Namine’s teeth are doing well. There are no worries about that. She’s always been prone to cavities, due to her small jaw and how close together her teeth are, but despite that, she’s taking pretty good care of them. (The dentist was especially impressed with how well she’s flossing.)
I’ve written in the past about the dentist’s concern for Namine’s teeth, so let me back up a little. Namine was born with Pierre Robin Sequence (PRS), and it has affected her jaw; it was what caused her to need a jaw distraction at an early age, and it is why she needs braces and a jaw expansion.
The dentist’s plan is to take impressions of Namine’s teeth in six months. Then a year from now, Namine will have braces as well as upper and lower jaw expanders put in.
The term “jaw expansion” sounds almost as scary as “jaw distraction,” but it’s really not. It involves cementing rings (not unlike those Namine had in her omega loop days) to her molars, to which the actual expander attaches. It is cranked once a day, which expands it and, consequently, Namine’s jaw.
The braces are necessary along with the expanders because the natural tendency of the expanders will be to pull apart her front teeth. The thing is, that’s not where the problem lies. Namine has teeth trying to come in above her canines, so the braces will keep her teeth in their proper positioning.
Namine will have the braces and expanders for two years. During that time, her jaw will grow as she grows, and widen with the help of the expanders. There is yet, however, one dimension of Namine’s jaw which still may need attention: its length. And that’s where the second mandibular distraction comes in.
It’s the dentist’s fear that Namine’s lower jaw is too small for her. It has grown with her since the first distractor equipment was removed in 2010, but perhaps not enough. So before the two years of braces and expanders is over, the dental team will meet with the cleft palate team, including the surgeon who performed Namine’s first jaw distraction (and still follows her closely) in order to discuss whether or not a second distraction will be necessary.