Overjet, deciding against surgery: question

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#16 Post by **I love my teeth** » Tue Apr 06, 2010 1:00 pm

lennaaker--

I am wondering what my overjet measures now--I will ask next time I see the OD in 2 weeks, but I tried to measure myself (very scientific!) I think it's somewhere between 5-7mm (using the cap of a pen--again very scientific!!) So, it is really reduced, could it be reduced more, I don't know....I took my 10yo son in for a consult yesterday, and my chart was with his, so of course I thumbed through my own and saw the letter from the OS to the OD after my consult for BSSO surgery--it stated to "leave 5mm ect, ect" so I assume my OD is supposed to leave a 5mm overjet in order for him to advance my jaw. I think that makes sense--so I am not sure if he could completely reduce my overjet with braces, because he really isn't supposed to try according to the OS.

again, good luck with your decision, I guess it depends on the reason for your overjet, mine is an underdeveloped lower jaw, so it seems there is little option for me except adv. surgery.

#17 Post by **leannaaker** » Tue Apr 06, 2010 1:21 pm

See, this is what is bugging me. My problem is an underdevelopped lower jaw also. I have slight crowding on the bottom, moderate crowding on the top.

They are telling me *no* change in my overjet with treatment (I think in fact, it will likely look worse, because the space will seem bigger with everything straightened out.)

I am now looking at extractions, and they worry my profile will "dish in" as a result.

Ugh.

#18 Post by **daffodil** » Wed Apr 07, 2010 2:29 pm

my overjet is 11mm and when my orthodontist explained what she could do without surgery, she said that it might result in my face looking flat :/

#19 Post by **leannaaker** » Wed Apr 07, 2010 4:27 pm

So Daffodil, did you go ahead with the surgery?

#20 Post by **I love my teeth** » Wed Apr 07, 2010 5:45 pm

I had several consults when I was in my early 20's (which was early to mid 1990's

) and all the orthos at that time said the same thing, underdeveloped lower jaw, braces and lower jaw advancement....I said no way. I think my over jet was measuring less than 10mm at that time, I didn't have a lot of spaces, asthetically, it didn't bother me or my husband (fiance at the time)....so I let it go...fast forward to age 38--we moved to Canada from the US (for a 3year work thing)---saw a new dentist, who said I should have it looked it (like everyother new dentist I had ever seen!!)--but for some reason this time I said OK, and again, the consult yeilded the same results as it did 15years earlier braces and lower jaw advancement....my point being 15years, about 5 total orthos in 2 countries, and the diagnosis and treatment were the same--the only difference is my overjet is now worse and my braces time as a result is probably longer

is there a reason why you are so against the surgery? If I could get out of it I would, but after knowing the inevitable for 15+years, I think I have finally come to terms with it, and now I want it done and over with. and move on with my life!!

So, please, please really think about the reasons you are against it, and think about the fact you have to live for another 50+years with your teeth, the older/wiser me thinks better to fix it right than just asthetically! Please make an informed decision.

#21 Post by **leannaaker** » Wed Apr 07, 2010 9:55 pm

I hear you, and my reasons are like many, I'm sure, and sound selfish, which they are.

My issue is not just my overjet, but also crowding. I have a horrible time at the dentist....no matter how I brush, flush, I end up getting cavities. I just can't keep these things clean!

So simply straightening my teeth would have a big improvement. But on to the surgery:

I'm a teacher. Not willing to take off time from work to do the surgery. Great! I can get it done in the summer. So my entire summer (I travel or do professional development every summer) is ruined with eating food from a bag for 2 months. I may be selfish, but I value my time and my freedom to use it as I see fit. Besides the alarming number of people who have permanent numbness from surgery. Besides my immense dental phobia, which involves gag reflex and fear of choking. From what I've read of recovery, I'd need to be bascially sedated the first 2 weeks home from surgery. (and no, I'm not overplaying my phobia.... I need conscious sedation for any work done, and nitrous for x-rays...never been able to get full mouth x-rays done). Many times, I leave my dentist sobbing from fear (and my dentist is *wonderful*, patient man, who never makes me feel like an idiot, nor does he cause me pain)

I have no jaw pain, maybe I will at some point, but I want it to be easier to clean my teeth, and for them to look better. This is a big step for me, someone with no dental care until age 17 when I had my wisdom teeth removed. My parents didn't believe in dental care.

#22 Post by **TigerLily** » Fri Apr 09, 2010 11:53 am

Well, I'm 2.5 years into braces treatment, getting them off in two weeks, yay.

I was a compromise case, in that I really should have had lower jaw surgery, I have a very small lower jaw. I had overcrowding on my lowers, but my uppers were straight (but overbite and overjet).

I should have had my braces off about 6 months ago, but we went with a try on IPR to reduce my overjet. She was not keen on doing extractions as she thought it would flatten my profile too much.

My overjet has been reduced, but via my lower teeth being tipped. At this stage I'm not sure it was worth it, I think I'd feel differently if it had been half the time and half the money, too many times I had my life impacted by braces (being tired etc), but perhaps I'll feel differently once my braces are off and my upper lip will fall over my teeth properly. So in hindsight I think I should have gone for a surgery option. But if it had been my only option then it would have been too big a thing (especially from a monetary perspective) and I probably wouldn't have done it. I'll update how I feel when my braces are off!

#23 Post by **almost50** » Fri Apr 09, 2010 1:35 pm

I had lower jaw surgery last December. I'm 48. I took less than 2 weeks off work, and almost went back to work earlier. I went to a Christmas party on Christmas day (the day after being unwired and 10 days after surgery) and people that didn't know couldn't even tell I had surgery. I was on a soft chew diet and couldn't open my mouth that wide but managed okay at the Christmas dinner.

I'm healthy but not exceptionally healthy. I had a good doctor and was lucky that surgery went well, I guess.

My point is that it's not that huge an interruption to your life. And a few weeks of discomfort is better than a lifetime putting it off. I put it off for 10 years, wish I had done it earlier cause you heal much quicker and better the younger you are.

(And with the amount of advancement you need I really wouldn't recommend extractions cause it would look bad.)

#24 Post by **daffodil** » Fri Apr 09, 2010 3:47 pm

lenaaker,

I got braces on this January and I'm preparing for upper and lower jaw surgery late next year.

#25 Post by **socksy** » Fri Apr 09, 2010 4:42 pm

My insurance specifically precludes coverage for jaw surgery so there was absolutely no way I could afford it. The cost would have been at least $50,000. But now seeing the results that have been achieved (my teeth are straight and beautiful), I'm glad that surgery wasn't an option for me. I really hope you will seek more consultations with other orthodontists so you can weight your options fully. Good luck with your decision!

#26 Post by **leannaaker** » Sat Apr 10, 2010 8:17 pm

I really do appreciate everyone's perspective,thanks.

Surgery is a no for me, though I appreciate the positive perspectives of those who have gone through. Right now, I am at a point of deciding between extractions or not. And I do have a second consult this week.

I found this article in my Google searching and found it interesting: http://www.lewisart.biz/cerny/

It seems to suggest there are plenty of healthy and aesthetically pleasing compromise treatments that can be achieved without surgery. (And yes, I know you can find anything you want to support your line of thinking, but this article in particular, I feel, addressed my concerns.

Thanks guys.

#27 Post by **yj207** » Sat Apr 10, 2010 11:19 pm

lol opps I guess I got confused from the pics! I have pretty bad overbite and overjet and surgery wasn't an option for me, nor was it given to me by my ortho. I worry about the dish in profile but so far everyone told me that I do not have to worry about that. Everyone meaning any dental professional I run into such as dentists, oral surgeons. (I work as a cashier and sometimes see their credentials and ask them questions) I did get 4 extractions and my gaps are all closed already and my right side of my face looks very good but my left looks like it still needs to go in more. My overbite still needs to get fixed but so far so good. I guess my case wasn't extreme enough that surgery wasn't necessary. I also have an underdeveloped lower jaw and my teeth on the bottom are smaller than on top but somehow its all fitting together. Hope you figure out what will work for you! Keep us posted!

#28 Post by **DrJasonKTam** » Sun Apr 11, 2010 7:08 am

When making a decision about surgery, it isn't only about the bite. There are facial features that need to be taken into consideration. Therefore, looking at a picture of teeth alone really isn't very helpful.

For example, a general "compromise" with a larger overjet is to extract two upper premolars. However, the problem could be due to a deficient lower jaw, while the upper jaw is in the correct position. Proceeding with upper extractions would mean trading one problem for another. The teeth will now be aligned without overjet, and look great in intraoral pictures, but the upper jaw and lower jaws will both appear deficient.

Surgery is definitely a big decision, and is not for everyone, both psychologically and in lifestyle. It's a great idea to accumulate all of the professional information you can, before coming to a decision.

Good luck!

#29 Post by **leannaaker** » Sun Apr 11, 2010 10:26 am

Dr. Tam, thanks for the info. This is what all of my research is turning up (concerning facial profile).

When I found the article (linked above), I was heartened to see that there are aesthetically pleasing outcomes for large overjets. I suppose part of my problem is that with the teeth crooked, narrow arch, and overjet, the overjet is particularly ugly. I am hoping without extractions this can all be done to an aesthetically pleasing result.

Thanks everyone, again, for your stories. I'm really excited to get started!

(The best of all of this is that because I teach 9th graders, I can tell them about what I'm doing, and they all understand and are supportive). Should be a good couple of years.

#30 Post by **leannaaker** » Sun Apr 11, 2010 10:27 am

Tigerlily, can you post or send me pictures of your before and after? Do you mind?

Thanks.