Treatment Plan (or lack thereof)

Well after I left the hospital and went home to wait for surgery, it was a giant fog. I have to say that I don't remember a whole lot from that time, other than being in a LOT of pain and that my parents took my son to their place for the weekend so that I could rest and not worry about scaring him. Bless their hearts.

I went home on the Wednesday, probably sometime around noon, and crawled into bed with a heavy dose of narcotics. Still with my front lower teeth flopped out, still with my lower canine hanging on by a thread in my mouth. I know that somehow I made it to Friday like this, because that's when I went in for my surgery - the oral surgeon put my face back together.  Essentially this involved pushing the block of bone holding my upper front teeth forward, pushing the block of bone holding my lower front teeth back together, and re-inserting the lower canine that had been avulsed.  Since it had been loosely attached and remained inside my mouth all this time, it had a good chance of being viable.

Here are before and after photos from the procedure:

The interesting part about these photos is that the wires and arch bars are attached and holding my bone/teeth where it's supposed to be, but did nothing to address the broken condyles.  According to the x-rays, only the left side was displaced, and the right side, while a complete break, was not displaced.  The general treatment plan for this type of condylar fracture pattern is to leave well enough alone, hoping that the undisplaced side would help to maintain the position of my mandible and allow the whole thing to heal on it's own.

As you can see, I wasn't even wired shut. A diet of soft food only - strictly NO chewing - would help to keep the pressure off the breaks and allow them to heal.

The other thing that I notice when looking at these photos is how straight my bottom teeth are, and the top don't look too bad either, with the exception that I am missing the cap from the lateral incisor. Embarrassing, yes, but only a temporary situation.  Since the wires that hold the arch bars in place are  wrapped around individual teeth (and mine were crowded to begin with) they don't do great things to your teeth orthodontically.  Now that I'm 11 weeks out from this day, I can see how much my teeth have moved, and not in a good way. You will see in later posts.

From this point on, I am in for weekly visits with the oral surgeon to monitor my progress, jaw placement and tooth status. The main things he was watching for are that my jaw is healing in the correct position and that none of my teeth (particularly the one that he had to replace) are dying.