Here are a few images of my open bite before I started the orthodontic treatment and the ones to the right show after I had my braces removed last month. It’s quite a difference. My arches are wider, my bite is fully closed. Dr. T. also corrected the “tilt” in my upper teeth which is so noticeable. You can also see that my pearly whites took a beating this year. I have many stains and have noticed some translucence in the front teeth. I immediately scheduled a thorough cleaning, for which I’m way overdue. That may remove some of the yellow surface stains and I may even have them professionally whitened, $200 in my dentist’s office. Go big or go home, right?
I thought I would do a post to outline the costs I incurred throughout this process. Keep in mind that I live in Ontario where OHIP covers medically necessary (not cosmetic) maxillofacial surgical procedures done in the hospital. Also, my husband and I don’t have any private health insurance through work so we paid a lot of things out of pocket that would likely have been covered in part or in full by a good private plan. Definitely worth investigating before starting this process. So here is what it all cost.
Orthodontics & Surgeon Fees – $13,500
This included the initial records, case planning, braces, permanent retainers, removable retainers and final records, my initial consultation with the surgeon, records, case planning and all of the visits in his office pre and post-op. The fees were charged separately between the two offices but I don’t want to break it down in case you’re seeing the same professionals and are quoted more or less; these fees were based on my specific treatment plan. But based on my research, they fall within the normal range.
Double Jaw Surgery – $0
I read somewhere that this type of surgery runs around $30,000 in Canada and around $50,000 in the U.S. Luckily for me, it was covered by OHIP.
Hospital Stay – $0
I wasn’t billed anything for my two-day hospital stay.
Medication & Supplies – $150
The medications I took following surgery and all of the little supplies I needed to recover came out to $150.
Parking Fees – $100
Includes all the hospital parking fees for the pre-op appointments and my husband’s fees visiting me in the hospital.
A good private health insurance plan through work may have covered part of this or the whole thing, It may seem like a lot to pay out of pocket but I can’t put a price on the increased quality of life and I couldn’t have hoped for a better result. But if I could do it over, I’d buy a good private health insurance plan way before starting this journey.
Adjusting to my new smile
Adjusting to my new face has been a struggle. I’m not comfortable with my smile right now even though I know the teeth are nice and straight and close, it’s just psychological. When I look in the mirror I get creeped out. I’m sure this will just take some time. I haven’t really posed for any pictures since I took the photos in the orthodontist’s chair. It’s hard to describe the feeling, but it’s like looking in a mirror at a fun-house, only the image doesn’t ever change back. It’s mind-boggling. They do tell you to prepare for this psychological effect but my feeling is that only time will help me get used to it.
The only evidence that I had jaw surgery remains a general tightness in my lower face. All of the feeling is back but there remains a sort of stiffness, very minor but I do feel it throughout the day. The progress is so, so, so slow, like Dr. Tocchio has warned me over and over. If I had to put it into estimates, I’d say it’ll take another 5 months for this remaining part to be gone, which brings me to the one year mark and is on par with the doctor’s estimates.
Today I went in to take my final records photos and x-rays at Dr. Cameron’s office. I will call them in a week or so and see if they can email me the images to post on my blog. I look forward to seeing the drastic difference in my bite and also, a better idea of the structural changes that have happened to my face.
I take instructions very seriously so while we were doing the final records photos, I was told not to blink and I think I nailed it! More photos soon…
I picked up my removable retainers from my orthodontist office today. The imprints for the trays were made last week. These removable retainers are meant to prevent a relapse of my bite. Here’s a picture of the trays on my teeth.
Before putting the trays they made me initial a paper that said if I don’t wear these removable retainers as instructed my bite could relapse. The instructions said that I should wear them 24 hours a day for the first 30 days. I only need to wear the upper tray during the day, and both while I sleep. After a month, I’ll only have to wear both trays while I sleep. Eventually, I’ll wear both trays one night a week for the rest of my life.
In the six days it took to wait for my trays, I felt a slight change in my bite. The feeling was similar to when you have an orthodontic adjustment and you wake up the next morning feeling a small change in the way your molars touch. My orthodontist said that teeth settle a little when the braces come off and not to worry about it. He checked my bite thoroughly and said everything is just fine. Within one hour of wearing the trays, my teeth were already a little sore. The trays were already correcting the slight movement that happened over the last six days.
I thought I would be pretty bummed to have to wear these trays, but it was surprisingly comforting. After all the work that I’ve had done on my jaws and teeth, it felt a little scary to be free of any type of hardware. It’s a bit of a pain to have to take these out every time I want to eat or drink anything other than water. After I eat, I have to brush my teeth and rinse the trays before putting them back in. Putting the trays on dirty teeth can cause cavities. The trays are clear so they warned I should never put them on a white napkin because I risk throwing them out by accident.
I’m adjusting to my new smile and enjoying my new bite. Having this new mouth is like having a brand new BMW after years of driving an old clunker.
Before removing the braces, my orthodontist installed the permanent retainers on my upper and lower teeth. This process is simple enough except that it involves keeping your mouth wide-open for 10 minutes straight, which is a bit challenging after surgery, but whatever, just get these brackets off! Here’s a glimpse of the bottom wire.
I’ll be wearing these permanent wires for the rest of my life. I will also be wearing a removable retainer for several weeks to make sure my teeth don’t move over the next couple months. They took impressions of my teeth for the removable retainer today and I will be picking it up in a week. My teeth may shift a little bit over the next week while I wait for the retainer, but my orthodontist says that this will be fixed overnight with the removable retainer. Eventually I will be wearing this removable retainer one night per week for the rest of my life. This is only precautionary. I don’t even think all orthodontists do this. It’s a bummer that I’ll be wearing it probably all day for at least a month, but I have to think long-term. It would definitely suck if my teeth shifted over the next year after all this effort! After applying the permanent retainers, the braces came off. Here’s a picture of all of the material I had in my mouth.
Removing the brackets was pretty painful for me for two reasons. The first is that I have very increased gum sensitivity right now due to my surgery. This is not always the case for everyone. To remove each bracket, my orthodontist use some type of pliers to apply pressure to the bracket until it literally snapped. If you’ve had surgery within the past five months, try pushing on your teeth with your fingers to see if you feel any pain. If you don’t feel any pain, you probably won’t when they remove your brackets. If you do, pop some Advil before you go! For me, it felt like he was literally pulling out all of my teeth. I was in so much pain that I was crying almost the whole time, and my right fist kept creeping upwards as though I was going to punch him in the face! At one point, the assistant had to hold my hands down, we were all afraid. The process only took about 20 minutes. I was so, so relieved when it was over and visibly shaken. Dr. Cameron explained that clear brackets are more difficult to remove and than metal brackets. They require more pressure to break. This is the second reason why the removal was so painful for me. I asked him if clear brackets are not such a great option for jaw surgery patients who suffer from increased sensitivity. He said everyone is so different so it’s hard to say.
My bottom gums were very angry after they removed the bottom brackets. Here’s a photo. Can you tell I was crying? Ouchie. My gums are very swollen and Dr. Cameron said the swelling will disappear over the next week.
Then came the final part, removing the glue off my teeth. This didn’t take long at all, maybe five minutes. Afterwards, my teeth were polished using a gritty toothpaste to brush off any stains that had accumulated over the past 15 months. I was so worried that I would have some stains or some decalcification on my teeth. Remember that I couldn’t really brush my teeth for three weeks straight after surgery! Would my teeth look rotten underneath all those brackets?!
I asked Dr. Cameron if I should be afraid of this. He said that teeth can look chalky after the braces come off. He said this usually goes away after 24 hours. When he finished, I took a deep breath and looked into the mirror. I was absolutely surprised to see that my teeth looked extremely healthy. After everything I put them through! The hygienist even commented how white my teeth look despite the whole process!
I’m so happy to have my braces removed. It’s a little bit weird to look into the mirror. I really do like the way the teeth look and I also can’t believe that I now have a closed bite. It just feels like looking at a stranger in the mirror! Two hours have gone by now since the appointment and with each glance in the mirror I feel more and more comfortable with my new smile.
I also ate for the first time without my braces which felt amazing. My teeth feel so smooth, like jewels! Well, this has been a big day for sure. I’m laying in bed right now getting ready for a nap. When I wake up, I’ll probably have forgotten I’m free of my braces and it’ll be awesome to remember.
This day arrived much sooner than I anticipated. It’s bizarre that at times throughout the process, the seconds went by so slowly. But now looking back, it seems like the months just flew by!
So what now? I still feel some tickling around my mouth area. I saw Dr. Tocchio yesterday and he said this is normal. He said it can actually take up to four years for nerves to completely regenerate. He’s had some patients recover all feeling after three weeks, which is pretty incredible, but most after one year. Occasionally, it can take up to four years. He thinks mine will take one year. I’ll be seeing him again in two months.
In one week, I’ll be picking up my removable retainers from Dr. Cameron’s office. In another month, I’ll be returning to Dr. Cameron’s office to have my final records taken. That’s when I’ll get the after photos of this whole process. I’ll make a post at that point to compare all of the before photos with the after photos.
So until then, I hope this will give you hope for your own journey or courage to go ahead with the surgery if you’re still considering it!
SO WORTH IT!
I had my final orthodontic adjustment before my braces are removed next Wednesday. I asked Dr. Cameron if it was normal that my bottom teeth are always showing when I talk and smile. He asked me to smile to show him and he said I should practice smiling without showing so much bottom teeth. Well I got home and took three pictures of my “natural” smile and it’s toothy alright. Here’s some photos of me smiling naturally on the left, and practicing not showing my bottom teeth on the right. They all looked strange to me as I was taking them but when I look at them altogether I think they’re all just fine. Smiling is a beautiful thing, especially after such an ordeal. Just another thing to adjust to!
It’s been six months today since I had double jaw surgery. My braces will be completely removed on September 11th and I can’t wait to post a lengthy update at that point. For now, I thought I’d post a list of the highs and lows of my experience so far.
- Knowing that I had the balls to do this. A lot of people live with pain and discomfort because they’re too scared of the surgery. I can officially say that I’m courageous.
- Laughing, smiling and eating to my heart’s content without needing to apply heat packs to my cheeks. The happiness-curse is finally lifted.
- Feeling like my face muscles are finally resting, like my mouth is actually closed, like my jaw muscles are relaxed for the first time.
- You know the “for better or for worse” part of marriage vows? Check and check.
- Discovering that I no longer get ear aches when there’s a cool or warm breeze. I never imagined those ear aches were caused by the position of my jaws.
- Learning to use this amazing utensil that is in my own mouth: my front teeth. Biting into a slice of pizza and the whole piece comes clean off, not just the cheese.
- Being able to smile without my tongue sticking through my teeth.
- The shuddering of my jaw muscles submitting to my new bone structure on day 2.
- Looking into the mirror on day 3 and generally the whole of day 3.
- Being told everything is completely normal when it feels completely not.
- Contemplating waking my husband to tell him I think I’m dying on day 4.
- The few days I was depressed and couldn’t get out of bed during week 3.
- When I started crying and told Dr. Tocchio I’m ugly during week 4.
- When people think I had this major surgery to straighten my teeth.
You know what, I had to think hard for the lows because my mind is already forgetting the worst parts about this process. I guess it’s a coping mechanism, remembering the good and not the bad. I’d say the very lowest moment was that point when I thought I might be dying from slow suffocation. I wasn’t getting enough air through my teeth (even though my oxygen levels tested normal at the hospital), and it’s like the whole world was sleeping and no one cared that I was perhaps dying. I could have used some anti-anxiety meds in the first week.
That’s all for now and I can’t wait to get these damned braces off next week and seeing what’s underneath all this metal, and eating all sorts of stuff that gets stuck in these brackets!
Here’s a story about my day.
It’s Sunday morning. I wake up and brush my teeth and see a bit of blood, which isn’t unusual after double jaw surgery. Then I look in the mirror and see that I have a little bubble of infection on my gum. F****** great!
I immediately weigh my original plan of sitting by a pool all afternoon sipping cocktails against having my gum-zit poked by a weekend dentist.
An hour later, I’m filling out a form at an emergency dentist at Yonge and Davisville. By some miracle, I got an appointment that very hour and free parking right in front of the building. I decide that my volunteer work has earned some good karma. Aside from the abscessed gum and all.
I fill out a form and they call me in straight away. So far, this is the shortest ordeal of my life. They tell me they need to do an X-ray. I protest that I’ve had so many X-rays since jaw surgery that my very presence could give them cancer. They acquiesce and I sit in the chair. Within a minute I decide that I paid too much for my braces. No coffered ceiling, chandelier or patient-iPad.
The dentist enters and I waste no time diagnosing myself with “Doritolitus” (eating Doritos with such vigour as to cause acute gingival distress.) The dentist wants a closer look. My lips barely curve upwards when he spots the intruder on the incisor. By that point, the abscess (Abby, for short), has completely overcome the tooth.
Dr. Weekend supports my diagnosis of Doritolitus and says there’s no infection, just swelling, but he should scrape around to make sure no crumbs are stuck in there. I watch my reflection in his glasses. Dr. Weekend murders Abby while his hygienist squirts my face with an oversized lapel flower, at least that’s what it feels like. I leave the chair needing moisturizer and de-tangler.
Back at the front desk I’m half-stunned by the experience and holding a bloody Kleenex and debit card. “That will be $80 please.” That’s the most affordable dental bill I’ve had in a year. I say now that’s a price I can live with!
So the lesson here is that Doritos are dangerous.
Those with an open bite will understand why this moment was such a victory. I was eating a piece of cheese when I was blown away that I can actually bite into things now. Here’s an imprint of my new bite. There are so many benefits (for me) after jaw surgery, but this is one of the most important. Those who can bite down do not understand how such a small action can impact your daily life. I’m so happy!
It’s been just over 4 months now since double jaw surgery!
I saw Dr. Tocchio last week and he took a side profile X-ray so I could compare my new bite against the old. What an amazing transformation. I can’t believe I have this perfect bite now after a whole life with an open bite! I have no more jaw pain and I can finally eat normally. I’m dancing right now. I’m singing and running through a field of butterflies. No I’m not, but I’m close. Dr. Tocchio pulled out my old X-ray and said “Remember this?” When I saw the After X-ray, I summoned all of my inner focus, looked him straight in the eyes and said “You’ve completely changed my life.“ He must hear this all the time because it didn’t faze him. “For the better, I hope.” Maybe when this is all over, I’ll write a jaw surgery jingle and send him a dancing tooth telegram. Ha, ha!
My face has completely changed since surgery. My surgeon told me my face wouldn’t change, or that it’d be barely noticeable, but I see a HUGE difference. Some days, I look in the mirror and I feel good about how I look. Other days, something weird happens – I look in the mirror and I feel like I’m looking at a caricature of my old self, like an optical illusion: my eyes look super big, my eyebrows too high, my mouth too big! I have to walk away from the mirror. It’s totally psychological, looking into the mirror, expecting to see what I saw for 30 years, and what shows up is a mind-boggling distortion. I feel almost too expressive. It’ll take a few more months to get used to this.
Eating with my new mouth
I can eat anything now including hard nuts and lettuce and even kale, completely normal!
Well, almost. I’m still favouring my left molars, but I’m practicing with my right side and it’s slowly getting more comfortable. My mouth can open almost three fingers wide now so I’m on track for full range of motion soon.
My new bite has completely improved my quality of life. Eating is such a pleasure now. It feels like my jaws fit together perfectly. I can bite into a slice of pizza and it’s a clean bite, everything comes off (not just the cheese!) Having had an open bite my whole life, it’s very funny, I’m not accustomed to biting things with my front teeth, so my husband actually reminds me to do it. I’ll bite into pizza using my molars, forgetting that I can eat normally now!
This next part isn’t food related, but when I lay down to sleep, I don’t have a trace of the old jaw discomfort. My whole head and neck feel perfectly at rest. Before surgery, it always felt like my mouth was being forced open when I was laying down. Like my jaw was hanging open but also being forced open. No more of that!
I’m seeing my orthodontist next week and I’m very curious to see where I’m at with orthodontics, because my surgeon thinks my teeth are ready to be de-braced. I know my orthodontist is a perfectionist and that I shouldn’t get too excited. Also, I noticed that my front teeth have moved into a weird position, so that will probably have to be fixed next visit. But the end of the braces is near! Here I am wearing my Tortoise Torture elastics, that I only wear while I’m sleeping or scaring small children. These ones have been brutal, but they definitely moved my teeth like crazy this month! Hey, you can see my power chain in this picture. I don’t see any gaps in my top teeth, so mission accomplished. My teeth have gotten pretty yellow since surgery, even though I brush a million times a day (more like 6). I’m told not to worry, that a good polish after the braces will take care of it, and some white strips will do the rest.
Discomfort: The Heat
On hot days, my face will feel swollen, even though it looks totally normal. My lips feel like they’re blowing up, but nothing is really happening. We’ve had several heat waves this month and if I’m outside too long, my whole face will start tingling and sort of seizes up. Dr. Tocchio said this is totally normal. So far, everything I’ve asked him about has been totally normal. I’m definitely more relaxed about my symptoms than I was in the beginning. But seriously, the hot weather has been a pain. It was the same with cold weather. My nerves are happy at room temperature, everything else makes them crazy!
Traces of Numbness
The residual numbness in the lips and chin has been annoying. It’s soooooooo slow. This process takes so much patience. I’d say the numbness is about 25%. I can feel everything. There was one area I couldn’t feel, on my lip, and Dr. Tocchio poked it with a tool and it felt like he was stabbing me. He was only barely touching my lip, so it’s definitely alive.
That’s all I can think of for now! I can’t believe how fast time flies. Some of you are taking me for a trip down memory lane with your summer surgeries. I hope time flies just as fast for you all! What a journey. It’s been great to blog about this, because it’s on my mind a lot, but after about 2 months, everyone in my life got over it and was ready to move on, and I don’t want to bore them with these details anymore, but I still want to talk about it sometimes! I’m so glad I did this blog.
It’s been 100 days since I had double jaw surgery! Here’s an update on my progress.
I still feel some stiffness in my lower face and upper lip. For girls out there, the feeling is very similar to have a hardened mud mask on the skin. I have most of the feeling back on my face, including my chin, but not 100%. People still point out that I have food on my lips or chin.
The remaining swelling is mostly in my upper lip as well as a very little bit of swelling on opposite sides of my chin. They say your face can still change over the next three months and even for up to a year. This is a little scary to me because I feel like I look pretty normal now. I used to have a narrower face and I wouldn’t want it to get too narrow yet, but it’s out of my hands! So we’ll see…
I feel much more comfortable with my face now except for the way I look when I’m smiling and showing my teeth. I’m very self-conscious about that. I can’t tell if I actually look funny, or if I’m really not accustomed to seeing my teeth in a closed bite. I feel like my smile looks very unnatural. It might be because my upper lip is still very stiff and doesn’t move up naturally when I smile.
I saw my orthodontist last week for my second adjustment post op (my third visit since surgery, but nothing happened during the first visit.)
They replaced the both wires with much stronger wires. I instantly felt like I had been donkey kicked in the mouth. This was definitely the most painful adjustment since surgery. Also, I was given new elastics. These are much thicker and stronger. He said I should wear them while I’m sleeping, and if I could also wear them for 1-2 hours during the day, that would be great too. I was surprised because I’ve been wearing elastics almost 24 hours a day since surgery. I enjoyed the rest of the day elastic-free.
That night after brushing my teeth I spent about five minutes wrestling on my new elastics, snapping my lips several times in the process. Ouch! Even my post-surgical elastics didn’t give me this much trouble. When I finally got them on, I quickly realized it would be impossible to wear these elastics day and night, they are way too painful. I can’t even talk while I’m wearing them. In fact, before I put them on, I say “See you tomorrow!” Yeouch. Beware the giant tortoise!
One of the physical features I found very alarming after surgery was my upturned nose (my “Nixon nose”). I know this has been a concern for other patients out there. I don’t think I mentioned it before so I wanted to post a comparison between then and now. This was my nose on day 4 and you can see above that it went way down…
My nose was straightened during surgery so my bite could be aligned with my forehead, nose and lips. No one would ever notice this, but for the sake of showing you all the changes that happen, take a look at the part between my nostrils. Weird! Also, it always feels like I have a booger in my right nostril (the smaller one), but it’s actually the way the cartilage is now, it’s like… pushed to the side. And it feels foreign. But I’ll get used to it I’m sure. I guess to straighten my nose, my surgeon had to push this business to the side! I’ll ask him next time I see him.
I can eat almost anything except for hard nuts and lettuce. I’m training myself to eat salad by chopping it very finally with the food processor, like this…
Exercise & Energy
I started exercising again two weeks ago, four times per week. I haven’t had any problems keeping up with my Pilates class. However, I find that I get very tired in the afternoon, around 3pm. I know everyone generally feels tired around that time of day, but this is more than that. It feels like extreme fatigue. It’s probably due to the exercise and having less energy to go around my body. I have a rest when I can, but I hope to push through this phase. Exercising feels great.
Well, that’s all I can think of for now. Let me know if you have any questions!