I'm... errr... not getting braced

Message

#1 Post by **sirwired** » Thu Oct 30, 2008 6:06 pm

I went through braces as a kid starting twenty years ago (jaw expander, brackets, many yrs of 24/7 retainer until the thing broke.)

I am currently suffering from gum recession on several teeth, and both my regular dentist and perio state that it is from my bite, and not hygiene. I am satisfied with my smile. (It isn't perfect, but it's good enough for me.)

After a gum graft (and another one scheduled) I went to an ortho today for a consult. He stated that he could fix the residual issues with my smile with just brackets. But to fix my bite, he said that I would need upper jaw (and probably lower jaw) surgery which insurance probably would be very reluctant to cover, and on top of it, he was not very confident that it would stop the recession.

The lower jaw surgery to correct a misalignment sounded especially unpleasant; it would remove a chunk from my jaw and then rotate what was left into place to fill the gap.

Basically, he was very reluctant to recommend the surgery (plus braces of course), and then in the end, still have further gum recession. In addition, he told me that one of the results of the surgery would be a need for more gum grafts, which is what I want to avoid in the first place.

His suggestion is to fit me with a mouth guard (even though I don't brux) to keep my bite locked in place overnight. He thinks that would do about as much good as the surgery and that either he or my regular dentist could do that for a heck of a lot less than any ortho work.

I must say, that is the cheapest time I have ever spent with a dentist. $25 and I got to chat with him for quite a while...

I guess I appreciate his candor, but I was kind of hoping for a more definitive solution. Though after reading the very occasional horror stories on here where orthos have bitten off more than they could chew I suppose I should be greatful.

SirWired

#2 Post by **TheNewEmperor** » Fri Oct 31, 2008 1:33 am

WOW! I hate to say it ok but....go get a 2nd opinion....I know, I know....but you just want to be sure sure sure, right?

In anycase, you know if you can live with his suggestion or not. I don't know what type of gum graft you get but I got the type with donated tissue (yes, dead peeps tissue) and it was a breeze.

#3 Post by **sirwired** » Fri Oct 31, 2008 5:30 am

My gum graft was a Free Gingival Graft using tissue from my palate. The recovery was not too bad. Actually, my palate healed faster than my gum did, so no need for cadaver tissue for me.

I have another one scheduled in mid-December. That one is for my rear molars, so it will be harder to get to. I'll see how that one goes.

I suspect my dentist will also request a second opinion. I'm kind of in a holding pattern right now until I hear back from him.

SirWired

#4 Post by **BrightLights** » Fri Oct 31, 2008 10:20 am

I have a question not to get off your subject but who does the gum graf (dentist or ortho ) and how much does it cost? Did it hurt?

#5 Post by **sirwired** » Fri Oct 31, 2008 10:41 am

BrightLights wrote:I have a question not to get off your subject but who does the gum graf (dentist or ortho ) and how much does it cost? Did it hurt?

The graft was done by a periodontist and it cost $1500 for two teeth ($800 was covered by insurance for my out-of-network perio.) Everything was numbed down hard so I didn't feel any pain during the procedure. I was on ice and strong pain pills that day, but I didn't need anything but Advil the following day. Other than not chewing on that side of my mouth for a week, recovery wasn't bad at all.

I'd say the worst part was not being able to brush that quadrant of my mouth for a week. Yuck. By the end of the week, the dressing over the graft site looked like a barnacle.

SirWired

#6 Post by **Lela** » Fri Oct 31, 2008 12:46 pm

"The graft was done by a periodontist and it cost $1500 for two teeth"

Were the teeth side by side? That seems like a lot for two teeth. I just had five grafts of the same type done (by a perio, all on the same day) in July and paid $500 per graft. Thank goodness it was per graft or I'd have been in for a huge bill with the 14 teeth they covered.

I agree that not being able to brush was the worst part.

The first week of braces was actually much more painful.

Preventing further gum recession was also my motive for finally getting braces. I hope you are able to find a solution, Sirwired. I think I would try a few more consults before making a final decision.

#7 Post by **sirwired** » Fri Oct 31, 2008 12:52 pm

Well, I just reviewed my insurance coverage, and there is no way in heck I can afford that jaw surgery, even if it would work.

Cigna medical insurance will only cover orthognathic surgery if the deformity is causing real medical problems like difficulty chewing, weight loss, pain, speech dysfunction, or sleep apnea not correctable through other means. Basically, I meet the criteria for the severity of the deformity, but none of the criteria for its medical necessity.

My MetLife dental insurance has a puny $2,500 / yr max, so that is completely, totally, out of the question also.

SirWired