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When I was 14 or so, I noticed the gap between my top two front teeth was sufficiently wide as to cause an occasional speech impediment, and also just didn't look so great. Being a teenager, I thought that there must surely be a simple way to remediate this, and so complained to my parents about it. I complained enough to warrant a special checkup at the dentist aside from the regular visits, and a referral to an orthodontist. I so did not know what I was in for....

KosAbility logoKosAbility is a community diary series posted at 5 pm ET/2 pm PT every Sunday by volunteer diarists. This is a gathering place for people who are living with disabilities, who love someone with a disability, or who want to know more about the issues surrounding this topic. Our use of "disability" includes temporary as well as permanent conditions, and small, gnawing problems as well as big, life-threatening ones. Our use of "love someone" extends to beloved members of other species.

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It turned out that my 'Wife of Bath' look (wasn't yet acquainted with Chaucer) was the least of my worries. X-rays, impressions, measurements were taken, and they led to a whole different prognosis and treatment than just closing that itty bitty gap. It was discovered that my upper jaw was too small, and the lower too large, and the only answer to that not becoming worse was surgical intervention.  I suppose I knew that my 1/4+" underbite might also need to be corrected, but had never considered that that might be a major issue....and so we began a multi-year plan.

First, there was the goal of simply straightening the teeth, which also included the removal of wisdom teeth. That was accomplished as an outpatient visit at the oral surgeon's office in an afternoon. He used sodium pentothal as an anesthetic, and doubled the IV dose just for good measure. He knocked me out so completely that he had to carry me out of his office 4 hours later. When I finally woke up at home, I noticed something uncomfortable at both corners of my mouth, managed to get awake enough that I could get to the mirror and see what, and then snip out the stitches where he'd had to make incisions on both sides to widened my mouth to complete the wisdom tooth extraction.  I was 15 then, and the next three years were spent coaxing the teeth into the right spots to be ready for the surgery.

 Yes, you read that right. Surgery was the only way the experts thought that the facial structure could be corrected, but it couldn't be done until I passed a predicted final growth spurt, so that the bones were pretty much set where they were going to be and wouldn't move, grow, or otherwise undo what the surgery was to accomplish. Given that I was 5'6" at 15, and 5'10" at 17, seemed to demonstrate that it was a prudent course of action.

So here is what happened next. The surgery took place on December 18th just after I turned 18. It took, I am told, 14 hours, and required all three units of my autologous blood donations (27 needlesticks for those three units), and two more from a family friend (AB-, aren't I just so special?). They basically removed both maxilla and mandible, lengthened and widened the maxilla, shortened and narrowed the mandible. I woke up very late that night in the surgical ICU with nasal trumpets, arterial lines, wrist and ankle restraints, and my mouth wired shut. My mother fainted when she saw me, the surgical aftermath was so unpretty. Financially, I was covered under the parents major medical and dental, and the tab was upwards of $80,000. The oral surgeon mandated Haldol for me, since he was so concerned about my mental state at that point (I refused to take it, btw).

I spent the next two months sucking down Ensure (and learning a lot of ways to make it taste better), carrying a forceps and snips kit in my purse just in case I choked or barfed, and lost 40 pounds. The bruises and swelling lasted well past that. Developed quirky sign language all my own, and felt superior when I'd curse a blue streak because nobody could understand me enough to be offended.  Two more years of braces to get everything where it was supposed to wind up, and it was all done.

And I say all that to say this: when my lovely daughter began to show signs of that same bulldog expression when she was about 10, and I was able to report that and my history to her orthodontist, it set her on a course of preventative, rather than corrective, treatment, and although her experience was rather prolonged, encompassing orthodontia with special appliances to keep the upper and lower jaws matched, she never had to face major surgery, general anesthesia, blood donations, serious daily impairments while recovering, or psychoactive medications.

To look at the before and after photos, it would be hard to tell that both were me. I'm happy with the results for the most part, these 27 years later. But I'm much happier that the fantabulous kitkat did not have to endure the really miserable stuff. The lesson I took away from both of our experiences was that caught early enough, the condition could be corrected, and I am so glad we caught it earlier with her.

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