Monday, April 6, 2009

I love my orthodontist

Look at this letter! It was worth waiting for.

Dear Sir or Madam:

Stephanie presented to me for an initial orthodontic consultation on November 30, 2007. Her subjective complaints included migraine headaches, chronic TMJ pain, and chronic oralfacial muscle pain. Stephanie also reported severe pain upon eating hard foods and had therefore contained herself to a diet of soft foods.

Upon clinical examination it was noted that Stephanie exhibited excess gingival display due to excess maxillary vertical growth. The mandible also displays excess vertical growth giving Stephanie a dolichofacial facial type. Popping and clicking was detected in both temporomandibular joints. Class I molar occlusion was noted bilaterally with moderate crowding in the upper arch and severe crowding in the lower arch.

Cephalometric analysis revealed a mandibular plane angle of 53 degrees, where the normal measurement should be 33 degrees. Her SNA was 74.5 degrees (norm: 82 degrees), her SNB was 67.5 degrees (norm 80 degrees), and her resulting ANB was 7 degrees (normal: 2 degrees). The cephalometric analysis demonstrated that despite Stephanie's Class I dental occlusion she has a severe Class II skeletal relationship.

It is my opinion that this discrepancy between the dental and skeletal relationships is a major underlying contributor to her current muscle and joint pain. It is my opinion that Stephanie's TMJ and muscle pain are secondary to her skeletal deformity as previously described. If Stephanie's skeletal deformity is not addressed soon via surgery she will be at very high risk of developing permanent joint changes leading to a lifetime of continued joint and muscle pain.


Okay, so to tell you the truth I don't understand what most of this letter says. Anyone? Anyone? What's all that degree stuff mean? And I have excess vertical height on my mandible, also? No wonder my face looks kind of horse-like (growing up, I HATED the "why the long face" comments I used to get).

He also included x-rays and photos from my initial appointment - and sure enough, my TEETH were Class I! Who knew? No wonder I had no idea that I had an overbite - I didn't have one! Now there's no denying it, for goodness sake.

This gets dropped off at my benefit coordinator's office TOMORROW, along with my journal of pain and migraine counts - I'll post that and my personal appeal letter soon.


V said...

Fingers crossed for you hun! Don't think anyone can dispute that letter hun!

I think the cephalometric analysis is to do with all the measurements they take of your skull... So the degrees are the angles of the different planes... But I'm not a head and neck surgeon so I'm not sure :)


Katherine (Kate) said...

Fingers crossed this does the trick and you can just focus on the details of surgery/recovery itself!

As far as what it means, it's just the fancy jargon for what you already know: Excess manible verticle height + excess maxillary growth= too much up/down growth of your bottom jaw + upper jaw respectively, or the 'long face' you mentioned. They sure know how to make it sound like we're freeks, no? haha.

All those degree measurement are like V mentioned, and deal with the angles considered normal in how the face is put together. If you want to peak, here's a link that shows what all those abbreviations mean and where specificly they apply. Fairly medical, but at least you can see what the're talking about :)

funkyrhodes said...

I think doctors have conventions for the sole purpose of having someone they can talk to and actually understand each other! I hope that letter does the trick for you!