My Dentist Nightmare Part 3

Welcome back after #scriptober everyone! It’s this time of week again! I’m back with a whole new moan-up about my ongoing jaw surgery saga. This post is a long one, but it’s a story that I believe needs, not only to be shared for my own sanity, but documented as a wholesome warning to all who clench (and ‘foolishly’ believe the first, second, third, and fourth opinion of medical professionals). Here goes everything…

I was told it would be a very long waiting list. But with a small flicker of light at the end of the tunnel I had enough energy to keep existing day by day. Not to be dramatic, but a gradual pain and loss of basic functions can really take it out of you. I was beginning to pine for the time I had broken actual limbs. They were a quick fix; this was not, and worse of all this was dependent on a multitude of experts and the waiting lists to see them, all of whom had differing opinions anyway! But then it got to about the time I should’ve been contacted. I was leaping at the door when the post arrived on a Saturday, and I was rushing home from work to await my letter. Work was getting…difficult. Having to try and find somewhere to eat privately or something actually edible to pack with me was the least of my worries. I had well used up all of my holiday on fruitless appointments. My clenching at pain as I sat at a computer screen all day was getting harder each day. And yet, the letter never came. I called and called and called the hospital. They had never received a referral. Turns out, one had never been sent. But my dentist had done me one, or so he said… it was just never sent…

After using up all of my mobile minutes, I finally got to the root of the problem. The dentist hadn’t failed to send it. The hospital had actually rejected it, saying my case want bad enough to meet the criteria of surgery and I would be fine to live as I was. My dentist, being just as horrified as I was at this verdict without even seeing me and basing it off of an older x-ray, had argued the fact, and they hadn’t wanted to admit they had made a mistake by rejecting my case to me. Then, I was instantly flagged as an urgent case. They blamed it on an admin error but my dentist was sure it had a lot to do with waiting lists being what they were. I had already been waiting for six months by now and I wasn’t even on the list! Eventually, my appointment came and I travelled by car well over an hour to get there. I didn’t mind that though, noting the scheme of things. What I did mind however, is that upon arrival the surgeon asked me where my orthodontic paperwork was. I hadn’t none. I didn’t know what that even was!? Turns out, surgery is only done with recommendations from an orthodontist, and it was her understanding that I was doing this for cosmetic reasons privately, at the tune of £4,000 for just the braces I would need from orthodontics to help set my jaw! There had been some sort of monumental mess up for the millionth time, and I think the state of my mouth and mood at this point helped me to gain the referral that I should’ve had originally…to the functional orthodontists.

But it didn’t stop there. I waited. And waited. Again. But I was prepared this time. I called them repeatedly; the hospital and the orthodontist in question. They were adamant that they had sent my referral to the ortho’s. Then the ortho claimed they hadn’t received a thing. This went backwards and forwards between different departments…for 3 months no less. Each were blaming the next person and the next. Then the orthodontists were accused of losing it, then even the poor bloody postman was blamed by the hospital. Everyone on the other end of my phone sounded a heavy mixture of defensive and bored. Nothing was ever going to be done, so I did the dreaded ‘can I talk to your manager’ line. I’m not a complainer, but this wasn’t retail; this was my life! I threatened to complain, took names and numbers, left mine with them countless times only to never be called back. This telephone ring around when on for a further three weeks. In the end I got a hold of the hospital manager for the max fax department, who had to email my referral over to the orthodontists using their personal email address. It had been done and was on their system, just no one seemed to manage to get it from A to B until that point. Common sense seemed to have escaped many individuals entirely. At this point I had started wondering what would happen if I took a hammer to my own face just so I could be seen quicker, or at the least be given something for the pain. Would they fix my jaw then? It had been three years of not being able to close my mouth by now. But hope was on the horizon…

Turns out, it was a private practice, for mostly cosmetics, and boy oh boy could I tell. All of these people with mild crookedness to their teeth or those young enough to get seen and treated accordingly; when their issues first arose in youth, were sat in the waiting room with me, oblivious to the fight I had to get here. I can’t lie, I was shaking. A lack of sleep and sustenance can do that to a person. It was fight or flight; what these people said to me today would change my life for the better or condemn me to whatever you would call this now. Although this was just a consultation appointment, the woman could see that I was nervous as all hell, but assured me that I had finally made it here and that the process is underway. She wrote a letter to my current dentist, instructing him to craft me a mouthguard that covered all of my teeth (as they are meant to do!) and even asked if she could use me as a study for her paper on how mouthguards are notorious for causing skeletal/functional problems when they don’t fit. Turns out it’s still a widely debated topic in academia, and unfortunately it takes a long time for fact proven in fields to trickle down into standard practice. I was told that next time I would be x-rayed in a way that my skull was scanned, and moulds would be made, not from biting into something I’m unable to, but with an actual scanner. From this they would play around with what changes they could make to have my jaw meet again. I all but cried, but knew by now not to get my hopes up. The relief was, as usual, rather short lived…

Back to the Drawing Board

I went back to my dentist. His curiosity had clearly gotten the better of him as he had me fitted for a new guard. He chuckled about the state of my teeth and in all fairness to him I did too. For it was truly absurd, the development of it from a bite fitting together too much like a puzzle piece to one of iceberg-like collision and almost a thumb width apart. When I got the mouthguard back, he was confused as to why I would even want it after so long- as if it were pointless trying to protect what little I had left. I was distraught to find that once again, I had been given an ill-fitting mouthguard which would (according to my new ortho) only add to the problem, but I suppose that I was lucky in the sense that I finally had one, and that my teeth were not so supaerupted that they still touched when wearing the shield. How long would that last though? I could tell that he didn’t understand why I was being so ‘difficult’, but the orthodontist had been very clear that this was a necessity these days to prevent such problems. Incidentally, her claim that dentists don’t understand this issue was pretty clear. I trawled forums for answers, and while academic papers and personal claims back up my experience, myself and others that have been left to suffer are indeed the outlier, and so guidelines have not been updated with this information. In fact, these side effects are so rare I was never even consulted on these risks before given one.

I left deflated once more, and concerned about the long term detriment to my withering quality of life. It was a sort of break though, being able to close my mouth in my sleep knowing I’m not wreaking further havoc on my tooth surface at least. The damage had already been done though, and the year long waiting list without any protection had meant I had to have a further 6 impact fillings on my molars. While these teeth didn’t touch, I suppose the impact of the soft foods I was eating and brushing my teeth had led to their inevitable demise. I had to take the mouthguard away once more whilst waiting for them to be tended to, or else it would be like constantly biting on the raw nerve once more. With all of my teeth feeling so sensitive, I was given prescription fluoride toothpaste which I now use exclusively, along with toothbrushes meant for babies!

Eventually, I could return to the ortho for my imprints. This would be what they used to determine the moment of truth; the epic plan to save my gnashers! It was all very hi-tech in there. I had an x-ray that spun around my head and one that even held me in place by earplugs, all the while standing upright. It was so space age that when I did lay down in the dentist’s chair they used a scanner resembling an ear light to document my teeth and bite, which appeared on the screen beside me. It worked best on dry teeth, and I could even see the realistic rendered shine of my gums and bite on the image. They used spatulas to keep my mouth open as I lay nearly upside down, blood rushing to my head and the familiar blasts of air clearing my mouth of moisture. However, my wisdom teeth were so supraerupted that the poor woman couldn’t scan them. You see, even with my mouth open at its widest they are still almost touching. She said life must be hard for me and I was so grateful for this empathy since my journey of being ‘helped’ had begun. I was starting to wonder if I had actually lost my marbles, but the fact that they kept going away and coming back assured me that I wasn’t ‘pestering’ everyone I had seen up till now.  After consulting various orthodontists, these kind nurses confirmed that this was one of the worst cases they had seen; it would take a whole team to figure it out! The digital images would be used to create a 3D printed scan of my teeth for them to play around with, seeing if they could get my mouth to somehow close. I was told that this was also better for the environment and cheaper in the long run, which was pretty bloody cool. They took images too, of the gap and my profile from different angles. To make the before and after photo all the more dramatic, I suppose, and with great excited fear I left, wondering what the verdict would be.

Sitting in the waiting room a few weeks later, I was terrified. What would they say? What would they do? The previous night I had awoken with a huge chunk of my wisdom tooth missing; so sharp it sliced up my tongue. I hoped that this wouldn’t be a bad visit. I hoped that by bringing the mouth guard that I had been using sparingly with me, I would be assured it was safe to use to preserve my tooth. It had come in a little blue plastic container, which I swapped awkwardly between hands as I used the clinic’s sanitising hand gel that keeps the practise clean. That alone made me feel like they were well qualified and knew what they were doing here. It was some comfort, but because of that I was even more afraid of what they would say. This was the final step; the final gate literally keeping me from being able to ever sleep or eat properly again. And they said it was a 6-month waiting list to be seen by the surgeon, who will decide if they break the top jaw, bottom jaw or both. So, it wasn’t up to them directly after all. And I didn’t think my nerves could take it!

I was told, to my dismay, that without a scan of my teeth beforehand it would be hard to know what had specifically caused my open bite. But who has scans of their teeth laying around when there’s nothing wrong with them? The orthodontist I was seeing asked if I had any conditions, or if I had been taking medicine at the time this had all began that would’ve made my bones grow. It’s rare, but for whatever reason, when the superuption of teeth to meet each other didn’t work, their theory was that my actual jaw grew to compensate for the ‘gap’ my mouthguard had caused. Overcompensated. Horribly. According to my x-rays and models, even if they removed all of my teeth my jaws wouldn’t ever meet. The only option was to carefully break my face, removing a large wedge of my upper bone and then potentially doing the same to my lower jaw to have them meet. I appreciated their honesty and the in-depth way they explained the process. I was still cautious to be relieved given my experiences thus far with false promises, forgotten appointments, rejected referrals and general disbelief or genuine lack of knowledge of my predicament. But this was good news to me; something might finally be done!

And my joy at hearing surgery was on the horizon made me look positively nuts. I think I actually was a bit loopy at the time. Completely off my rocker from insomnia. It’s so sad that braces alone wouldn’t have done the trick, given how it had been a tooth movement problem to begin with. I imagine the time frame of almost four years to be seen contributed to further bone growth. Nothing had been nipped in the bud so to speak, and what’s more I myself hadn’t noticed for a long time the detrimental effects the guard was having until it was too late. The plan now then; the procedure, if all goes well, is that I see the jaw surgeons and they approve me for surgery. Even the orthodontist gave me their several different phone numbers to chase them up because they often ‘lose referrals’ (as they done mine already. Twice.) The surgeons, as a team, will assess what to do and see if I am fit for surgery. They will likely check my ball joints in my jaws also, in case I have been damaging these, along with my muscles and tendons from my clenching pressure every night and the unusual angles I’m contorting my face at to eat. Once approved, I will have upper and bottom train track braces fitted. I will have them on for 18 months, then after that period time there is a waiting list for the actual surgery, which currently stands at TWO YEARS, then another 6 months post surgery, the braces will be kept on so that the jaw breaks correctly and sets in the right way. This means the braces will be on for an estimated total of 4 years once fitted. I was thrilled though. Being 30 and with braces on I thought about my MSc graduation photos, then job interviews, and oddly enough when I eventually get married, how on earth will I look? How will I be perceived? Those were fleeting thoughts however. Daft ones. For at this point, I am very worried about so much more than aesthetics.

My first thought was; with the braces on, what do I do about my grinding? I can’t wear a guard or easily have cracks or dentine filled with more fillings. Then I worried about the side effects of the surgery, my jaw being wired shut for so long afterwards, the fact that I may have sensitive teeth during this stage and so cannot breathe properly onto them or drink my liquids through the syringe they give you for the months afterward. I worry that the surgery will go wrong, or not work. I am scared they will sever my nerves, numbing my face, and at worse making it even more difficult to talk than it currently is. I’m scared I will never be able to eat or sleep properly again, but will also not be able to feel to kiss or taste as I once could post op. I am afraid they will break it too much or not enough, causing its own array of functional problems. I’m worried that I’m going to suffer in the cold months, and that the metal in the screws they put into my bone will go awry or be rejected, crack my face or cause arthritis. I’m scared my entire face will look different; worse than how it has already increased my chin length. With upper jaw surgery, my nose might change, my lips might change. I worry I won’t recognise myself even more. There’s also a chance that it will go well! But…then relapse, so I am stuck in this odd state of being, worse off than before. It is not as though they can reverse any damage not undertake the procedure twice. Regardless, even if it does go well, I know that my clenching will continue. “We can’t change that”, was the elephant in the room, but my biggest worry though, is not being able to do any of this, because I’m told I’m not eligible for surgery, and that my fate to continue on like this is sealed by them forever…

Stay Scripturient,

-E

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