A Day of Appointments

Today was a very full day of appointments. Rachel and I left the house about 7:30 and did not get home until 5:00pm!!

First appointment was with our dentist, Dr. Hoffer, for a crown on a tooth that is transposed in her mouth and was going to impact her new jaw alignment based on molds that had been taken. The crown took just over 2 1/2 hours, but when it was all said and done, Dr Hoffer did an amazing job on the crown and it should work out perfectly.  

SideNote: I absolutely love our dentist!! He's gentle, kind, very knowledgable, and up to date on the latest and greatest dental techniques. His wife is a pediatric dentist whom the girls went to for many years! 

After her crown was down, she switched chairs and had a routine cleaning. After almost 4 hours at the dentist office, it was lunch at Chick Fil A, and a trip into Home Goods and Walmart. 

Next appointment was out in Beaumont, with Dr Carter, Rachel's orthodontist. Thankfully they have a CT Scan machine in office that takes the scans that Dr Martin needs for planning out surgery. So new CT scans, new molds, a new bracket on the crowned tooth, and new wires and rubber bands. 

Everything is stabilized for no additional movement prior to surgery and we won't see the Orthodontist again until the week before surgery. 

A trip through the McDonalds drive thru for a McFlurry and then on the road home. Getting home just before 5:00pm. It was a very long day. Rachel's  mouth is sore. But everything was necessary to keep on track with surgery in a month. 

Dental Appointment and a Tooth Pulled

Today was a scheduled, routine dental check up for both Rachel and her sister. However, Rachel ended up having a tad bit more done than just cleaning and a check up. 

At Rachel's November Orthodontist appointment, Dr. Garcia gave Rachel one month to work on loosening up a tooth. She told her to wiggle it as she sat and watched TV, etc. If it wasn't out or close to being out by the time we saw her at the next appointment, she would write our dentist a note, asking that she pull that tooth. 

No amount of wiggling was going to make that tooth come out, therefore we came with a note in hand today to have Dr. Hoffer pull the tooth. Thankfully, Dr. Hoffer had an Olaf Rachel could borrow to cuddle while her nitrous gas took effect and through the process of having that tooth pulled. 

Once the tooth was pulled, there was no doubt that ANY amount of wiggling on it would not have helped. This tooth was not coming out on its own and it HAD TO BE pulled. Check out the root on this thing!!!

As always, Rachel was a trooper and nothing that a little Motrin and a McDonalds McFlurry didn't help take care of! 

Now there is room for the tooth that was needing to come down to come down and perhaps soon, she'll have the rest of her top braces on!

Orthodontist Consult

Children born with clefts usually require lots of orthodontia, which for Rachel, is the next leg of her journey. 

Rachel has a permanent tooth that is crooked, and we really just needed some direction for the future. So I made an appointment recently to see an orthodontist known in our area for her expertise in treating kids with clefts. 

After some X-rays, and a peek inside, the Orthodontist sat down with me and showed me Rachel's xray and penciled in what teeth she has in, waiting to come in, ones to watch, etc.

After much discussion we found it best to continue to watch a couple of teeth, and wait until she's a few years older before braces.

A set of braces prior to the next BIG surgery, which is a jaw realignment, are very important. That set of braces will straighten out all the teeth and align everything perfectly in anticipation for surgery.

Dr Garcia was a huge help, and told us not only can we check back in every summer (once a year consults are free) or as our regular dentist takes X-rays, I'm welcome to bring them in for her review so we can be ready when the time comes!

A Dental CT Scan

When Rachel had her "special tooth" extracted a few weeks ago, our Pediatric dentist was telling me about a new CT machine that her husbands (he's a dentist too!) office had gotten, just that week. It's the latest and greatest in 3D Xray that allows you splice and move and plan out the dental care of patients for example with orthodontics and oral surgery.

A couple of days after our appointment, we received a call from our dentist informing us that if we brought Rachel in within the next two weeks, for them to practice on Rachel, they'd do the scans free of charge. We took advantage of that idea and worked out a time in which everyone was available. That appointment was this morning.

This new machine circles your head and scans it while you stand still. Rachel did perfect! She stood still and bit the stick as best as she could. Within 10-15 minutes, the scans started to download on the nearby computer. The scans were amazing! Mr. Doctor Hoffer sat and spliced through the scans and together with Rachel's dentist, they kinda sorted out what tooth was what. They were very appreciative of me allowing them to use Rachel as it was interesting to them to see all the adult teeth forming within her gums, not to mention the obvious of her issues of having been born with a cleft. He's going to take her scans and consult with a few orthodontists to see what they think and share the technology with them. But it was amazing to see.

It looks like Rachel has all her adult teeth! Her 12 year molars are already growing and she has many adult teeth starting to push their way up on to the baby teeth. You could also see the area where her bone graft was done. It was all very interesting, and I'm thankful for the opportunity for my kid to be used as a guinea pig! :) Click on the picture to enlarge.
They burned the images, as well as the software to a CD which I was able to bring home and have Steven load on to our computer and he could see the scans for himself. This will be helpful to have with Rachel's medical file that I keep.

Rachel's "Special Tooth"

Rachel had this tooth that was in the cleft of her alveolar ridge (the clefting in the gum). It was high up in her gum, and you really couldn't see it unless you lifted her lip. We've always called it her "special tooth".

This tooth has been a constant headache for years. It's hard to brush and hard to keep clean.

When Rachel had a dental appointment in March, this tooth had developed some decay on the backside of the tooth. Since her bone grafting surgery in November, the tooth had adjusted a little bit and was more exposed.

After consulting with Rachel's plastic surgeon, he gave his okay to have the tooth filled or extracted. She was far enough post op that either was fine.

We opted for the extraction.

So this afternoon, Rachel had her special tooth pulled. While this picture is blurry, this gives you an idea of how Rachel's upper teeth looked, prior to the extraction. You can see a tooth that is a little darker on the top, growing in sideways, that is her 'special tooth'. Or shall I say "was". It's now in a little treasure box waiting to be placed under her pillow. It was a little sad watching this tooth we've referred to as her "special tooth' be pulled. It's just another step in this journey.

Our Pediatric dentist is awesome! Her prescription for pain relief...a free yogurt at Golden Spoon!!! Which is totally awesome because that's always where we stop on our way home from dental appointments. Here Rachel is holding her Rx, mouth full of gauze, and red marks on her nose from where the nitrous gas mask made indentations. Rachel did awesome with the extraction. Our dentist is the best and makes sure there's no pain and the experience is overall a pleasant one, which in Rachel's case, with as much work as she's had done on her mouth and will have in the future is a huge bonus!

Playing Catch Up

It's been almost two months since I've blogged on any of my three blogs. It seems life has just been busy, or I've been too busy, which is probably the better thing to say.

The last few months have had a few events worthy of sharing...

In Mid April, Rachel's 1st grade class, along with another class, walked about a mile to the local Stater Bros for a tour. Thankfully it was a nice overcast morning and the walk was actually quite nice. Having known someone who's worked for the company for 40+ years (my Dad!), he worked his magic of knowing the right people and we had an amazing tour! Just as good as the one Rachel had when she was in preschool. Although on this trip, the kids each received little nylon Stater Bros backpacks! Which was really cool! Two weekends ago, Rachel participated in her very first Tae Kwon Do Tournament! She was so very excited for the event and did awesome! She got 2nd place for her Purple Belt Form, and she came in 4th for sparring! She was very pleased with herself and her trophy, so much so that she took the trophy to school the very next day to share!Last week marked the one year anniversary of Rachel receiving speech. She's come a long way over the last year and I think we're finally on the homestretch of nearing the end of weekly therapy. Rachel loves to talk, and sometimes talks nonstop. Over the weekend she mastered two new words with the "R" sound we've been working on - 'Dork' and 'Nerd'. It's nice to be paying out the bucks for speech therapy so that you can understand when you're child calls you names. LOL.

Rachel has less than four weeks left of the 1st grade and is doing extremely well! When the end of the school year approaches and it's been a great school year, with an awesome teacher, I tend to get sad. And that is exactly how I feel in regards to Rachel's teacher. She's absolutely amazing and I am so glad I've been able to be a part of her class every Monday morning and be available to help her in various other ways throughout the school year. Teacher requests have already been made for next school year and hopefully Rachel will have the same teacher Hannah had for 2nd grade and it'll be a good school year once again.

In two weeks Rachel sees her dentist and will more than likely have what we refer to as her "Special Tooth" extracted. This tooth is where her cleft was in her gum and always been quite a challenge to keep clean. Now that the back is exposed more, thanks to the bone grafting surgery in November, the back is decaying and it either needs to be filled, or extracted. After consulting with our plastic surgeon, he said since it's been at least 3 months since bone grafting, then either route is fine. Since it is a baby tooth we'll probably go the extraction route. We'll wait and see what our dentist wants to do the day of the appointment.

It's almost been 6 months since Rachel's surgery. It's hard to believe it's been that long, and yet, hard to believe it's only been that short of time. We have a follow up appointment the first week of June with her plastic surgeon and it'll be nice to hear what he says and thinks 6 months post op. That appointment also falls after Rachel's dental appointment, so he'll be able to see how that went as well. The cartilage in Rachel's nose is finally starting to loosen. Her nose has been so hard since surgery, and now, just as Dr. Martin had predicted, it's all softening. I've been following the story of a 9 year old boy who had his bone graft surgery this week, and all I can say is, I'm so thankful to have that part of the journey behind us...

Dentist Appointment

Rachel saw the dentist today and everything checked out just perfectly! No cavities!!! Yippeee! She did just fine through the cleaning and even survived the nasty fluoride treatment. We also got the x-rays needed of Rachel's mouth in preparation for her surgery in November.

Dental Appointment

Last week Rachel saw her dentist for cleaning and a check up. Xrays showed a couple cavities in between her teeth as a result of not flossing. We also talked about the Xray and 'growing pains' we briefly saw her for in November. She recently had lunch with the orthodontist she had consulted with and with a print out of the Xray they had taken, they labeled all Rachel's teeth. Based on the Xray, and the teeth buds they already see forming, they are thinking that Rachel might have two extra teeth, including her one tooth we've labeled her funky tooth. Their thoughts are that perhaps these two teeth will just be removed when Rachel has her bone graft in a couple years. Interesting to say the least!

This afternoon, immediately following school, we headed back to the dentist to have those cavities taken care of. The dentist was going to try to see if could knock them out in one visit. But she ran into a bit of a problem...

One of the cavities was so close to the nerve of the tooth, that she had to do a root canal and put a crown on the tooth. They call the silver crown a "Princess Hat" for her tooth. After talking with our dentist, I learned that root canals and crowns on baby teeth are way more common than not, as the nerves in baby teeth are pretty big, and the enamel of their teeth is pretty thin. It's very common to have to do this on kids.

So, we didn't get all her dental work done in one visit. Our Dentist felt it was best to give Rachel a rest and come back in a couple of weeks. Rachel was already getting a little upset and she felt if she kept going, it would just make the situation worse.

By the time we stopped for Golden Spoon on the way home, she was good, no tears, nothing. Which is good. She has so much ahead of her when it comes to her mouth - more surgeries, braces, tons of orthodontic work, that we're hoping she never becomes terrified of the dentis.

Orthodontic Growing Pains

Off and on over the last couple of months, Rachel has been complaining that her tooth hurst. Her front top tooth is the one she always points to. We'd looked in there and kinda came to the conclusion that her 'funky tooth' as we affectionately call it, the tooth that is sideways in her cleft aveolar ridge (her gum) was moving down and pressing on her good tooth.

I took her to our pediatric dentist on Tuesday and she checked her over - no cavities, no visible problems. She took an Xray which showed her jacked up upper teeth, but nothing that really jumped out.

Our dentist emailed her Xray to an orthodontist to look over and his conclusion was that she has so many issues where her cleft is, that more than likely the pain she is experiencing is growing pains in the area of all the movement and change. Our plan is to keep an eye on it as there really isn't anything that can be done right now orthodontically.

Dental Appointment

I absolutely LOVE our pediatric dentist. She's amazing with children and both the girls absolutely adore her. Rachel had completely forgotten about her last visit (to have fillings) and showed no signs of distress or anxiety when it came time to go to her appointment.Rachel got a clean bill of dental health, which is always a relief to me whenever any of us go to the dentist. And Dr Hoffer once again put some extra sealant on a few of her upper teeth, including the one in her cleft gum which is extremely hard to brush. Aside from a little upset when it came time for the vitamins, she did a great job and we'll be back in February!

The First of Many

Today, Rachel had the first of many, many years of dental procedures.

At last month's check up and cleaning, it was discovered that she had four tiny cavities that needed filling. We were going to break it up over two appointments, but the dentist was able to knock them all out in one appointment! Which not only was an answer to prayer, but it saved us about $70, as the insurance doesn't cover the nitrous gas and we won't have to come back for another appointment and another round of nitrous gas.Overall, Rachel did great! She sat so still while Dr. Hoffer got all the 'bugs' out of her teeth. Rachel did cry as we were walking out to the car. But I think it was because she was extremely numb and the sensation was new to her. A trip to the Dollar Tree for an additional prize and a stop at McDonald's for an ice cream and Sprite helped in the recovery though. If anyone is looking for an awesome Pediatric dentist, I have one and will highly recommend her!! Thank you all the for the prayers for Rachel this morning!

Appointment with the Dentist

Rachel had an appointment this morning with the dentist. This dentist was recommended to us from the dentist on Rachel's Craniofacial team a couple of years ago. I was happy to discover she accepts our dental insurance, and it is at the recommendation of her staff that I found my new dentist, who happens to be her husband!!

I'm ashamed to say, it's been two years since I've had my kids to the dentist. But we're there now, and our insurance covers the new office and the girls both had pleasant experiences today, so we'll be better about going every 6 months now.

I had told Rachel ahead of time what they'd be doing, etc. She was happy to get there and see that they had TV's in the ceilings and that Kung Fu Panda had just started. She was even more excited when the hygienist gave her sunglasses to wear while she shone her bright light into her mouth. Rachel was such a big girl and a good girl while they took xrays of her teeth, even having to go back and repeat a film, and then do another xray that better showed the activity in her cleft aveolar ridge. She sat very still for the xrays and all through the cleaning too. She got to pick a treasure from the treasure chest and get a sticker and that made her happy. She was even happy when she got her very own goody bag - a new toothbrush, floss, toothpaste, and a little timer for brushing your teeth!The dentist came and checked out Rachel's teeth. She was very impressed with Rachel's lip repair. It always feels so good to hear professionals say that. LOL.

We knew Rachel would have orthodontic issues in the years to come. But it really hit me today when I saw that xray of her upper gum line and all her teeth jacked up and every which way. You sometimes 'forget' your baby was born with a birth defect because the obvious visual signs are gone - the lip has been repaired, the gapping, black hole has been repaired. No one can see how jacked up Rachel's teeth are, unless she smiles really big and you can see that something is a little off.

It was my goal today to get a picture of her teeth, to share here on her blog. You see the commercials for Operation Smile, or The Smile Train. You see the advertisements in magazines. Pictures of three or four year old children with unrepaired cleft lips. You can see how messed up their teeth are if they have a cleft in their aveolar ridge, their gum line. THAT is exactly how Rachel's teeth look behind her beautifully repaired lip. I explained to the hygienist that I keep an informational blog about Rachel's cleft and would she mind shinning her bright light so I could get a picture. She did better than that, she put this device in her mouth that props the mouth completely open for surgeries, etc. But those pictures turned out blurry. Rachel has a tooth up in her gum that can't be seen in this picture. It's a tooth we recently found! It's also a tooth I was told today we need to be making sure we get it clean and pay special attention to it. It's in a place that's hard to get, making it more susceptible for problems. The dentist applied some special sealant on a couple of those teeth, which should help.

Apparently Rachel has very porous teeth, something unusual for kids. Her teeth also have deep grooves, and as a result she has four teeny tiny little cavities in her big teeth in the back. Those will need to be filled. We go back in April to have those fixed. They take extra caution with kids and try to make the experience as positive as possible. So in addition to numbing the area, they will give Rachel some laughing gas for the two appointments. We need to keep Rachel's thoughts towards the dentist on the positive because she'll be dealing with dental issues for years and years to come. So whatever works!

Also looking on Xray, the dentist did say it looked like she was perhaps missing an adult tooth. Which is VERY common in children with cleft aveolar ridges. Something orthodontics will take care later down the road.

Overall, the dentist said she looked good. If you call four teeny tiny cavities and the fact their Mother hasn't had them to the dentist in two years, good. Rachel enjoyed the experience. She didn't quite get the needing to wait to eat or drink for a while afterwards (give the vitamins time to dry or soak in??). Rachel listened to the dentist and allowed me to help her tonight after she'd brushed her teeth. LOL.

Dentist

Both the girls had dental appointments this afternoon. This dental clinic is the School of Denistry at the medical center in which Rachel gets all of her cleft affected treatment and care.

Just like last time, Rachel did AWESOME! This time they even took X-Rays and she cooperated perfectly! They were amazed at how well she did for those. It was pretty amazing to see an X-Ray of her upper teeth where her cleft gum is. She kept the apron on and kept the little films in her mouth just like they asked her to. Her teeth all checked out fine. They said her teeth are pretty close together for baby teeth and that we needed to start flossing her teeth. She also has two more molars to come in. But all in all, it was a great appointment and we're to go back again in 6 months.

1st Dentist Appointment

Rachel had her 1st dental appointment today. The office was a Pediatric clinic which was such a huge hit, Hannah was asking to get her teeth cleaned and looked at. LOL. I'll probably switch dentists for Hannah and bring her here next time. Rachel did such a wonderful job. She cooperated and did what they asked, course it helped having televisions in the ceiling, playing a Disney movie. Overall, the dentist said her teeth look good. Not as many teeth in as she should have, but cleft affected toddlers can sometimes teeth slower. No Xrays taken today. Just a check up and brushing of her teeth. And of course the recommendation to come back in 6 months.