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complicated questions

Posted: Mon Mar 30, 2009 3:39 pm
by tmw2n
okay, i had a consult with my ortho, and he's recommended if i want to go ahead with treatment i need jaw surgery, which means it's going to be free, as itll be n the nhs (i'm in the uk)
i have an overbite and a couple of my back teeth dont meet well when i bite down i'm also wearing down some of my lower teeth in my sleep.

the jaw surgery he's recommending is to move my lower jaw forward about 5mm, which seems no much of a move. however, this is where things get complicated. i am transgendered, gonig from male to female. and im worried that moving my jaw forward will result in making my face more masculine, the exact opposite of what i'd like.

i've been unhappy with my teeth since i was a teenager, and i's taken me about 15 years t get round to trying to do something. does anyone (especially girls, as i'm trying to get my head round hw much difference this type of surgery would make to jawline and face shape) have any feedback or before / after pictures from having their lower jaw moved forward a similar distance?

i'm seeing my ortho again in two weeks, and i have t tell him if i want to go ahead, and if i do braces go on then. thanks in advance for any help, and sorry if this post has made anyone uncomfortable.

Posted: Mon Mar 30, 2009 4:01 pm
by Lingualita
Hi,

I truly understand that you're worried that your jaw might seem to masculine once you've moved it. From what I've understood each mm can make quite a difference, so it's important to get it exactly right to get the right balance of your face :)

I'm having a severe overbite myself. I'm a 23 year old female who's just started with braces. I will most likely need surgery to fix my bite. But since I haven't yet met my OS, and since I'm still in the beginning of the process, I haven't got too much of advice so far.

My advice is that you should post this exact message in the discussion for Orthodontic surgery as well, unless you've already done it :) That's one, or maybe the, busiest board, and people have lots of experiences to share on orthodontic surgery.

Another advice is to be honest with your OS about your fears, aspirations etc, so you'll finally get the result you'd like.

Good luck![/u]

Posted: Mon Mar 30, 2009 4:14 pm
by tmw2n
thanks, i've reposted it in there as well, hopefully i'll get some feedack. as i understan it, i wont see the surgeon until ive aleady got braces so need to decide whether i want t go ahead with surgery or if i want to see if there is a way to deal with my issues without surgery

Posted: Mon Mar 30, 2009 4:46 pm
by Andromeda
Hi I'm a 23 year old female and I'm not having any surgery but I've always thought a nice square jaw looks very good on both males and females. I've always wanted a more square jaw that is a bit further out than it is. I feel like mine is a little recessed and it seems to make my face look a bit longer than I'd like. I think profiles look nicest when the lower jaw, upper jaw, and forehead are all kind of in line with one another but I don't think it's gender specific. We all have things about ourselves that we might wish we could change physically but personally, I think having a healthy alligned bite is the most important thing in this situation. I hope things work out well!

Posted: Mon Mar 30, 2009 5:31 pm
by smile2006
I would think it important to discuss this with your surgeon. Oral surgeons are usually concerned about aesthetics when moving the jaw. Some facial proportions are different for males and females. They do alot of measurements and come of with the best plan for the bite and the overall appearance. Are you comfortable discussing this with your OS? I know if you are having genioplasty the look of the chin is considered by some to be gender specific. I wish you good luck.

Posted: Mon Mar 30, 2009 6:08 pm
by Wireless
I have an issue with the shape of my jaw that causes a deep overbite condition to recur. When I was a teenager / young adult, surgery was not available to correct the problem. Adult orthodontics moves the teeth and not the jaw. Over time, my teeth tend to move back to where they were, requiring re-correction. I'm now wearing braces for the third time because of relapses.

In my case, the jaw is in the correct position but has an improper curve. Because of this, my ortho did not recommend surgery this time either.

Surgery is definitely a drastic step and you are right to give it serious consideration before going forward. If you do, you are more likely to have a stable correction.

If you don't have surgery, be sure to ask your ortho how to keep the overbite correction stable after treatment.

Good luck with your decision!!

Posted: Mon Mar 30, 2009 6:19 pm
by newsboysgrl777
Wireless wrote:I have an issue with the shape of my jaw that causes a deep overbite condition to recur. When I was a teenager / young adult, surgery was not available to correct the problem. Adult orthodontics moves the teeth and not the jaw. Over time, my teeth tend to move back to where they were, requiring re-correction. I'm now wearing braces for the third time because of relapses.

In my case, the jaw is in the correct position but has an improper curve. Because of this, my ortho did not recommend surgery this time either.

Surgery is definitely a drastic step and you are right to give it serious consideration before going forward. If you do, you are more likely to have a stable correction.

If you don't have surgery, be sure to ask your ortho how to keep the overbite correction stable after treatment.

Good luck with your decision!!
Wireless, did you always wear your retainers when you were done with braces? Or no? Will teeth always shift no matter what? (Retainer worn or not?) I ask this because I am a candidate for jaw surgery, but my current ortho told me my overbite is so slight that braces alone should be fine. My question is - even with wearing my retainers, will my teeth still shift back? And, I want to add that what she calls slight doesn't mean non-existent! I don't know how many MMs we're talking, but I DO have a significant overbite, but obviously not significant in my ortho's eyes. Does that make sense?

Sorry for thread-jack...but didn't know where else to ask this. Thanks

Posted: Tue Mar 31, 2009 6:47 am
by Wireless
newsboysgrl777,

I did wear retainers as recommended at the time of my treatments, which were in the 1960's as a teenager and in the 1980's as an adult. My case involves a deep overbite where my teeth are relatively straight, but my lower front teeth contact the gums behind my uppers.

At the end of my first treatment, I wore retainers full time for about 2 years and at night for three or four more, which was the practice at that time. The deep overbite returned in about 10 years. At this point, I broke the tips on three of my four lower front teeth in addition to having gum irritation. This was the early 1980s and I got opinions from two dentists that I was too old for treatment and they wouldn't do anything unless the problem was a lot worse. I think I am very glad I didn't find out what they would have done!

A new dentist taking over my retiring dentist's practice told me he could fix the problem with braces and did a treatment that extruded my rear teeth. It appeared to work well and for the first time my lower front teeth weren't hidden by the uppers. However, this dentist told me that once properly aligned, adult teeth would tend to stay in the correct position (Wrong!!!) so other than a night appliance I wore for a couple of years, there was no retention.

During the past 20 years, two things happened. The extruded rear teeth slowly went back to their original position, and my front incisors tilted inwards. My current ortho explaned that years of pressure on the rear teeth from normal things like chewing, clenching and bruxing would push the rear teeth back into their sockets. Retainers may have prevented the tilting but not the loss of vertical correction.

My current treatment plan is to intrude or push in my lower front teeth and then do some extrusion of my rear ones. This should be a more stable correction than extruding the rear ones only. I've also been told I'll have to wear retainers at night the rest of my life and possibly require permanent bonded ones, depending on treatment results. Ask your ortho what the plans are to ensure you won't have a future problem.

I'm not sure where you live, but in the US, health insurance won't pay for jaw surgery if the problem can be corrected by ortho treatment alone. If I wanted to pursue this route, I would first have to find an ortho willing to state there was no other way to treat the problem.

Going forward, I plan to confirm with my ortho what time of long term follow-up is needed to be sure everything is staying in place, and also take pictures to keep on file to show corrected results. In my case, my ortho and regular dentist are exchanging info, so my dentist will know what to check during regular visits. I suggest providing your ortho history to any new dentist you go to. If I had done this 20 years ago, it is the one thing I can identify that would have really made a difference. I'm hoping this will keep me from "round 4".

Sorry for the long explanation - I hope the details are helpful when you review your treatment plan!!