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Orthodontics before surgery

Dr. Hockel was the coordinating orthodontist for Dr. Movahed as I continued on orthodontic prep.

As a starting point, my teeth were super crowded and I had a very high and narrow palate due to mouth breathing over my early development.

Our first month of visits were focused on straightening out the teeth. As it was my first time getting braces, that was definitely an experience. Initially, I flat out completely hated it. Yikes, all the bits of food in your braces that get stuck.

Key tips to surviving:

  • After you get an adjustment it will be sore for a bit. Go eat some ice cream, soy cream, or whatever cold, frozen pulp you can find. Eating a nice panini is not happening!
  • Get a Waterpik. I gave up flossing. Couldn’t do it with the flossers required to get underneath. Went straight to Waterpik. My general dentist noted that the spaces were clean between so it was doing good. I even bought a travel Waterpik too for trips. It is better indeed if you floss, but I had trouble with it.

As the teeth got straightened out, we expanded my bottom palate which could move with orthodontics. And he started putting in springs and spacers to increase the gap where Dr. Movahed would make his cuts between teeth for the sectioning of the mouth. In MMA surgery the top jaw is always cut into 3 sections and spread open more. The bottom is just expanded with orthodontics. In my case though, with losing a tooth he would basically do the three section split there too.

There were minor typical issues here and there but Dr. Hockel worked through every one the best way he could. Finally, he could sign off and say teeth-wise, we were ready for surgery.

He was also key in signing off when my teeth were in close enough position to begin fabrication of the 5 month lead time custom joints.

I’ve seen some other blogs where people did not do orthodontic work first before surgery. This to me is crazy as a mechanically minded engineer:

  • If you want to get the jaws in the right position your teeth need to be at least reasonably aligned ahead of time or how would you make sure the surgeon could touch down at the right points.
  • If you don’t put the spacer in ahead of time to open up between the sections made, they would have to cut closer and closer to your neighboring teeth and potentially have more problems with those teeth surviving.

Moral of the story: don’t skip the pre ortho. Unless for some reason Dr. Movahed signs off and says absolutely none is needed, which maybe you have straight teeth and it’s all good. But I can’t imagine anyone who truly has a mouth breathing issue not needing some pre-expansion work.


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