Tuesday, 6 November 2012

Chapter 1 - Told I would need Jaw Surgery


So lets get started. From a young age I was told by my dentist that I would need to be referred to a maxi facial clinic with regards to my bite and jaw length. At this time in my life I could not see what was wrong with my face and thought that some brace work might fix the issue. When I was first seen at St Mary’s Sidcup, I was surprised at how dramatic they thought my condition would be and told me I may need 1 or possible 2 operations on my lower jaw when I reached 18. This was a big blow to me and from this point I believe I became very conscious about my face. As I was concerned, I confided in my primary school friends. But when I did so, they all started to notice my jaw and some of the boys in the class would point fun at me.

After this stage I was told I would need 7 teeth removed (some of these were baby teeth). I went ahead with this and I was fitted with braces on my lower teeth only. I wore the lower braces for around 4 years and had them removed at the age of 16. I was then told when there was enough appointment availability at the hospital, I could precede with treatment in preparation for my jaw operation. This would include more brace work on both my upper and lower teeth. By this time in my treatment I had developed quite a noticeable curvature in my jaw (asymmetry) and my jaw looked to swing to one side. This greatly reduced my ability to bite on my back teeth. But as I had grown with this deformity I did not notice any difficulty.

By the age of 19, after nearly three years of waiting I went to my dentist for a check-up and expressed my distress of waiting so long to start treatment. My dentist suggested that I could be referred to Kings College hospital and Guy’s hospital in London. He advised that they were much better equipped for this type of surgery and also stated the waiting lists would not be so vast. True to his word, I was seen at Guy’s hospital a few months later. I was signed up to Mr Shaun Matthews’ clinic at Kings College who deal with facial surgery and Dr Cobourne the orthodontist at Guy’s for the pre-surgical and post-surgical brace work. At this point I was reassessed and had all new x-rays completed of my upper and lower jaw. This was when it was uncovered that I would need both my bottom and top jaw operated on. The upper jaw needed to be popped outwards and rotated slightly to line up with my nose and the bottom jaw with the large curve would have to be rotated around to reach the mid line with my nose. Unlike St Mary’s who wanted to wire my mouth shut for a period after surgery , Mr Matthews stated he would like to fit in titanium plates and screws to hold my jaw in place indefinitely and use elastics for the first few weeks. By doing so, this would hold the jaw whilst the bones secured themselves back together again. Mr Matthews also stated that he would be able to do all of the work in one operation and there should be no need for the second operation.  Having discussed all the risks with the team I decided to proceed with the treatment.

Please note that at this time maxillofacial surgery has now been re-labelled in my case as orthognathic surgery.  Orthognathic surgery relates to the mandible and maxilla (upper and lower jaws) and is the surgical correction of a birth default or an abnormality that has presented itself as a person has grown. Maxillofacial surgery is a procedure used to treat disease, injury or defects of some or all areas of the face and neck. 

In September 2008, at the age of 20, I was fixed with rather large metal brace work. Unlike the small and fragile looking brackets and wires I had worn before these braces felt much heavier and larger. This was a little bit of a shock to me as I was already conscious of my jaw and the way I looked prior to braces. Now I was a 20 year old lady with serious confidence issues and now having to contend with braces. At this point in my life I was attending my first year of university and working as an auditor and admin assistant 16 hours a week. I had no other health issues and was reasonably fit. I was in a relationship with my boyfriend for over a year and he was fully aware of what laid ahead, in terms of treatment. When I first had my braces a few people at work and university commented. But it was not as bad or as damaging to my confidence as I thought it would be. My family, friends and boyfriend were really supportive and when I was feeling down would always remind me that it would be a short term measure and it would not be like this forever. All in all, my treatment should have taken 3 years. However, we are now 4 years down the treatment plan and still going. You will discover why my treatment has been so extended as the blog progresses. 


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