April 7th, 2010

laughing - hates life

The technology that punishes you for smiling

I wrote this shortly after getting my braces removed last year. It will be of interest only to those who have once had braces or are considering getting them. To the former I say, "Keep wearing your retainers"; to the latter, merely, "Godspeed."

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Brace-face. Metalmouth. Train-tracks. Chances are, if you had braces in middle school, you got called those things. One plus about getting braces as an adult is you probably won't be. At least, I wasn't. But I thought them every day when I looked in the mirror.

Ordinarily I'm not that vain a person. I don't go into hiding if I have a zit or a bad hair day. I wear sunscreen and don't usually bother with fake tans, so my legs are pasty Northwest white, and I don't care who notices. I often forget to bleach or trim the rather thick hair on my otherwise feminine arms. My physical flaws are part of me; love me, love my chipped toenail polish. I didn't even mind letting people see me lumbering around nine months pregnant.

But I did not like being seen in braces. I smiled with my lips closed for photos. I would consider going to visit old coworkers if I was in the neighborhood, then reconsider--"I have braces. Maybe I'll wait till after I get them off." Metal brackets and wires lining my teeth, top and bottom, back to front, at age 33, made me feel far more uncool than I'd felt since, well, middle school. And I didn't even *have* braces then.

Part of the trouble was that I didn't get braces for aesthetic improvement reasons. My smile garnered compliments before. People, even dentists, sometimes asked if I'd already had braces. But I did have one crossbite--a spot where, when I bit down, an upper tooth ducked behind a lower tooth instead of settling in front of it like it's meant to--and that was wearing down the teeth in question, and throwing off my whole bite to a degree. It was worth it, said my perfectionist dentist, to look into braces, and get that fixed before I broke the crossbitten tooth in half.

I consulted two orthodontists. What I hoped for going in was the Invisalign option: clear plastic trays designed for your own teeth, which you wear all the time but take out for meals and toothbrushing, and which no one can tell you're wearing unless they look really close. The first orthodontist flatly told me, after I'd waited 45 minutes to talk to her, "No." Invisalign wasn't an option for my case. Titanium was required to haul those teeth into place. And by the way, it was going to take four hours to put the braces on, it had to be from 7:30 a.m. to noon some weekday because that's just how they did it, and I'd have to wear them for about fifteen months.

Maybe I'm not in middle school anymore, but I did want to cry.

The second orthodontist looked around my jaw and said, "There's not much wrong here." I liked him already. "Could I do Invisalign?" I asked him. He shrugged and said I could. But it would cost more because of the lab fees involved in designing tray after tray for each stage, and would also take longer overall. Patients often start with Invisalign, he said, but get frustrated at how long it's taking and how little progress is being made, and switch to metal braces. For adults who want it done fast and economically, he said, metal is the way to go. And by the way, in *his* office they'd put the braces on in about an hour and a half, and I'd wear them, say, ten months.

He was definitely my guy.

So, despite my initial preference, I went with metal. It was just ten months, right? Sure, they'd look stupid and feel scratchy, but I could cope. How bad could it be?

Those who say the first few days of wearing braces feel akin to having been hit in the mouth with a baseball are not exaggerating much. The office staff was friendly and efficient throughout, but there was nothing they could do about that "sensitivity," as they euphemistically called it, except hand me a box of wax to stick on the sharpest spots, and advise me not to chew anything tough this week. My mouth hurt everywhere, on all levels. The metal brackets ripped up the inside of my cheeks when I chewed, spoke, smiled, or slept. Tiny ball-tipped hooks protruded from the rings encircling my molars, and those hooks dug especially deep holes in my flesh. (Months after having my braces removed, when I thought of those wounds, my tongue still dove back to those spots defensively and tried to soothe them.) The roots of all my teeth, suddenly finding themselves under permanent tension and being pulled in new directions, throbbed in protest. Chewing anything was an exercise in pain. Room-temperature chocolate was way too hard to manage--which would have been a matter for heavy grief, except fortunately chocolate melts if you suck on it.

The wax I was supposed to stick on the sharp parts was only of marginal help. I couldn't wear it while eating, as it would come off and get swallowed, so the most painful part of the day--chewing--still had to be done without protection. I learned to take a dose of Advil half an hour before meals, but at breakfast that was tricky. I wake up hungry, as a rule, and want my breakfast ASAP.

Also, eating solid foods was disgusting. Seemingly one-quarter of what I tried to eat ended up lodged in my braces until I was wearing a packed layer of rice, lettuce, meat, and bread all across the front of my teeth. Even on the non-painful days, that drove me into fits of disgust and paranoia.

So for that first week or so, and for a few days every time they adjusted my braces, I relied on a mostly-liquid diet. It's what I still recommend to anyone getting braces. Why torture yourself?

Every time I thought my mouth could not get more full of stuff, they would add another facet. One was "crosswires"--those tiny round rubber bands that middle-school kids learn to snap out of their mouths and send flying across the room. I never mastered that skill, but got all too accustomed to the feel of the things, stretching from one upper canine tooth to the bottom canine on the opposite side. This phase lasted a few months and was intended to haul the teeth in my lower jaw over to the left, to center them properly. (While the orthodontist was fixing my crossbite, he figured he might as well straighten every last tooth in my head too.) At other phases, they added a super-tight rubber band that they laid along the wires, splashing a bright color of my choice onto my smile; and, another time, a new set of molar-encircling rings to my farthest-back molars, which previously had gone untouched.

That made flossing even more of a task than usual, and it was a huge task already. Imagine having a wire fixed across all your teeth, and try to imagine how you're supposed to work a string of floss *under* it to clean between your teeth. The answer is, you get a special tool, a little floss-threader that works like a needle to your thread of dental floss. It does the trick, but only once you get the hang of it--and that alone takes a while. I spent half an hour trying to get all my teeth flossed the first night, and wound up throwing the box of floss across the room. Even once I mastered the floss threader, flossing took five minutes every night. Without braces it takes perhaps thirty seconds. And anyone with a toddler knows how valuable five minutes can be.

Professional dental cleaning was no easier, logistically. I had to schedule three back-to-back appointments on the same day: first the orthodontist, to remove the wires; then the dentist, to clean as best as they could around the glued-on brackets; then the orthodontist again, to put the wires back on. After a few unsuccessful phone calls trying to schedule those ("Oh, sorry, we're not in the office on Thursdays"), I made the orthodontist's receptionist call the dentist's receptionist and work out the times between themselves, and tell me afterward what they decided.

My final sentence with braces stretched a little beyond ten months--it was one year almost exactly. When the nice lady at the orthodontist pried off the last rings and brackets, and took a metal pick to my teeth to scrape away the bits of glue, I welcomed the unpleasant sensation. Gone! The damn things were gone! A good flossing (ah, so quick!) and brushing and mouthwashing rinsed away the stale taste in my mouth. My teeth were slick and clean and straight. The orthodontist set me up with Invisalign-style retainers, which I wear only during sleep, and sent me on my way.

A year and a few months later, I still love the results. I didn't expect to notice any difference besides the absence of the crossbite, but actually my teeth are giving me less trouble all around. Less sensitivity than before, temperature-based or otherwise. Less accidental biting of my cheeks. Almost zero random whacking together of teeth that shouldn't whack together at quite that angle. Yes, I do wear my retainers, and yes, I'd rather not. But if it means keeping braces at bay the rest of my life--hell yes, I'll keep wearing them.

I'm still ambivalent on how I'd answer if someone asked, "Should I get braces?", or "Should I go with metal or Invisalign?" As I just said, I love the results, so yes, it was worth it...but just barely. I imagine if you had truly misaligned teeth before, the "worth it?" question will get a more obvious "yes." As for the second question: well, Invisalign will hurt too, make no mistake of that. But it will hurt less, since you have no sharp metal edges to rip up your soft tissues, and at least you can eat and floss normally. Take that under consideration before you decide. And always get a second opinion.

And keep smiling--even if your orthodontia scrapes a groove in your lip every time you do so.