In this video I take you with me through my whole day while getting my braces removed, or "de-bonded." After two years and two months of straightening, twisting, breaking, pulling, pushing, expanding, and constricting....it's finally time to be free! My treatment was really quite short in comparison to how long they usually take. I mostly attribute this to a pretty aggressive and non-stop application of new and somewhat experimental technology. Things went as smoothly as I probably could have expected, and I'm really grateful for that. Like I say in this video, I also have to give myself credit for being an active participant in my treatment and advocating for myself. This debonding actually happened last spring (March 2018) but I'm just getting around to uploading it. I hadn't actually watched these clips since I took the video itself and it brought back so many memories for me. I hope that emotion comes through and that it gives many of you out there hope that your time is coming soon too! :)
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Happy New Year/I'm back! In this video, I take you along with me to my last few appointments before my de-bonding scheduled for March 2018. I share some final challenges that my team is working through in my treatment and some possible detours we might (or might not) take before removing my braces. I also reflect a little bit on my journey and how this whole experience has been for me! I don't go into too much detail because I will be doing a full sit down video for that. Honestly this is a little side blog I'm running and not putting much effort into publicizing it, but so many of you have reached out to me with gratitude and questions, and shared with me how this blog has helped you avoid surgery and take a much less invasive route to fixing similar orthodontic issues. I'm touched that I could help ya'll! I hope you enjoy this video! Remember to like/comment/subscribe if you have any questions or just want to say hi :) After yet another long hiatus, I'm BACK with another update video! In the second half of 2017, I was switched into what are called "finishing wires". The wires I was in before--expanding wires--are round in shape and are made of Nickel Titanium steel, which can expand when there's heat present. The finishing wires are rectangular and are made of stainless steel and are more rigid, less flexible. They can be used to apply pressure and torque, but has far far less expansive abilities. The finishing wires mean that most of the major movement is complete and the treatment is now more focused on making smaller alignments and straightening. I also had my first dental cleaning since May of 2015! I know, a super long time--actually my cleaning in 2015 is what inspired me to revisit my orthodontic treatment to begin with. The cleaning was pretty painful, a lot of scraping and pulling and I was pretty displeased! I also finally got an estimate that my treatment would likely finish by the end of 2017 or at the latest, spring of 2018!
After a bit of a break, I'm back to share some orthodontic updates through the first half of 2017!
In the first half of 2017, my treatment was primarily focused on intruding my back molars so that my bite would start to close. My width had been achieved and was maintaining well with the molded TPA. They had put in some gel under my molars to help push the teeth into the bone, and they also tried various TADs to help this movement. Initially they tried putting one single TAD in the roof of my mouth, and connected it to my upper back molars using a power chain. However I think the palatal bone had not finished healing from the MARPE, so the TAD got infected and came loose pretty quickly. Then, we tried placing a TAD on either side of my palate (the bone has been pretty stable there so far). This held pretty well and helped close the bite considerably. However this does cause a bit of an inward tipping but can be corrected easily. Unfortunately these screws also came loose by the time I returned from a trip to Cuba in May. When I came back, they evaluated my progress and found we had gotten enough intrusion from the TADs.We would be able to continue intruding using elastics and wire mechanics later on.
Hope you enjoy these updates! More to come very soon.
The day has finally arrived--it's time to remove my MARPE! In this video I take you along with me during my appointment to get the expander removed. There are some unpleasant surprises along the way...I share some learnings and advice on what to expect after having the expander removed! Full post below:
Removing the MARPE After the initial 1-2 week active expansion, the MARPE is left in for a longer period of time and acts as a retainer. In this time, the space between the now separated halves of the maxilla is filled in with new bone and solidifies. I had my MARPE in for six months before my orthodontists decided it was time to remove it. While the MARPE did not give me any discomfort or pain (in fact, I often forgot it was there!), I was still excited to get it removed and feel the roof of my mouth again. The first step of removal was to unscrew the four mini-implants that were anchoring the MARPE into my maxilla. I was given the numbing shots again so I wouldn't feel the pain of the screws coming out. There was still a lot of pressure and some discomfort. After the screws were out, my orthodontist started prying off my molar bands. They were cemented in so it took a LOT of force to tease them off my teeth. Once they were loose, the whole MARPE was remove from my mouth! It felt SO free and SPACIOUS! Especially because I have such a narrow maxilla AND a 'high'/'v-shaped' palatal vault, my tongue had never been able to comfortably fit into the roof of my mouth. Now, it had so much room! --Trigger warning for anyone prone to claustrophobia & panic attacks--- Installing the TPA I had barely started exploring my newfound freedom when my orthodontist immediately started fitting something new into my mouth - she said it was a trans-palatal wire. I hadn't looked this up at all but assumed since it was just now being introduced to me, that it wasn't that big a deal. When it was fully installed, I naturally relaxed my tongue, expecting it to rest against the roof. About halfway up, my tongue bit a thick metal bar. I noticed that this wire was actually traversing horizontally from molar to molar, completely blocking off access to the upper half of my mouth. Immediately, my body felt ice cold as my claustrophobia set in and I felt a trapping sensation all around me. I know this sounds like an overdramatic reaction, but it was really a huge surprise to me. This bar was preventing me from swallowing properly and my throat was filling up with saliva since I was leaned back in the patient's chair. I've had panic attacks before but this one was quite intense and I burst into tears and started blubbering. My orthodontist, the faculty supervisor and other student orthodontists around me started gathering over and just gawked at me as I fell into this panic. I was trying to tell them--I can't talk, I can't swallow, I can't do anything and I feel trapped. What is this thing in my mouth?! Here's a couple things that I think would have made this less traumatic. Even writing this post over a year later, I can still feel the same sensation of panic--that's saying something. 1) They should have told me before the appointment what exactly a TPA is, feels like, and when it would be installed. 2) Heads up on changes I could expect following the installation 3) How long they typically leave this in Once I had calmed down, the faculty doctor stayed to answer some of the questions I had. My first one was -- how long are you leaving this in? He said ideally for the rest of the treatment, or at a minimum 6-8months. My anxiety climbed. I asked, how long does it take for people to adjust to this and feel normal? He said about two weeks. I asked, are there ANY other options we can consider since I'm having such an intense reaction to it. They said not really. I asked, what happens if we just take it out? He said, there's a risk that we lose some of the width achieved with the MARPE. I told them -- I've been incredibly strong so far and didn't even flinch when they drove 12mm screws into my skull. I said I would give it two weeks to adjust but if it didn't work out we needed to have a plan B. I left in a shock that day. I wasn't able to swallow, chew, talk, or breathe normally because of this device that was inhibiting a basic human reflex (tongue to roof). I felt miserable but decided to do my own research (yet again) to find something that worked for me. I found a couple options with very little effort. 1) Get a custom TPA built using a longer wire that could contour to the shape of my palate 2) Get a removable TPA built that I could wear at night and take out during the day I scheduled a follow up appointment for a week later. During this week, I basically stopped talking because my tongue was so bruised and swollen from hitting the wire constantly. I actually had painful sores. I also lost about 10 pounds in two weeks just because I could barely eat or drink. At my follow up appointment I talked to my orthodontist about the two options. She said the removable TPA would not work as having it out for so long each day created a risk of losing width. She said we could go the custom TPA route but it would take a week to prepare, which I was more than fine with. So they took out the TPA and took a mold of my palate to send to the lab. Installing the custom TPA I returned the following week to have the custom TPA installed. After a few minutes of work, my orthodontist asked how it felt. I asked, how what felt? The new custom-contoured TPA fit my palate SO well that I actually could not feel it at all. I wanted to make sure that the functionality of this TPA was the same and they confirmed it was. I was so incredibly happy and relieved by this. At the same time, I was pretty angry. If this TPA was just as effective but so much more ergonomic and comfortable, why wouldn't they use this in the first place? Was it because of the tiny bit of extra work involved? The biggest takeaway here is that you should NEVER stop being proactive about your treatment. Any time something feels wrong or off, it's your responsibility to speak up. You are not a trained professional and can't tell them if something is the right approach or not, but you can tell them if it doesn't work for you. Ask all the questions you want to. It's your body, and your right to know what's going on.
I'm back!! Better late than never....right? Again, I'm still working on catching up my blog to meet where I actually am now in the course of my treatment--SO, this information is a little old :) As always, I've linked my video below where you can follow me to my appointments and get updates on how everything is going. Full post below as well!
After getting my TADs installed on the buccal sides of my jawbone, I was told to immediately start wearing elastics connecting the TAD to my lower teeth. The objective of this was to start correcting my underbite by pulling the lower arch backwards. However, it was hardly a day before I started feeling a lot of sensitivity and sharp pain around the area where the TAD was installed. I had stayed away from any hard or sticky foods, and brushed very carefully so I know I didn't 'traumatize' the TAD and shake it loose myself. Initially I brushed it off thinking this was normal and just part of the healing process. However it got to a point where the pain was making me physically uncomfortable, so I reached out to my orthodontist to schedule an emergency appointment.
At the appointment, my orthodontist took a look and saw that one of my TADs indeed had come very loose, so she removed it and reinstalled it a bit higher. This time she drove it in even further so it was super flush with the gums. We were hoping that this time, the TADs would osseo-integrate more successfully. By that, I mean that the screw would nestle into the bone and lock itself in. Also, this time we would wait two weeks before starting the elastics, in order to give my bone some extra time to heal before loading it with weight. My orthodontist explained to me that genetics often plays a big role in bone density and strength - unfortunately it is pretty common for people of my ethnic background (Southeast Asian), to have weaker bone. This means that the TADs are at risk for never becoming as strong an anchor as we hoped. However, I still had faith it would work to a certain extent. After all, my MARPE was secured to the roof of my mouth using TADs as well and they have lasted me 6-7 months already without any trouble! When it comes to orthodontics, especially experimental treatments like mine, you have to be really open to trial and error to find what works for you. Every method is definitely NOT tried and true. You will run into lots and lots of bumps in the road but that's part of the process. These were my last appointment before my MARPE was scheduled to be removed!!! I was really looking forward to having more freedom in my mouth. Stay tuned for that next--there will be a video of the procedure! :)
Hello friends!
I know it's been quite a while since I've updated the blog. I've been doing some traveling, started a new position at work, and life just generally got quite hectic. Many of you have reached out to me for an update or follow up, so I finally made some time to catch up :) I'm still a bit behind on my videos so for the sake of chronology, I'm going to continue going in order of my treatment (even though in reality I'm far past this.) In the next month or two I hope to catch up so I'm finally posting in real-time. Here's a video update after my TADs were installed on my upper arch.
In this video, I've just had my new TADs installed in the buccal side of my upper arch. Buccal means it's the side of the gums that's closer to the cheek. Lingual means it's on the side closer to the tongue. They installed one TAD on either side of my arch. They did the usual preparation by first applying a numbing gel, then giving me stronger numbing via injections. As usual it's not super painful, just feels like a lot of pressure. You get used to it after a while.
Almost immediately after they gave me elastics to connect from the TAD to a hook on the bracket of my lower canine. The intention here is to help my entire lower arch move back to correct the slight underbite I have. The reason they connect the elastic to this TAD instead of a hook on my upper molar, is because the latter would 'extrude' my molar, meaning bring it out of the bone. Since I already have an open bite, this would only make it worse. Connecting it to the TAD would enable us to move the arch without worsening my open bite. They also connected my four lower front teeth with a power chain, so that when they get pulled back they won't separate and form a gap in the middle. Something to note here is that bone density and strength varies GREATLY from person to person. It's mostly due to genetics and physiological inclinations based on our ethnicity. I'm Indian by ethnicity and apparently we tend to have weaker bone (not always the case). This is both a good and bad thing. In the case of my skeletal expansion with MARPE, it's great news because my maxillary suture split more easily. In the case of these TADs, it ended up meaning that they take longer to heal and "osseointegrate". Osseointegrate means how the implant locks and secures itself into the bone so that it's stable enough to bear a load. In my case, they immediately placed a load on the TAD after installing it. The elastics were pretty loose and not the most aggressive ones they have, likely because they didn't want to shock the TADs too much. It's all experimentation and seeing what works for your system. If you enjoy these posts and videos and find them useful, please leave me a comment or like so I know what you all like! I will continue to make content and share my experience as often as I can. Cheers, Divya
After my diastema opened, the MARPE was left to retain the width as my orthodontist proceeded with the rest of the treatment. The first thing they added was a power chain between by front teeth to close the gap that had formed by pulling the teeth together. On my lower left side, they connected a power chain between my second and third molars to fix the incorrect rotation of my third molar. At every appointment for about 2-3 months they would replace this power chain to continue rotating the tooth. On my upper arch, the tooth just beside my right front tooth was always tucked in at an angle due to overcrowding. With the braces, this tooth was almost totally rotated to be facing out properly! By April my orthodontist said my crossbite had improved significantly! Still not perfect, but they planned to achieve the rest with palatal archwires and expansive wires on my braces. They told me the plan is to keep my MARPE in until about July....
With the new year on our heels, I'm hoping to post more regular updates for you all (hopefully once a month). For now, here's a video update from when my diastema formed :)
I realize it has been about five months since I've posted anything here! Life got a bit crazy and I had to put this blog on the backburner as things picked up at work. But seeing all the comments and messages really pulled me back into this project and reminded me I need to do my best to share this info to help others. Especially since I know how hard it is to find anything about MARPE online. Obviously my treatment has progressed quite a bit since my last post, but for consistency I'll pick up where I left off. Click 'Read More' to see the first update since my MARPE!
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