for possible orthodontia)
So, in the process of getting the fillings, etc taken care of very recently, my first orthodontic consultation back in August, was with the same office I visited 5 years ago. I was hoping they would tell me there were new options to fix my bite. No such luck. I was told the same thing again-surgery or possibly remove a couple top teeth to make room to move my front teeth back. Another OD said that removing teeth would be a terrible idea as it would ruin my profile even more. My bottom jaw, as her x-rays showed, is too far back/too small and she also recommended jaw surgery to bring my bottom jaw forward to close the 10 mm overjet that I have. I was also very thorough in getting two more OD's opinions and they all said basically the same thing. Surgery is the only option to fix my bite. It would be on the bottom jaw and possibly the top, depending on what the rest of the records/molds show.
The one thing that I thought 5 years ago after I had the OD consult was that this would be a cosmetic procedure and I knew that insurance would not cover that type of thing, so I thought it was completely out of the question due to financial reasons. But the same OD this time said that it is a functional issue, not cosmetic (even though the cosmetics would be improved once my bite was improved) therefore, may be covered under my medical insurance. REALLY??? Now I was interested and the research began!! Wow, have I learned a lot! It's somewhat overwhelming!! I have since had one surgical consultation with another scheduled next Friday, the 26th. I am really looking forward to that one, as their office was recommended by the OD I am choosing. The other dr. I saw on Monday does not do very many procedures per year (15-20 cases in their office of 3 surgeons) The other Dr. is with a teaching hospital and their office called to schedule with me once they got my information from the OD consult. I had to get insurance pre-authorization for them since they are out of network though, but that is done and I am anxious to go meet that surgeon. (Sorry, I am really rambling!) My OD said that they send almost all of their surgical cases to this particular hospital and they do about a case a week. I will just have to be very careful with insurance information, referrals, pre-authorizations, etc. every step of the way to make sure things are covered. I am anxious to find out if it will be proven medically necessary for insurance purposes and then I can move forward with the braces. I decided that if it's not covered, I will not do it and won't even bother with braces as they would straighten my teeth slightly, but not correct the overjet at all really. (teeth aren't that crooked, jaws just don't meet properly) I don't need to spend 6,500 for hardly any improvement! So I will go for the whole thing! I will update after my next appointment unless I hear before then from insurance about the other consult I had on Monday. Wish me luck!!
I have been living (unhappily) with my teeth/bite for a long time! I am 42, with 3 teens that are in various stages of their own orthodontic work:) we had put their needs first since they are in the rapid growth stage of their teen years and would benefit the most from treatment right now...anyway...
*had braces as a teen for 3 or 4 years for large overjet (measured recently at 10-10.5mm-yikes!)
*teeth shifted after braces, even before I got the retainer, used the retainer for years after
*have had 5 crowns placed, 11 teeth with composite bonding on the front surfaces to provide better cosmetic appearance due to poor enamel
*had to have a crown replaced recently that caused my bite to be off on the left side causing aches and pains in my jaw, especially when I first woke up in the morning (grinding or clenching possibly)
*had the crown ground down to adjust the bite after need for root canal was ruled out/jaw is feeling better
*decided to consult with orthodontist (again-last consult was 5 years ago!) to see what could be done with bite before continuing with more needed cosmetic dentistry
* new dentist replaced 2 large fillings, filled several cavities, sealed 4 molars, adjusted the thickness of some of the composite bonded teeth (in preparation for possible orthodontia)
So, in the process of getting the fillings, etc taken care of very recently, my first orthodontic consultation back in August, was with the same office I visited 5 years ago. I was hoping they would tell me there were new options to fix my bite. No such luck. I was told the same thing again-surgery or possibly remove a couple top teeth to make room to move my front teeth back. Another OD said that removing teeth would be a terrible idea as it would ruin my profile even more. My bottom jaw, as her x-rays showed, is too far back/too small and she also recommended jaw surgery to bring my bottom jaw forward to close the 10 mm overjet that I have. I was also very thorough in getting two more OD's opinions and they all said basically the same thing. Surgery is the only option to fix my bite. It would be on the bottom jaw and possibly the top, depending on what the rest of the records/molds show.
The one thing that I thought 5 years ago after I had the OD consult was that this would be a cosmetic procedure and I knew that insurance would not cover that type of thing, so I thought it was completely out of the question due to financial reasons. But the same OD this time said that it is a functional issue, not cosmetic (even though the cosmetics would be improved once my bite was improved) therefore, may be covered under my medical insurance. REALLY??? Now I was interested and the research began!! Wow, have I learned a lot! It's somewhat overwhelming!! I have since had one surgical consultation with another scheduled next Friday, the 26th. I am really looking forward to that one, as their office was recommended by the OD I am choosing. The other dr. I saw on Monday does not do very many procedures per year (15-20 cases in their office of 3 surgeons) The other Dr. is with a teaching hospital and their office called to schedule with me once they got my information from the OD consult. I had to get insurance pre-authorization for them since they are out of network though, but that is done and I am anxious to go meet that surgeon. (Sorry, I am really rambling!) My OD said that they send almost all of their surgical cases to this particular hospital and they do about a case a week. I will just have to be very careful with insurance information, referrals, pre-authorizations, etc. every step of the way to make sure things are covered. I am anxious to find out if it will be proven medically necessary for insurance purposes and then I can move forward with the braces. I decided that if it's not covered, I will not do it and won't even bother with braces as they would straighten my teeth slightly, but not correct the overjet at all really. (teeth aren't that crooked, jaws just don't meet properly) I don't need to spend 6,500 for hardly any improvement! So I will go for the whole thing! I will update after my next appointment unless I hear before then from insurance about the other consult I had on Monday. Wish me luck!!
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