Wilckodontics on Monday....here we go!!!

[dantocanada]

For those of you who have read some of my earlier posts, you may remember that I am a 40 year old professional male from Toronto, Canada, who has recently lost 125 lbs and decided to get my teeth fixed as part of my “extreme makeover” project. So the first, and arguably the easiest phase of my journey is coming to an end. I had lower ceramic braces installed back on July 21st. So I am almost at the 5 month mark, and to be honest, it has been pretty easy going and I’m very pleased with the results. Very little pain, and barely anyone has actually even noticed that I have them.

Unfortunately, tomorrow morning at 9:30 begins phase 2 – the hard part. This is the part that I have been dreading since I made the decision to take this journey last spring. That is when I get my upper brackets installed ahead of Wilckodontics surgery (AOO – Accelerated Osteogenic Orthodontics) on my upper arch first thing Monday morning. About a month after my surgery, I will have a Palate Expander placed to widen my upper jaw, which I’m told will be in for about 6 months. If all goes well, after about 30 days of expansion (so mid-February), they will install my top archwire and through the magic of Wilckodontics, by December of 2015, I will be all done! What was once a very crowded narrow smile with major crossbites on both sides will be a beautiful, normal smile. Or so they say!

Why I decided to do this is still one of those things I am constantly rethinking. Yes, I’ve always disliked my narrow smile, but it was tolerable, that is until my teeth started to wear down prematurely. So, when I learned that the consequence of my malocclusion would be losing my natural teeth to crowns, bridges and implants, I decided that it was time to face my lifelong anxiety about Orthodontic treatment. Why I’m writing about this today is I find this community to be wonderfully supportive, and I find chatting with all of you quite therapeutic…because to be honest I’m freaking out! I keep worrying about how hard it is going to be to carry on my professional career with a mouth full of hardware. Not to mention the inevitable discomfort…oh who are we kidding…pain! The one downside I seem to find in those that have described Wilckodontics is that it seems to be quite painful, and the healing process is fairly lengthy. Not that SARPE isn’t, but I guess I’m rationalizing here. In any case, it’s too late now to change my mind and I just have to keep reminding myself that this is all just a means to an end, right? A brief sacrifice for a lifetime of good oral health and a great looking smile.

Going ahead with this procedure will hopefully also help me to accomplish two other major goals: one being already achieved, which was that I have finally quit smoking (since October 1st) after more than 20 years. Apparently you can’t smoke after oral surgery – it interferes with healing. So, having this procedure was a great excuse to quit. The second goal I hope to have this experience assist me in achieving is that I need to lose another 40-50 pounds, and having oral surgery should help me to minimize my desire for eating, especially since I will be on a soft-food diet for at least the first month after surgery.

Anyways, I wanted to start this post so I could journalize my experience. I’ve noticed that while I’m not unique for having Orthognathic surgery, I do seem to be unique in the fact that I am undergoing Wilckodontics surgery. Not many posters on this site seem to have undergone this procedure...certainly no one recently. There are 2 stories in the main “Stories from our readers section”, but those seem to be many years old. For most, the main impetus for seeking out Wilckodontics is the fact that it speeds up the time that traditional orthodontics takes by about 75%. While I have to admit that is an attractive feature, my real reason for selecting to go down this road is to expand my upper jaw. In traditional SARPE, the Palate is surgically cut and spread apart with an expander. With Wilckodontics, the teeth are simply pushed into newly formed bone, the end result supposedly being more solid bone support and less potential for nerve damage. Also, by some miracle of insurance bureaucracy, my insurance company is actually covering 90% of this procedure, where the SARPE would have cost about $800 out of pocket more.

I think that’s enough rambling for now. Thank you for taking the time to read my story, and I will be sure to give everyone an update next week as to how the surgery went and how I’m feeling.

[TheProfessor]

Great post, and congratulations on all your self-improvements! I looked up a blog on that procedure (with pictures of all the gory details) and I think you are very brave! It sounds like the hard part will be waiting for your gums to heal, I think you will adjust to the top brackets and expander ok. Good luck on Monday!!!!

[dantocanada]

So, as I mentioned in my previous post, yesterday morning was d-day for upper bracket installation ahead of my Wilckodontics surgery on Monday. Because of my surgery they did not install the wire yesterday and won't until sometime next month or early February. The lower wire was changed a month ago, and ordinarily my adjustment appointments are 8 weeks apart. Therefore, I figured that since I'll have no wire, and no adjustment, this weekend would be my last chance to eat a good meal. My plan was to go out with some friends for a really good dinner at a nice steakhouse last night as it was going to be my last good dinner until who knows how long after my surgery. Well, that didn't quite work out as planned.

The upper brackets went on okay, and my ortho came over for a final inspection. She was just about done when her attention turns to my bottom teeth. Then she rambles something in dental-eeze to the assistant, and I catch the word “powerchain”. Ah crap, I think to myself. That’s not going to be good for eating a steak tonight. Sure enough, on goes a powerchain on my lower front 6 teeth, plus a criss cross work of wire ties on my lower back teeth on both sides. That is in addition to the fact that all of my lower brackets were already wire tied to the archwire. Anyways, I didn’t want to cancel on my friends and I really wanted a steak, so we went to the steakhouse and I’ve learned something new: when your braces cause your teeth pain, simply ignore it and power through. After a while, the pain seems to diminish enough to enjoy your meal. However, that was also last night. I’m not sure I could handle it today as my lower teeth are quite tender. And the brackets on top are really starting to irritate the inside of my lips. I’m really disappointed that I thought I would have one more weekend without discomfort. Apparently I was wrong.

[dantocanada]

Update 1: Starting day 2 post surgery. Sorry for the long post, but a) I wanted all those who are considering this relatively new procedure (only about 15 years old) to understand all the ins and outs, and b) I have a lot of time on my hands….

But first, before I tell you how I’m feeling, some of the fun details:

Monday morning,

8:30: Arrive at Periodontist office, not having eaten anything since 8PM the night before, and not having had anything to drink since 11PM. Anesthesiologist has arrived and is getting set up. He comes out and explains again that he will not be using a General Anesthetic, but instead will be heavily sedating me. Essentially, I will be out of it, but may hear / see things occasionally, but assures me I won’t care. I sign the “don’t sue me” release form. Then the Dr. comes out and goes over the procedure again, says he expects to finish around 1pm, and he will call my friend who is picking me up about 45 minutes before finishing.

9:00 I’m in the chair. They give me a blanket because it is freezing in there. 9:08 (I remember the time being announced on the radio) the Anesthesiologist inserts an IV in my hand after hooking up all my pulse, BP monitoring, etc. Tells me he will let me know before he starts the drugs. The dental assistant comes in to do a series of last minute x-rays. Those take longer than expected because my arch is way too narrow (I know this as she keeps complaining about this and adds to the years of dental assistant complaints), I remind her that is why I am there.

9:30, Anesthesiologist and Dr. now in the room preparing to begin. He announces the drugs have started and I should feel them in 30-45 seconds. That is the last thing I remember hearing. I don’t think I even made it to 10 seconds. Throughout the procedure, I probably came close to consciousness 4 or 5 times, each time I would hear things, but I didn’t quite put together what was going on. I did hear a drill at one point, but didn’t feel anything. A couple of times I would hear talking and open my eyes, and I would hear “His eyes are open” and that would be the last thing I would hear as my right hand would start to cramp up (the IV going into my vain) and I would go back to sleep. The Anesthesiologist later explained that this is common practice as they don’t want to over sedate. In any case, it didn’t really bother me – like he had said in the first place – as I really wasn’t processing thoughts logically.

3:50PM. It’s finally over. Yes, that’s right, you read that right. Procedure ran almost 50% overtime. That’s almost 6 hours for one arch. Why? Apparently my narrow arch (again) made access more difficult, and the fact that this was the first time this Periodontist has completed this procedure (yes, that’s right – I was the guinea pig, but I got a decent discount on the cost. I was also reassured not only because he has been practicing surgery for more than a decade with raving online reviews, but also because he had the full support of my Orthodontist - so far I have no complaints). I’m given some post-surgery meds with some Apple juice (my first liquid of the day) and I am allowed to leave with a mouth full of gauze and the usual post-op instructions (soft food, it’s going to swell, yada, yada). I’m pretty woozy, and make it down to the car which is parked just out front okay. Pretty dazed on the ride home.

Around 4:30 PM, I arrive home and immediately drink a Protein Shake because I’m starving and take some pain meds. I then take an opportunity to take a good look at my Frankenstein face in the mirror. My gums are swollen quite large and each tooth (that’s 28 in total) has a stitch above and behind it (that’s 56 stitches – man is that going to hurt when they’re removed) as the gums were cut and retracted on the inner and outer sides of my Maxilla. Pretty shocking. Then it’s off to bed at 5:00 PM. I wake up around 8 and make myself a smoothie and take some more medication. Not that I was hungry, but all I’d had for nutrition all day was a protein shake, and the meds need to be taken with food. Then come the fun pre-bed teeth cleaning routine. So, I can’t brush my top teeth, only my bottom teeth which needs to be done carefully because I’m also not allowed to spit. I haven’t eaten all day, so screw flossing. Then it’s mouthwashing with Peridex for my top teeth. 45 seconds of rolling my head around because I can’t rinse either. Both spitting and rinsing apparently disturb the blood clots. So after that ordeal, it’s off to bed around 9:30 for good.

When I woke up yesterday morning (around 7:30), I was actually feeling quite good, with the exception of a fairly large blood stain on my pillow that soaked through the pillowcase to the pillow itself. I had been told to expect this for the first couple of nights, so I am using an old pillow I planned on replacing anyways. The pain was minimal, and swelling appeared to be about the same as the night before. That lasted until about 11 am, when the swelling and pain started to intensify. I was now in full-blown chipmunk phase, and this was the first time I deemed it necessary to take some of Percocet I was prescribed for pain, although to be perfectly honest, a Tylenol 3 probably would have sufficed (as the pain wasn’t that intense), but the Percocet is much more fun. The rest of yesterday was alternating between Percocet / Antibiotics / Anti-inflammatories / napping / watching TV / eating smothies and oatmeal. At one point I was actually brave enough to try a piece of soft bread with peanut butter. Not such a good idea. Mental note to self: no more chewing for a couple of days. One other item I did notice of significance is that my upper palate (which remember is already pretty narrow) had swollen up so that I could barely get my tongue in between my top teeth. As I write this, it is still quite swollen. My Dr. explained that this is because bone grafting material had to be added to the inner and outer sides of my maxilla to assist the bone in healing from the coricotomy cuts.

Waking up this morning, I found some more dried blood on my pillow, but now I am really swollen and I also have purple bruising below my eyes. My Dr. told me that the swelling / bruising / pain will be at it’s height 48 – 72 hours after the procedure so here I am – at about hour 43 - so 28 hours to go supposedly before I head down the other side of this mammoth hill. I had a smoothie for breakfast along with my morning meds (Antibiotic / Anti-inflammatory). I’ve just taken a Percocet and I’m heading off for my noon nap. Still debating whether I go to my parents place for Christmas Eve. Right now, I think I can handle it, but I’ll see how I feel later this afternoon.

That’s it for now. Thanks for reading. I'll update again soon.

[dantocanada]

A quick update for those who have been following: I'm now on to day 6 post surgery and I'm not going to sugar coat it: I'm miserable. The first few days actually weren't too bad. But the last 3 have been terrible. The throbbing jaw pain is relentless and the only thing that helps is Percocet, which I really don't like taking due to the nasty side effects (nausea, dizziness, headache). It's so bad that I actually have to take additional meds in the middle of the night just so I can sleep. I went for a follow-up appointment to my Periodontist on Friday and he was actually surprised at the progress I'm making from a healing perspective. He admitted that he thought I would be a lot more swollen and bruised than I was. While from a physical standpoint I'm looking pretty good, I just feel awful. This morning I'm trying to use Tylenol 3 instead of the Percocet to address the pain because I"m tired of not being able to function. Still on liquids only - the few times I've tried to eat soft foods is not very much fun. So all in all, I can't say that I'm a big proponent of WIlckodontics yet. Perhaps when I get around to seeing some teeth movement in the next couple of weeks I will feel differently.

[dantocanada]

Update - Day 9. I can't believe it, but I'm still in a lot of pain and still am barely able to chew very soft foods. I don't know why I can't believe it, because the online testimonials I read before the procedure described pain that required narcotics for up to 2 weeks, but I guess for some reason I just thought that wouldn't be me. Well, it is. This has without a doubt been the worst 9 days of my life. And the first time on my braces journey that I am starting to doubt the wisdom of going down this road. Unfortunately, it doesn't do me a lot of good to lament that point as it is far too late. Stopping now would leave me with more screwed up teeth than when I started, so I just need to keep the prize in mind, which is a healthy beautiful smile.

The next step in this midevil torture journey is molds for an RPE on the 5th (along with spacers in my back molars) and then RPE installation on the 15th. Right now my palate is swollen up so that there is basically no space at all in my palate. The pain is like when you burn yourself eating something really hot, but yet it doesn't go away. How they are going to take molds in there on Monday is a mystery to me if this swelling does't go down, let alone fit an RPE in there 10 days later! I went to the Periodontist this morning (awesome guy - he's come in to the office just to see me twice now since he has been on vacation since the 24th), and he spent an hour poking around and taking xrays, concluding that all is good and I'm healing well. I have to admit, that does make me feel a little better.

I would like to ask a question to any of you out there who have had SARPE: was the recovery period this painful for this long? SARPE was the alternative to the Wilckodontics procedure that I had, and in my research and reading the stories of others on this board, I don't think I have seen people suffering like I have. Maybe I have and I'm just forgetting. I don't know, but I am curious to know if after other Orthagnathic surgeries you found yourself still needing pain killers to sleep by day 9 post surgery.

Anyways, that's it for now. I'm going to take another Percocet and take my afternoon nap. I'll post again with another update in a few days.

[gutsygumshoe]

I had double jaw surgery recently and was still taking painkillers regularly throughout the day and night until day 10 or 11... after that it got more bearable so I didn't need them (although it didn't fully go away). However I'm on day 14 now and I think I'm gonna have to start taking them again because it's starting to flare up again. I know it's a different procedure to what you had but I was still needing painkillers at the same stage you're at now.

I'm sorry you're having such a bad time of it Maybe if you're concerned you could get in touch with your surgeon? They might be able to put your mind at ease at least.

Hope you start to feel better soon! Happy new year

[dantocanada]

Happy New Year everyone.

Thanks to all you faithful readers of my rambling missive. I think today's update is going to sound a little whiny. I apologize in advance, I'm just feeling a little down today about all this stuff going on in my mouth. So, as I mentioned last time, after surgery I had been having a pretty rough time. The turning point was actually New Year's day when the pain finally started to subside. I am almost completely off the narcotic pain meds now, only taking them when the pain flares up (once or twice a day). I haven't completely gone back to work yet, working the last two days from home, and only about half days. I still get very tired and don't have a lot of energy. Tomorrow I'm going to attempt to go to an offsite meeting in the afternoon.

I've been both to my Periodontist (who did the surgery) and my Orthodontist and they are both pleased with the progress of the healing. I was like a minor celebrity at both offices - I had about a dozen people come in to look in my mouth...they were all curious. The only potential problem that my Periodontist seems puzzled about is the fact that my Palate is still very swollen - in fact the swelling seems to be getting worse. Yet, there is no sign of infection, and no pain. I'm trying to look at it as a positive thing because I have had to learn to speak more slowly and pronounce certain "s" and "sh" words differently so that I don't have a lisp. This is good practice for the Expander that is going to be installed next week.

The other thing the Ortho did yesterday was they took an impression of my upper teeth for the RPE. Then they Hygienist was half way through installing the 4 spacers between my very sensitive back molars when the Ortho came by and told her to forget it. No Spacers today because they want to do another impression next Monday instead, hopefully when the swelling in my palate has gone down some more. So now I get to go back next Monday for another impression and Spacers and then Thursday to have the Expander installed. Apparently they feel I have nothing better to do than go back and forth to their office.

Which brings me to my whine - I'm starting to really doubt the wisdom of this entire adventure. I know, I know, it will all be over in 12 months and I'll be ecstatic that I did this when I have the new smile I've always dreamed of. It's just that right now, after going through two weeks of pure agony, I'm feeling a little sorry for my self. I'm still concerned with how I'm going to talk properly with that massive expander taking up so much room in my very narrow palate, not to mention the pain. So that's it...I guess the emotions of the last couple of weeks are finally starting to get to me. I'm having a lot of trouble getting back into the swing of things, especially around going back to work. I just can't seem to find the motivation. I think being at the Ortho yesterday during what seemed like "Kids time" (I was the only adult patient there - usually there are at least a couple of us) also got me depressed about all this. I understand that more kids go through this than adults, but I really think that Ortho offices should schedule "adult only" times. Would help a lot with the anxiety. I'm really not sure why it bothers me, but it does. Can't help it and can't seem to get over it. Anyways, if anyone's got some kind words of encouragement, I could certainly use them today. Thanks for reading.

[TheProfessor]

I'm sorry to hear that you are having such a rough time. But, on the bright side, it sounds like you are healing since the pain isn't so bad now. Hopefully the swelling will go down soon.

With regards to the kids at the ortho--do you really care what a bunch of teenies think about you? Plus, I'm sure they have much more interesting things to think about than the old guy with braces! Just ignore them the next time you go....

Hang in there and keep your eye on the prize. I know it is hard to imagine it now, but it will be worth it in the end! The time will pass quickly and a year from now all this suffering will seem like a bad dream....

[Featheryy1221]

I'm sorry you're feeling this way. And I hope your swelling goes down!
TheProfessor is right though; once you're done with this stage it will all seem like so long ago. I know that's not very helpful as its the present, but keep that in mind. You will get through all of this!
From my experience, my time with my expander seems like forever ago now, and at the time I thought I was doomed forever. But I got through it. And now it's just a small part of my life that brought dramatic changes (positive changes).
There will always be bad days and good days. On the bad days try to remind yourself why you did this. Think of the positive results you'll have. And mostly, keep busy. (When you're recovered more of course). It'll help the time go by faster.

Keep your head up!

[dantocanada]

Thanks guys. I really appreciate the kind words. I'm feeling much better today. This is my second full day without using any pain meds, and I think that was honestly clouding my head and my judgement. I know that in the end, this will all be worth it.

[dantocanada]

Update: Things are going much better now. All surgical pain is gone. Stitches have been removed. Swelling is finally receding. Bottom line...all is well. Mentally I'm also feeling much better about this whole experience as well. In fact, I was really surprised today when I ran into a colleague from one of our branch offices who just got Invisalign because she was inspired by seeing me with braces back in the fall. Funny, she's only had them for a few weeks but said she regrets not getting traditional braces because she's having a hard time brushing after every meal and wearing them for the required 22 hours per day, which is exactly the reason I didn't do it. We were talking about it, and one of my other colleagues overheard and mentioned that his wife also has Invisalign. Anyways, sometimes you feel like you're all alone, so it's nice to know there are others you know who are going through a similar experience.


I said surgical pain was gone because on Monday I got Spacers installed for my RPE that is going in tomorrow morning. I was dreading having the Spacers because I've heard everyone on here complain about how painful they are. Even the Hygienist warned me before hand that this is the worst part about braces for most people. So when she placed them, it was a tad bit uncomfortable, but overall not that big of a deal. In fact, the whole night I had no issues whatsoever. But then morning came. Holy crap! These things really hurt. I get it now. So, just to recap: surgical pain gone, Spacer pain in full force - can't chew using back molars. Worst braces pain (not quite as bad as the surgery though) I've had so far.

I'm trying really hard not to think about my pending torture device installation tomorrow morning. I'm off work now until Monday so I can get used to it over the weekend. Next week I am on the road in meetings all week, so that will be interesting to see how I sound. I'll give an update next week.

[Nozzelnut]

Good luck with expander install.

The spacers are the worst! I wish they could come up with something else for that...


ETA Did your periodontist say how many "holes" they made? (Wilkodontics the drilling holes treatment correct?)

[dantocanada]

Not so much "holes" as "cuts". They are called "Coricotomies" Essentially, he made what appear to be shallow trenches around each tooth on the front and back of my upper arch. He explained that they were made in certain patterns and lengths to facilitate tooth movement in a certain direction. He also had to make sure that he avoided nicking the roots, so I had to have a CAT scan ahead of time so that he could see where exactly all my roots / nerves were located. And yes, that does sound as fun as it was.

[dantocanada]

Day 3 of living with a Palate Expander. Oh boy, I thought Wilckodontics was the tough part...I clearly was wrong. This is going to be the torture that sends me off the deep end. Where to begin...my tongue keeps rubbing against the bar, so now it has a sore developing in the middle of it. Both the bands that hold the expander in place have massive buccal tubes with these sharp wing like tips (kind of look like large hooks - maybe for elastics?) that are digging into my cheek. First time in my treatment I've had to religiously use the wax. On the bright side my speech is improving and I am learning how to enunciate words that require the use of my palate. Only when I'm tired or talking fast do I start garbling. But the silver lining in all this is eating has become nearly impossible and totally unenjoyable. Everything gets stuck in the huge expansion bar (that makes my tongue feel like its in jail) that goes from second molar to second molar, and because of the current position of my lower teeth, the buccal tubes contact my lower teeth every time I bite down. Sometimes it catches my cheek as I'm biting down...and that really hurts! My ortho said there is no point in adjusting it because the teeth will start moving in a few days and the problem will be solved. I am supposed to turn 24 times total for 6 mm of expansion. My first turn was at the ortho's office on Thursday. It didn't really hurt - just strange pressure that felt exactly like I expected it to feel...as if someone was pulling your jaw apart. My next turn will be tomorrow, and then for the next 22 days.