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Archive for the ‘at the moment – office visit’ Category

I arrived at Dr. G’s office shortly before my 11:00 am appointment.  At that time, the waiting room was quite empty, just myself sitting there.  Before my name was called, there came another young patient with her dad and younger brother.  After the orthodontic assistant called my name, I went in to the treatment room, and I was told to sit at the first chair.

Next to my chair, Dr. G greeted me while getting ready to work on my teeth.  I pulled out my camera and sat on the patient chair, and then Dr. G lowered my chair so he could start working.  He first examined my teeth, and then he opened the bracket doors on the top row first, and then he did the same to the bottom row.  (I think I did a good job taking the picture below, because Dr. G was just about to open the door of one bracket.)

After all brackets’ doors were opened, Dr. G used his tool to push out the bottom wire from the brackets.  He removed the bottom one first, and then the top one.  (The whole time I could smell the cologne on his hand.)

He then told me that I could clean my teeth in another room.  It was an exciting moment that my wires were removed temporarily, because I could clean the areas my SoniCare toothbrush can’t usually reach, and I could easily floss.

After I was done, I came back to my chair and saw that there were some extra things on the table next to my chair.  I asked Dr. G what are those.  Here, I have to say that a good orthodontist answers your questions with patience, and Dr. G is such a person.  He told me with patience that the little tube-like thing is the wire stopper (see where the left arrow points in the above image), while the longer piece, sort of like a ligature with a bunch of “0” shapes, is the power chain (see where the right arrow points in the above image).  The wire stopper is to keep the wire from sliding (I actually have already seen that on my former and current wires, but I didn’t know it is the wire stopper and needs to be separately attached to the wire; I thought it is the part that connects two pieces of wire segments together….)  The power chain is for closing the spaces faster.  While he was telling me these, he also bended a little section of one wire.

Because he mentioned the wire stopper, I asked him why my top wire has the tendency to move to the right (this happens to both the former and current wires)?  He said one reason can be that I chew more on the right side, so the wire will move to the right.  (Oh… I see.)

After he finished explaining, he began to put the power chain around my brackets on the top row.  He told me it would go on all the brackets on the top row, and there would be a lot of pushing and pulling, which was exactly what I experienced when he put the power chain on my braces.

My top central incisor and canine were still a bit sensitive at the moment when I was at Dr. G’s office, so when he was putting the power chain around the brackets of these two teeth, it hurt.  I was hoping my teeth wouldn’t bleed or wouldn’t fall down when Dr. G was doing lots of pushing and pulling.  It proved afterwards that I worried too much, because besides the discomfort, my teeth are still there and they didn’t bleed.

After Dr. G put the power chain on my top row, he told me to sit on my chair for a bit while he checked on other patients.  I used this time to take a picture of my teeth that has the power chain on.  Because the power chain is clear, it is a little bit difficult to see in the picture below, but it is really there, and each power chain’s “0” shape goes around each of my top row’s bracket.

 

When Dr. G returned, he began putting wires back to my braces.  He inserted a new wire that he just customized for me (the one with a section bended) into the top row, but he still inserted the same bottom wire that he removed earlier back into the bottom row.  He then closed the doors of each bracket.  (Compared to the second orthodontic assistant who put the wires in and closed the doors of the brackets during my first follow-up office visit, which was uncomfortable, Dr. G this time did a way better job, because I felt comfortable when he put the wires in and closed the brackets’ doors.)

 

Dr. G told me that this time I would need to wear rubber bands to correct my bite.  (It is a tiny rubber band, which looks kind of cute….)  While I was holding the mirror, he taught me how to apply the rubber band to the hooks.  Basically on my left side, I would need to attach the rubber band on the top canine’s hook and the bottom first molar’s hook.  He said it is very important that I wear the rubber band all the time.  The only times I can remove the rubber band are when I am eating and brushing.  I need to change to a new rubber band twice a day, one in the morning, and another at night.  (I remembered the conversation I had with my colleagues that doing what the orthodontist tells you is a must, because if you don’t, you are going to prolong the treatment.  So I will do what Dr. G tells me about the rubber bands.)  And then he handed me a bag containing many rubber bands for me to replace and a tool that has a hook at the end to help me connect the rubber band over the brackets.

 

After this, today’s treatment was pretty much done.  Before I got off the chair, I asked Dr. G one more question.  I was wondering if I could get one more bracket on each of my top second molar, because I feel that the space between my top first molars and second molars is widening, and I don’t want them to stay where they are right now forever.  Although people can’t see my top second molars when I smile, I can feel they are neglected with my tongue.  Dr. G again replied patiently that today he puts the power chain on my top row to close the space, and the second molars are going to follow naturally too, and then when it is the right time, he will put the bracket on my top second molars to bring them in.

I thanked him for today’s treatment.  Before I walked out of the treatment room, I took a picture of my teeth.  In the image below, I see that the top wire is pretty straight except for the section that goes over my top left central incisor.  I remember what Dr. G told me earlier, that this bended section is to bring the top left central incisor to the same level as its counterpart on the right, so visually the teeth on the top row can eventually look more leveled off.  I have always wondered how Dr. G is going to fix my top left central incisor which extends downward a bit more than other teeth on the top, and today I finally know how.  (I think this method is quite smart, but does that mean this tooth will be pulled upward into my gum by the force of wire?)

Below is another picture I took that shows where the rubber band connects.  (Dr. G told me that he may want me to wear rubber band on my right side too when I come in for the third follow-up appointment.)

So today’s treatment lasted from 11:00 am to 11:40 am.  I took my patient profile to the front desk to check out and verified when my next appointment is.  I originally had it scheduled on 6/18 at 9:15 am.  Even though Dr. G wants me to come back in six weeks, I can only make it to Saturday’s appointment (which only happens once a month), so I am still sticking with it, and I will come back in four weeks.  In order to get the first morning appointment, I also scheduled for the following appointment on 7/16 at 9:15 am.

While I was driving back home, I was thinking about the possible changes that are going to take place on my teeth, and I was feeling excited.  My teeth are going to look more leveled off on the top row, the spaces are going to close with the help of the power chain, and my bite will be aligned with the help of rubber bands.  Those were promising thoughts, so I was happy.

After I arrived home, I pulled out the bag of rubber bands from my bag to look at it.  The cover of my rubber band bag has a sea lion on it.  (Dr. G said there are several different animals printed on the cover, and I happened to get sea lion.)

Below is an image of what it looks like inside this bag.  Because Dr. G suggested for the next appointment in six weeks, so I guess there are enough rubber bands for six weeks.  The white thing is the tool that will aid me in connect rubber bands to the hooks.

Overall, I had a good experience during this second follow-up office visit.  As opposed to the previous two times where the orthodontic assistants were mainly working on my teeth, this time it was the orthodontist who worked on my teeth, and I really liked it this way.  (Maybe the orthodontic assistant is very experienced, but I still feel more assured when an orthodontist is working on my teeth.)

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After almost two months since the initial orthodontic treatment, I went in for the first follow-up office visit.  My appointment was at 9:15 am today.

After I checked in, I was soon to be led to the second chair in the treatment room.  I was hoping to see the orthodontic assistant, J, again today because she was really nice during my initial treatment, but it seemed like she was not working this Saturday.  It was another orthodontic assistant who worked on my braces today.

This lady (I didn’t ask for her name) didn’t tell me what she was going to do (J would tell me what’s coming next so I would be prepared), and after I lay down on the chair, she started doing something on my brackets.  It took me a few seconds to realize that she was opening the doors of my brackets.  (I wanted to capture the moment, so I asked for her permission to make pictures while she was working on my teeth, and she said sure, but unlike J who would stop the task for a moment to let me take clear pictures, this orthodontic assistant continued working, so this time I didn’t have too many pictures of my teeth.)  I felt that she was using a tool to push open the doors of the brackets.  I felt force on my teeth when she was pressing on some brackets to open their doors.

After the doors were all opened, she first removed the wire from the top row, and then from the bottom row.  I was given a chance to brush and floss without the wires!  It made me feel happy to brush without the wires.  Knowing that she would close the doors of the brackets later, I was also brushing on the brackets, and then I flossed.  Not that I floss often, but it sure was much easier to floss without the wires, but because the doors of the brackets were open, when I opened my mouth wide to floss, my mouth’s inner flesh was pressing onto the poking bracket’s doors.  That was uncomfortable, so I quickly picked a few difficult-to-reach areas to floss (mainly toward the back), and then I went back to the treatment room.

After lying on the chair again, Dr. G came to look at my teeth.  He asked me how I feel about braces, and I told him that I am used to it now.  I then told him that I feel my teeth are misaligned (when I said this, I meant my middle two teeth on the top row are off from the center).  He said that my central incisors will stay crooked until later, when he gives me bigger wires and rubber bands to correct the alignment, and then I would see the teeth getting straight.  After hearing this, I was thinking that, okay, I don’t know when that is going to happen, but I can’t wait… I hope the middle top two teeth can be straight and aligned soon, because I see that right now the middle top two teeth are pushing my dividing muscle tissue to the right, and I don’t know how it is going to affect that muscle tissue if the two teeth keep pushing it toward the right side.

And then the orthodontic assistant came back.  She brought two new wires, looking a little bit bigger than the ones I wore before.  Remembering that others said it hurts to get the braces tighter, I asked her if it is going to hurt.  She said that because the wires are little bit bigger, for sure I am going to feel more pressure on my teeth.

She first put the wire in on the bottom row.  I guess it is not easy to put the bigger wire in, so she was using force to make the wire go in to the opening doors of the brackets.  On some brackets, I felt that she was pressing on my teeth that I got a bit worried that my teeth would break….  Finally, she put the bottom wire in and closed the doors, and then she moved on to working on the top wire.

It also took a few minutes for her to get the top bigger wire in, and again, I also felt stronger push on my teeth for few seconds when she was pushing the top wire in to some brackets’ opening.

After she closed the doors of the top brackets, she was done.

Before I left, I asked her a few questions.  I asked her why I am changed to bigger wires today.  She said that Dr. G examined my teeth and thought that the initial wires have done their job, so he wants me to switch to bigger wires this time.  She told me that with the bigger wires, I will feel more pressure on my teeth, and my teeth will move faster.  I also asked her why my initial wires moved from right to left on the top row.  She said it is because the smaller wires are thinner, so it moves while inside the brackets, and it doesn’t mean that my teeth move with the wires.  (Okay… then my guess in yesterday’s blog post is wrong; I thought moving wire means my teeth are being moved….)  Lastly, I asked her that how many pairs of bigger wires would a patient switch to.  She told me it depends, and the wires I have now are bigger than before, and depending on my teeth’s condition by the next follow-up appointment, I might switch to another pair of bigger wires.

Before I left, I went to the front desk to schedule for the next appointment.  The next time I will come in will be Saturday on 5/21/2011 at 11:00 am, so five weeks from today.  I wanted to get appointments at around 9:00 am, but the earliest one is at 11:00 am for the next month’s Saturday appointment.  Wanting to get early morning appointments, I also made an appointment for 6/18/2011, and I got the 9:15 am spot.

This follow-up office visit lasted about 35 minutes, so I left Dr. G’s office at 9:50 am.  Since the moment I get the bigger wires on, I keep feeling constant pressure on my teeth.  This feeling is sort of intriguing, because when I got my initial wires on, I also felt constant pressure on my teeth, but after few days, I was used to the braces and sometimes I even didn’t feel them until I felt pressure again, and soon after, I got used to feeling pressure on my teeth.  So revisiting the feeling of constant pressure on my teeth makes me remember I have braces.  Hopefully it is like what the orthodontic assistant said, that the bigger wires will make my teeth move faster.

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At 9:00 am, I showed up at Dr. G’s office.  The receptionist checked me in, and then asked me to sign the patient’s informed consent form and the contract.  I thought I was going to talk to Dr. G again to ask for timing, expected result and all that before signing the contract, but, oh well, I read the consent form first and signed it.  I then read the revised contract and made sure the total cost, down payment, and the monthly payment are the agreed amount, and then I signed it.  (Okay, I signed it.  I am really going to start the treatment.)

Then I waited in the waiting room for a while before the orthodontic assistant, J, called my name.  She first led me to a room to take impression of my teeth.  I didn’t know what impression was, so J explained to me that it is to take model of the teeth so the impression now can be compared with impression later to see how much teeth have moved. 

First, she mixed the impression materials together to form a red-orange color, and then she put the mixed materials on a tray.  She then inserted the tray into my mouth to cover the bottom row of teeth.  It felt a bit weird because the material felt like half-wet-half-dry clay and it would turn hard inside my mouth.  After the bottom was done, she changed to get my top row.  Having the impression material touching my top row of teeth was even more strange, and I was afraid that before the material turned hard, it could get into my respiratory airway, as least I had the feeling that the material was moving slowly towards the respiratory airway….  But of course the material didn’t fall into my respiratory airway, because I listened to J’s instruction to breathe through my nose instead of my mouth.  This process took approximately 15-20 minutes.

After I rinsed my mouth with water and used the restroom, I went in to the treatment room to wait for Dr. G to start my treatment.  Shortly, Dr. G came and I asked my last burning questions (i.e., timing, how teeth will move, expected results, wisdom teeth, etc.) before J began to put the device into my mouth to keep my mouth wide open.

She then washed my teeth with a blue-colored soap, so the brackets would be glued to my teeth better later.  After this, she rinsed my teeth with water and then dried my teeth to begin putting brackets on my bottom row of teeth first.  I have 16 teeth on the bottom (including two wisdom teeth on the back), but she put brackets on 14 teeth, excluding the wisdom teeth.  Dr. G then came to examine if the brackets were positioned right, then J used a blue light to dry the glue.  After the bottom row was done, I felt like using the restroom again, but I couldn’t talk with the device in my mouth, so I was just hoping she could get the top row done quickly.  Then it came the same procedure for the top row: put brackets on my teeth (14 teeth on the top, no wisdom teeth on the back, but brackets only are on 12 teeth), Dr. G came to examine the position of brackets, and J dried the glue with a blue light.

The brackets came with blue chips attaching to them, and before the wires could be put in, those blue chips needed to be removed.  J removed those blue chips for me, and I was finally released from the chair and mouth-opening device.  Having the brackets in my mouth for the first time was so weird, and I told Dr. G and J my feeling.  They were both laughing because the way I said it, and told me that I will get used to it.  I then quickly rushed to use the restroom.

Later, Dr. G told me to brush my teeth to remove the trace of the blue chips.  It was also weird to brush my teeth with braces on but  not difficult, because the toothbrush they provided was pretty good, which had a narrower bristle size, so it was easy to brush from above the brackets, below the brackets, and on the brackets.  (Too bad that I didn’t ask to take one with me home.) 

After this, I went back to the treatment room to get wires on my teeth.  I was expecting that it would hurt somehow (or a lot), but in fact, it was pretty comfortable.  Besides the minor pressure on my teeth when J was putting the wires in, I didn’t feel pain at all.  So after J made sure that the end of the wires wouldn’t pock the inside of my cheek, I was done!  I now have braces on my teeth!

But, when I bit down, one of my top teeth was touching (sort of hitting) on one of the brackets on the bottom.  I was thinking how Dr. G would work around this because J told me that the brackets are glued to my teeth and they can’t be removed.  Dr. G examined my bite and the area where my tooth was touching the bracket.  He then put build-ups on two of my bottom teeth so that tooth won’t touch the bracket.  Now when I bite down, my tooth on the right touches the build-up.  Dr. G told me that when this right build-up gets worn up and falls, the left one can still prevent the tooth from touching the bracket.  I was feeling happy that I wouldn’t knock down that bracket eventually by biting down too often, but I also didn’t realize that this prevents me from chewing any food too until later I had my first meal after getting braces.  And I probably need to have the build-ups on these two teeth for one month or so, so that means I can’t chew on anything for one month because my teeth don’t touch each other….  This is the part that I don’t like, but as of now, this is the best solution to this issue.

Before I left the treatment room, J showed me a set of pictures when someone with braces doesn’t do a good job brushing one’s teeth.  Those pictures were nasty, because that patient has cavities on all his/her teeth except for the areas where brackets were previously attached.  J told me that those cavities are permanent, which made me decide at that moment that I will do a great job brushing my teeth.  After this, J gave me an orthodontic care kit which has all the tools I need to take care of my teeth with braces, and also showed me how to use some of the tools, such as the proxy brush and floss threader.  I thanked her for being so nice and headed to the front desk to pay the down payment.

After I walked out of Dr. G’s office, it was already 12:15 pm.  The overall experience was not too bad, and I guess I was the happiest patient on that day, because I had fun taking photos of myself, laughed quite often, and exchanged joyful conversation with Dr. G and J during the three hours I was there.  One good thing about getting Damon braces is that the patient doesn’t need to visit the orthodontist so often.  I am supposed to see Dr. G again in six weeks, but because I can only go on a Saturday, and they only open one Saturday per month, my next appointment is on 4/16/2011, which is almost two months from today.

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