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.