My daughter is starting orthodontic work. The first step was having an expansion appliance placed in her mouth to create room for missing teeth.
The appliance our orthodontist recommended was called a "T-Rex" or a "Pendex T-Rex" and looked like a retainer that has been split into two equal halves. The T-Rex widens the upper jaw through the turning of a small key, which expands the appliance against the premolars. I had never heard of this procedure before; in fact, one of my friends said her dentist called the procedure "barbaric." My orthodontist however, explained that the T-Rex is the most effective way to expand the mouth without have to use external headgear. He added that most kids adapt to the appliance in just a few weeks and only experience tenderness for the first day or two.
My daughter and I examined a model of a T-Rex, and even experimented with turning the key. We decided that the procedure didn't look as barbaric as my friend claimed.
Installing the appliance
The installation, if that's the proper word, took less than 10 minutes. Afterwards, the orthodontist showed me how to properly turn the key. The key is nothing more than an inch long piece of wire with a bit of a tab on it. It is inserted into the center of the appliance, in a small opening which I think of as the "wheel" of the appliance. Once inserted, it is pushed backwards towards the rear of the mouth and then removed. As the wheel is turned, the T-Rex gently exerts more pressure against the premolars, pushing them towards the back and sides. He gave me some additional instructions and his home number, in case we had problems later on in the evening.
Pain and Discomfort
My daughter was teary eyed the entire way home. Her speech was garbled, she drooled quite a bit, and complained of discomfort in her jaw. The orthodontist warned me that children will feel pain and discomfort for a couple of days, and that the pain could be managed with two Advil every 4-6 hours. I gave her regular doses of Advil for two days; by the end of the third day, the pain had disappeared for good. Our orthodontist indicated that some children feel a tightness every time the key is rotated. This didn't seem to be the case with my daughter.
How and What to eat
Eating with a T-Rex was a big challenge. For the first day, my daughter couldn't manage anything more than scrambled eggs, puddings, applesauce and smoothies. Bread was a real problem for her, because it stuck to the roof of her mouth. We experimented a bit with foods that worked and didn't. During the first week, foods that worked for her included baked potatoes, small McDonald burgers, Swedish meatballs, fish sticks, and cooked carrots. For fruit, we pureed everything into a smoothie which she drank with a straw. Some foods, such as pastas and soft green vegetables such as peas and beans, seemed like they would work but didn't. They tended to get caught in the appliance and made eating quite difficult for her. After a week, my daughter was back to eating pretty much her usual foods. Eating tiny bites and chewing slowly made a huge difference.
Even though she's back to normal foods, there are still some things my daughter must avoid. Foods such as pizza, French bread, crunchy fruits and vegetables, nuts, popcorn, and corn on the cob are on the forbidden list. Hard foods such as these can bend the wires in the appliance. Soft, chewy candy are also not allowed. These soft and sticky foods can cause cavities and dislodge the wires as well.
Talking
For the first couple of weeks, my daughter talked as if she had stuffed about 20 wads of chewing gum in her mouth. She eventually learned to slow down her speech and now talks quite normally. Most of her friends can't even tell that she's wearing the appliance anymore. As far as the drooling, it still happens from time to time. My daughter got in the habit of carrying a hankie with her in case of any mishaps.
Cleaning the appliance
For the first 3 weeks, I had to help my daughter keep the T-Rex clean. The food seemed to lodge behind the plastic retainer and caught quite easily on the little metal loops in the back of the appliance.
Before cleaning, my daughter swished her mouth out with water to remove loose particles. After two or three rinses, we then irrigated the appliance with a syringe. I would put the tip of the syringe near the front of the appliance where it met the roof of her mouth. By flushing water over the "backside" of the appliance, I could dislodge food trapped against the roof. For the food caught in the wire loops, it took some heavy water pressure to remove the particles. Beef was particularly hard to remove since the fibers would wrap around the wires.
As the T-Rex expanded, the cleaning was easier to do. There's a larger opening for the syringe and the food was much easier to swish out of the mouth.
Turning the Key
Turning the key was the most difficult part of the whole procedure. The key is inserted into a tiny wheel that is rotated back about 90 degrees. Turning the wheel is easy enough, trying to find the opening was tough. It's pretty dark in a kid's mouth! Eventually we wised up and used a bright flashlight which made the job much simpler. Because the openings in the wheel were so tight at first, I keyed the appliance myself for the first couple of weeks. After a while, my daughter was able to manage this task on her own.
My daughter has had the appliance for nearly 2 1/2 months now, and tells me that she doesn't even notice it's there anymore. Her teeth have been moving nicely into position, and we can see a huge improvement already. There's no denying that the T-Rex is a lot of work to maintain. Between turning the key and keeping the appliance free of trapped food, we spent a lot of time hanging over the bathroom sink that first month. But, even my daughter will agree, it is definitely preferable to wearing headgear. As far as being barbaric, she'll have to disagree on that point as well. As my daughter puts it to her friends, "I have my own T- Rex. How cool is that?"
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