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On Wednesday, July 19th I had my second orthodontic adjustment. This was dramatically different from what most people go through during an adjustment. I got fitted with orthodontic implants. This is a very new technology, that has been in use in Europe for about 5 years, and only for the past 2 years – in North America. My orthodontist is also a surgeon himself, and has been practicing use of these implants for a little over a year.

The purpose of using these implants is to move some teeth without affecting the other teeth if they’re already positioned well or would be adversely affected if they were used as anchors. In my particular case, all back teeth have to be moved forward, and relying for this on my front teeth would be wrong, because they’re in good relationship to each other as it is (Relatively speaking – they have shifted since the treatment started. Some gaps appeared at the bottom and top midline has shifted, but all in all, they’re well positioned above/below each other and bite is also fine in the front).

The procedure begins with an X-ray. They did a Panorex, so the doctor can see the exact current positioning of the teeth and evaluate where the implants should be placed. He decided I needed 4 of these suckers, right in the front. 4 spots were frozen topically, then I got 4 shots. That was pretty unpleasant, but objectively speaking, DURING the entire placement, these anaesthetic shots were the most painful things. Now, AFTERWARDS, is another story, but I’m getting a little ahead of myself…

After the shots I was told to rinse with Peridex for 30 seconds. It was kind of awkward because 2/3 of my face got numb very quickly and I wasn’t controlling my mouth that well. The face was frozen from about middle of the nose bridge, through the nose tip, down to the chin. I rinsed as best as I could and spit out. Then they waited around for a few minutes and it began!!

Using a sharp hook that dentists use to clean out stuff from between your teeth and poke in cavities, Dr. touched my gums to test where I still had sensation and where it was numb. Then, looking at the Panorex a lot, he used that same sharp hook to make holes, markers for where the implants would go. It didn’t hurt but feeling the pressure from your gum being pierced is no fun. Then he grabbed a small sterile package with a titanium “screws” (that’s what the implant is, basically). He said the size was 1.64 or 1.46, something like that. That’s probably the diameter in millimeters. The screw head, the part that I now see screwed into my jaw, looks to be about 2mm in diameter. So he put this little screw onto a tip of a screwdriver, and started driving it into my jaw. Each implant took about 45 seconds to fully screw in.

Then he gave instructions to one of the assistants what kind of wires to put in, how to tie wire figure 8’s to what teeth, and where to put powerchains.

By the time they figured all that out (about 5-7 minutes) my anaesthetic shots were unfreezing and I started feeling very raw pain, all over the mouth and face. They gave me ibuprofen, but it was a little too late, as it took a couple of hours to work. If I knew it would be so painful, I would’ve taken Ibuprofen at home prior to this. A megadose, too.

Interestingly, they said some people don’t feel anything at all, others feel this incredible pain (which I did). I personally think this can’t NOT hurt, it just some people’s shots take longer to unfreeze, so they probably start feeling pain a bit later.

On the pictures below, you will see how they tied my teeth. They chose one tooth to act as an anchor for those that are to be moved forward. That anchor tooth is tied with a wire to the implant, to prevent it from moving itself. Then the brackets are fitted with a clear powerchain, which will pull the back tooth forward.

You can see my teeth, especially the bottom ones, have loosened up considerably and look pretty messed up. Lots of spacing there now, about time to start keeping them place!

Wire ties and partial powerchains.

Obviously, it’s done in steps. So first one tooth will move foward, and once it’s in the right position, it will become an anchor for the tooth behind it, and so forth.

At the end, I rinsed with Peridex one more time, they took pictures of my new hardware setup – or as the doctor called it “jewelry” – and I was on my not so merry way.

Length of treatment with these is still undetermined for me. I wasn’t given a specific answer, except a “reassurance” that it’ll be “more than 6 months… hopefully less than a year”. Basically for most of the treatment I’ll have these in, that’s my entire treatment pretty much. Once the implants are out, there will be only minor re-adjustments left, like put the midline back to the middle, and sort out other small things.

Afterwards, the pain was horrible, really quite monstrous. My mouth felt like one raw open wound. I went straight home and took a nap – no way you can work feeling so much pain. By the end of the day, I took 8 ibuprofens total but it still hurt. It’s almost like it didn’t help at all!

After the nap, I felt I could eat a bit, and had watermelon cut in small chunks. It was easy to crush with the tongue and swallow. Still, took me a while (I ate 1/2 watermelon, my only food in about 12 hours), and as soon I wanted to eat a clementine orange, I realized all my teeth hurt and I can’t bite down. This was way worse than when I just got braces. Implants cut into the lips like crazy, again – much worse than the brackets ever did. They’re positioned under much softer part of the lip, so I feel them more.

I was prescribed Peridex for 2 weeks, to keep bacteria away from the implants (it was a minor surgery, after all), but I wasn’t up to going to the pharmacy that day, so at night I rinsed with a strong solution of sea salt. Same thing in the morning. It stings like crazy, but is a good idea, as the pharmacist told me today. I did get the Peridex and started rinses.

Adjustments will now be more frequent – yay! Instead of the regular 6-8 weeks apart, I’ll have to go in for a check up every month, which I think is fantastic. At least I’ll feel like there’s something happening, at least some progress, however minor.