Day 52: Catch-22

  • Pain: 0/10
  • Inconvenience: 4/10

If I open my mouth any wider, my elastics will snap. So this is all you get!

I’m not sure if you can see the appliance in the roof of my mouth or not, but it looks exactly like the picture below. Its sole purpose is to restrict my upper palette from narrowing. How long it will remain in service is a question that attracts different responses depending on whom it is directed to. If you speak with my surgeon, he’ll tell you it’s only necessary for 1 more month. By then, the bone will be fused back together and completely filled in, so the appliance won’t be necessary. However, if you’re talking with my orthodontist, she will kindly inform you that it will exist for the remainder of my treatment. The most annoying part of the appliance (aside from having a raw tongue and being unable to swallow and talk properly) is that peas get stuck in the middle of it. They fit there quite perfectly, in fact.

Transpalatal Arch appliance, or TPA for short.

I took my elastics out last night in anticipation of my first bite of solid food. If you read my last update, you’re aware that it didn’t go over as planned. Afterwards, I was unable to get the elastics back in. They hook onto my most rear molars, and that’s a difficult area to get to when your cheeks are swollen and numb. Today, however, I managed to get them into place properly! The trick is to start by wrapping them around the furthest tooth you can reach, and then looping the elastic over each successive molar until you finally hit your target. I’m going to be very disciplined in wearing them because I want my bite to close up as soon as possible. It’s also reassuring to know that I’m not the only one in this predicament.

My current stockpile of Ensure empties. One day, these fine implements will serve as the backbone of the Fortress of Ensure.

I’ve also realized I’m in something of a catch-22. I need to chew to regain the strength and mobility in my jaw, but I need to remove my elastics to do so. Removing them prevents my bite from closing, thereby leaving me with the inability to chew. It’s a vicious circle. But hey, I’ve finally graduated from my Tigger toothbrush to a more adult-sized instrument.

“You look like a little boy.”

Lastly, I finally had my hair trimmed. People can finally see how skinny I’ve become because my jaw bones are clearly sticking out of my face. In fact, my sideburns have to wrap around them. I’ve also been told that I look like a little boy now that I don’t have a mop of hair covering my face. I’d like to extend a special thank you to my friend who took care of that for me. Note that, due to the term “hairdresser” being dated, I’m officially rebranding these fine people as noggin fluff engineers.

Have I mentioned that I’m well over halfway towards my full 90-day recovery? The glass is half full, my friends.


  1. I’m definitely with you on the feeling let down. Before I found this blog everyone else I’d followed seemed to be talking about waking up, feeling miserable, but finding that their teeth fit almost perfectly together. When I didn’t have that same satisfaction I felt like I’d been tricked. Not just because of the bad molar relationship, but because my front teeth were barely any closer to touching. My surgeon emphasized that I had more of a chin and my gummy smile was gone–making me feel like all I’d accomplished was something cosmetic…and as a result making me feel like the whole thing was pointless as I was quite happy with my appearance before. I kept thinking, if all of this rides on my orthodontist now, why did I need to have surgery in the first place? My ortho has a great reputation, so I know he’ll rearrange my teeth into some workable configuration with time. I think it’s just going to take me longer to be able to say for certain if it was worth it. If I can come out of this looking like someone I can recognize as myself I’ll know this wasn’t a huge mistake. If my teeth fit together on top of that, I’ll say triumph.

    p.s. since they rotated my lower jaw, my tongue sticks out crooked, which I thought was kind of funny. I am now training it to come back to the straight and narrow!

  2. My teeth didn’t all touch after surgery either. As with Graham, over time my teeth grew back together and now all of my molars touch the way they are supposed to.

  3. My surgeon wasn’t able to totally fix my overbite “due to where my teeth fit” he says. But now my orthodontist has bands pulling my teeth forward, so they don’t really fit that well right now anyway. My predicament isn’t nearly as bad as yours was, Graham, but let’s just say chewing on my left side is a LOT easier than chewing on my right.

    • T, I’d still it more time. My bite wasn’t fixed perfectly either, but over time, my teeth grew back together and I learned how to use my new bite. I was a little let down in the initial months because I expected perfection, but I now realize that perfection isn’t the goal. Rather, a bite that allows you to eat, talk, and smile with ease is the goal.

  4. I had double jaw surgery and my chin extended due to an overbite. I to have not been able to tear into food like a burger etc. without tearing it apart with my hands.

    I am in my 4th week of post surgery. Because my jaw bone was thinner than normal and expected, my surgeon had to put wires on my teeth to keep my jaw immobilized, talk about terrible. I go to the doc tomorrow to hopefully get the wires cut off and the mouth plate taken out of my mouth. Other than that swelling is almost gone, I am down 22 lbs., and am in no pain. Just praying I can get some of this stuff out of my mouth.

  5. Graham, my appt with surgeon when awesomely! I (unexpectedly) was granted permission to eat (carefully and softer foods, of course)!

    I’m glad I’ve been reading the blog as I go through each of my days. It’s been helpful to hear others are finding chewing to be challenging and often times just plain weird feeling.

    As for part of my lip not responding right now, he said that’s normal and my muscles hadn’t been used in a while and I was given some facial exercises to practice. I *think* I’m seeing progress. Either way, I’m going to try not to worry about it too much at this point in my recovery. I’ve been assured it’s normal and happens to jaw surgery patients often, with varying parts of the lip affected.

    Again Graham, thank you for this blog. I laugh and nod in recognition, frustration and triumph as I read about others’ experiences. It’s amazing how the little things, like phantom drooling and food left on your chin, don’t seem as bad when you hear others having the same experiences.

    I recommended your blog to a friend who is going to go through the process. She said she and her husband found it already! I encouraged her to read not only your posts, but the comments you’ve received as well.

    Oh, I almost forgot! I took a right-now “after” picture. I was able to see it next to the “before” picture. Wow! What a shocking and dramatic difference between the two!

    Thank you again for sharing this with fellow jaw surgery patients. I look forward to continuing to read your blog as I go through my recover each day.

    • Karen, before-and-after photos are always a joy to look at, aren’t they? The changes are somehow subtle while, at the same time, drastic. But all in a positive way. =)

  6. Graham, thank you for this blog. It’s been such a comfort.

    I had double jaw surgery and genioplasty Sept. 6, 2012. I’m healing very well, but I have a couple concerns. Most of my chin is still numb. Also, when I smile, the left part of my bottom lip doesn’t “work”, leaving me with a crooked smile.

    I see the surgeon again on the 12th of this month, but I was interested to get your take on it.

    • Karen, I wouldn’t worry about feeling returning until the 3-month mark has passed. Many surgeons don’t even expect feeling to return until after the full 90 days. However, it’s different for every person. I would give yourself another month before worrying, though.

      As for part of your lip not responding, I didn’t personally experience that. Nerves being bruised will cause temporary loss of feeling, but loss of movement must be muscle-related. Ask your surgeon about that and let me know what they say. I’m interested to hear a professional’s opinion on the matter.

  7. bro i had a TPA for the last 5 years of my life, they took it out about 3 weeks before my jaw surgery, and now they’re putting it back in again when i get my splint out in a week. can you say FML? oh by the way, i’m jealous of the tigger toothbrush you had. i’ve been using a princess one.

    • Courtney, a princess toothbrush sounds like it would be just as effective as far as children’s oral care goes.

      That’s a shame to hear that you need to have your TPA put back in. Look at the bright side, though—this will all be over soon!

  8. Stephanie, I most definitely was not able to open my mouth wide enough to bite into a burger on Day 51. In fact, I didn’t regain that kind of movement until somewhere around the three-month mark. The only thing I did to help stretch my jaw muscles out was chew gum and let time play its healing game.

    My face was also uneven around this time. I can assure you it is 100% due to the swelling. Don’t judge your appearance until at least 3 months have gone by. Your face will appear lopsided until the swelling is completely gone.

  9. Argh, I’m driving myself insane. At day 51 I’m still unable to open my mouth wide enough to bite into q burger….were u able to do so?
    My doc gave me a bunch of tongs to stack into my mouth to open my bite, what exercises were u given in order to help u open yours?
    Day 51 my face is longer on one side than the other….was urs like that or will it even out after swelling goes down? I’m still very swollen on my left side and my lower jaw…I’m being patient but I’m still worried!

  10. I have to wear my elastics until Christmas time. After that, my teeth will more or less be where they’re going to be.

  11. Am not gonna do another surgery again thts for sure. Graham, how much more time do you have to keep your elastics? Lol, i lost one hook, u fink i swallowed it. This surgery even make people have a metal diet.

  12. Indeed! Did that friend of yours eventually realize it was all worth it?

    Please say yes.

  13. I had a friend that had this surgery done, as well. She said that when she woke up from surgery, not only did her teeth look wrong once she got everything removed and was on the retainer/spacer, she also said that her entire facial structure changed because of the 2.5 cm of bone removed from her lower jaw.

    But let’s be overjoyed – you’re more than 2/3rds recovered!

  14. Bummer that the hook doesn’t work for you. Mine is white, plastic and flat with a hook on one side and a notch on the other. My 24-7 elastics go on my back molars, and the hook is the only way I can get them on efficiently.

    I can’t believe your device has a storage pod for a pea! 😀

  15. My hubby grabbed a pair of needle nose type pliers that lock. They work great for elastics. Except when you slip and jam them into your lip. Then not so much fun 🙁

  16. Nope, but I had one from my surgeon from before. They don’t really help when you’re reaching back to your molars though (at least not for me).

    The one I got is pink. How manly. :-/

  17. Did the bag of elastics come with one of those little plastic hooks? They really, really help with getting bands in.

  18. Audra, it’s just to keep my palette widened. I have 2 gaps in my top teeth that were put there on purpose so the surgeon had an opening to cut through (*shudder*), but they’ll be closed up by braces.

    Cindy, I’ll put a pic of my giant teeth up in the next update. 🙂 I’m starting to get used to them. They took me by surprise at first.

    As far as the splint goes, some people are able to jump right back into eating when it comes out, but others, like Audra and myself are left with open bites and can’t. I think every case is different and depends on the position of your jaw before surgery.

  19. Can we get a pic of you smiling next? I wanna see lol!!!

    Damn so its even difficult for you to speak and eat still, I thought once I would get my splint taken out that I would be able to speak much better….is that not the case?

  20. That looks like a torture device. Does your ortho want to use it for anything other than just keeping your palate widened? Do you have gaps that need to be closed or something?

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