Saturday, June 14, 2003
The Reason for the Surgery
My upper jaw is narrower than my lower jaw, causing my lower teeth to be too crowded. According to Dr. Karlis, this condition is known as a "functional skeletal deformity." Yes, I am deformed! Over the years, this condition has caused one of my lower incisors to move forward, which in turn has pushed out one of my upper front teeth. (These two teeth sticking out are the primary reason I am unhappy with the way my teeth look.) Dr. Weston explained that one appraoch to correct this would be to "tip out" my upper teeth, but this would in the long run weaken the foundation of my upper teeth, causing them to be unstable and risking problems in the future. The surgery will cut the bone, allowing it to be expanded, creating more room for my teeth on top. This is apparently better in the long run. I will have approximately six or seven millimeters more space on either side of my upper jaw.
My upper jaw is narrower than my lower jaw, causing my lower teeth to be too crowded. According to Dr. Karlis, this condition is known as a "functional skeletal deformity." Yes, I am deformed! Over the years, this condition has caused one of my lower incisors to move forward, which in turn has pushed out one of my upper front teeth. (These two teeth sticking out are the primary reason I am unhappy with the way my teeth look.) Dr. Weston explained that one appraoch to correct this would be to "tip out" my upper teeth, but this would in the long run weaken the foundation of my upper teeth, causing them to be unstable and risking problems in the future. The surgery will cut the bone, allowing it to be expanded, creating more room for my teeth on top. This is apparently better in the long run. I will have approximately six or seven millimeters more space on either side of my upper jaw.
Thursday, June 12, 2003
My Surgery Is Scheduled
Today I met with Dr. Karlis at NYU, in the oral and maxillofacial surgery department. She will be performing the surgery, known as "Two Piece LeFort Osteotomy of Maxilla." I will have an appliance installed on my upper teeth, with bands on two molars and two premolars connected to a device that will create outward pressure and expand when I crank on it with a small key device. Dr. Karlis will cut open the inside of my jaw above the teeth (inside my cheeks) and saw the bone apart, so that it can be expanded and new bone can grow. The goal off this procedure is to expand the width of my upper jaw, allowing the orthodontist to correct my crossbite and alleviate the crowding of my teeth. Today, Dr. Karlis and her assistants had me fill out insurance and consent forms, and answered some of my questions and addressed some of my concerns. Chief among my concerns is the cost. Oxford has pre-approved the procedure, but because it is out of network they only pay 70% after a $500 deductible. Dr. Karlis said she would accept whatever the insurance company pays but that I would be responsible for some of the hospital charges, probably about $300 to $400. I just know this is going to end up costing me more than I can afford. Dr. Hrisch filled out a medical history form for me, and he checked my pulse, breathing and heartbeat. After finishing with Dr. Karlis, I went upstairs to see Dr. Weston in orthodontics to schedule the spacers and installation of the appliance, so I now have the following schedule:
• Wednesday, July 2: I see Dr. Weston to get the plastic spacers
• Monday, July 14: I go back to Dr. Weston to get the appliance installed. (This is the day I will have to write a check for $3,000.)
• Friday, July 18: the surgery with Dr. Karlis
I also have to go have blood taken pre-surgery, on a Tuesday.
Cleaning With Dr. Varnai
I had my cleaning with Dr. Varnai on Monday, June 9. She was very thorough, first using a water drill on all of my teeth (this was incredibly uncomfortable and painful), followed by scraping and then finally polishing. She said she is concerned about my two front teeth and is going to recommend "light pressure" for my orthodontic treatment. Since I had braces as a kid, apparently there may be more cause for concern when it comes to moving them. She said she wants me to get a cleaning every two months while I have braces, which seems like a lot. She also had me sign a contract for the implant I will be getting. I had to write a check for $100 for this. NYU is going to send in the claim form to my insurance company, and I will be reimbursed. Last year I sent in all of the forms on my own and received prompt payment from the insurance company. With NYU handling this, I just know I will end up having to fight and argue over this to get reimbursed. My next appointment with Dr. Varnai is Monday, August 4. She also wants me to visit the restorative cinic in 5W for a restorative consultation for the implant, after July 1. It's a good thing I have an employer that tolerates me taking so much time off for these inconvenient appointments. Every visit takes forever.
Today I met with Dr. Karlis at NYU, in the oral and maxillofacial surgery department. She will be performing the surgery, known as "Two Piece LeFort Osteotomy of Maxilla." I will have an appliance installed on my upper teeth, with bands on two molars and two premolars connected to a device that will create outward pressure and expand when I crank on it with a small key device. Dr. Karlis will cut open the inside of my jaw above the teeth (inside my cheeks) and saw the bone apart, so that it can be expanded and new bone can grow. The goal off this procedure is to expand the width of my upper jaw, allowing the orthodontist to correct my crossbite and alleviate the crowding of my teeth. Today, Dr. Karlis and her assistants had me fill out insurance and consent forms, and answered some of my questions and addressed some of my concerns. Chief among my concerns is the cost. Oxford has pre-approved the procedure, but because it is out of network they only pay 70% after a $500 deductible. Dr. Karlis said she would accept whatever the insurance company pays but that I would be responsible for some of the hospital charges, probably about $300 to $400. I just know this is going to end up costing me more than I can afford. Dr. Hrisch filled out a medical history form for me, and he checked my pulse, breathing and heartbeat. After finishing with Dr. Karlis, I went upstairs to see Dr. Weston in orthodontics to schedule the spacers and installation of the appliance, so I now have the following schedule:
• Wednesday, July 2: I see Dr. Weston to get the plastic spacers
• Monday, July 14: I go back to Dr. Weston to get the appliance installed. (This is the day I will have to write a check for $3,000.)
• Friday, July 18: the surgery with Dr. Karlis
I also have to go have blood taken pre-surgery, on a Tuesday.
Cleaning With Dr. Varnai
I had my cleaning with Dr. Varnai on Monday, June 9. She was very thorough, first using a water drill on all of my teeth (this was incredibly uncomfortable and painful), followed by scraping and then finally polishing. She said she is concerned about my two front teeth and is going to recommend "light pressure" for my orthodontic treatment. Since I had braces as a kid, apparently there may be more cause for concern when it comes to moving them. She said she wants me to get a cleaning every two months while I have braces, which seems like a lot. She also had me sign a contract for the implant I will be getting. I had to write a check for $100 for this. NYU is going to send in the claim form to my insurance company, and I will be reimbursed. Last year I sent in all of the forms on my own and received prompt payment from the insurance company. With NYU handling this, I just know I will end up having to fight and argue over this to get reimbursed. My next appointment with Dr. Varnai is Monday, August 4. She also wants me to visit the restorative cinic in 5W for a restorative consultation for the implant, after July 1. It's a good thing I have an employer that tolerates me taking so much time off for these inconvenient appointments. Every visit takes forever.
