< Treatment Timeline

So although a lot of children and teenagers have braces at some point in their adolescence, cleft lip and palate patients are (in my opinion) the experts when it comes to braces. As a patient myself, I have worn braces in some form or another for over half my life. From when I lost my last baby tooth when I was nine to now at twenty years old.

A brief timeline of my braces during my cleft treatment

9 yrs old

• A wire structure across my palate (not visible)

• To prepare me for my bone graft.

10–16 yrs old

• A clear plastic retainer with false tooth that hooked onto my back molars (not visible)

• To keep my teeth in place after my bone graft and to fill the gap where my central incisor hadn’t grown.

16–20 yrs old

• ‘Train tracks’ (visible)

• To straighten my teeth.

• Elastics across the braces (elastic chains) and between the jaws (daily replaceable ones)

• To help move my teeth and to align the jaws correctly for jaw surgery.

• To keep the jaws in the right place after surgery.

19 yrs old

• Worn with the train tracks: A bite raiser (a very thick but soft bit of plastic) (not visible)

• To try to soften my bite to alleviate pressure on the top jaw after the first round of jaw surgery. (This is not an expected part of cleft orthodontic treatment)

20 yrs old

• A plastic retainer (like the one worn from 10–16) (not visible)

• To keep my teeth in the right place and to fill the gap where the central incisor should be while I wait for my false tooth bridge to be created.

• A clear plastic retainer (like a gum shield) to be worn on the bottom at night (not visible)

• To stop my bottom teeth from moving.

A couple of ‘highlights’ from over a decade of wearing braces

When I first got train tracks, my false tooth was stuck to the tooth beside it, but not attached by a bracket to the brace. However, after a very hard bite of some rocky road at Christmas (maybe not the best treat in hindsight), the false tooth broke off.

Although at the time I was mortified, I was surrounded by family friends who’d known me from being a baby. At first I felt really embarrassed, but then realised none of them really noticed it had even come out because of the way my lip covered a lot of my top teeth. We quickly organised an emergency orthodontic appointment so I didn’t have to go to school looking like a pirate.

This time my orthodontist glued an extra bracket to the false tooth and wired it onto the brace so it couldn’t come off again. In actual fact, this just made it blend in even more since it now had a bracket on it like the rest of my teeth.

As part of the brace work to prepare my bite (teeth placement and jaw alignment) for jaw surgery, I had to wear elastics that hooked onto the top and bottom parts of the brace. I can remember at one point wearing four elastics at the same time, where my jaws were being pulled together at twelve different points on my brace! It wasn’t particularly comfortable at first, but I soon got used to it, with the most annoying part being when the elastics might accidentally ping off or be accidentally swallowed (oops!).

After my second round of jaw surgery, my orthodontist decided that to get my bite into perfect alignment, I would need to have a procedure called interproximal reduction. This sounded very serious at first, but it is a method frequently used in lots of orthodontic treatment – my orthodontist herself had had it done. At first I was very worried because this procedure used to be called ‘enamel stripping’. This sounded like a huge procedure that would break my teeth. In actual fact, it took less than five minutes and I couldn’t even see the difference! All it entailed was a small saw to remove a millimetre of enamel from two of my teeth to give them room to settle into the right positions.

Although the elastics were probably the most annoying part, the other issue was food. Whilst I wasn’t too bothered about missing toffee apples or never trying chewing gum, after any meal, a mandatory check with a close friend to check I was ‘okay’ for food stuck between my teeth was a must. Although, in the end, I guess this was just a heightened version of checking for spinach or coriander in anyone’s teeth.

The final ‘highlight’ of over a decade of braces has to be patience. Whilst my friends would moan about the year and a half they were lumbered with the metal, their satisfaction would be nothing compared to mine: after enduring over ten years to finally be brace-free! It’s definitely a long process, but it has taught me that good things truly do come to those who wait. The years of careful cleaning and orthodontic appointments have certainly paid off, and I am so glad I had the determination to see the treatment through to the end.

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