We took Emily to NYU today for a consultation with Dr. Grayson, the ordodontist on the cleft lip and palate team. Unfortunately, Dr. Grayson was out sick but we met with his current Fellow (whose name escapes me). We had a great visit in the sense that Emily listened very well and did what the doctor told her.
He told us he saw nothing out of the ordinary based on Emily’s age. She’s missing her two upper canines (which we knew) and most of her top teeth fall behind her bottom teeth when she bites down.
Simply put, this is called an underbite, or “crossbite”. More technically put, this is called a class III malocclusion and is very common in children with cleft palate. Here’s a very helpful article on About.com which defines the various classes of malocclusion (misalignment of teeth).
So, what’s in store for Emily now that she’s been diagnosed with this? Well, she’ll need to get a full set of x-rays and other imaging in about 6-8 months at which point they’ll create a treatment plan at NYU. The orthodontist told us she’d need a combination of two devices to help pull her upper jaw forward and align the teeth.
A palate expander will need to be installed in her mouth. And by “installed” I mean cemented in there for about six months. Here’s an excellent article on why this is so important, complete with a picture of the appliance.
She’ll also need to wear something called “anterior pull headgear” at night. And thank GOODNESS it’s only at night, because, well, here’s what it looks like:
According to the doctor, she’ll wear it for six months and it will really help move everything where it needs to be. She may have to wear it again in another 8 months to a year. It depends on how her jaw grows. Yes, I’m anxious about this. It look awfully uncomfortable and she’ll be 5 when she starts wearing it. But I know she needs this and, like NAM, we’ll do what we need to do for her.
Now for the fun stuff…here are a few pictures from our day in the city:
Here is the delightfully cheerful outfit she picked out all by herself (okay, I talked her into the pink boots)
The sun was a bit glaring on the ride in, so I gave her daddy’s (broken) sunglasses to wear. We ultimately pulled into a rest stop and bought her a pair of kid sunglasses for the rest of the trip.
The ride home (I was doing this in the front seat)
Her hair..unbraided. I think big hair may be making a comeback!!