The END is finally near!

[iBorg]

Why YET another blog?

Staring at a blank screen, I really don’t know where to start.
Is my treatment important enough to merit recording my progress? Is my story worthy of telling others? Is there anything unique about it that may help others making decisions concerning their own treatment?

At first I thought my story was unique. I’m late forties (in my mind its the early forties) and am braced for the second time. I thought both my age and being a second timer made me unique. I also thought my fear was worthy of discussing. After reading others stories, I realize my age is not really unusual for this group. About a quarter of the participants have done this before. My story isn’t different except it is MY STORY. That does make it a bit different. Still not a great reason to blog. That changed when I asked my ortho, the Amazing Dr. P about implants. My treatment story has become a bit more involved. Asking that question about implants, the answer is unknown at this time, has made my story atypical.

Hopefully this story will have some value.

Mike

[iBorg]

A Change in Direction?


On Friday I got a phone call from one of the people at my Ortho’s office. I know it was a wandering conversation. Of course the fact that I had knee surgery in the morning and was still feeling the effects of the drugs may have been a factor. During that conversation I mentioned that I was curious whether enlarging the holes from where my pre molars were pulled for my first round of orthodontic work and replacing the missing pre molars with implants would be a good option.

On Monday, my wife and I met with my orthodontist to discuss my son’s need for braces. I’m sure my wife was thinking there goes the new car for another year. After she looked at the pictures and X-rays she understood that my son really needed palette expansion if he wasn’t going to suffer major issues when his permanent teeth tried to find room in his mouth. At the end of the meeting, my ortho asked me about the implant idea and explained the cost. I was stunned that the cost was about four times what I hoped for. She told me to think about the implant idea and call if I wanted to pursue it.

On Tuesday I called my general dentist and talked with her about the implant idea. She could see the possibility but was uncertain if it was doable. She did offer to have her office staff see what if any my insurance company would pay. Later that day I got a call that my insurance company would pay a third of the bill. With their fee schedule for items not fully covered, it was financially doable. I also called to make arrangements for a further exam by my ortho.

On Wednesday, my ortho’s staff did a full records exam including X-rays, photos and molds. I had hoped for a decision by the end of the week. I was told it would be a month later.

Now I sit and wait and wonder what is the right course of action. My ortho did say it would prolong my treatment at least 12 months. She also said that there would be no additional charge for the increased treatment time. There are several questions I must answer before I decide what course of action to take. These include:
What will this course of action do for my functionality?
How will this affect my TMJ?
Will I grind less after treatment if I go for the implants?
How will this affect my appearance? What will it do to my jaw line and smile?

With Dr. P saying she would not charge for the extended treatment time, I will probably follow her suggestion. I believe her concern is my ultimate outcome.

[iBorg]

Meryaten:

When I started treatment, anything that would extend my treatment time would bother me. I'm six months into the process of what was originally an expected treatment time of 18-24 months. I've already been told that my treatment time will be closer to 24-28 months. That no longer bothers me. I would much rather have a good smile when I'm done as opposed to having them off by the time I'm fifty, which was my original goal.

If the treatment time estimate is only increased 12-18 months and the end result would be much more positive, the time investment seems worth it. If it would increase my treatment time much longer than that, I'll have to decide what I want to do.

One of the advantages of my ortho taking a month before she gets back to me, is I can think through scenarios prior to being told all the options. I quite literally may be able to tell her at our meeting if I want to pursue this avenue or not. I also know she will consult a periodontist prior to her recommendation. She also is having a couple of predictive models made.

I don't think she is rushing her decision, which has prevented me from rushing mine.

Mike

[joney]

Hi Mike

Good that you are starting a blog. Good luck with your decision. I had one top premolar removed when I was a teenager. My ortho explained to me that rather than my current treatment (I had the matching premolar removed) that I could go with the implant option. He did say it would make the treatment more complicated but we didn't discuss it much more. My aim was just to have straightish teeth and luckilly I don't have TMJ. I know that if you were to go down this route it might give you a wider smile. It's great that you're not bothered by the extra treatment time. Big decision and not one to be rushed so it's good that your looking carefully before deciding.

Whatever you decide I hope that the treatment goes well.

Regards
Joney

[iBorg]

I'll try to update a few bits and pieces. I'm SOOOOO anxious to find out what route is recommended for my treatment. I was so nervous when this started that the word implant or surgery or a hundred other words would have sent me flying out of my ortho's office. Now, I'm content and happy with the decision. I'm experiencing so little pain or other things in the way of TMJ issues that I wish I'd started sooner.

KiwiK:
As this episode plays out, it will be interesting what I learn about myself. Maybe someone else will be able to gain from it.

joney:
At first the longer treatment time would have turned me off but, considering other things such as the GI issues from the medicines for the TMJ, the time is not an issue. This time last year, I had difficulty walking up half a flight of stairs. I'll trade taking twenty minutes to clean my teeth before bed any day of the week for that. A year and a half longer, not a problem.
I hope you don't develop bite issues as you get older. Mine were brought on by a misshaped jaw bone. My new dentist looked at my X-rays and said here's where it hurts and rubbed my jaw exactly where the pain was. "Was" is such a nice word.

Rage:
I have to admit your blog has been an inspiration. If you, being Ms. over active, can adapt to braces and other hardware, I can adapt to braces and implants. Maybe someday we'll both be able to eat caramel corn and peanuts again!

Mike

[joney]

Hi Mike

I hope you don't develop bite issues as you get older.

Me too for obvious reasons. Although my teeth were really crooked with a big open bite I've never had any problems with jaw pain. I would really hate to think that I would be swapping crooked teeth for pain. I would rather have my crooked teeth than that. Do you think your TMJ was caused by extractions? I've heard of this before but don't know if it has been proven.

Look forward to hearing more of your story.

Regards
Joney

[iBorg]

I'm not sure if the extractions are the sole cause of my TMJ as my left jawbone is pretty flat compared to what it should be. I do think the poor ortho work of my youth resulted in a poor bite which led to grinding. I believe the grinding is the major factor in my TMJ. For example, when I wear my bite plate I can't really grind like I do without it. When I have the bite plate I also don't have significant TMJ. It does flare up but the pain is minimal and very short term (like ten minutes).

I believe there have been studies that indicate patients that have had the "four on the floor" treatment show a tendency to develop TMJ. Maybe it’s caused by the treatment, maybe its coincidence.

Hope your treatment goes well.

Mike

[iBorg]

An Unwanted Decision

Today has not been a good day. Yesterday I received notice that my pre certification for insurance was turned down. Apparently, there was a work around concerning implants within the insurance. That work around has been closed. What made this idea feasible was the ability to have insurance pay for at least some of the work and establish a fee structure for the remaining portion. When I first discussed this with my ortho she said it would cost about $2200 a tooth. After further discussion today I realize that instead of looking at a $6000-8000 bill, I'm looking at a $16,000 bill. While I might be able to justify an $8000 bill, I can't justify $16000.

I called my ortho's office today and was told she is out of town until Monday. I have my meeting set for Monday to discuss treatment options. I suggested canceling it but was told to keep the meeting.

I am deeply disappointed. I had hoped to end up with a great smile that was readily visible. Now, I know I'll have to settle. I’d much rather have something put in where the premolars were so that my teeth would not be pulled back into my mouth and hidden. I guess I feel like I've lost control of my treatment due to finances. I hate it when dollars make decisions.

Mike

[joney]

Sorry to hear this Mike

I was looking forward to hopefully hearing your story so I could see how it would have gone had I followed the implant route instead.

I'm not sure how the whole American insurance thing works, is this a definite no-no or are there other avenues?

I would still see the ortho next week and see what they say.

I hope you can find a solution.

The good news for you at least is that your TMJ is under control. I'm crossing my fingers for you.

Regards
Joney

[smallbutmighty]

Hello Mike,
Mike, What a disappointment -- it seems at first anyhow. Maybe this is a challenge to get creative with finances. Find out from your providers if you can have some kind of no interest or low interest payment plan. Especially if you are having your son go to the same orthodontist, many have family plan rates. When we were planning to build our house 8 years ago, the changes that I made to the plan kept adding up. The guy who would price out the changes would always laugh and say, "It's only money-- you'll get more." Well, there were some upgrades that I could have done back then that would have made a difference in the quality of life and the cost of maintenance that we have to change now, and it costs way more. Over the long run, you may be saving yourself lots of future grief and money. My mouth was one of those issues for me, too, and I have been paying dearly in more ways than money for not following through at the right time. Good luck!

[iBorg]

Folks:
I appreciate your thoughts. I'm going to meet with the ortho on Monday and hope she has some creative ideas. Of course this may not even be possible and I'm experiencing this range of emotions for nothing.

I'm exploring a couple of things right now but it just feels hopeless. Maybe I need to accept "It is what it is and it ain't what it ain't."

If we did not have other expenses, it would be a lot closer to doable. I just cannot figure out how to pay that much and still pay down other debts and save for our children's college. I guess the question is at what time does it go from justifiable to selfish.

I'll let you all know what I hear. Hopefully, I'll get some positive news.

Mike

[iBorg]

Well folks the last few days have been a bit interesting. I've confirmed the cost. What makes this process so very expensive is that one dentist, such as an oral surgeon will place a post, while another, often a general practitioner will place an abutment on the post and then later a crown.

Thanks to a PM from SecondTimer, I contacted a couple of medical schools that are within driving distance. WVU, offers the service at a price that is close enough to my mental boundary that if the ortho tells me that this will result in a functional difference and I'm a good candidate, there's a very good chance I follow through with this.

I'll keep you posted on Monday’s meeting. Please keep me in your thoughts.

Mike

[Ives]

Good Luck tomorrow Mike, here's hoping you find the answers your looking for.!!!!!!!!!!!!!

[iBorg]

Ives, KK, bracedagain, Meryaten:
I appreciate the positive energy. Not sure exactly how I feel about this. First there is the question of practicality. Then I need to consider is the additional cost of the implants worth the result. Tomorrow will be an interesting day. As it is, I do have a case of the butterflies. I'm sure it will get worst as my appointment draws closer.

Thanks once again for your thoughts.

Mike

[iBorg]

When I was younger, I remember my father asking which car to buy, the white one or the blue one. I said silver. Today was that type of day. My ortho had a model of my teeth, bite samples, X-rays and pictures for our meeting. The implants are not practical. The oral surgeon wants at least an 8 mm opening for an implant. That is possible on my top jaw but is not possible on my bottom. She fears that kind of movement may aggravate my TMJ. Been there, done that, sure as whatever not going to do that again.

She suggested another plan, the silver option. She is going to move my top teeth as forward as possible and then respace those teeth for veneers to help fill some of the space. The remaining opening will be filled with a fixed bridge.

She is going to try the same thing on the bottom. If my over bite becomes excessive in this process, jaw surgery may be necessary.

At least I believe this is the plan. I asked her to email me a written plan so I'm certain what I've volunteered for. She did have two springs installed in the top arch. She will also contact my general dentist to discuss this approach.

I'm happy with this plan (or scheme depending on your English). The end result will be my teeth will remain visible instead of being pulled back in my mouth and this should not cause further issues with either my TMJ or grinding. It also will cost about half the lowest estimate for implants. I'm also going to be wired for somewhere between 24 and 36 more months. That's a whole lot more than the original 18-24 but the result will last my lifetime. Why hurry it only to be disappointed?

Thanks for stopping by.

Mike