Tuesday, 26 January 2010

The TPA is starting to hurt a little bit, on the centre of my tongue. I have been using the saltwater washes still, and eat Rinstead pastilles when I am at work, but it is still a bit sore. Perhaps it is because I have to use my tongue so much when I am eating. Food is still getting tangled in it, but I have learned not to stress about it so much.

Otherwise, I have got so used to the whole assembly that I'm starting to forget it is there. I can't wait for it to do its stuff - but the first goal I am really looking forward to is getting shot of the TPA!

Saturday, 23 January 2010

Shepherd's pie and porridge also work OK (although not both together, obviously).

Friday, 22 January 2010

Gradually getting used to the whole assembly in my mouth. The braces are not too bad at all – they just feel as if I have a bit of knitting tangled around my teeth.

The TPA is a bigger deal, but I am slowly getting used to that too.

It feels as if I have a horse bit in my mouth – I go riding from time to time, and now I will have a lot more sympathy with the horses, especially when I am putting the bridle on. To put it in more equestrian terms, the TPA feels like a curb bit with a very high port.

Another good analogy, I feel, is with the medieval torture instrument called the "Scold's Bridle". This charming device was made of metal and used exclusively on talkative or quarrelsome women. There was a big metal cage that fitted around the head, and an iron piece, sometimes with spikes in for added effect, which fitted into the mouth and lay on the tongue. If the woman kept quiet, all was well. If not, it was agony. According to Wikipedia, similar devices are still used today in the BDSM fraternity.

Perhaps I ought to post this on a kinky sex site and get lots of money ...

The TPA caused my mouth to produce more saliva than normal at first, but this seems to have calmed down now. I was worried about slurping and dribbling in public places, but thankfully this has not happened.

It does also rub on my tongue a bit. I am not having the problems that Macy/Stacy seem to have suffered, but it is a little bit sore. I have carried on washing my mouth out with salt water, though, as I did after the extraction (1/2 teaspoon of salt dissolved in a cup of warm water) and this seems to solve the problem. The orthodontist recommended paracetamol (acetaminophen) rather than ibuprofen to sort out any pain, but this was not necessary after the first day.

The most bothersome thing is eating. My choice of foods has narrowed yet again. Just about everything gets caught around the TPA if I'm not careful.

Soup is OK, but it has to be really smooth, or the bits can be a problem. I had tomato and lentil soup earlier today, and the lentils snagged on the appliance. However, I squished them up with a spoon, and the problem stopped.

Bread is a bit tricky, because it goes soggy when you chew it, and you have to suck it off the TPA (gross). Best to take small bites.

Pasta didn't work nearly as well as I thought it would. I had some tortelloni on the first night, and this managed to wrap itself around the device. I think I will give it a miss in future.

Risotto was OK. The day after my fitting, I was invited out to a team lunch at work (uh-oh) at an Italian restaurant, and risotto was pretty much the only option for me. No chewing pizza – the bands around my molars are still a bit sore for anything like that. I managed OK with the risotto, as long as I took it slowly, but the bits of pancetta got caught unless I moved them to my very back molars.

Coffee is OK, obviously.

Wine is OK – thank God.

Chocolate is OK – hurrah!

Even sponge cake is OK, which was a lovely surprise – it is more crumby than bread, so doesn't stick.

Fruit is OK, as long as it is soft. I have had some clementines, which were fine, and some banana, which was also OK as long as I chewed it thoroughly.

Omelettes and poached eggs should be fine, as they break up easily.

Fish should be do-able as well.

I am going to miss my crunchy vegetables, though. I didn't realise how often I ate them. I will have to whizz them up into soup if I have them at all.

Sleeping with the TPA was another thing that concerned me. However, it doesn't seem to be a problem, especially since I sleep with my head slightly raised.

Tooth-brushing is fiddly, but that is because of the brace. I use a soft brush with a small head, and have to go gently because my teeth twinge a bit when I brush around the brackets. I brush my tongue as well, to help keep the TPA clean. Then I follow with a salt-water rinse for hygiene and controlling any soreness.

I am starting to forget that the TPA is there, from time to time.

I have also discovered how to get a musical note out of it, by twanging it with my finger, but perhaps I had better not do that too often.
18 January 2010

Back to my team of tooth fairies in Baker Street, for the final stage of the procedure. Today the Trans-palatal arch (TPA) would be fitted, and then the wire would be applied to activate my brace.

I really wasn't looking forward to the TPA. The examples I had seen on the net looked like instruments of torture. As Macy (or is it Stacy?) says on ArchWired, the actual appliance looks like a partially unbent paper clip. As its name suggests, it goes across your palate (the roof of your mouth), from one molar to the one on the opposite side, to hold these teeth in place. It follows the shape of your palate but does not actually touch the surface. It has a little kink in the centre so it fits around the ridge at the centre of your palate.

Mine had a metal hoop on each end, which would be fitting around the molars. This is what the spacers were for – to create enough room for these bits.

Fitting the device was painless, but I did suggest that the orthodontist might be something to do with the Spanish Inquisition. She took it very good-naturedly.

It did feel bizarre inside my mouth, and I was constantly aware of my tongue pressing against it.

Apparently the TPA just needs to stay in place until my canine has slotted into alignment with the rest of my teeth, which should take only a few months. Thank goodness.

Then the wire was threaded through the brackets (this felt like a very fiddly job) and secured with elastics. Having my canine tooth wired made me squeal a bit, as the pressure was applied, but the rest were not too bad, although I was aware of the tugging feeling on my teeth.

Everything is done now, until my next adjustment, at the beginning of March.
15 January 2010

Oh goody – extraction day today. The head dentist at the practice would be doing this for me.

As you have already seen, I am no stranger to this procedure. In fact, when I was a nipper, I had to have all of my milk teeth pulled out, because they were way too comfy where they were, and stayed put while my big teeth grew around them. This may have been where my problems started. In any case, my astonishing array of dinosaur teeth made me look like a little mutant, so obviously something had to be done. The dentist took the quick, to-the-point approach, rather than the care I am currently enjoying. I remember the injections, and the weird mouth feeling, and the crunch-crunch-crunch as the pesky little teeth were wrenched out. I remember spitting mouthfuls of blood out of the car window on the journey home. Happy days ...

Many, many years later, here I was again. I wasn't scared, but did feel a little flutter of concern as I lay down in the chair.

I had no need to worry – the dentist was a master of the extractive art. Like his orthodontist colleague, he very kindly explained each step of what he was doing. The injections in the mouth were not great, especially the one in the roof of my mouth, but they were bearable. Then there was a certain amount of pressure, and the feeling that part of my nose was being pulled out (have no fear – it wasn't), but no pain. Then, suddenly, it was done. It must have taken less than 20 minutes from start to finish. The dentist let me have the tooth as a gory little souvenir.

I felt a wee bit fragile travelling home in the rush hour, but I think that was just the after-effects of my own adrenaline. I also suspect I might have swallowed a tiny bit of anaesthetic, because my throat felt a bit weird on the way home – but again, that could just have been me coming down from the stress.

I couldn't eat anything for supper, but frankly that was the least of my concerns. There was almost no pain – just a bit of a dull ache, which was easily sorted out with ordinary painkillers.
12 January 2010

OK. Having been back on the ArchWired site, I now know what a Trans-palatal arch is. Two brave American women explained exactly what it is, what it feels like, and what it does to your life – see their story here: http://www.archwired.com/TPA.htm

Oh boy. Here comes the scary bit.
11 January 2010

Today I had the brackets for my braces fitted. I didn't know what to expect – I had read tales of people feeling as if they had a mouthful of metal. Again, the orthodontist was lovely, and explained each step of what she was doing. Having the brackets attached to my teeth was painless – first some bonding stuff was applied, then the bracket was put on top and the bond was activated with UV light. It was a bit fiddly, but that was all.

The orthodontist explained that she couldn't complete the procedure today because she still needed to fit something called a "Trans-palatal arch". This device would be holding my molars in position while the front teeth shoogled around into their correct places.

The side brackets had little spiky bits sticking up, so the orthodontist gave me some silicone wax to apply to cover them over. This helped a lot – I couldn't feel the brackets once this stuff was on.

I had to have the spacers left in, or at least have new ones fitted, but this wasn't as bad as last time.

In the meantime, I would be having my premolar on the left-hand side extracted, to make room for the toothsome tango that would be happening over the next year or so.
5 – 8 January 2010

The next day, I was back at work. I stopped off at my usual café and discovered that morning croissants were now to be off the menu. I tore the croissant into small pieces, but it was still uncomfortable to chew.

At lunch, I was very relieved to have soup and mango fool. By this time my whole attitude to food had changed radically – from "Yum!" to "Can I manage this?" Meal planning was going to be a challenge from now on.

Over the week, I began to figure out things I could eat without too much pain or mess. Soup, obviously. For breakfast, I could have soft Nutrigrain bars, which needed very little chewing. I was aware of needing to have enough protein and nutrients, so went for tuna sandwiches, egg sandwiches etc for lunch.

For supper, pasta or chilli was manageable.

In the evenings, I searched the net to find out if anyone else was going through this kind of experience. I found a great site called ArchWired (www.archwired.com), specially for adults wearing braces. I had no idea there were so many people doing this. The personal stories on the site included accounts by pregnant women getting their teeth fixed before the baby came along, parents who had taken their children to the orthodontist and then decided to get work done on themselves, and people in their 40s and 50s who decided to go for it. Many of the people posting are from the United States, but there are also some Australians and some stiff-upper-lipped British folks, so I felt less of an oddball. There was information about coping at work, food suggestions, and even tips on ... er ... romance. Definitely not just an experience for teenagers, then!
The orthodontist at Baker Street has a lovely, calm, pleasant manner. She explained what having a brace entailed, and said the whole realigning process would take around 18 months. What a relief – I had envisaged it taking years and costing a fortune. It's still not cheap, but it could have been so much worse. Certainly better value than a boob job.

I decided to go ahead.

The orthodontist and her nurse took x-rays of my mouth, then made me stand against a wall and grin like an idiot while the ortho took photos of the offending teeth.

Next, I had moulds made of my upper and lower teeth. For those of you who haven't had the pleasure, the dentist loads some dental putty in a jaw-shaped mould and presses it on to your teeth. It only takes a few minutes to set. The lower jaw was no problem, but when the orthodontist did the upper jaw I started to gag. She explained a really neat trick to stop the gag reflex – move my legs alternately, in a "cycling" motion. It worked just fine. I was impressed.

Last of all came the first uncomfortable bit. The orthodontist squeezed elastic bands between my upper molars, to space them out a bit for the next stage of the proceedings. The spacers had to stay in for a week. This did feel really odd, and I was very conscious of them.

Still, I was on my way. The Big Change had begun.
1 January 2010

Before going on, I'm taking a moment to look back, to explain why this teeth thing is such a big deal for me.

I have to go way back, to when I was 17 years old. I had come back from seeing my family abroad, and was staying with my grandparents in London. The day after arriving at Heathrow, my Grandma took me to the dentist.

I thought I was just there for a check-up. I had a huge fright when the dentist started rummaging around in my mouth, saying things like "forceps please, Nurse". I should have shouted, or got up and left. I was in too much shock to do anything, so I just lay there while he pulled out my right canine tooth.

My Grandma thought it was very funny. She and my Mum had arranged this without telling me.

I knew my teeth were a bit crooked, and that my sticking-out canines would have to be tamed some day, but I had hoped to have some say in the process.

Not only did the guy pull my tooth out, but he also chopped away the bit of bone that held it in its (admittedly unusual) position at the front of my gum. I had to have stitches and everything.

As the final touch, he filed down the first premolar on that side and had a crown made for me to "look like" the missing canine tooth. It never did. Over the years, my teeth skewed round to one side, off-centre, and I never lost the sense of something being forcibly taken from me, and of being ever so slightly deformed as a result.

Now I had the chance to do something.
28 November 2009

This story begins on a flight back from Paris to London. I was eating a cough sweet to clear my ears, when I found myself crunching on something that definitely wasn't Strepsil-flavoured.

In the airport I dashed to the loo and had a look in my mouth – half my crown had gone.

I had a very good idea where.

That same day I got the crown patched up at an emergency dentist. As I lay there and tried to ignore what was going on in my mouth, I thought again how much I had always disliked having this crown in. Having to fix the wretched thing was the last straw. I was also conscious of the way my teeth had grown crooked around it. Not a world-shattering problem, perhaps, but still, a constant niggle at the back of my mind ...

I asked the dentist if there was any possibility of having the crown removed and getting my teeth straightened. It was a long shot; I thought I was way past the age when these things are possible. I was surprised when he said yes – and even more surprised to find it wouldn't cost the earth.

The dentist fixed me an appointment with an orthodontist who worked at their branch in Baker Street.

OK, I thought. Just an appointment and a few questions. That can't hurt.