Wednesday, October 10, 2012

Trying to be a good mom

Being the mom I want to be is not just about healthy family dinners, holiday traditions and quality time. It's also about making good decisions for my kids.

Sometimes it's difficult to know what is right.  There are so many things to weigh and we can never see what the future may hold.  When Allie was 7 we took her to the orthodontist, knowing braces were in her future.  The orthodontist wanted to have 4 baby teeth extracted.  Allie COMPLETELY FREAKED out at the dentist--my normally quiet, reserved child was kicking and screaming so bad that they made us leave out the back and come back another time before they opened when no one was there and finally decided Allie would need sedation.  Allie had had tubes put in her ears the year before and had a bad reaction to the sedative, so we decided that the baby teeth would come out on their own. We would deal with braces when they did. I don't remember anyone mentioning anything about her bite or jaw growth; this was, I was told, to make room for her adult teeth to come in.  Looking back, maybe we should have forced her to get sedated to get those teeth out.  Hindsight is always 20/20.  Trying to spare her then may mean more pain now.
this is her jaw closed--top teeth don't overlap bottom teeth 

A couple of years ago, we went back to the orthodontist and were told that Allie's bite needed work and if we addressed it too soon and then took the braces off and she grew a bit more then it could reverse the work done on her bite.  She also needed 4 teeth extracted which could have meant going through the gum, drilling into the jaw and extracting the teeth--neither Jason nor I liked the sound of "drilling into the jaw" in four places, so we asked for alternatives: wait two years for those teeth to come in on their own.  So we did.  I thought we were doing the right thing by waiting.

Now here we are, two years later.  I went to the orthodontist, expecting a referral to an oral surgeon for the extraction and then to start treatment...only the orthodontist I saw--same practice, different orthodontist--said orthognathic surgery would possibly be part of treatment.  Orthognathic surgery involved cutting and sectioning the jaw and then fusing it back together with screws and then wiring the jaw shut until it is healed.  I was horrified.  BUT, I want to do what is right for my daughter and as painful and horrific as that surgery sounds...a PROFESSIONAL who has been trained in this field is recommending it.  Of course, I am getting a second and actually even a third opinion.  This kind of surgery, to my personal belief, is not something to be taken lightly.
photo credit: Staples Orthodontics

Allie's "prominent chin" as the orthodontist kept referring to it is hereditary, my dad has it, my uncle has it.  It's sort of "the family chin".  My mother says it's a "strong chin".

her top front four teeth are behind the bottom, the rest of the molars, etc. line up/overhang fine
My question is: is it worth the risk?  Obviously, if she develops pain or has issues chewing down the road, then it will be necessary.  But if she doesn't, is it worth the risk?  Our body is beautifully and  wonderfully made and I am not a big fan of altering it unless there is a medically necessary reason.  My feeling is that God made us in this wonderful and special way and once we start messing with that we could be asking for trouble.
Some of her teeth are over others, most line up fine, her midline is good.

Right now, being the mom that I want to be requires me to research this surgery, to learn about alternatives, to know the risks associated with the surgery so that I can make an informed decision and not just say: that is horrific, you are not doing it (even though that is what I want to do).  Right now, being the mom I want to be means getting up the courage and strength to fight with this orthodontist to get copies of the records so that we can get a second opinion (they don't bill insurance until we start treatment so they don't want to give up the records even if I pay for them).  Right now being the mom I want to be means not backing down because I don't want my daughter exposed to more radiation than necessary.  Right now being the mom I want to be means instead of spending time baking, I am researching which orthodontists in my area have had success treating this condition without surgery and what were the results and methods and are they more appealing and will they take Allie on as a patient and finding out if they feel she is a candidate for the non-surgical treatment.  Right now being the mom I want to be means that I am making appointments with orthodontists all over the tri-state area.  Right now being the mom I want to be means being HYPER-aware of Allie's jaw and how she chews her food; observing that not only can she close her mouth, she keeps her mouth closed when relaxing.
bottom lip should not extend beyond top lip
according to the orthodontist
I will be honest, I have been beating myself up quite a bit, too.  Why did I not have her sedated for the extractions of baby teeth?  Why did I not go back to the orthodontist sooner?  It's my fault.  Had they started treatment earlier, maybe this could have been avoided.  I had no idea surgery was even a possibility.

Sometimes we have to arm ourselves with information and make informed decisions.  I know some people believe you need to trust professionals, but I think you also need to do your own research and make decisions that are BEST FOR YOUR FAMILY.

Being a mom is hard work.  It means wearing a lot of hats and advocating for your children.

UPDATE:  We had our second opinion appointment and were told this is a skeletal issue.  We knew she had inherited this jaw from my father and we also knew that her teeth lined up this way when she was a toddler.  Anyway, the only way to correct it is with surgery when she has finished growing IF it becomes a problem of some kind for her.  The doctor said she had a beautiful smile and not to address it unless it was causing a problem of some kind, as orthognathic surgery is not something to be taken lightly.  I did ask if we had intervened sooner if this could have been avoided and he said definitively no and that I would have been mad at him if we had intervened sooner because there would have been nothing he could have done about the lower jaw.

ANOTHER UPDATE:  We had a third opinion appointment, the orthodontist is considering a palatal expander, but wants to get copies of the x-rays from the other practice first.  We are praying they can do something with the palatal expander.  He did say this would "help" but not "fix" the problem, as she was born with/inherited a skeletal condition.  He also did, however, agree that surgery was not something to enter into lightly IF there were no other issues and if other family members with this jaw did not have issues.  He said many oral surgeons do not even like to do this surgery anymore.