9 months in

I decided i'd do an update on my treatment, as I realised it's been nearly half a year since I last posted. I guess this just reflects that in the world of moving teeth nothing happens quickly!

To summarise what's happened since April:

- I've had something called an e-link attached to the hooks on the upper wire at the front to hooks on the molar bands at the back, to close an extraction gap on either side at the top where the first molars were extracted shortly before my braces were put on in January. The gap on the right hand side has closed significantly faster than on the left, which is a bit frustrating in a way as obviously both gaps would need to be fully closed before my treatment can progress to surgery. The fact that the gap has closed up quicker on one side has I believe shifted my mid lines which are certainly more out than before.

Right upper side has elastic link to close extraction gap.
Also shown is elastic band.

Extraction gap of left side has closed a lot slower.

Midline has shifted

- My front teeth have continued to be brought forward at the bottom and back at the top, to continue to decompensate them, which has certainly opened up the gap at the front. I know the underbite was always there but when you see the gap grow from 1mm to about 7mm it certainly makes my bite look worse, and affected my speech. I knew all this was going to happen however and i'm happy because it shows the braces are working and i'm one step closer to eventually having jaw surgery.

This is the gap when I am biting together

- I'm wearing an elastic band on my right side now. I'm not exactly sure what this is for, but I have been wearing it 24 hours a day. I don't even take it out whilst eating and just chew on the other side. It only ached a bit on the first few days I wore it. Then after a few months one day when I forgot to put a new one on after taking another off, I realised it was aching when I wasn't wearing one, so I guess it's working in shifting whatever it needs to and my bite is adjusting.

That just about sums up everything that's happened. I'm now 9 months into orthodontic treatment and my appointments are about 6 - 7 weeks apart. I've become totally used to wearing braces now and I guess it's just become normal being careful what I eat and having to clean my teeth very thoroughly. For those that haven't read this blog before - the braces are moving my teeth in preparation for double jaw surgery (orthognathic surgery) to correct my underbite: my lower jaw will be broken and moved back, whilst my upper jaw and part of my midface will be moved forward. The last two photos really show how bad the bite is from the side (my upper canines nearly hit my lower molars!) and the effect of the misaligned jaws on my profile.

3 months in

Since this week i've now been in braces for 3 months, and also had my second adjustment a few days ago. I've not had as much pain from the braces as I envisaged when I first had them put on - however the one part that definitely is not pain-free is during adjustments and having a new wire put in. That said it goes away pretty quick. My orthodontist changed my wire to one I believe is made from a different material and appears slightly thicker than the last. It wasn't until I looked in the mirror in my car as I was setting off home that  I noticed four hooks on the front teeth (shown on the photo below) which I didn't have before. I'm not actually sure what these hooks are for but I assume it's to attach elastics, possibly to close the gaps in my upper teeth where I had one molar taken out each side (if it was this then i'm not sure what the lower hooks would be for?). I know they use these bracket hooks to help change your bite, but I assume I wouldn't have these as that would be the role of the surgery? I'm also wondering why they were put on this new wire if they weren't being used yet - i'm assuming that they've been put in place now until they are needed because the wire won't be changed again. He said my bottom teeth are still in the process of being brought forward and that I should start to see some gaps in between them as a result. My bite seems to feel different fairly often as things are obviously moving around. The gaps between my upper and lower incisors is certainly getting bigger, and i've noticed a small gap between the two top central incisors. The slight staining of the bracket glue is still there but I had a dental check up a few weeks ago and my dentist didn't seem to think it was a problem and that any staining could be cleared up after this whole process is over and the braces come off.

Waterpik

I'm always extra careful cleaning my teeth after an adjustment in case something pings off. I'm determined to go through this whole process without breaking anything! After reading a lot of other jaw surgery blogs I decided to buy a waterpik water flosser which I use pretty much every day. I'm not sure if it's quite as effective as flossing, which I also use, but so far it certainly seems to remove lots of bits of food from between my back teeth. The two photos here show the movement over the first three months. It doesn't look that significant but the two upper front incisors have definitely straightened out, and the lower teeth starting to move forward as it should.

3 months ago

Teeth now

2 months in braces

I thought i'd write my thoughts on my progress since I realised earlier today that i've been wearing my braces for two months. It's actually gone quick, and it feels that wearing them isn't such a focus for me anymore and that i'm just getting on with my normal working life and that wearing them is just part of me now. I took some photos which although don't appear to show a massive difference compared to where I started, it certainly feels like there has been movement. A couple of things i've noticed from the photos:

1. Just how much the bracket glue is tea stained! I did mention in a previous post how I noticed early on how quickly they seem to discolour. When I searched online about braces and staining a lot of people seem to talk about the ligatures discolouring, but in my case it's definitely the areas around the braces that are brown in colour. I am certainly brushing my teeth, and I guess as long as it's not the teeth staining i'm not overly worried. I have my first dental check up since having my braces on in a few weeks, so I might mention it then and see if the staining is a problem or if it can be removed. To be fair I think those photos showed it up even more because of the flash! I don't notice that much when I look in the mirror.

2. The gap in between the front upper/lower teeth is getting bigger, only a small amount, but certainly bigger than before. I know the gap will only get bigger too. You can see from the side-on shot how my upper and lower teeth are nowhere near where they should be - notice how my upper premolar hits a lower molar, which i'm sure wouldn't be the case in a normal bite!

3. In the last photo you can see how far forward my lower jaw is. I have been told i'll be having both my upper and lower jaws moved, but I don't know the distances. I've recently been watching some videos of double jaw surgery patients on youtube and it's amazing how good their final results are, and how balanced their facial profile has become. I'm hoping that having such an 'extreme' discrepancy in my facial balance will result in me having a big difference by the end of the treatment process.

Getting used to braces

I've recently had my first adjustment and i've now noticed a few things about life in braces..

1. Nowhere near as many people would ask me about the fact i'm wearing braces as I thought. Because I had to wait several years before having braces put on, I had spent a long time thinking out this type of treatment and building myself up towards finally starting. When it came to actually having them on, only a few people seemed to pay any notice. I did wonder if others noticed but thought I didn't want to talk about it, which I suppose I can understand. I decided to have silver ligatures so I don't stand out any more than I do already. As a nearly 30 year old male I don’t think I would look right with bright green braces!

2. My teeth would start to look a little stained. I drink tea very often and I noticed a short while after having braces on that my teeth would have darker patches of brown around the brackets. I looked online about this and apparently it's the adhesive that's staining and not the teeth, which I hope is true as despite it taking a long time i'm trying my best to clean my teeth thoroughly, as I when the braces eventually come off I wouldn't want to find damage or more stubborn stains underneath where the brackets were.

3. That i'll automatically start mashing food. When I had my braces on I had to mash virtually everything. I completely avoided some foods but others like bananas i'd mash into a pulp and swallow. I've now started doing this a lot of the time even if I can chew. It's a little tender since I had my first adjustment and I assume this will be the case every time, so I just started thinking it'd rather not take the risk of pain or breaking something and simply to make things a bit easier for  my teeth. It's been quite interesting discovering which foods need a lot of chewing, like cherry tomatoes and peppers.

3. The changing of the ligatures felt like the teeth were being pulled out! I knew it would hurt, but it was quite a sharp pain. At least it was only for a moment, and I assume it's to make it all tighter and continue to shift my teeth. I also noticed that the ligatures are all tied as an O shape, whilst the four on each of my first pre molars are a figure of 8 shape. From what i've read online this may be to exert more pressure. I've also had a thicker wire put on the top and bottom and was told by my orthodontist that as the bottom front teeth begin to be pulled outwards to the front (they are tilted back to mask the underbite) I will probably see some gaps start to form.

I haven’t had these braces on for that long, but i’ve been surprised how quickly i’ve got used to them and adjusted what I eat and how I clean my teeth. The biggest issue i’ve had with them so far was the effect on my speech, as my job involves talking a lot, although again I’m getting used to it. I’m assuming as treatment progresses and my teeth continue to move around, I will always be aware of how they have changed and having to change aspects of what and how I eat.

Reasons

The reasons why I want my underbite fixed are to me quite simple; for a functional bite and for aesthetic improvment to my profile, by having more symmetry and balance between my upper and lower jaw. When I started researching orthognathic surgery I hadn't fully appreciated how the position and length of the either jaw can have a profound impact on your appearance - you only have to look at the 'before and after' pictures online to see the difference this type of surgery can have.

My underbite means that I can't really chew food as efficiently as someone who has a normal bite - my teeth have tried to compensate for this, but ultimately my molars don't make contact in the way they should. I'm also worried about the extra wear on my teeth in the future; these are my only pair of teeth and I want to hold on to them for as long as possible! I also feel my speech isn't as clear as others although i'm not sure if my enunciation will improve as a result of this treatment. I also have TMJ issues including clicking and locking but i’ve been told that jaw surgery won’t address this.

The issue

In preparation for having the braces on, I had two molar teeth taken out a few weeks before the braces were put on several months ago. I can now say the teeth extraction were more of a pain (not literally), more to do with the wound constantly bleeding than anything else and having trouble chewing.

As you can see from the photos i've uploaded my teeth are fairly straight thanks to orthodontic work in my early teens. The problem is that since then my lower jaw has grown too much and my upper jaw too little, creating the class III malocclusion, which can only be correct surgically. In the short time i've had the braces on, although it doesn't really look like it in the photos, I can already feel my teeth changing slowly but surely, with the top front teeth being pulled in and the bottom ones pulled outwards. This is to reverse the camouflage that the front teeth have gone through to try and hide the underbite. I know the gap of the underbite is going to increase so that all the teeth are in the right position after the jaws are repositioned.

Before, with the molar bands on

With braces on

Profile shot

You can see from the photos my teeth before being braced, with the braces on and my profile, which really does show how much of a disparity there is in the length of my jaw, giving me a very concave appearance, with a flat mid face and a very prominent lower jaw.

A bit about me

I'm a 20 something male in the UK currently wearing braces in preparation for orthognathic curgery to correct my underbite. I've only been in braces for a few months, but it's been quite a long journey even to get here, which i'll no doubt write about in future posts.

Given that the journey i'm going through is a long one, I have plenty of time to think about it and decided it would be a good idea for me to keep a blog since i've found others so helpful, including the ones i've linked to that i've been reading for quite a while.