Growing up I had the same dentist from childhood to adulthood. My dentist’s office was run by Dentist Chung (in Vietnamese I called him Bác Sĩ Chung – which means Dr Chung translated directly) and his sister running the office.
The office was in Garden Grove, in between the Korean and Vietnamese districts. Walking in I would always smell the incense from an herbal shop next door.
The office looked like it was from the 1970s. They had this really old but comfortable couch and constantly played oldies music from the local radio station.
I distinctly recall being afraid as a kid going in, and somehow the office manager convinced me if I did a good job with a cleaning I could someday get the dentist’s chair. With my warped sense of rationalizing things, it all made sense and I calmed down.
When I was in early high school Dr Chung said, “you should think about getting braces and fixing your underbite.” I really had no issues with my teeth so far, but I entertained his proposal. I went to an Orthodontist consult.
The Orthodontist I saw was in the heart of Little Saigon – the Vietnamese area of Westminster. When coming in I waited in the reception area for a bit, where the Orthodontist admitted me in the office.
He asked me to bite down and said pretty quickly – “class 3 malocclusion jaw surgery – recommend jaw surgery.” He explained to me that the process would be to remove my 4 wisdom teeth, have braces for 2 years, have jaw surgery, and then have braces again for potentially another year. He didn’t explain much any pros and cons and ushered me away to talk to the assistant for more details.
In another room, the assistant put on some DVD of the process of dealing with class 3 malocclusions. It meant that I had an underbite, and what they needed to do is remove my wisdom teeth to make space, and then crack my jaw and move it back. The recovery would involve sewing my lips (?) and going on a liquid diet for a while.
The assistant also said that some people liked having this jaw surgery because of improvements to their facial profile. She also mentioned that some people don’t even recognize them after the surgery.
The assistant ended with saying, “You know, Vietnamese are a superstitious bunch, so some say that doing jaw surgery will change your destiny!”
Okay, count me in for not believing in superstition, but really that is the absolute worst thing you could say to a teenager after getting a quick 5 minute consult, a gory video on the treatment of an underbite, and somebody saying it will change your destiny. At that point, I decided not to go along with my surgery and went along my merry way.
A couple years after the consult, I called the dentist’s office to book an appointment, and I was told the dentist had a heart attack! He evidently had been eating a pretty unhealthy diet (I know correlation isn’t causation, but he did eat McDonalds every day for lunch). Fortunately he bounced back and started working again.
A couple years after the heart attack, he actually had another heart attack and this time fatal. When he passed away, my family went to his funeral and saw his grieving sister, and the dentist’s daughter who I talked on and off with throughout going to the office. Oddly enough, the dentist’s daughter did a quick internship at one of my old startups back in the day.
After grieving the loss of my dentist, there were the practical issues of finding a new dentist. Pausing for a moment, I remembered, my optometrist’s brother (whose parents live next to my parents) was a dentist.
Dr Tan Huynh was also in the heart of Little Saigon, but when I drove into his office, they had computers that could do x-rays, and an efficient staff to make cleanings and appointments way easier. I had realized at that point I had been going to Dr Chung’s office with technology from the stone ages.
With the first consult, the dentist asked me to bite down and asked if I considered braces and jaw surgery to fix my underbite. This time being older, I peppered him with questions on pros and cons. He mentioned my teeth were functionally fine at the moment, but in the future I might not be able to chew as my teeth wore down. Asking what age I might not be able to eat, he threw out what seemed to be the random number of 60.
Remembering the experience at my last Orthodontist, I wasn’t convinced the pros outweighed the cons (eg – cons meaning my destiny would change).
When I moved up to Vancouver, I was faced yet again on finding a new dentist. Jason recommended me to visit an office nearby, where Dr M was the first to see me.
He did the whole consult and analysis, but this time they took pictures and some fancy 360 xray scan. He brought up again my underbite, and we again talked through the pros and cons. I asked whether I should try to fix it and he said a lot of people have underbites and just manage it. Apparently when eating I push food through my back teeth immediately.
During the pandemic when I got my first cleaning I saw Dr F, a younger dentist who was one of the co-owners of the office. She saw my bite and asked if I wanted to fix my underbite, and after the 4th mention in my life it got my thinking a little bit more seriously about it. This time she said Invisalign might be able to fix it.
I came back to another appointment after my cleaning to get an Invisalign consult. They did some scans and because of the pandemic they wanted to limit in person meetings, so the follow-up was a zoom call.
Dr F proceeded to say that she initially thought she could take out my middle bottom tooth, but to fix my underbite. However she concluded Invisalign wouldn’t work and that I should see an Orthodontist.
This time I was a little more open to it because I was no longer traveling as a consultant during the pandemic, and wearing a mask would make it pretty easy to hide the fact I had braces.
Weeks later I saw the orthodontist Doctor D and they did the initial analysis. He basically said I have two options. First, remove 2 wisdom teeth, braces for 2 years, jaw surgery, then braces for 2 years. Second, remove 6 teeth, braces for 2 years and you are done.
I peppered him with questions on the pros and cons health wise, and he said functionally both would lead to the same outcome. He said the jaw surgery would change my profile, but would come with more risks since it was a surgery. I decided to go with option 2. I also wondered why when I was a teenager I wasn’t presented with a non jaw surgery option, but I’m guessing it was because the technology of modeling these outcomes weren’t available.
Dentistry is an interesting field because most dentists and orthodontists can’t tell you definitely what will happen with your teeth in the future. It all seems to be what risk/reward you are comfortable with.
As part of the assessment I had to pay $500. If I chose to move forward with braces they would credit my account, but if not, I would lose it. I think sunk cost fallacy nabbed me this time as this pushed me over the edge to do a final commitment of the decision.
Before putting on braces, and I had to get 6 teeth extracted. To ease the pain, I got 3 extracted from my regular dentist, and 3 extracted from an extraction specialist doctor. Let’s just say, the extraction specialist finished the entire job in about 30 minutes while my regular dentist took about 1.5 hours. My regular dentist felt so guilty taking so long she gave me her cell phone number and told me to call her if I had any post extraction complexities.
The process of wearing braces involved seeing the orthodontist about every 6 weeks for an adjustment, and compliance to get the results you want. In addition to braces, you have a wire running across and little hooks where you can attach rubber bands to. Throughout the process compliance meant always wearing and rotating the rubber bands as needed as well as avoiding eating really hard food (like nuts), to avoid breaking your bracket. Slipping up on compliance inevitably leads to a longer total process.
When I saw my Orthodontist, I noticed I was the oldest person in the office as it was mostly kids and teenagers. Often I would overhear my Orthodontist sternly warn the kids that they weren’t being compliant by either not brushing their teeth well or not wearing their rubber bands. I would then hear parents berating their children in one sentence, and in the next sentence begged them to be compliant. It usually ended with the parents trying to guilt trip their children by saying seemingly unhelpful things like, “don’t you want good teeth like your brother.”
Getting braces as an adult is a bit different as I was on a mission to be compliant and to finish it as soon as possible because I paid for every penny of it. Psychologically, something different clicks in your head when it is your money on the line.
The initial side effects I had were teeth sensitivity. There were times hard food was difficult to eat (like sandwiches, cucumbers, steak, etc), so I bought these tiny tots scissors originally intended for parents to use when cutting food for their babies. The scissors were an obnoxious bright blue color, but I liked it because it was compact and had a case.
One time I had a business meeting with a customer at a restaurant and when the food came I took out the scissors. The person next to me paused and asked why I had bright blue scissors. I explained to him the whole dental situation, and then the whole table caught wind of the conversation and asked me about the scissors. It was a bit awkward in the beginning, but then the whole table spent the next hour talking their dental issues. Also through this experience I learned bringing scissors is generally helpful at restaurants if you are sharing food.
2.5 years later (6 months behind schedule mind you), I had an appointment to remove my braces. The doctor told me saying, “there was a lot of movement of your teeth, we probably need to install a permanent wire retainer behind your bottom front teeth”. And at the same time I was told I needed to wear a retainer full time for 6 months, and then at night time for the rest of my life.
I was a little shocked as I never really put two and two together that after the braces I would have to wear a retainer at night in my mouth for the rest of my life. I wonder if ortho offices gave a really honest assessment of the entire process (brackets breaking, wires poking, teeth sensitivity, retainers for the rest of your life), if fewer people would opt in.
Am I happy with the result? Well my underbite is fixed now, but really the whole intended health outcome of being to chew when I’m 60 might require another blog post in 20ish years.