8MM Overjet - Options?

[AJKelly77]

Hi Everyone!

I am a 37 yr. old woman and have never been on a forum before. I find it confusing! But during my search regarding braces, I keep finding posts on this forum. I thought I would throw out my situation to see if anyone else has had a similar experience. I am very aware that we are not ortho's and no one can diagnose and everyone is different…just looking for similar situations.

So….After being self conscious since I was in grade school (yup, I was called beaver), I finally bit the bullet and decided to inquire about braces. I am tired of being hyper-aware of an angle of having a picture taken at, or remembering to jut my lower jaw forward so the over jet isn't as pronounced. I have only had one consult so far and it was enough to turn me off the process completely. The office and staff were fantastic, but when the ortho came in it was a VERY quick few minute "Hello, smile, ya, you need jaw surgery" kind of conversation. I was floored. And here I was worried they may suggest extractions…but JAW SURGERY?! I listened to her spiel which didn't really explain anything and then asked…are there any other options. "Well, you could just do braces, but it won't look good." That was it…no explanation of why, or what it would entail. I tried to get more info but couldn't think of the right questions…I was still reeling about the suggestion of surgery.

I left very disheartened.

I have booked a second consult to see what another would recommend and I will be prepared with questions.

So, here is my mouth description!
I apparently have an 8mm over jet…under developed lower jaw. Narrow upper arch.

I guess my question is….are braces only (perhaps with extractions) not an option at all? She was very quick to not even want to discuss it.

I mean….I am not looking for a perfect smile. I would be happy with straightening and pulling back the front teeth…I know it won't completely close the over jet…but I think it would be enough to satisfy me.

Has anyone only done braces with success? Pictures of before and after would be so appreciated.

(Not sure how to post a pic yet….so that will come!)

Thanks for listening!

[buffon85]

i am sorry that i don't have an answer. if I were you I would have more ortho consults and I would also visit a surgeon to discuss it.
It was my biggest fear (that I may needed surgery) but I would do everything to have the best possible result. i hope the braces can give you a nice smile! best of luck!

[AJKelly77]

Thank you for your reply, Buffon85. I guess education is the best way to get informed and make a decision!

[gabriella36]

AJ, I completely get where you're coming from. I'm 33 and in braces for the first time. You can read my story on this forum. It was a tough decision for me to make initially, and then I was completely taken aback when each of the three orthodontists I consulted with recommended surgery. I had to push back, do a lot of my own research and find an ortho I was comfortable with, who was comfortable with my decision not to pursue surgery.

Here's my two cents on jaw surgery, for what it's worth.

It's expensive, most insurances in the US don't cover it because it's seen as elective or cosmetic, and let's be real, it is. They can talk a big game about sleep apnea and bite problems, but ultimately jaw surgery is all about perfect aesthetics. It makes me angry. I'm someone, like you, who was looking for my teeth to be straightened, and for as little as possible to be done with regard to my facial aesthetics. It took me six months and three consults to find an ortho I could work with, and one terrible oral surgeon consult to slam the door on the idea of surgery for me.

I think I'm in the minority, honestly, at least on this board, so I want to be careful and say that whatever choice you make is totally fine as long as it's your own and you don't feel pressured.

Keep talking to orthodontists in your area. Don't let them push or bully you into a treatment plan that doesn't jive with who and what you are.
Ask questions. Ask more questions. Ask questions if you think you're being pushy or rude and remember that you are the customer in this circumstance. Once you choose an ortho, they work for you. You're paying them a lot of money for the outcome you want.

It's the sad truth that you're the only one who can advocate for yourself. Do it.

Read:

http://nymag.com/scienceofus/2015/06/wh ... teeth.html?

http://www.theatlantic.com/health/archi ... ry/397934/

Good luck!

[kim3721]

Your consultation was quick because ortho's do this a thousand times a day, and usually their right on the money. I too also have an 8mm overjet / overbite. I'm sorry to say, but you need Jaw surgery to move your lower jaw forward. Removing teeth will not look right in the end, my ortho explained the same concept to me. I go in for surgery on August 31st of this year and at first I tried to avoid it just like you, but honestly its the only way to get a decent result. Good luck finding a different answer -- I tried the same as well, you won't find it from a reputable ortho.

[pjade1]

I would get more consultations to see if they all come up with the same type of plan. I had a 5mm overjet and severe overbite. I had three consultations and out of the three, one of them said I needed jaw surgery. My first consultation said I would need braces for 18 mo, my second consultation said I needed them for 24 months and lower jaw surgery. My third consultation said I did not need jaw surgery and that I would be in braces for 30 months with a possibility of adding a forsus if the elastics didn't work. I went with the third consultation and I am happy with my choice. I felt good with him and what he had to say. He said I definitely did not need jaw surgery and I didn't need any teeth extracted either. He just told me at my last visit that I would not be needed a forsus and that the elastics were doing a nice job. I feel really good with how my teeth are moving where they should be.

If you get all of them to say you need jaw surgery, then you probably do but I would get more consultations. You never know. At least you will have a more informed decision.

[EWUgal15]

I apparently have an 8mm over jet…under developed lower jaw. Narrow upper arch.

I guess my question is….are braces only (perhaps with extractions) not an option at all? She was very quick to not even want to discuss it.

I mean….I am not looking for a perfect smile. I would be happy with straightening and pulling back the front teeth…I know it won't completely close the over jet…but I think it would be enough to satisfy me.

You're beyond the point that orthodontic devices can encourage growth in your bones. Braces can correct your teeth, but they won't fix your skeleton. You would still need to be aware of the angle photos are taken at and what your side profile will look like if you went down a path of only braces.

It's expensive, most insurances in the US don't cover it because it's seen as elective or cosmetic, and let's be real, it is. They can talk a big game about sleep apnea and bite problems, but ultimately jaw surgery is all about perfect aesthetics.

It's true that most insurances don't cover jaw surgery, but by no means is it 100% cosmetic. The position of the lower jaw affects how your TMJ works, how your teeth line up in your mouth once they're straight, even your natural posture. Yes, it can change how your face looks, but there's more to it than just aesthetics. If you don't believe me, try dealing with popping every time you open and close your mouth, random head and neck aches because you're forcing yourself to hold your jaw in its natural position, or worse yet, your jaw locking up in the middle of a meal.

I was diagnosed with 9mm overjet due to a recessed lower jaw. My thought at first was that braces alone could fix my problems. That would be true if I were 12. I had a dentist tell me that he would prescribe me muscle relaxers and corticosteroid injections to my TMJ before he would recommend braces. Those would only be temporary solutions. I visited the orthodontist who practiced with him who said that braces alone could not fix my problem. He referred me to my current orthodontist who took molds of my teeth and fully explained to me what needed to be done and how that would affect my body. I have TMJ issues. If you look at the anatomy of the TMJ (which everyone has!), you will notice that the points of the jaw bone rest on a cushioning plate. When the jaw functions normally, there's no pain, wearing on the bones or anything like that. Well, my jaw slips on and off that cushioning plate when I open and close my mouth. My x-rays show that naturally, my mandible does not sit where it should, so when I open my mouth, things go to where they should be and slip back into a bad place when I close. This is a skeletal deformity and the only way to fix it, being an adult, is surgery. In the long run, it will mean that my side profile will change: my upper and lower jaw will align as they naturally should and be proportionate, my jaw will no longer slip on and off the cushioning plate in the joint, the unnecessary wear on my bones will stop, my head and neck aches will stop because I won't be forcing myself to hold my jaw a certain way, I won't run the risk of having to wear a mouth guard 24x7 in order to keep my teeth healthy. All of those things are why I decided to pursue surgery. It's not just an aesthetic thing. Its a quality of life thing.

Please don't think that I am trying to tell you the only way is to get surgery. I am not an orthodontist, dentist, or doctor of any kind. Talk to as many orthodontists as you need to in order to make an informed decision that you are comfortable with. Don't let us forum folks sway you (especially me!). If you don't want surgery, you don't have to do it. It sounds like the first orthodontist didn't take the time to explain things to you. Definitely find someone that will give you as much time as you need to ask questions and get a full explanation. A lot of people associate braces with a Hollywood smile. Let's face it, if we weren't concerned with how we look, we wouldn't spend money on nice clothes, makeup, or mirrors. But there's more to it than that for a lot of people.

[gabriella36]

Just chiming back in to say that EWUgal has the right of it, and to be fair, I've had several horrible interactions with oral surgeons that provided me with nowhere near the amount of detail and thoughtfulness that EWUgal did. In my personal case, I don't believe I have TMJ, and the oral surgeon was telling me how to commit insurance fraud, not how the joint works and how it could impact me in the future. EWUgal gave me a lot to think on!

[EWUgal15]

Just chiming back in to say that EWUgal has the right of it, and to be fair, I've had several horrible interactions with oral surgeons that provided me with nowhere near the amount of detail and thoughtfulness that EWUgal did. In my personal case, I don't believe I have TMJ, and the oral surgeon was telling me how to commit insurance fraud, not how the joint works and how it could impact me in the future. EWUgal gave me a lot to think on!

I spent a lot of time doing a TON of research on the subject. I tend to have quite the soap box about it, and I do apologize if I came off over bearing and/or insistent in any manner. Having heard when I was 11 or 12 that I should have braces and not ever getting them as a kid/teen, then ending up with TMJ problems the way that I have kind of made me angry at my parents for not being more proactive, but really they had no way of knowing.

I also have to say, looking back on my original post and re-reading it a bit more carefully, I realized that I forgot to mention that BSSO (which is the most common surgery for the lower mandible) is not 100% guaranteed to fix TMJ symptoms/issues. Sometimes I even need that re-iterated to myself because I've done so much research. A lot of that research suggests that it helps to relieve the symptoms, but there is also a fair amount that shows that it doesn't. Thankfully, my orthodontist's son had jaw surgery with my current oral surgeon and the orthodontist made his recommendation based off of personal experience. Both my orthodontist and my surgeon have never encountered a case where surgery has not improved/help relieve TMJ issues like mine, so I feel very hopeful that this will work out for me.

I'm very sorry to hear that you had such poor experiences with oral surgeons, gabriella. That sounds terrible and I don't blame you at all for choosing the route that you did. I'm glad to hear your treatment is progressing well. Sometimes I think options are pushed on us in an attempt to make a lot of money very quickly, so good for you standing up the way you did.

[Sunshine84]

I also have a 9mm overjet. My first consult said that I would need surgery but I have already decided against it after seeing what my sister went through. My second consult said I could do 24 months with braces with possible extractions. He actually thought it was the better of the options. I have had them on for two months so I don't have too much to report. I am like you and am ok with a little overjet but just wanted them pulled back and straighter. I think in the end I will be happy with my decision. I would get another consult, some seem more likely to just push the surgery. I will update my progress as my braces are on. Good luck, I know where you are coming from

[AJKelly77]

HI to all who have taken the time to reply!

I am not very savvy or consistent with using a forum…first time and I tend to forget about it! I do appreciate all your feedback and experiences and it has given me a lot to think about.

I have a second consult next week..will update!

Thank you again!

Amanda

[redwilllow]

I have probably worse overjet than you. My ortho told me if I want perfect then I would have to have jaw surgery, but as soon as I stepped into his room, he asked me what did I want from treatment? I said to him I want better, I dont expect perfection just no longer a nasty crowded mouth with a narrow top arch. I have a post with my journey on it, and I will update with pictures as soon as I can but I have to say if you arent happy with the ortho do not go for it until you meet one you feel has gone through everything with you properly and understand all of your options!

[avngal]

Ok, I am in my 50's and went to an ortho doc too but decided at my age forget about jaw surgery and he agreed. I went with 6 month smiles. Fortunately I have a space between my two front teeth so while my over jet cannot be completely corrected my front six- eight teeth can be straightened, the gap closed and my over jet reduced a bit. This is fine with me. Explore all your options!

[nhyn]

I have a 9mm overjet and crowding also, and the ortho did mention to me that jaw surgery would help fix it completely, but it is a major surgery and she didn't think I had to have it (I really don't want to do it anyway). Before we did the full consultation (x-ray, mold etc.) she thought I'd need 4 extractions - which from talking with people, is a normal approach for this type of malocclusion, but after the full consultation the ortho said I could get away with having only 2 extractions on top, and she'd do some IPR on the bottom to make space. Obviously everybody's case is different, but as you can see here in this forum, many people who have overjet did not have to have surgery.

[AJKelly77]

Update: I had the second consult at the end of summer. He was shocked that the first ortho would even suggest jaw surgery….he said I was not a candidate at all. He went through everything with me…explained what each tooth was doing and needed to do. Told me that braces would do the job and even close the bottom space where I had two molars pulled after a root canal. When I asked about whether or not he would be able to close the over jet, he was very confident that he could. I did not tell him anything about the original consult until he finished my appointment as I didn't want him to be influenced.
Oct. 7th, after two premolar upper extractions, I got my braces on! I am so excited! It has been an amazing experience with my new ortho and his team. I feel so comfortable and love that they take their time explaining and making me feel at ease.