Dental Part 14
Early in this journey before I had established a happy truce with Invisalign, I left a v/m for one of my brothers asking him to remind me why I did this. His chuckling return v/m suggested I had done it because my vanity is completely out of control. Ouch! 
While the primary goal is to fix my bite and avoid unthinkable dental work, as my brother correctly surmised, one does not have to scratch the surface too deeply to discover aesthetic motives.
First, straight teeth look better than snaggle teeth and let’s be honest snaggle teeth don’t age well. They just continue their march toward yellowed chaos. Of course when my teeth are straight, they will still be unattractive due to the chips, black triangles and varied lengths. But once overcrowding has been eliminated and the bite corrected, this opens the door for my talented dentist to work her magic. I can’t imagine what she will recommend but it does seem a bit silly to do all this and skip the pretty part.
It was pain in the crowded area that landed me in the periodontist’s chair initially. I asked the periodontist what happens if the pain converts from intermittent to constant. I was horrified to learn that the offending tooth would have to be extracted. In addition to a million other questions, how do you make that look good??? My substantial vanity could not possibly tolerate that.
Before proceeding, I did not fully grasp a significant aesthetic benefit. I was concerned that expanding the arch to make room for straightening the teeth would impact my appearance negatively. The periodontist assured me that the impact would be subtle and positive. I accepted this and moved on to the next question. For this article however I delved more thoroughly into this question and discovered that dental bone loss wreaks havoc both functionally and aesthetically. If function has declined, form has already been compromised. Rather than making your head spin with the details, will sum it up as simply as possible:
- Your outer facial appearance is a function of the underlying bone structure.
- If your bones change, so does your appearance.
- Healthy stable bone is maintained by the activity of healthy stable teeth.
- A bad bite and/or poor dental hygiene results in gum disease, unstable teeth and bone loss.
- Unmitigated bone loss results in tooth loss.
- Tooth loss without immediate implants results in a truly alarming rate of bone loss. Btw, just say no to dentures.
- Bone loss causes the lips and cheeks to recede, ie skinny Irish lips disappear and one gets a Wicked Witch of the West chin.
I had 360 degree bone loss as a result of years of a bad bite and early gum disease. I was delighted to discover that by addressing my bite and bone loss I also stopped sunken old lady mouth in its tracks. Yes indeedy I am very good with that.
And an important side note to consider. When looking up at a 10,000’ mountain it looks much larger when standing at sea level than it does at 5,000’. So it goes with your nose. If your lips recede, guess what is going to appear bigger? For those of us with prominent noses, this is totally unacceptable.
The moral of the story is to go to an accomplished periodontist in your 30s and periodically thereafter to monitor the status of bone health and gum disease. Chances are the dentist who is cleaning your teeth will fail to explain the details. Even if you follow all the dentist’s instructions about dental hygiene as I did, bone loss can still occur. And if vanity is of no concern, healthy teeth and a good bite have long term positive impacts on general health.
For the Curious and/or Vain
In my research, I read many articles on aesthetics and bone loss. The following article, while specifically addressing facial bone loss after tooth extraction, explains general consequences of bone loss quite well. Below is an excerpt. Now I know why I instinctively want to hang on to my own body parts. https://drkhazian.com/dentures-facial-bone-loss-premature-aging
“A well-shaped, symmetrical face with healthy looking facial skin needs an intact and healthy underlying bone structure. This is demonstrated well in young adults with intact boney structures. The same is observed in middle aged or even old individuals who have been able to maintain their facial structure. It might be called graceful aging but it is not an accidental phenomenon or due to luck. It is directly related to the state of their oral and dental health. A 65-year-old individual who has been able to maintain all his or her teeth looks much younger than the same age individual who has lost teeth and wears dentures.”
To understand how poor dental hygiene can cause periodontal disease and bone loss, read the following.
https://www.nidcr.nih.gov/OralHealth/Topics/GumDiseases/PeriodontalGumDisease.htm#canPeriodontal
Even with excellent dental hygiene, bone loss can occur as evidenced by my situation. Finding a succinct, non-technical article explaining why has proved difficult. Will continue the search and include upon discovery.
Maybe I wasn’t so great after all. Worse, she crouched down just before impact. I yelled don’t bend down but it was too late, she came in fast and low. I was propelled into the air, landed flat out leaving my skis exactly where they were. What a great photo that would have been.
So I am attempting to force the tray on my lower teeth and my finger slips and digs into my tender, Frankenstein gums. Yes, the F bomb came out of my mouth, vigorously you might say. It was not my finest moment. Of course I stood in the no longer serene room and apologized to all the young moms.
Soooo, let’s get to the question you have been dying to ask. How do you look after surgery? Not bad at first but the swelling kicked in on Wednesday and peaked Friday. 
Fair warning, these photos do not grasp the extent of the swelling but perhaps this story will paint an accurate picture. Earl was away for the weekend and when he returned on Sunday the swelling was almost gone. 
He duly noted that and then told me that I had looked like an old lady who lost her teeth. Hot.
Peak blackness was Sunday but those babies lingered through the following weekend. Come up with a good story. People either stare or ask. I like the “askers”. What I needed was some black lipstick to complete the look but alas my black lipstick was in Key West where such things are needed.
braces/invisalign by more than half. The first selfie above was the day after surgery, the second was 3 days after and the selfie with the zombie base makeup was at 6 days. And for comparison, the nonselfie photo was taken just before all this started. My vanity demanded inclusion of a normal photo.
Earl calls it “the press”. It is a relentless cascade of questions designed to skillfully penetrate or as the case may be, ruthlessly jackhammer through the chaff to uncover the truth or essence of a thing. Once found, the big picture and the way forward magically appear. Like all magic however, it can be used for ill-advised purposes such as searching for the answer I want. After initial research on the pros and cons of orthodontics at my age, I figured my dentist was an idiot. Hmmm.
A friend from the gym is the root canal guy of Annapolis and when I suggested I needed a new dentist, he recommended another local with a great reputation. The sign on the door said she was a Prosthodontist. I had absolutely no idea what that meant but visions of excruciating pain and suffering bubbled up.
And guess what, it is impossible to have a good bite with snaggle teeth. I don’t care how many times the dentist has me smash that blue paper between my teeth and he grinds away some offensive spot, the bite is wrong. For me, the term is subclinical periodontal disease. Everything looks fine on the surface but when you open the closet door, things start tumbling out.
Happily the path forward has been revealed. I am taking it. Invisalign and Wilkodonics may not have been the answer I wanted but they are the comprehensive solution I needed. The money has been paid, appointments confirmed and frankly, anxiety sky high. Next step is kicking off the Invisalign process…
The tooth fairy was clearly in a bad mood when visiting me. This along with my parents’ decision to forgo braces has led to adult snaggle teeth. A dentist would refer to this as significant overcrowding. My teeth are not straight when viewed from any plane. They jog up and down and back and forth with a bit of caving in to make it really interesting. And when my permanent teeth arrived, the dentist decided to grind down the extra long canines to avoid that unpleasant vampire look. I am not making this up. Plus my teeth were very cavity prone. Not sure it had anything to do the bandaid box of sweetarts I brought to school everyday but lots of cavities meant lots of dreaded dental visits often without novocain. To make it worse our family doctor supplemented our diets with constant antibiotics. That does amazing things to the color of your teeth.
Fast forward to 58 years old. I figured by keeping my teeth tidy and gums healthy, the really scary dental work magnified by an active imagination could be avoided. To this end I had my teeth cleaned 4 times a year, flossed, proxabrushed and replaced amalgam fillings with composite. But the snaggle teeth would not be ignored and I started to experience pain. My dentist said I needed braces. Whoaaa, I am 58, is that even possible? He said to see an orthodontist. This was the beginning of a learning curve that culminated in a decision to fix my teeth with Invisalign and Accelerated Osteogenic Orthodontics (AOO) also known as Wilkodonics. Unfortunately there is an incredible lack of awareness about Wilkodonics, even among the dental community. So in an effort to change that, I will chronicle the process from beginning to end. Hopefully it helps someone else out there.