Wednesday, January 30, 2008

More Hardware

Anyone recall this post?

The one in which I share the news that (according to Joseph's orthodontist) my son will likely need major corrective surgery on his jaw at around age twenty.


After having detailed records taken -- x-rays, photos, molds of his teeth -- and meeting with two orthodontists, we discovered there's a good chance Joseph will not need surgery down the road.

(Thank. God.)


Joseph does need some (rather expensive) orthodontic work.

And he needs this work to begin ASAP.

Starting with this:

It's called a "palate expander."

(Though to me it looks more like some sort of medieval torture device.)

What does this thing do?

Exactly what the name implies-- it expands the upper jaw.

And it does so via the turning of a metal "key" (my job, once the hardware has been installed in my son's mouth).


After turning said key once a day for approximately four weeks, the expander simply stays put for another three to six months-- and is then replaced by a retainer that will be "cemented" to the roof of Joseph's mouth for another eight months.

Did I mention the head gear?

Oh yes, there will be head gear.

This hockey-mask-like thing will have to be worn every night (for at least 10 hours)-- attached via rubber bands to the expander, and then eventually to the retainer.

Needless to say, Joseph is not pleased.

And he hasn't even heard details about Phase II.

You see, the orthodontists tell us that our son is "an interesting case": he has a pronounced cross bite; a bit too much space between several teeth; and top molars that line up a full tooth behind the corresponding bottom ones-- yet "surprisingly, he doesn't have that 'Jay Leno' profile."

As a result of these anomalies, braces will follow.

And -- to avoid creating more/larger gaps -- so-called "mini screws" will likely be drilled into the bones above his eye teeth (by an oral surgeon) in order to anchor the braces.

Joseph will need to wear this apparatus for at least two years.

(And I was worried about the invasiveness of a CGMS.)

Oh, and my God-- the cost.

We're talking all told, over $6,000.

To be honest, when I first saw this figure I thought the whole thing was hopeless.

However, we do have a dental insurance lifetime benefit of $1,000 (I know-- seems like a drop in the bucket, but it helps), and the orthodontist offers a no-interest payment plan.

Also, by the time we reach the more costly Phase II, Evan will be in elementary school-- so I'll be in a position to work at least part time.

I just have to believe the money part will be OK.

And hope to high heaven that the actual wearing of all this new hardware will be OK for Joseph as well.


Shannon said...

Poor Joseph!!!!!!

I can't believe in this day and age they haven't come up with less tortuous equipment to do the job.

Penny said...

It realaly does look like a medieval torture device. (I really don't like teeth so the picture nauseated me a little.)

Poor Joseph. Not only does it sound a tad painful it's going to be going on during his pre-teen years. That's a tough time for anyone.

It's not bad enough that he has D to contend with but this too. It makes me mad. I'm not sure who I'm mad at, but I'm mad just the same.

But, knowing Joseph as I do through your posts, I'm sure he'll take it all in stride and be just fine.

(It still makes me mad though.)

Jillian said...

Poor Joseph!

I agree with Shannon you would think they would figure out a better way to do all of this by now.
I too have a severe cross bite, so some of this is a glimpse into what I'll be going through in the coming months. I had a friend who had a plate expander it really changed her speech (just fyi). I'm sure it will all work out and all of you will figure out a way to deal with (financially and emotionally.)

Carey said...

Poor kid. Sorry about the bad news.

Allison said...

But just think, surgery would have been WAY more expensive.

So yay no surgery!



Alison said...

Ahh the palate expander. Memories. I had to have that as a kid as well. I totally feel for you. It was a rather strange experience but the results turned out great in the end. Like you, my mom was also the designated key turner lol. I'm very suprised that they're still using some of that stuff actually. To be honest though, as annoying as the palate expander was, I actually found having to wear the rubber bands awhile to be even more annoying. It is a big process but it'll be worth it down the road guys. Hang in there. :)

Sandra Miller said...


It was a little bizarre, sitting in this very high-tech orthodontist's office looking at computer-animated images of how all this "tortuous equipment" works.

I kept asking if there were any other options...


We had our follow-up consultation with Joseph's original orthodontist about two weeks ago-- and then yesterday, I went in for the second opinion.

My head has been swimming with all of this for a while now.

I'm mad too.

And yeah, the timing for Joseph isn't wonderful, however, his attitude has been better than I thought it would be (so far).

At first he was really upset, but when he realized that many of his friends either have (or are getting braces) he started focusing on how terrific his teeth are gonna look...


I've read about the speech changes too-- though I haven't told Joseph about it yet.

I'm sort of taking it in stages, getting him used to the idea of wearing all of this stuff first...

As far as the financial part-- if we could just not do anything, that would really be the best thing.

But, knowing that his bite is so far off-- and could really cause problems for him down the road if we don't do something now, makes "doing nothing" not an option.


That's the first thing I thought when we got the news. :-)

I was so glad that we could do something-- and that it wasn't surgery.

Then I saw the treatment plan.


But still, I'm totally with you on the "yay no surgery!"

And Alison-

Thanks for chiming in here-- I was hoping that someone who experienced wearing this stuff would comment.

I'm so glad to hear that you feel it was all worth it. :-)

Colleen said...

Two sons, two sets of braces, one expander. Vacations, what vacations?? But - they're grown and when they see a new dentist, they (new dentists) always comment on what a great job someone did with their teeth.
About the expander - my biggest fear was dropping the tiny screwdriver down his throat - never did though!
Take a photo when he starts and is finished (yay!) - both of our sons love the photos I took the day the metal came off!
Oh - another fun experience, sitting at the dinner table when one of those tiny rubber bands pop off and fly across the table. Ahhh, the memories.
Joseph is cool, he'll do great!

Sandra Miller said...

Thanks, Colleen. :-)

landileigh said...

i went through that with my daughter, exactly what you are describing. she also had oral surgery to remove her 6 front upper teeth. she had no room for her permanent teeth at all.

but when i see this picture:

it makes it all worth while!!

Paige said...

Oh no. I remember the day that I got my braces (at 16) like it was yesterday. I cried, my mom cried - I was pretty miserable. At least Joseph's not dreading it too much yet. I'll be thinking about you guys.

Donna said...

I never had the expander thing, but I had the head-gear and those oh-so-fun rubber bands. Sorry you have to go through all of this. It will probably be harder on you than it is on him. But Joseph seems like the kind of kid that takes things in stride so I'm sure he'll do fine. Hang in there! :)

Major Bedhead said...

Good lord. That looks horrendous.

My sister had that palate expander and for a while there, she looked like she was missing every other tooth. I used to call her Cletus. No wonder she used to hit me....

Anonymous said...

I had a palate expander - got it when I was 11 and had it for 10 months. I had it on the top and on the bottom too. It was extremeley painful the first few times, but you get used to it. It's definitly not as bad as it looks. And the speech thing, you get used to that too and eventually sound almost normal. The cemented in retainer is not painful at all and you barely even notice it - I got glow in the dark that way it would look cool. They're super common.

I never even thought braces hurt - it wasn't even an issue for me - it was more of an annoyance that I had to leave school once a month to go to the ortho. That all took 3.5 years but it was def worth it.

leslie said...

I had braces w/headgear - back in the dark ages pre-expanders when they pulled permanent teeth to make room. One of my kids went through the expander and 2 separate rounds of braces, another had oral surgery to attach brackets to two teeth that hadn't descended, which were then pulled down and aligned w/rest with braces. Child #3 is just starting braces after a couple of years of retainers didn't do the trick.

Our orthodontist is richer than we are to be sure! None of the orthodontia was horrible. The girls have complained most about bone pain for a day or so after each orthodontic appointment when things are tightened but it hasn't been intolerable. Wearing the headgear at night is uncomfortable but avoids the misery of having to wear it at school

Joesph will get through it ok - it's tedious and uncomfotable but so much better than the major surgery you were anticipating!

Kendra said...

Gosh. This much "stuff" for one kid to deal with - it just ain't fair, Sandra. I had braces for 2 years, pretty simple case - and golly day did they ever get painful now and then - but to be honest my biannual cleanings at the dentist still make me wince more than they ever did. I'm amazed at how positive Joseph is, he's quite a guy. :)

Jamie said...

Holy Schmoly! Ok, so there's no surgery - that's good ....

I'm with Shannon though - I can't believe that in this day and age they haven't come up with something a bit more, um, streamlined to fix this.

One thing though - he doesn't have to go out in public with the head gear. Poor dude. Not fun stuff :(

Sandra Miller said...


Thankfully, there's been no talk of removing teeth.

Though one braces option involved creating gaps that would require putting in two fake teeth.

We nixed that one right away.

Instead, opting for the "mini-screws."


So far, the dreading has been minimal.

Though, knowing Joseph, it's going to take some major getting used to that expander.


I hope you're right!


Since Joseph already has a bit of a gap between his top front teeth, that expander is gonna give him quite the Mike Tyson smile.

He is NOT liking the sound of that at all, but I keep telling him-- "it's only temporary, it's only temporary... "

Anon & Leslie-

Thanks for sharing your experiences with this.

You're right-- though it may be annoying, unpleasant (and at times, even painful) Joseph will get through it.

And it will be so much better than surgery.

But still.

He already has the diabetes to deal with-- and that is exactly what makes this whole thing more than a little maddening to me.


I think he's quite a guy, too. :-)


That he doesn't have to wear the head gear in public is definitely a silver lining in all this... :-)

Nicole P said...

Holy crap. What a suckfest.

For Joseph, for you. But I have every confidence - that Joseph's confidence - and yours in him - will help him to weather this stuff with aplomb.

As for the money. Why is it that we have to PAY so much to be tortured by medical equipment? That is, in my opinion, one of the world's greatest injustices...

Sandra Miller said...


Thanks for the vote of confidence. :-)

And yes-- that we have to pay so damn much for this "suckfest" does indeed make it feel all the more unfair.

Anonymous said...

I'm sorry he has to go through this. On some levels, I'm glad you're able to do this for him.

My childhood dentist didn't tell my parents that he had concerns (very similar to Joseph's) until I was nearly 18. Yeah, who wants to go through that when you're in college? (Besides the fact that my parents didn't have the money.)

So, I didn't have the work done. I could decide to do it now. I'm facing at least SOME work in the near future, but I doubt I'll go the full orthodontia route (because adult orthodontia isn't covered). It's not causing me problems, despite warnings it would.

I'm not sure how I feel about all of it. Sometimes, I wish I had the perfect smile. Sometimes, I'm happy for being unique.

Sandra Miller said...


There have been (many) moments over the last couple of weeks when I've thought we should just do nothing.

That Joseph doesn't need "the perfect smile."

But then I'd think about everything these orthodontists have told us-- and how what two years ago was just "a subtle underbite" has turned into much more.

And that it could get a lot worse by the time he's grown.

I also worry about how much more difficult it would be to address these issues when he's an adult.

So yes, I'm very glad we can (at least I hope we can) do this for him, too.

Bernard said...

One of our daughters has had a palate expander. That part is annoying but not terrible. The rest does sound awful.

Do you have a health care savings account at your employers? You know the one where you put money in during the year and take it out to spend on health costs not covered by insurance. If you can enroll in this, at least you can save some tax dollars on these expenses. It will (slightly) ease the pain in your pocket.

I hope Joseph does OK with all this torture. Let me know if he needs a small sussy.

Anonymous said...

my brothher had to wear that, he got used to it. God bless him. HHJoy