Monday, January 30, 2017

Monday January 30, 2017
Week 21

The update this week is about my new 'elastics' (aka rubber bands). As an 'undergraduate' dental student, we were presented with very little information about orthodontics. We learned a few techniques, did some practice exercises and graduated with only a vague understanding of how teeth could be moved into better positions. Over my career, I have observed my patients undergoing orthodontic treatment and have marveled at the transformation that occurs. As a patient now, I have high hopes that I experience the same transformative effects. I am not disappointed.
Elastics are designed to move segments of teeth as a unit. My assistant at Dr. Jusino's office, Mary Margaret, explained that the goal of this first phase of elastics is to move/'pull' all of my upper front teeth downwards to give more overlap with my lower front teeth. I thought, 'yeah, right'. Mary Margaret was right and it is happening FAST! I don't analyze my teeth on a daily basis but it is hard to ignore a changing bite and a changing smile, all for the better. As dentists, one thing we hope to find in an ideal dentition is something called canine/cuspid guidance. Simply put, it means that the canine teeth (eye teeth) bear the load when the jaw moves right and left, forward and back, when the teeth are held/closed together during these movements. The canines have long roots and thick enamel which bears up well under function over the lifetime of an individual. Canine guidance helps protect the front and back teeth by acting as a shock-absorber during movements.  Without canine guidance, the front teeth and back teeth can wear down more rapidly over time, especially in someone who habitually clenches or grinds their teeth. My bite fell into this category. I have never had canine guidance.....until last week!
 Even as a well trained and experienced dentist, I was skeptical that anyone could effect enough tooth movement to achieve canine guidance for me. I had many potential outcomes in mind for this orthodontic adventure but canine guidance was not on the list because I did not think it could be achieved. I am now a believer and continue to be more than pleased with my decision to pursue orthodontics as an adult.

When I was harnessed with elastics at my last appointment, Mary Margaret gave me four packets of elastics, each one containing about 50 pairs. She said to replace them three to four times daily...when I ate meals and at bedtime. I thought four packets was a lot but then discovered that keeping one in strategic locations was very helpful to the process. I keep one with my toothbrush upstairs at home, downstairs at home, at the office and in my purse. I am never far from a fresh set, as you can see in this photo taken in a computer center at the University of Michigan, early one morning as I was creating this blog entry. 

The key with the elastics is to keep them fresh and KEEP THEM IN! Surprisingly, they stretch out quickly and after about three hours, I don't feel much tugging. To keep them working well, the teeth need to experience a sustained steady force. It does no good to wear 'exhausted' elastics for an entire day; while they maybe in place, they aren't working and in fact, all that had been achieved when they were attached, fresh out of the pouch, may be lost by not keeping good tension on the teeth.
Successful orthodontics is all about compliance. As much as I love my braces, I don't want them on my teeth any longer than absolutely necessary. I'd like to think that I am Very compliant and that Dr. Jusino is pleased with my progress when I next see him in early March.


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