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PostPosted: Tue Dec 15, 2009 11:23 am 
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Location: The Netherlands
Hey folks :roll:

First I gotta say its kinda strange standing there in the bathroom taking pics of my teeth, but I'm hoping this will get me some answers on possible things to treat my problem. Also, this is quite a long post, if you don't want the history just look at the pictures and the text below it.

I've been walking around with an overbite for a long while, I started wearing braces and had 4 molars removed when I was 15 years old, after wearing them a year but not taking my teeth and their health seriously the orthodontist got sick of me and decided to just remove the braces. Back then I had a lot of stuff going on in my life and I couldn't really care much about how I looked or whether it would get worse.

Now I'm 22, and I'm starting to get really insecure about my overbite and overjet, I have already gone to the orthodontist but they gave me a bad feeling, they looked at my teeth for a short while and really rushed things, explained that I needed to wear braces for 2 years combined with a jaw surgery for my lower jaw.

I asked if there was another solution like just wearing braces and then they told me I had to remove more molars and wear headgear for a while, and it MIGHT get better but it wouldn't be perfect (not that I want it to look absolute perfect or anything)

Anyway I was kinda rushed out of the door and didn't really feel much informed after my last appointment, so I made another appointment but the first consult will be on the 15th of January, and I'd really like some insights from you guys on what might be possible and how bad things are.

Here's some pictures I took with my cellphone, I'm sorry they aren't great quality but this will have to do for now.

Image

I have about 1 cm overbite according to my orthodontist, but I'm not really worried or bothered much by my overbite, more about my overjet.

In about a year my canine teeth (?) started moving inward, and my upper incisors started moving upward and tilting forward, this can be seen clearly on the middle pictures.

And about the last 2 pictures of my face, the first one is in relaxed position, and I'm fine with the way that looks but my upper lip protrudes a bit compared to my lower lip, and I really feel my upper incisors on my lower lip when I close my mouth. I did not have this problem about a year ago when I still had an overbite.

The last picture is when I pull my lower jaw backwards all the way which puts all my molars on top of each other but doesn't really feel natural to me, and it makes my face look seriously weird.

What I really want to know is the following:

My wisdom teeth are all almost through but is it possible that this may have caused my teeth to shift forward even though my jaw is fully developed already? (Which I think it is at an age of 22, almost 23)

Also, is there any possibility for a compromise solution, like leaving the overbite but treating the overjet with braces? Because I don't really like the idea of jaw surgery especially if its only for cosmetic reasons.

I understand no one here can give me a definite answer about whats possible but I'm just looking for some insights from people who might know something about it. Please give me your thoughts and thanks for taking the time reading my post. :wink:


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PostPosted: Tue Dec 15, 2009 11:38 am 
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Also, there's this warning about people posting full face pictures on fetish sites but I figured it doesn't really matter if I do it because I'm not wearing braces.

If its against the rules or there is a problem with it though let me know and I'll fix the image.


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PostPosted: Wed Dec 16, 2009 6:47 am 
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I do think that wisdom teeth can shift everything. I had perfectly straight teeth in high school. My dentist seriously thought I had braces because I had a "perfect bite".

Three years later my wisdom teeth came in and my front teeth on the bottom became crowded and crossed in front of each other.

I would definitely see another Ortho. You have to be completely confident in who you let rearrange your facial structure.

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PostPosted: Wed Dec 16, 2009 10:23 am 
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Yeah the appointment I had for another consult was actually referring to another orthodontist, I didn't really hear a lot of positive things from my previous or tho so I'm glad I decided to look elsewhere.

I'm sure if I can keep looking I'll find an orthodontist that I feel comfortable with.

I really hope they can somewhat fix my overjet without requiring surgery to make it fit though, I'm kinda anxious about that.


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PostPosted: Wed Dec 16, 2009 12:56 pm 
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trigger1901 wrote:
I'm sure if I can keep looking I'll find an orthodontist that I feel comfortable with.


By "comfortable with" are you sure you don't really mean one that tells you what you want to hear?

Your overjet is significant - in excess of 8mm I'd say judging from your pictures. Your malocclusion has caused your upper canines as well as your lower incisors to over-extrude because there is little contact with the opposing teeth. Your overbite will likely get worse if the over extrusion continues without proper treatment.

You write that you are becoming self-conscious about your teeth. Attempting to correct your malocclusion without surgery may very well lead to less than desirable results in terms of profile and lip competence - which will only worsen as you age, resulting in an appearance older than your biological age.

Your opinion is that jaw surgery is cosmetic. It is worth noting that many medical insurance companies do not consider overjets in excess of 5mm to be "cosmetic" and will approve payments to cover surgical treatments in those cases.

It is wise to seek multiple opinions, but in doing so you must attempt to keep an open mind and weigh the pros and cons objectively. Otherwise, you may wind up very unhappy with the results and the results may not be easily correctable down the road.


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PostPosted: Wed Dec 16, 2009 1:24 pm 
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With comfortable I'm more referring to the way I'm treated, I don't really get a good feeling about an orthodontist taking a 1 minute look at my teeth and telling me I have 2 options, one which was only vaguely described, after which I was somewhat rushed out.

My overbite is actually 1 centimeter which I guess is pretty significant. I sure don't like the idea of surgery but if a jaw surgeon or an experienced orthodontist tells me I really need to do it in order to prevent it from worsening then I'll surely do it.

The thing is that I'm not really bothered by the overbite right now, and looking at my dad who has about the same overbite as I do, I don't really see him look or age worse because of it at all.
Its just that I'm not comfortable with my teeth being tilted forward so that it stays in contact with my lips.

I understand that if I want a perfect good fit I'll need jaw surgery no matter what, but if there's a way to push my upper teeth back a bit to make me feel more comfortable, and there's not a big chance of medical issues arising in the future from untreated malocclusion then frankly I don't find the whole process of 2 years with braces + jaw surgery (with ofcourse some risks) worth it.


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PostPosted: Wed Dec 16, 2009 1:35 pm 
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By the way thanks for pointing about the over-extrusion, I wasn't even aware that this was caused by little contact. I'm still hoping there's a compromise solution instead of jaw surgery but I guess I really need to put things in perspective after some consults.


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PostPosted: Wed Dec 16, 2009 1:55 pm 
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trigger1901 wrote:
My overbite is actually 1 centimeter which I guess is pretty significant.


I think you may be confusing overbite with overjet. Overbite is normally measured in terms of percentages. E.g., the upper teeth cover 75% of the lower teeth. Ergo, you would have a 75% overbite.

Overjet on the other hand, is measured by the horizontal difference between the facing edge of the lower teeth to the bottom edge of the upper teeth. In other words: i->! In the majority of cases an overjet is measured in millimeters. In your case, since 10 millimeters is equal to 1 centimeter the orthodontist used centimeter - which should give you some indication of the severity of your overjet.


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PostPosted: Wed Dec 16, 2009 3:50 pm 
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Hi. I'm not sure exactly how many mm your overjet is, but mine was 10mm, If you look at my story you can see before and after pics from my tx. My ortho didn't even bring surgery up. I had my 1st premolars extractedto make room to bring the front teeth back and my lower incisors were tipped forward slightly.

The only thing about not having jaw surgery is that your chin is not brought forward. Aesthetically, the jaw appearance can be improved only with surgery, but if you're only concerned with your smile, surgery may not be necessary. The braces alone can fix the lip protusion too.

Like you, I think that my wisdom teeth may have contributed to the overjet somewhat. I didn't need to have the upper wisdoms extracted for my ortho tx, but I eventually extracted them anyway because one had a cavity.

Your overbite would be easily corrected with the braces, so that's not an issue of needing surgery or not. It's the overjet that is the primary concern.

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PostPosted: Wed Dec 16, 2009 5:27 pm 
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I went through a similar thing. Got braces on when I was 15 but due to a lot of other bad things going on in my life at the time I couldn't handle it and had them removed after two days. I got them back on in june 2008 at 21 and im so happy i did. I had a very bad overbite along with a huge gap between my top front teeth. I was told I would need jaw surgury because my jaw was back so far and kind of crooked but i refused to have surgury ( no health insurance and already had to take a loan out to get the braces). My ortho understood and has done everything he can to correct my problems without surgury. Now 18 months later i don't have an overbite, my jaw isn't crooked, and i love my teeth. And my jaw was really far back but now it's not. And i had a hard time finding an ortho because i'm not too trusting, i actually drive an hour and a half now to see him.
Estimated treatment time 18 to 24 months.

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PostPosted: Wed Dec 16, 2009 6:37 pm 
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I have a classII Div 2, non extraction non surgical underway, 2 years +3 months and not nearly finished yet.

What I can tell you is that after 2 years of root moving' I'm only now getting to the bite stage, and from what i'm experiencing is what I think I see what is wrong with yours

right now the only teeth that touch (unless forced and moved) are the canines. That's by design right now as they need to be detorqued. As with your's they're tipped back.

The big queston is , is when you close your mouth, do you find them to be the two teeth that touch, and if so, when you clench, do you find or feel, your lower jaw sliding backwards (very subtle), untill all your teeth touch?

That's the key.

Depending on the actual situation, some if not many classII's will be found to be borderline skelatal. Meaning your lower jaw is being pushed back by your collapsed canines. Leaning inwards, and when you close your mouth and bite your jaw slids back into a class2.

The fix is to reset the teeth to the correct positions, your lower jaw will as in your natural state come forward if (or without), the canines that are leaning back pushing your lower jaw backwards.

The clue is if you have a perfect upper arch and perfect lower arch and you still have an overjet, you quite clearly need surgery.

Surgery ensure's (if perfect you'd never need retainers) your teeth should act as the retainers..

That's that all teeth should 'touch' and hold each other's place. If they can tip your lower's forward to touch your uppers, that will hold the theeth in place.

100% go for as many assessemts that you can do. While the fixes for a classII are limited, it's definitely not surgery or the highway even though class II is the most complicated in adults.

NB: as was stated **depeding on your _specific_ case** if they summarily declare extractions, be very aware. It works for most, but you must be sure and have your ortho explain it it you. Your feeling from the 3 minute diagonises, 'have to have surgery', is correct. Too cavaliar and you must get 3 or 4 other opionions. If it interests you the mechanics, or better the biomechanics, it's really simply to understand how what if you take the time to learn.


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PostPosted: Wed Dec 16, 2009 7:27 pm 
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ClassII, I'm interested in how your Class II bite is being corrected without extractions. I'm already done with my tx and had extractions, but I'm just curious what the other option was as it was never given to me.

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PostPosted: Wed Dec 16, 2009 8:03 pm 
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No other options unless borderline.

I'll still have 'a sunken jaw' when my mouth is open, but when i lock down and close my jaw the teeth will fit like hand in glove. that's the molar relationship.


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PostPosted: Wed Dec 16, 2009 9:05 pm 
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I was told by another doctor in September (professor of orthodontics) that my problem could have been corrected with surgery and braces alone. Had I known that at the time I would have run out the door the moment my former ortho mentioned extractions. I wish I would have gone to him first. I may need surgery anyways, but if it makes me better than I am now I say bring it on. I have such a TINY chin that it needs to be advanced. Plus my TMJ is far worse now than ever.


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PostPosted: Wed Dec 16, 2009 9:22 pm 
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I too had braces as a teenager--but they think I went through a late growth spurt and my upper jaw grew and my lower jaw didn't......resulting in an overjet. I was told at around 22-23years old, braces and BSSO due to the underdeveloped lower jaw......I said no way....it doesn't bother me cosmetically, I'm not doing anything about it..............WELL------15years later, the overjet is significantly worse..if yours is 10mm, mine was more...it was clearly worsening over time..if I compare smile pics of myself from 10-15years ago and now....so at 38 I finally got the braces and will be having the BSSO at some point. I could really care less how my profile looks, and if I could opt out of the surgery I would...but neither the OD or the OS think my upper teeth can be pulled back enough and without the BSSO my overjet would return :cry:

My advice, you are still young, fix it all now...don't wait--it will get worse!!I would personally only go nonsurgical if the OD could guarantee without a doubt that the overjet won't return. I also had no extractions. I currently have a TPA in place as he is pulling my canines back--then the rest of those babies get pulled back--I can't wait!!!!!

good luck, any questions let me know!

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