...and more braces!

I had an ortho appointment back on March 5th where they put new elastic ties on, but kept the same wire and placed spacers between my very back molars to make room for more bands. Yes, I was really looking forward to that! I guess I am just a big baby, but those spacers killed me the first time around. They actually weren't too bad this time. I actually forgot they were in after a few days and tried flossing that spot and popped one out! I  used the ortho's technique of using floss to put it back in. It turns out that the contacts of my teeth are too tight to use the plier type tool thing so they had to floss several of them in(both times). Anyway, I got it back in there and it stayed, so that worked out!

So the follow-up appointment was just today to get the  bands placed. Not too pleasant, but obviously not as bad as getting the whole set of braces on! I just feel like I don't have room that far back in my mouth for all this metal! I also got heavier wires placed today. I think they said 15's but I'm not sure exactly what that means!

I did get good news recently that the insurance approval was extended for another 90 days (good til June 14th) I wasn't worried about it, but just needed to get it done. The ortho talked to the surgeon today before my appointment (good timing) and the surgeon still thinks that just doing the bottom jaw is the way to go, she is worried about changing the top since when talking and normally smiling, it looks fine and she doesn't want to change that. My ortho will be making adjustments to make sure the bottom fits the best way with the top without changing the top. She did say that I will be having the biggest jaw advancement that can be done (10mm) That's huge!!  She also said that I should be good to get the surgery done before the insurance needs to be extended again. As long as I stay healthy, which might be a little challenge since I work in an elementary school and the germs have been flying lately!

The next appointment will be at the end of April, so not too long away really. That appointment will include impressions, pics and scans to send to the surgeon and between the ortho and surgeon they do their digital surgery planning-cool! I'm glad they do it that way, since they only get one crack at my face and I want them to know the plan ahead of time!! I guess as the treatment goes on, they will see how things are looking/fitting to see if the top needs done too. I just want the best result if I am going through this!

I think they said I would get a new wire at the next appointment  too and they would be planning the surgery wire from the impressions for all the hooks and things.

I also need to ask when I need to see the specialist she was referring me to, so I can check  that my jawbone is good enough to withstand the surgery! Has anyone else had to do that too?

Braces!

Okay, so now that I got the metal installed today, I am having a lot of "what am I thinking?!" moments right now! My appointment was at 2:30. I met with the ortho and went over a few things before they started with the braces but I didn't even leave until about 5:00. They had some trouble fitting the band on the upper right tooth and now those two teeth (top and bottom) are the only ones touching when I bite down. This will be fun to eat on!  They did say they would probably refit that band when I have my next appointment but that's not scheduled till the beginning of March. Should I call and tell them or is this just part of the process as things start moving anyway?

The ortho did say that we will probably be able to set a surgery date for the summer when I see them in March. That would be fabulous! She is still sticking to the 4-6 months timeline of braces before surgery. I guess I am comitted to the process for sure now that I have the braces on! I went to the store and got a lot of soup to eat. My mouth already feels torn up inside. I will have to baby it for awhile.

Going back to work on Monday and doing a lot of talking will be lots of fun, I'm sure! Things are on the move now, literally! I started this process back in August so it's good to finally get the braces on and start seeing some changes-for the better!:)

FInally got approval!

I last posted about my information being submitted for insurance approval on the 7th...well the dr.'s office said it was faxed over to insurance then, but when I called them on Monday, they had no record of a pending request! It then took a couple of days to get in touch with the insurance person at the drs. office to get it submitted again. Meanwhile, I had those appointments for molds and braces already scheduled because I anticipated approval by then.  SO, insurance finally got submitted and then this Monday I called and they gave me the 19th as the date it would be finalized.  I called on the 19th and it was approved! FINALLY! It was only about 8 weeks after my initial consultation with the surgeon! 

I have been a little frustrated with the wait, okay, ALOT frustrated. I have a hard time being so patient!! I am sure everyone feels that too! In the meantime, I had an appointment to get final molds for the braces on the 17th, but since I didn't have approval yet (wasn't going to get started until I had it) and I didn't have my permanent crown yet,( did that yesterday) it was best to wait on the molds until both of those things were done. SO I rescheduled that appointment for the 28th and pushed out the braces appointment till the 4th of January.  That will only be a few days to get accustomed to metal in my mouth before I have to go back to work, but at least I don't have to take time off work as soon as we go back after break! 

Anyway, now I am excited but also so nervous thinking that I am actually committing to this process. Am I crazy?? I don't even want to think about how long ago I had braces when I was a teenager! Too many years!!  But as my husband said (he is so nice!) I shouldn't worry about the braces, that's the easy part, I need to worry about the surgery! Yikes!! See what I have to deal with?!?

I am going to enjoy the holidays brace-free and not feel guilty about eating a few sticky, crunchy foods since once I have braces that kind of stuff will be out!! I will try to post after I get the braces on.   Merry Christmas and Happy New Year!!

It's always something

So, the Saturday after Thanksgiving, I was getting ready for bed and brushing and flossing and all that good stuff when out pops one of my crowns!! That is not supposed to happen! That is really the last expense I need right now since I am trying to get ready for braces! On Monday, I called my dentist and make an appointment for that Thursday-luckily the tooth wasn't in pain or anything. Once I get there, the dentist takes pictures and x-rays and can see an area of decay. Bummer. So after 3 hours !! in the dentist chair, lots of drilling, 4 molds, etc. it turns out that under the buildup of the tooth for the crown, there was lots of decay-my tooth was "mush" (yeah, the dentist said that!!) and if much more time went on, I probably would have had a horrible toothache! It's all better now, just waiting for the permanent one to be ready. I did have to go back to the dentist again when the temporary crown fell off when I flossed! oops!! They used a stronger cement this time to hold it longer. 

I also called the surgeon's office this week and asked about my insurance approval-it still hasn't been submitted and my consult was at the end of October.  I am a little anxious (and frustrated). When I spoke to the lady on Wednesday, she said that it was in the stack to be done on Friday (today).  I REALLY hope it was done today, but I will call Tuesday or Wednesday of next week to see if it's in the system. Once the medical group gets it, it only takes about a week to get it approved, so that's good. I guess I am more nervous since the surgeon is out of my network. 

In anticipation of getting the approval, I called the orthodontist and  asked about setting up the appointment(s) needed to get my braces on.  She had actually talked to the surgeon the day before, so she said I can make the appointments. My next one will be on the 17th for more impressions (I hope it doesn't pull out the temporary crown!) and possibly spacers if needed, then the 21st to get the permanent crown placed and then finally getting braces on the 27th! Please keep your fingers crossed that I get the approval quickly and without any issues so that I can get this process moving along!

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!

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!

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!!