Thursday, March 8, 2018

Thursday March 8, 2018
Week 2 after D-Day

Life is Good!
Here are some random thoughts that went through my head after the braces were removed.

....oh, my gosh! I forgot to put my elastics in! Oh, wait! I don't have to wear them anymore... teeth feel naked! it Really true? My braces are off? I am actually Done?!
....ugh, I'm off to bed and have to Floss...Oh! Wait! The braces are Off! Flossing is going to be a breeze!
....nuts? I can eat nuts? Pass the bag of almonds!

These photo collages were graciously supplied by Dr. Jusino and represent the 'Before and After' appearance of my teeth, bite, facial profile and smile. If you can ignore the droopy chin and eyebrow asymmetries ( I guess I need a new esthetician) of this now 60-something orthodontic 'project', you should be able to see what was accomplished over 17 months of treatment. 
See if you can identify the following: 1) The change in the midline of the upper and lower front teeth. 
2) The change in the curvature/alignment of the upper front teeth.
3) The change in the curvature/alignment of the lower front teeth.  
4) The change in the position of the lower second bicuspid relative to the lower first molar..this one is tough; hint: look at the middle photos on the right side of the collages. 
5) The difference in length of the upper front teeth. 
6) The change in overlap of the upper front teeth with the lower front teeth.  
These may seem like small changes but collectively they result in a more balanced bite, profile and smile. The outcome was well worth the time invested and the effort expended modifying my lifestyle to achieve this goal.

Thursday February 22, 2018
Week 77
Month 17.5

IT'S "D-DAY"!!!
D-DAY = Debanding Day
It has been Exactly 77 weeks; 539 days; 12,936 hours since I was banded and wired for my orthodontic treatment beginning September 8, 2016 and I AM DONE!!!!!
It is difficult to explain how GOOD my teeth feel now that they are properly aligned. I entered into this project with the goal of improving my bite. Changes to the appearance of my smile were secondary but all I can say is, WOW. My bite feels Great and my teeth Look Fabulous! 

This is the photo that was taken just a few minutes after the bands were removed. Go ahead, Zoom your computer to see my smile up close. It's wonderful! And, you'll have to take my 'word' that the bite that Dr. Jusino achieved for me is equally wonderful. What I notice now that the braces are off and my teeth are positioned where they belong is that smiling is easier; the actual physical movement of my facial muscles into a smile doesn't feel stretched like it had for many years. I always felt that either my teeth were too big or that I had too many to fit into a comfortable smile. Not so...they were just in the wrong place. 

Here are a couple of photos that were taken within a day or two of having the braces removed. At the time the photos were taken, I  wondered if my smile would appear awkward or staged. What I see is a smile that looks graceful and natural. Am I biased? Perhaps. But, I know that moving forward, I will feel more confident and comfortable when I am included in photos with family and friends.

This is Not the end of my blogging entries because removal of brackets and wires is not the end of an orthodontic journey. Stay tuned for more reflections on life-after-braces. There are some valuable insights for anyone considering orthodontics or in the midst of treatment anticipating their own personal D-Day!


Sunday January 28, 2018
Week 72
Month 16

In reviewing my blog postings I just discovered that they Have Not Been Posting as I had planned/scheduled. They are wayyyy behind dating to late October. I have rescheduled the postings and there will be one each day at 7 am for the next week to catch you up on my progress to date. Make sure you go back and read from October 10, 2017 so you don't miss out on any tidbits. As you read through them and catch up, there will be some nice surprises!

Sunday, February 4, 2018

Tuesday January 23, 2018
Week 72
Month 16
T-30 days

Every day I wake up and know I am one day closer to D-Day with Dr. Jusino. Exactly thirty days from today on February 22, my braces come off! Dr. Jusino took an impression of my lower teeth so he can (personally) make my lower retainer.

It's called a 'fixed lingual wire' and is bonded to the back of the lower front teeth to hold them firmly in place. For me, as an adult, I will keep this retainer bonded to the teeth for the rest of my life. The lower front teeth have the skinniest roots and are the ones most likely to relapse. Having a retainer that does not move in and out of the mouth give these teeth the best chance for long term stability.While you have to learn how to floss under the wire, it will be far easier to floss between 6 teeth than 28 teeth like I have been doing since September 2016. Of course I am looking forward to my new smile with straighter teeth and better bite but I am REALLY looking forward to not having to thread floss under the wires around Every tooth at night. HOORAY!

Saturday, February 3, 2018

Tuesday January 9, 2018
Week 70
Month 16

Today was Appointment Day with Dr. Jusino. After monitoring my midlines for the past six weeks, wearing single elastics on some days and double (bilateral) elastics on other days, I found out my efforts were successful! Dr. Jusino was pleased with the stability of not only the midlines but also the relationships of my other teeth and my bite. It all feels very good to me; So Much Better than when I started on September 8, 2016.
And, now for the Good News... I have an appointment for "D"-Day!....De-banding Day! This is Fantastic!  Yay!!!. When the braces are removed, I will have worn them for 17 1/2 months.  Dr. Jusino is confident that the completion of my treatment on the early end of his projected timeline is due, in a significant way, to my commitment to wearing the elastics. What more can I say?! Elastics Rock!

These photos are pups in our life. Lance and Rugby live with us. Captain lives in Ann Arbor, Corby lives in downtown Detroit and Morgan resides in Portland, OR

Friday, February 2, 2018

Tuesday January 2, 2018
Week 69
Month 16

Happy New Year! 
 It has been a wonderful Christmas Holiday season and while we are back to work today, the festivities continue with a few more parties and celebrations that center on family and food! One thing I noticed during the days of intense celebration was the tendency to 'graze' all day, from one buffet offering to the next. This posed a problem with my elastics, needing to wear them 23 out of 24 hours to maintain tooth stability while wanting to indulge in grazing as though it was an Olympic event (for 23 out of 24 hours!). I managed to find a balance between wearing the elastics while eating softer foods and needing to remove them for things that required serious chewing. If you wear them while eating, they will stretch out more quickly and should be replaced more often. I found myself replacing them every couple of hours to make sure I still felt the gentle tugging. I kept an eye on the midlines to make sure the alignment did not change. Dr. Jusino will let me know next week if I was successful.  

Thursday, February 1, 2018

Tuesday December 12, 2017
Week 66
Month 15

It is mid-December, and I am immersed in the busyness of Christmas preparations just like everyone else.  Being away for a seminar in Chicago for the past four days did nothing to help me accomplish anything on my to-do list. However, the  Continuing Education program was outstanding and provided me a lot of information that will help with my patient care. Being in the middle of orthodontic treatment always makes planning and packing for time away from home just a little bit harder. Remembering to pack my flossing gear along with plenty of elastics is especially challenging at the holidays because my mind is distracted with many thoughts above and beyond what normally flows over my synapses daily. I managed to arrive in Chicago without leaving anything behind at home.
Over the past two weeks I have had to re-adapt to wearing elastics on both sides of my mouth and I was noticeably sore as a result. Both my teeth and my oral tissues were tender. Being around more sweets at the holidays made my oral tissues even more responsive. In one of my early blogs, I mentioned how sugar can dry your oral tissues and make the bumps and bulges of brackets and elastics more bothersome. Indeed, I have found this to be true once again. But, I am adjusting and my comfort level is good, being unaware of all the hardware in my mouth. 
Today's photos show our office team packing Christmas baskets for the Franciscan Outreach Program in Southfield. This has become an annual event for our office and we look forward to it every year. 

Wednesday, January 31, 2018

Tuesday November 28, 2017
Week 64
Month 14

Welcome to the week after Thanksgiving! Today was a check up appointment with Dr. Jusino and I was anxious to see how well he approved of my midline. When Mary Margaret took off the wires to allow me to brush, she noticed how nicely the teeth were aligned. She even said to me quietly "maybe, just maybe he will think you’re done".  I told her I wasn’t confident in her prediction because he still has another  10 months of ‘cushion’ in his predicted time of treatment to find additional ways to achieve perfection….and that I was willing to be patient. 
Dr. Jusino was INDEED pleased with the midline and spent a lot of time looking at the bite. When Dr. Jusino looks intently at things, he is very quiet and doesn’t give you ANY clue to what he’s thinking. In the end, he acknowledged the significant progress and said "now let’s see if we can keep them there". I was instructed to return to wearing elastics on each side to balance the position of the teeth. HOWEVER, Dr. Jusino told me to "keep an eye on the midline and if it starts to move, stop wearing the elastic on the left for a few days”.  I thought this was kinda cool because it made me feel like I was making some of the assessment and decisions about my tooth movement. I’m not too proud to admit that, as a dentist, not being in the ‘driver’s seat’ in this process is really hard. Dentists are used to being take-charge decision makers and to be in control. It is professionally humbling to let someone else be in charge. Over the past 14 months, the  respect for Dr. Jusino’s skills I have developed over the years has been affirmed as a patient under his care. I give him a 5 Star rating!

The photos on today's blog are the results of our afternoon of decorating our office for the holidays. Each year, on the Tuesday before Thanksgiving, we close the office for the afternoon, unload the storage locker across town holding our decorating treasures and set to work like Santa's elves transforming our work-home into a Christmas wonderland. It takes 10 people 5 hours to get the work done but for the next 5 weeks, we work each day filled with Holiday Spirit!

Tuesday, January 30, 2018

Tuesday November 7, 2017
Week 61
Month 14

Good News about my midline! Continued use of the single elastic has NOT pulled the midline away from the perfect alignment I reported two weeks ago. I seems that the teeth are in an acceptable ‘holding pattern’. I am anxious to have Dr. Jusino see what has been accomplished so quickly.Maybe I am close to being done, way ahead of schedule?!

I thought I’d share an observation unique to those going through orthodontics, specifically those who are wearing elastics. The observation is this: single loose elastics show up in the strangest places. I have found them frequently on the floor around waste baskets and trash cans, likely because they have the incredible ability to Bounce. You can aim for a trash can and they bounce out onto the floor. The trick is to put your hand close to the trash container before releasing your grasp. If they have a shorter distance to fall, they have less inertia to bounce out. Other places I have found them include the floor of the car, in the bottom of my reusable lunch bag, in the bottom of my purse, in coat pockets, in the dishwasher (must have been left on a dinner plate), in the washing machine, BEHIND the washing machine and sitting on a shelf in the refrigerator! 

The best explanation for these odd sightings is because the elastics are manufactured in a way that several are stuck together in clumps and need to be separated for use. The separation process can unknowingly fling them to far-away places. But, I still can figure out how one ended up in the refrigerator. Does anyone else out there have an odd place for elastics to add to my list?  Comment on this post to add your odd elastic sighting!

Monday, January 29, 2018

Tuesday October 24, 2017
Week 59
Month 13

Last time I wondered how a single elastic could pull my upper teeth enough to center the midline.  I’m happy to report that it works like a charm!  It’s only been two weeks but the midlines are now centered. That was FAST! Since I have four more weeks to wait until my next appointment, I hope the movement doesn’t continue and ‘overshoot’ the goal. Stay tuned.

Regarding Oral Hygiene my own patients who are treated by Dr. Jusino pass through my office, I compare notes with them about their oral hygiene scores. Whether teens or adults, they all agree that achieving a 5 Star rating, even once, is an elusive goal. Even parents who supervise their child’s brushing and care of their braces are surprised that they don’t ever seem to achieve a 5. I asked one of the All-Star Team members at Dr. Jusino’s office about this frustration and I was told that Dr. Jusino believes ‘there’s always room for improvement”. Usually I would agree with this philosophy but I honestly can’t imagine how I can do any better. I might just have to frame my one 5 Star report because it may become a historical document!
I will concede the fact that while my teeth and braces are plaque free and the tissues are pink and healthy, the teeth are not without stain from my daily cups of tea. Perhaps the stain is what is holding back my scores. Admittedly, the single Five Star rating I received was the day I had the wires removed for my professional cleaning. My hygienist, Michele, worked her magic to polish off the remnants of green tea and they sparkled when I returned to Dr. Jusino's office for the wires to be replaced.  This is something to ponder. 

Sunday, January 28, 2018

Tuesday October 10, 2017
Week 57

Today was another office visit with Dr. Jusino. I am into month 13 of my treatment, estimated to be 18-24 months. When I look in the mirror, I have to admit thinking what so many people think at this point in their care: "My teeth look great and I can’t imagine what more needs to be done”. Am I anxious to finish? Absolutely!  I know that root and tooth stability is key to long term success but, this stage of allowing the teeth to ‘set’ in the bone seems to be endless. As an adult patient, this takes longer than with teens. Every time I look in the mirror, I have to remind myself to be patient.

During my visit, I was told that Dr. Jusino was working on ‘centering the midline’. He wants the point of contact between the two upper middle front teeth to line up perfectly with the point of contact of the two lower middle front teeth. In this photo, you can see the offset midline at the beginning of treatment. Elastics do a lot of different things over the course of care and for the next several weeks, he has me wearing only one elastic on the right side to try to ‘pull’ the midline to the right. The alignment is off by about 2.0 mm. It doesn’t seem like a lot but to a dentist, it might as well be a foot. Dentists have been trained to see this kind of detail so, using something like midline alignment (or non-alignment) is a measure of success. Dr. Jusino works very hard to achieve balanced midlines.  I’m curious to see the effectiveness of a single small elastic.