Archive | June, 2009

My natural teeth

7 Jun

For the first few weeks after my accident, and then again in the first several days after my chipped teeth were repaired, I’d often wonder what my teeth had looked like before the accident and lament that I’d never know. On this point, however, I was wrong.

When I got my braces off just short of eight years ago, my orthodontist made models of my teeth. These were to be used to shape the clear plastic retainers that I would have to wear regularly from then on. For most of the past eight years, the models have sat collecting dust in my old room in my parents’ house.

My old teeth

For me, the most striking thing about the models (which unfortunately my photograph doesn’t adequately show) is that they show that my right front tooth was actually slightly bigger than the left front tooth before the former was chipped in the accident. In the repaired version, the edge of my right front tooth (number 8 for the dental notation enthusiasts out there) slants so that the tooth approximately matches both of its neighbors in length where it meets them. In particular, the right front tooth is considerably smaller than its neighbor to the left, and it also looks weird.

The models also confirm that my bottom front teeth have moved a little bit. The two in the center now stick out slightly further than the ones to the left and right. This is something that I’ve suspected since my jaw was wired shut, when I detected a change in the way things felt to my tongue. I’m hoping that the movement is due to pressure applied by the wires in my mouth and that the movement is slight enough that my retainers will be able to nudge them back into place after I get the arch bars out.

Tags: , ,

Some pessimism

6 Jun

Several weeks ago, I saved a copy of a review on the treatment of condylar fractures to my hard drive. More specifically, the paper attempts to address the question of whether open treatment (surgery involving an incision) or closed treatment (such as the treatment used in my case) of these injuries is better. I wasn’t looking for an answer to this specific question in the article; my oral surgeon mentioned open treatment only as something that would be used if the closed treatment failed.

It was only today that I actually got around to reading the review. I was glad that I wasn’t reading it to find out whether open or closed treatments are better because the findings were inconclusive. Nonetheless, I did learn some interesting things from it. I was particularly interested in one of the findings of a study of Ellis and Throckmorton:

The patients whose condylar process fractures were treated by closed methods had significantly shorter posterior facial and ramus heights on the side of the injury, and more tilting of the occlusal and bigonial planes toward the fractured side, than patients whose fractures were treated by open methods.

I’m unfamiliar with many of the words in there, but to the extent that I understand the sentence, I think that it might confirm what I have suspected: that the asymmetretry in my mouth’s opening may be related to the way in which my bones have healed, and not just a result of stiffness in the muscles. In particular, the ramus is a part of the mandible, and apparently it is sometimes shorter after a condylar fracture has occured. This isn’t actually something that is of particular concern to me, but I do wish that my oral surgeon had acknowledged it to me.

Other studies found that patients with closed treatment experienced chronic pain and malocclusion (misalignment of the teeth), neither of which I’ve experienced since treatment.

Tags: , , , ,

Twenty-three with braces

2 Jun

These days, the only major sign of my accident is the arch bars on my teeth. The oral surgeon told me that they’d stay on until my mouth is opening normally enough that he is sure they won’t be needed again. As the days progress, I find myself increasingly impatient for this to happen. I don’t particularly mind the look, and the arch bars aren’t even that visible. It’s just that I feel like I’m about ten years too old to have braces on my teeth.

Over the last week or so, I’ve been stretching my jaw muscles more and more. The oral surgeon only told me I should work on opening wider, but sometimes I work on the side-to-side motions a bit, hoping that it might help to correct the problem of the right side of my mouth opening further than the left.

The truth is that I don’t even really know how far my mouth should be able to open, or even what straight is. The latter question seems like it should be easily settled, but it’s not so easy because my front teeth aren’t perfectly straight. Some of them have shifted slightly since the accident (owing to my inability to wear a retainer while my jaw was wired), and two were chipped and then repaired artificially. The oral surgeon wants me to focus on keeping my chin straight, but even that’s not so easy because my chin has a small bump on the right side where it was stitched up. As for the width of the opening, I haven’t been able to find out what is normal, but I’m pretty sure that it’s wider than my opening of about four centimeters.

If there’s one thing that keeps me from sitting around and exercising my jaw all day long, it’s the understanding that my trying too hard to fit in may well have caused the accident in the first place. I’m not quite sure what could go wrong here. I doubt that my muscles are strong enough to break the bone again, but I’d rather not find out.

Tags: , , ,

Newer Entries →