Monday, July 23, 2012

Who wants to break my jaw?!

Just a warning, this is going to be a long post!

Where I live there is only one oral surgeon and he doesn't do these types of procedures on a regular basis my orthodontist referred me to an oral surgeon in Seattle, Washington that he works with a lot. Seattle is about 12 hours north from me. I had a consultation with the oral surgeon last July, only a couple months after I got my braces, since I was going to be in the area anyways visiting family. The consultation with him was pretty straight forward, but not very informative.

I don't know if it was because I didn't really know a lot about the surgery which caused me not to have a lot of questions or he didn't really offer much information, but as I started to do more of my own research I felt less comfortable with the idea of going all the way to Seattle to have such a major surgery. I asked him about how many total visits I would need to make to see him and he said it was either 2 or 3 depending on if I was going to have just my lower jaw done or both.

That isn't very many visits and that was including the visit to have the surgery! I have seen people's videos on YouTube and they go to their surgeon at least once a week for the first few weeks after their surgery. That, on top of the distance, changed my mind about having him do my surgery. Luckily, I did receive the letter he had sent to the insurance company to request authorization and a letter he had sent to my orthodontist about my consultation, those two letters were very informative and I'm going to share a couple parts with you.

The letter that was sent to my insurance company stated the diagnosis of maxillary vertical excess with mandibular retrognathia. It also said that the surgical plan included maxillary LeFort I osteotomy with mandibular bilateral sagittal osteotomy, with oral surgical splints.The letter that was sent to my orthodontist contained the much wanted measurements I was curious about and also raised a couple questions. As of July 27, 2011 I had a Class II with an anterior overjet of 7.0 mm and an overbite of 8.0 mm. While preparing for my blog I re-read the letter and found a couple statements that I have no idea what they mean, for example, she does have a moderate to significant amount of lip incompetence with a resting lip to incisal edge distance of 7.0 mm. What does that mean? Is that good or bad? The other one was, there is a mild mandibular curve of Spee. Umm, ok...what's that? I'm planning on asking my orthodontist at my next adjustment.

Since then I have found a new surgeon, one that is in state and is covered by my insurance! The surgeon is in San Francisco, which is five hours south from me. Definitely not as far away as Seattle, but still a pretty far. My surgeon is at the University of California, San Francisco (UCSF) and I had my first appointment with them last month on June 8th. The appointment consisted of lots of measurements, lots of pictures, lots of questions, getting a mold of both my jaws and I had to have x-rays taken, but there machine was down, so when I got back home I made an appointment with my orthodontist and had them take the x-rays and send them to UCSF. I was so surprised at how much detail they were wanting because the previous surgeon didn't spend much time looking at my mouth, a very good thing and it helped me feel more at ease with the new surgeon. I guess they considered it more of a work-up appointment than a consultation. Anyways, the plan now is that they are going to present my case at some monthly conference they have called Orthodontic Treatment Planning (OTP), I think, which is actually this Friday, July 27th.

My next appointment at UCSF is on Friday, August 17th and that's when they will present me with the treatment plan. Luckily since I have already met with a surgeon I have a good idea of what they are going to want to do. The step after that is to submit the per-authorization to my insurance and once I have the ok, I get to schedule my surgery! With the surgeon from Seattle I did have the surgery already per-authorized, so I'm hoping that there won't be a problem with the new authorization. I'm hoping that I am able to have my surgery sometime in October because I want to be able to chew by Christmas, I was some tamales! I can't miss out on that. Thankfully my work is very flexible and have told me that I can have time off, just to tell them the dates when I know them.

I guess that's it for now. My next orthodontist appointment is on Friday, August 10th and then a week after that I have my appointment at UCSF. I will keep you guys posted once I get more information.   



12 comments:

  1. Hello Esmeralda! You commented on my blog (myjawadventures.blogspot.com) and I clicked on your name and found your blog! To answer your question - I am pretty sure "moderate to significant amount of lip incompetence" means that you have problems closing your lips entirely/correctly. I also had this problem, and it's nothing serious. It's just kind of like a side effect of having an overbite. After surgery, when the jaw is re-positioned, you should do exercises to build up your chin muscles like pursing your lips, squeezing, then relax and repeat. This will help you regain natural "lip competence". If you have any other questions or concerns (I had a ton before jaw surgery!) please let me know! There aren't too many blogs out there about overbites, so we're rare gems :) I'll be checking your blog again!

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    1. It’s nice to “meet” you Laura! I think you are right about the lip incompetence thing. I guess I never really noticed it; they need to stop pointing things out to me because before this I was happily oblivious and now it’s all I can think about! Plus, the word ‘incompetence’ doesn’t sound very good. I will definitely keep that in mind; I’ll probably start asking you lots of questions when my surgery gets closer. We are rare gems, aren’t we? Why do you think that is? Even on YouTube most of the videos are from people with underbites, but not many with overbites. I think I’ve only found one other person that had a similar situation with having an overbite with an overjet. Thanks for the support!

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  2. I honestly don't know why that is... perhaps it is a more common growth pattern. But don't even mention it, I'm here to help! By October I should be nearing the very end of the official recovery time (four months), so hopefully I'll be able to answer any questions! My email's on my blog, so don't hesitate to drop a line when you have a question! That also goes to anyone reading this :)
    --
    myjawadventures.blogspot.com

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  3. Hi! Thanks for making this blog. I live in the San Fran area and am just starting my 'journey' towards getting my overbite fixed. Would you mind sharing who your surgeon is? Sounds like you've found a decent one and it'd be great not to have to start the search from ground zero. :-)

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    1. Of course! As far as who my surgeon is, his name is M. Anthony Pogrel at UCSF. My suggestion to you would be to see who your orthodontist (is you already have gotten one) refers you to and then if you are using insurance, check and see if they are a preferred provider. If they aren't then check with your orthodontist to see if they have worked with any of the surgeons on your list. That's kind of how I did it. You are lucky in the sense that you live in a big area where you will have lots of choices! Take advantage of that.

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  4. Thanks! BTW, how long did your ortho or surgeon say you need to have your braces on before surgery and how long after? When I looked into this many, many years ago it was going to be a total of four years, so I decided to just wait.

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    1. The first surgeon told me that he liked people to have their braces on for at least a year before surgery. Then, it depends on if your teeth are in the correct position for surgery, if not then it might be a little longer. I believe the norm is about 6 months of braces after the surgery; it varies from person to person. Wow four years! Yikes, no wonder you decided to wait. With all the technology that is out now, it seems to minimize the amount of time people have to wear braces and be "wired" shut after surgery, which is nice! Hopefully this has helped!

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    2. Wow, that's less time than I thought. Hopefully my teeth fit into that amount of time. :-) Now I'm excited to make my ortho appointment. Thanks so much for the info and I'll keep checking back to see how your progress is going. Good luck!

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    3. I'm glad! You'll have to let me know how your consultation goes, I love hearing other people's stories! Thank you!

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  5. Hi Esmerelda - I have a deep overbite/ overjet and gummy smile, so it seems we'll have a similar journey. I look forward to following your progress.

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    1. It's nice to meet another person with a similar case! What's the status of your journey? I would love to follow your progress as well, do you have a blog?

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