Correcting a Crooked Smile: A Cross Bite Story

My oldest son has the "perfect storm" when it comes to his head.  We have had ear tubes, eye surgeries and the latest saga is his mouth.

I know that orthodontic treatment is a long process.  So, I have decided to do a "series" to document our journey. 

His teeth have always been... interesting.  Our pediatric dentist referred him to a orthodontist when he was six years old.  Because he still had his "baby teeth" the first visits were just "keeping an eye on things".  Once he lost a few teeth, it was go time to start the process of correcting his crooked smile.

This is the 6 point clinical evaluation from the Orthodontist: 
In the picture below, his anterior crossbite is pretty easy to identify.  
And here is the 6 step treatment sequence: 

1. Fit palatal expander appliance, RPE
2. Seat RPE - activate once daily for 10 days
3. Add limited upper bonds
4. Correct posterior and anterior crossbites
5. Deband and place retainer
6. Full orthodontic treatment may be necessary upon complete eruption

This has been quite the process with several appointments. 

To begin the process, his top jaw  needs to be "extended".  That is the nice way of saying it... actually the appliance literally spreads the maxilla (top jaw bone) out.

They told us we would notice his top two teeth "spreading apart"... I will share a before and after picture at the bottom of the post.  

First, he had to have several pictures taken and x-rays done.  The orthodontist wanted to see the pictures and compare them to the x-rays to get an overall representation of his mouth in order to create best treatment plan.

After the x-rays and pictures, he had to have "spacers" placed.  The type he had were like little rubber bands (although they can be metal too) placed between the teeth (in his case, molars) to create space for the molar bands. 

The orthodontic tech told him the spacers would feel uncomfortable at first, but he should be used to them in a couple days.  One thing about my son, don't tell him not to think about something, because he cannot get his mind off it.    

I will say, he complained all night after getting these put in.  I did give him some Ibuprofen before bed and he got to eat chocolate pudding and applesauce for dinner...
Funny story: 

The day after he got the spacers, he told me they felt like they were falling out.  So, totally freaking out... I made an appointment to have them checked.  Come to find out they are supposed to "hang down" just a little bit and it is totally fine.  Oh well, we are totally new to orthodontics, but, it was a good lesson! 

It took him several days to get "used" to them.  And, he continually complained that it hurt to "bite down". 

Speaking of biting... we were also told about foods that would have to be avoided.  I always knew that you couldn't chew gum with orthodontic treatment, but, now we get to delve into a whole world of "no, no, no".  Too bad we are doing this so close to Halloween... (haha, more candy for me).

Anyway, I am better with lists of "What Not" to do, so I found this really cool chart of foods to avoid.  True, this specifically says "braces" but our instructions for the appliance are pretty similar.  This is definitely not an exhaustive list, but  it provides a pretty basic beginning point... 
Picture from Webster Orthodontics 
At the next appointment they took impressions to make the actual device.  He tends to have a pretty strong gag reflex (which he gets from my Mom) and when the orthodontic tech placed the trays full of impression material in his mouth, he started gagging.  Granted, he and I were kidding around while he was sitting in the ortho chair, and she came up from behind him and just "stuck" the trays in his face... but still... he didn't like it... AT... ALL.  In her defense, the impression material sets FAST, so time is of the essence... so be ready for that part! 
At the next appointment the appliance was ready to be placed. 
They showed us how to use the "key" to turn the appliance.  We were instructed to do this for 7 days and they would check it. 

You poke the metal rod of the "key" into the hole in between the arrows and push it toward the back of his mouth.  Remember that gag reflex... ya... the first few turns were... not fun...

And, while we are talking about this "key"... it is DANG HARD to turn.  Even my strong husband has to "work" at it... 
We went back in about a week later, and were instructed to "turn" it another 7 times. 

Finally, at our latest appointment we were told to turn it another 7 times for a total of 21 turns.  Interestingly enough, in the original plan, it was supposed to be 10 turns... oh well, we do what we are told.

At this point, we will be seen again in 5 weeks.  And, truth be told, I forgot to ask what the next "step" is...  

Here is a before and "at this point" picture... WOW...

Once he has worn the Palatal Expander for a couple weeks, I will write a post about how it is going, his reactions to it as well as ours as parents. The Crooked Smile story shall continue! 

You can read Part II here... 

Labels: , ,