Anterior open bite, retreating 20 yrs later, intro and ?

[30andbraced]

That's great news! Thanks for sharing!

[jfriend33]

Sorry for the delay, been extremely busy! So last Monday I had my regular appointment.

Things started to get really scary. They basically said if in 4 months things don't start move faster they will have to re-evaluate.

I had a laser machine used around most of my TADs to get rid of excess skin. It made it a little uncomfortable previously to smile, as it stretched my mouth. But now its fine. Totally painless procedure.

So last visit, they did not change my ligatures? But they did install TWO more TADs for a total of EIGHT. The two upper TADs to the front as you can see are not being used this month. I liked the idea that they could be left and used later. Super cool.

ANYWAY if you look at my photos, you can see some improvement. I am so happy. My canines up front I can make them touch and I haven't been able to do that for years!

Next appointment, add two more TADs but to the lower buccal. They are also going to use different elastomer ties and connect the palatal tads to the buccal tads up top. The problem is they wanted to run it over the tooth and use composite to hold it. But since my one tooth is a crown (and that is the tooth that needs more intrusion) it wont stick to the crown. But they said it didn't matter.

So, in four days, I will have been in braces for 5 months. I honestly have to say, as an adult, or maybe its because I am so motivated, I have not been in ANY PAIN at all like I did when I was a kid. I almost think sometimes maybe they aren't pulling hard enough on my teeth??? Because except for a few cold sores now and again (and holy cow my right cheek was SWOLLEN from a cold sore once) I have not had any real teeth pain.

I did mention to the clinic the Rapid Molar Intruder device made of special springs. The reverse bent archwires. And besides a splint or sanding my teeth I really cant think of any other non surgical options? They want to leave elastics up front as a last resort. They claim it will elongate my teeth. Which I don't see how thats even remotely possible considering when I had braces 20 years ago, my teeth did not become longer. Heck I figured let them get longer, then I can file down my child ridges that never fully wore off.

Anywho. Thanks for reading. After my first appointment in June, I demanded to be seen every 2 weeks. I think it's only fair for now.

[rebecca121760]

Wondering... were you told you had condyler absorption? Wondering if it could be caused by the open bite? The surgeon we saw said that he has this and wants to do total joint replacement! We are seeking opinions. I so don't want to hurt this child. Joint replacements in a knee only last 20 years at best. So he might be redoing this surgery at age 30 or 36? Terrifying. Really am hoping not to make him have surgery.

[jfriend33]

Wondering... were you told you had condyler absorption? Wondering if it could be caused by the open bite? The surgeon we saw said that he has this and wants to do total joint replacement! We are seeking opinions. I so don't want to hurt this child. Joint replacements in a knee only last 20 years at best. So he might be redoing this surgery at age 30 or 36? Terrifying. Really am hoping not to make him have surgery.

Sorry rebecca, I just looked at what Condyler Absorption was. That can be a pretty severe face structure issue. I am so sorry you have to deal with that. Have you posted any pics here at metal mouth?

This condition is usually more common in females and is also known as Cheerleaders Syndrome. Its can be caused from sports injuries.

Now that being said, even though it does look severe (just googling it and hitting images) is his case that severe? I still think if hes still that young you could achieve some facial changes, but if the jaw is that sunken in, I really cannot attest to that unfortunately. You really should get a digital copy of his xrays, some front and side profile photos, and a brief history/explanation and just start emailing it out to people. Let's leave surgery as a last resort! And hey, worst case scenario if they cant fix with regular braces, he will already be in braces for surgery. They usually like to do the surgery consult first, before anything is done though.

I think it can also be caused by other issues, even breathing issues (although much literature acts like breathing problems and sleep apne occur AFTER this condylar resorption happens. Has he always had breathing problems? Maybe he has some breathing problems that need to be fixed.

______________________________________________________________________________________________________________
So in other news, I just had a checkup yesterday. Wow. I have teeth touching that have not touched in YEARS. Granted, I still have an open bite, I am just happy that my molars are aligning.

They added two more tads, for a grand total of TEN! This time they added on the lower, between my back molars. They are technically only using 6 and leaving the others as spares just in case.

I go back in 3 weeks to retie everything, then 3 weeks after that...drumrolll please....FULL frontal braces! Thank god! I have waited way too long for this! I have been going to this place for almost a year now (although only in braces since december).

Hope everyone else is having a GREAT week.

[rebecca121760]

update please! I so want to know how this is going for you. Thanks so much for posting pictures.

[rebecca121760]

By the way we are seeing Kent Lauson out in Denver. He is going to do his best to do this without surgery, but said he cannot 100% guarantee it. Noah will be in a palate expander for 9 months. He will be turning the key every three days which is a little slower than some, but if it helps with his pain and causes the retention to be better, I am all for it. After the palate expander they will start braces and be working with a myofunctional therapist and using a myoguard to stop the tongue thrust. We are hoping the palate expansion will help with his breathing through his nose. As he grows and things change we will figure out if the surgery will be needed.

[jfriend33]

By the way we are seeing Kent Lauson out in Denver. He is going to do his best to do this without surgery, but said he cannot 100% guarantee it. Noah will be in a palate expander for 9 months. He will be turning the key every three days which is a little slower than some, but if it helps with his pain and causes the retention to be better, I am all for it. After the palate expander they will start braces and be working with a myofunctional therapist and using a myoguard to stop the tongue thrust. We are hoping the palate expansion will help with his breathing through his nose. As he grows and things change we will figure out if the surgery will be needed.

Rebecca,
I am so grateful for this forum, aren't you? I really have enjoyed sharing my journey with you! I totally understand the 100% guarantee thing for surgery.

I am so impressed with you mentioning the myoguard myobrace! I really wish my ortho made me wear one of those years ago lol. I am kinda thinking though, and again, I am no dr, but possibly a chincup type headgear combined with this myoguard might make things easier for his bite to hold on to? I remember using something like that as a temporary retainer once.

How old is your son? Do you think maybe you could post a few photos of his smile/bite/profile on here? Blur his eyes out for his identity. We don't want any trouble. When I look back to 7th grade when I got my braces off, I was VERY excited to be rid of them, and get some fun colored retainers. Even though I still had a 1mm open bite, the ortho said it would close. And as we all know, that never happened because the cause of it (my poor tongue posture) was never treated. How motivated is your son for treatment? Does he worry about what others will think of him in braces? Is he scared about anything? I feel like if I would have had an adult, sit me down, and tell me several times, that if open bites dont get fixed, you will go broke paying for root canals and crowns and fillings. I mean truthfully some people spend more on the crowns/implants than they would have on Surgery! or braces of course.

Do you think that maybe you could find a dental school? One that is well rehearsed on cutting edge treatments? Even if you have to drive 2 hours a month, it would be way cheaper.

There is this guy that is the almighty TAD master. His website is copestheticce.com Jason B. Cope. He is the guy that has really focused on TADs and educating others on their use. You don't need to xray a person before every TAD. It wastes too much time, and doesn't prevent any injury anyway. The best practice is to just numb the gums ever so slightly. You will feel lots of pressure going in. Sometimes, depending on your bone density, it can be painful. But The point is to have the patient be the guide on if the TAD was installed properly. If they are in a TON of pain, they are too close to a root and have to back it out and go at a different angle. And let me tell ya, I was my student drs first patient for TADs. His first one was fine but after a few times he got really good at it FAST.

I will say that it has been a little over a year since completing my myofunctional therapy. My tongue still rests in the "right spot" the bony ridge. It was so strange at first to relearn how to eat,chew,drink, swallow, breathe, all of it. My tonsils have reduced in size by 50%. My mouth breathing is GONE unless I have a cold which is rare. I do wake up some mornings with my mouth slightly open and dry but my tongue is not hanging out. I have even recorded myself to make sure. My brackets behind my two front teeth (the fake tongue tamers) I don't even touch.

I do notice that my midline is a little off but that can be fixed. Also, my side that is more open, thats mostly due to the lower teeth, not the uppers. I have no clue how long I will be in full braces. Or if I will have to use elastics. I bet I will seeing as how all my brackets have the rubber band hooks on em lol.

My crazy elastomeric tubing that they use to tie my tads, one of them split connecting to my palatal TADs. The crazy part was, I had a old bag of my colored Strawberry elastics saved from when I was a kid. I was able to rig one up just fine, and I am sure only 1 week with that will not hurt anything.

Anyway, here is my photo, compare it to the one above, and you will see a difference!

[rebecca121760]

Wow! They are looking great! Yes, I love this forum too. Noah is 16 and if I can figure it out, I will post a picture. Yes, our orthodontist is 9 hours away. I just needed someone who had done this before and was willing to try. We have a really young orthodontist at our dentist office. I think she is going to help us for emergencies and possibly some adjustments. We have talked about moving out there for a year. We live in Missouri right now. Have a good day, I will see if I can figure out how to post them. In the meanwhile, they are posted on a website called realself already. You have to search open bite without surgery or something like that.

[rebecca121760]

Have you ever seen the u tube video by park avenue dentists about closing an open bite with orthodontics? It is amazing and I don't think she used tads.

[rebecca121760]

If you go to realself you have to make an account and then if you go to my username rebecca121760 or search can my son's open bite be helped with just orthodontics you can see his pictures. I tried to load it here but it was saying my file was to large. I will have to figure that out. Be blessed.

[jfriend33]

Well the plan slightly changed. I had two tads fall out. One wasn't in use anyway. So they replaced one.

In 3 weeks I am not getting front braces on the top and bottom. Now only on the bottom for now.

They said they could close everything up and be fine. However they said either my tongue is keeping it open or my lower lip. My facial shape is fine. I am not resting my tongue anywhere but the bony ridge. I am not mouth breathing.

The lower braces will pull my lip away and that should help if it's the issue.

My upper teeth are on the same plane now as far as my molars go. But my front teeth aren't. When I smile they said more gums should be visible.


We also discussed an acceledent. They said it is more for spaces in the back, for seating invisalign trays, etc, and not so much for molar intrusion. They said it's $900 and the machine only works for 20 mins a day for 18 months. Then it's completely disabled.


So I have been in treatment now for just about 1 year. Although only in braces since December. It's been 1 year and 2 months since completing my myofunctional therapy.

I pray my lip resting in the opening up front is the culprit. He's very adamant about going slowly to avoid any chances of relapse. Good stuff but time consuming.

[rebecca121760]

Well, I will say a prayer for that too. I am sorry for the setback. Dr. Lauer is all about slow and steady change too. The first few days with the palate expander sucked, but he is doing so much better now. I have never heard of an acceledent. I will have to google that one. Noah's treatment will be about 3 years total. A long darn time. Have a good week.

[Artana237]

Hi- I plead beginner's ignorance. I am the mother of a young adult in her early 20's who had diagnosed but untreated tongue thrust and whatever degree of open mouth issues. She had 2 stages of braces- first beginning at age 8 which included a mouth expander (maybe upper only, I don't recall exactly) and having I believe 4 teeth removed. The orthodontist noted the tongue thrust but didn't seem to have any treatment offered and at the time I had no luck tracking down info on how or who treated it. So jump ahead some 5 years after her braces came off and things have devolved from near perfect alignment to a stage where it is apparent that tongue thrust "won" . Seeking to find solutions. I found one person (dental hygenist, 1 person office) in my State who is a Certified Orofacial Myofunctional Therapist. I am trying to understand how or if they work in conjunction with an orthodontist. If there are "appliances" to add to braces which train the tongue and everything else that goes with it- roller balls or whatever (please feel free to say, I am just learning and "spikes" won't likely work with this young person), is a therapist necessary? The teeth are not going to go back to being aligned without some sort of orthodontics is my guess. Just trying to get this addressed and be as wise as is doable with what it costs to get this successfully treated.

Thanks and what is a Tad or Tads?


How does one become "allowed" to view photos? I hope I find the right thread to understand all this. It was a mystery all those years ago and now I am finding there "are others" who have this issue and are successfully receiving treatement/help.

Thanks in advance, this is a Godsend.

[jfriend33]

One school of thought is with correct tongue posture, there will be no malocclusion.

I know some people may argue against this, but if you research orthotropics they can correct issues without braces.

A person can do myofunctional therapy without braces. You may need a referral from a Dr or ortho depending on how your insurance works. I completed my 12 weeks before beginning any type of treatment. Go look on YouTube there are tons of videos and are great for practicing or familiarizing one's self before therapy.

The one problem with devices like tongue cribs, they can actually pull the molars it's attached to and worsen a bite.

How many millimeters is this open bite?

A TAD, or sometimes called the TSAD, or MSI (mini screw implant) is a newer trend in the last ten years. It provides extra anchorage to avoid using headgear or surgery or other things. Look for scholarly articles by a guy named Kope.

They are not a cure. They have a failure rate of about 1 in 10, but it only takes a minute to put in the replacement. Very little amounts of numbing with these, only in the movable mucosa or attached gingiva. That way if they hit a root the patient can give feedback, dr can adjust angle, and go forward.

Bottom line here, even disregarding perfect teeth. A open bite can be costly if left alone. The extra wear on molars can be expensive to repair. Avg root canal is 500-1500/tooth and a crown is the same. Implants are also expensive. People suffer from jaw pain and headaches too.

I would say why not try this before surgery. And at least throughout it all even if it doesn't work perfectly and surgery is required, at least the new tongue posture will ensure good retention and results that last a lifetime!

You could try ortho without myo. Many do. Devices like I have but a more extreme version called tongue tamers can sometimes correct poor posture (thrust isn't the real culprit).

There are also devices completely separate from orthodontics used with myology. Like a myobrace mentioned earlier. Those are geared more for younger mouths.

I would also see what her posture is like with her back. Does she stand up straight or have rolled shoulders? Any breathing problems (enlarged tonsils, adenoids, deviated septum, etc) can cause or exacerbate these open bites. Attack this from all angles.

For me I have discovered how much more easily I can nasal breathe. My huge tonsils are gone finally. I don't walk around with my mouth hanging open anymore. If my treatment ended today and this was it, at least most of my molars make contact which never was the case!

One final thought. Look at all the isolated areas in the world. They don't have as many bite problems as we do. They also don't have all the processed food available and are therefore doing more chewing. Our faces are evolving and becoming longer from eating all this soft mushy food.

When most general dentists ask their patients if they have ever had orthodontic treatment, almost 99% of the time the ones with straight teeth say NO. The ones with crooked teeth usually answer YES.

You will be able to post photos after you comment more and become an established member. Glad this was of help. There are a few good open bite threads here. One guy has beautiful results from tads but I don't think he had poor tongue posture.

[jfriend33]

Few questions for anyone that may catch it. In just a few days I have an appt.

If I am getting 6 braces bonded to my front lower teeth, and I already have a heavy duty square archwire on each side for the back, are they just going to have to do a few bends to get things going, or go down in size to a more flexible wire? I know the teeth aren't really crooked across the front side but their height is off on one side. I wonder if maybe initially they will be using a separate one for the front?

Also, I have been thinking. I know my screws that I have are roughly $60 a piece. They do sterilize and reuse them, but I don't think they reuse them for other people. I guess that does get costly. I am trying to understand why if I would decide to pursue the acceledent that I would be responsible in paying for it. I know that my pricing is heavily discounted ($3700). But I have been technically in treatment for 1 year and only partially in braces for 6 months. I feel like if my treatment would benefit even the slightest bit from this device, even if it costs $800-$900, it should be included in my treatment at no cost.

I mean after all this place is a teaching school. Surely they could use these machines for more than one person and just buy extra mouth pieces, right? I wouldn't care if they gave me a used one, ya know?

I am going to fight to get one included. Or at least more discounted if I agree to let them reuse it. And if they say they can't go lower in price, I should probably just buy it for $900 because they sell all day everyday on ebay for $600+ if in good shape. $300 total cost, not too shabby!

So who has been using a waterpik and what is their favorite model? I really want to buy the OralB pro 5000 brush as it has a range of brushes (one tailored for braces), pressure guide, timer, and earphone thingy. I have seen them sell for $80 many times. The reviews for the 7000 model are not as good. If you have braces and brush longer your brushing will be interrupted many times.

To anyone that uses proxabrushes, check out the ones made by Plackers. They last a super long time, the handle is long and angled. Very very reasonably priced compared to the other makers.