Tuesday, May 11, 2004
A Very Productive Visit Today
I had my appointment with Dr. Weston today, and we covered a lot of ground. He and Dr. Han spent a lot of time with me answering my questions and addressing my concerns. To begin with, I pointed out to Dr. Han and Dr. Weston that I was not told before the surgery that I would or even might wind up in the end with an overjet. I told them that I had been expecting nothing less than excellent results, and that the first time I had been informed of the overjet was at my last visit. I also explained to them my unhappiness with the lingering numbness and stiffness in my face as a result of the surgery. Dr. Han says he stands behind the decision for me to have the surgery, but he did acknowledge that that sometimes orthodontists can't predict beforehand what results will be. We went back and forth for a bit on this, but at the end of my visit I was convinced that Dr. Han undestands how I feel.
Game Plan Going Forward
I asked them about the game plan for going forward. As for the filing of my teeth, they are going to hold off on that for now. I might have some teeth in the back filed to help close my bite, and later in the treatment I will have the interproximal reduction, depending on how confortable I am with that vs. the amount of overjet I will have. I asked about when and where the elastics are going to be worn, and Dr. Han said that is complicated and we'd cover that as we went along (more on that below). I asked what the relationship of my eye teeth (the canines) on top and bottom will be at the end of treatment. The answer is that they will be in Class 1 (ideal) alignment. I asked them that, aside from the overjet and the fact that my center line will be off due to the incisor being pulled, is there anything else that will be not ideal at the end of my treatment. Dr. Weston pointed out the "black hole" gap between my two front teeth. They are going to try to fix that by making the two front teeth stand up straight. My X ray today confirmed that the roots are positioned in such a way as to make that possible. I will have the braces for another year, perhaps longer.
Now, a Powerchain and Elastics
I got a lot more gagetry at my visit today. To begin with, I got stronger steel wires on the top and bottom. I got a powerchain on the bottom, to close the gap where the incisor was pulled. A powerchain is basically a fancy rubberband that links from tooth to tooth. I also got elastics, better known as rubber bands. And this is where things get a little complicated. I am to wear the stronger rubberband (in the bag marked Scandinavia) on the left, from my lower rear molar to the upper canine tooth, and the medium strength rubber band (in the bag marked Italy) on the right. This is because I apparently need more correction on the left than on the right. I am to wear these 24/7. Then at night I am to use a Scandanavia band across my four front corner teeth, making a box shape in front. Also today, I had two more X Rays taken, including a panoramic. Dr. Weston took digital photographs of my teeth.
A Long Wait
My appointment today was for 1:30. I arrived at 1:20. Dr. Weston walked in from lunch at 1:45. By 2:15 I had still not been called, so I went back to the receptionist, who paged, "Dr. Weston, your patient is STILL waiting." Oh, the joys of the NYU dental reception area! My next appointment is for 9:30 a.m., and I think that I will try to make them all for first thing in the morning, as it seems the waiting time is just too interminable in the afternoon.
My Days With Dr. Weston Are Numbered
Dr. Weston graduates in July, so at my next appointment, my new resident orthodontist, Dr. Weinstein, will sit in. I will then see Dr. Weston once more, in July. He told me today that he is opening up his own practice in Westchester.
The Charge for Dr. Demarest
I forgot to add in my last post that I paid $165 for the two visits to Dr. Demarest.
I had my appointment with Dr. Weston today, and we covered a lot of ground. He and Dr. Han spent a lot of time with me answering my questions and addressing my concerns. To begin with, I pointed out to Dr. Han and Dr. Weston that I was not told before the surgery that I would or even might wind up in the end with an overjet. I told them that I had been expecting nothing less than excellent results, and that the first time I had been informed of the overjet was at my last visit. I also explained to them my unhappiness with the lingering numbness and stiffness in my face as a result of the surgery. Dr. Han says he stands behind the decision for me to have the surgery, but he did acknowledge that that sometimes orthodontists can't predict beforehand what results will be. We went back and forth for a bit on this, but at the end of my visit I was convinced that Dr. Han undestands how I feel.
Game Plan Going Forward
I asked them about the game plan for going forward. As for the filing of my teeth, they are going to hold off on that for now. I might have some teeth in the back filed to help close my bite, and later in the treatment I will have the interproximal reduction, depending on how confortable I am with that vs. the amount of overjet I will have. I asked about when and where the elastics are going to be worn, and Dr. Han said that is complicated and we'd cover that as we went along (more on that below). I asked what the relationship of my eye teeth (the canines) on top and bottom will be at the end of treatment. The answer is that they will be in Class 1 (ideal) alignment. I asked them that, aside from the overjet and the fact that my center line will be off due to the incisor being pulled, is there anything else that will be not ideal at the end of my treatment. Dr. Weston pointed out the "black hole" gap between my two front teeth. They are going to try to fix that by making the two front teeth stand up straight. My X ray today confirmed that the roots are positioned in such a way as to make that possible. I will have the braces for another year, perhaps longer.
Now, a Powerchain and Elastics
I got a lot more gagetry at my visit today. To begin with, I got stronger steel wires on the top and bottom. I got a powerchain on the bottom, to close the gap where the incisor was pulled. A powerchain is basically a fancy rubberband that links from tooth to tooth. I also got elastics, better known as rubber bands. And this is where things get a little complicated. I am to wear the stronger rubberband (in the bag marked Scandinavia) on the left, from my lower rear molar to the upper canine tooth, and the medium strength rubber band (in the bag marked Italy) on the right. This is because I apparently need more correction on the left than on the right. I am to wear these 24/7. Then at night I am to use a Scandanavia band across my four front corner teeth, making a box shape in front. Also today, I had two more X Rays taken, including a panoramic. Dr. Weston took digital photographs of my teeth.
A Long Wait
My appointment today was for 1:30. I arrived at 1:20. Dr. Weston walked in from lunch at 1:45. By 2:15 I had still not been called, so I went back to the receptionist, who paged, "Dr. Weston, your patient is STILL waiting." Oh, the joys of the NYU dental reception area! My next appointment is for 9:30 a.m., and I think that I will try to make them all for first thing in the morning, as it seems the waiting time is just too interminable in the afternoon.
My Days With Dr. Weston Are Numbered
Dr. Weston graduates in July, so at my next appointment, my new resident orthodontist, Dr. Weinstein, will sit in. I will then see Dr. Weston once more, in July. He told me today that he is opening up his own practice in Westchester.
The Charge for Dr. Demarest
I forgot to add in my last post that I paid $165 for the two visits to Dr. Demarest.
Monday, May 10, 2004
A Second Professional Opinion
With the amount of uneasiness I was having after my last appointmnet at NYU, I decided to seek a second professional opinion. My main areas of concern were this business of the overbite/overjet (Dr. Han's concession that I will have "not ideal" final results), the wisdom of having the lower incisor pulled, and the prospect of having all of my upper teeth filed. After investigating matters on the Internet and corresponding with others in the newsgroup for adults with braces, I contacted the office of Drs. Ciccio and Demarest, who worked with another patient here in NYC who had the same SAPRE surgery that I had last July. They happen to teach at the dental school at Columbia. When I made the appointment, they asked me to bring in my models and Xrays from the start of my treatment (I had to go back to Dr. Weston for that). I had two visits with Dr. Demarest. He was terrific, very friendly, and very helpful. The first visit, he took notes, collected my molds and Xrays, took a few photographs of his own, and looked at my teeth. When I returned a week later we talked. He asked about the reasons I was given for having the surgery (that my upper arch was too narrow to accommodate mmy teeth and that by expanding the palate as opposed to tipping my teeth out, it would preserve my teeth better in the long term). He explained to me that if I had seen him, he would not necessarily have recommended surgery, that my teeth could have been tipped out and held in place with a retainer worn nightly for the rest of my life. But that doesn't do me any good now. We talked about my overjet, and he also pointed out my open bite, which I had not noticed. He said he agreed with the decision to have my lower incisor pulled (which had been a sore spot for me) and he also told me what he would recommend doing going forward: Close the gap on the lower by making my teeth stand up straight and pulling them forward, file my upper teeth, then fix the bite with elastics. This matches what Dr. Han said last time. As we were discussing this, I got the feeling that, surgery aside, I am being well taken care of at NYU, and Dr. Demarest basically agreed with me. He said that there are good doctors at NYU and that I was in good hands there.
With the amount of uneasiness I was having after my last appointmnet at NYU, I decided to seek a second professional opinion. My main areas of concern were this business of the overbite/overjet (Dr. Han's concession that I will have "not ideal" final results), the wisdom of having the lower incisor pulled, and the prospect of having all of my upper teeth filed. After investigating matters on the Internet and corresponding with others in the newsgroup for adults with braces, I contacted the office of Drs. Ciccio and Demarest, who worked with another patient here in NYC who had the same SAPRE surgery that I had last July. They happen to teach at the dental school at Columbia. When I made the appointment, they asked me to bring in my models and Xrays from the start of my treatment (I had to go back to Dr. Weston for that). I had two visits with Dr. Demarest. He was terrific, very friendly, and very helpful. The first visit, he took notes, collected my molds and Xrays, took a few photographs of his own, and looked at my teeth. When I returned a week later we talked. He asked about the reasons I was given for having the surgery (that my upper arch was too narrow to accommodate mmy teeth and that by expanding the palate as opposed to tipping my teeth out, it would preserve my teeth better in the long term). He explained to me that if I had seen him, he would not necessarily have recommended surgery, that my teeth could have been tipped out and held in place with a retainer worn nightly for the rest of my life. But that doesn't do me any good now. We talked about my overjet, and he also pointed out my open bite, which I had not noticed. He said he agreed with the decision to have my lower incisor pulled (which had been a sore spot for me) and he also told me what he would recommend doing going forward: Close the gap on the lower by making my teeth stand up straight and pulling them forward, file my upper teeth, then fix the bite with elastics. This matches what Dr. Han said last time. As we were discussing this, I got the feeling that, surgery aside, I am being well taken care of at NYU, and Dr. Demarest basically agreed with me. He said that there are good doctors at NYU and that I was in good hands there.
