Dr. says I cant fix overjet without surgery. alternativs?

[jay123]

I went to my orthodontist to get invisaligns. I have an overjet but he says that I have a type one on the left and a type 2 molar movement or something on the right. But the type two is so perfect that realigning it will make me grind my teeth and worsen what I have. He says that the only way to move it back would be to remove a tooth. Otherwise I cant have my overjet fixed.

My overjet is 4mm and I was really hoping he would provide alternatives He said he would not. He said only braces could fix the crookedness but since my teeth arent really crooked it wouldnt be useful. I was really unhappy.

is this the only way to fix? If I see another ortho can I just ask to have my front teeth pushed a little- just maybe 1 or 2 mm with invisaligns without worrying about the molars?

Please- my overjet really really affects my smile and makes me so uncomfortable. I dont go out becaus I hate myself in pictures. its an awful experience.

[jay123]

anyone?

[sirwired]

Certainly you can ask for a second opinion, but don't be surprised if it comes out similar. When you do go, it's important not to say anything about the first ortho's treatment plan; you are looking for the doctor's honest opinion, not simply telling you what you want to hear.

There are a lot of situations in which invisilign simply will not work; they are a lot less versatile than conventional braces. And if your teeth are just hauled into line with no regard to angles or your bite, you could end up doing serious long-term damage to your teeth and/or gums.

[deathorglory]

I asked my dentist about Invisalign first, but he said that to move my molars (my molars are tipped inward towards my tongue), I'd really need traditional braces (which I opted for). He gave me the option for Invisalign if I didn't care about fixing my molars and said that to fix my overjet (8mm) MOST of the way, we could extract 2 top teeth and slowly close the gap, but it would be a weird combo of Invisalign and brackets because I'd have to wear elastics. Kinda defeats the purpose of Invisalign if you can tell I'm wearing stuff, right?

As much as I didn't enjoy the thought of braces as an adult, I didn't like the thought of shelling out money and having visible gaps in my mouth to still have issues even more. I'd much rather just fix everything correctly the first time. My sentence is 18-24 months in these train tracks, with jaw surgery sometime around the 1 year mark. Honestly, it hasn't been as bad as I thought it'd be. Some discomfort, yes, and a few weird looks, but I've also got a healthy self confidence, so it doesn't really bother me. I'm aware that now I look 14, but I make up for it with expensive shoes.

Look for a second opinion. If the second opinion is similar to the first opinion, *shrug* it's up to you, but since your overjet bothers you so much, don't you want it fixed?

[jay123]

I do want it fixed.


I dont mind if its regular braces or invisalign. Oddly the ortho didnt even bring up regular braces.

Is there anyway an overjet can be corrected partially without any movement of molars? For example- just move the front teeth back to reduce the overjet- maybe by rotating the lateral incisors?

I dont mind rubberbands etc. What I dont want is jaw surgery (dont think I need it) and dont want any headgear- I'm in a professional field and can't afford that.

Can invisaligns even correct overjet say by 2 mm?

I have no teeth gapping and have read online that invisaligns work best with some gap- so does this mean I cant get much out of it?

Any knowledge about how overjet can be corrected in adults besides removing a tooth?

[Anna5]

Hello!

I am just wanted to say you that I feel sorry for you that you are bothered so much by your overbite. I hope you can get it fixed! But what may reassure you is that my ortho says that even an 5-7 mm overbite is still within normal ranges and does not warrant treatment (unless you want perfection of course). So I think a 4 mm overbite is not that bad.... (mine is 5 mm but I am not really bothered by it). But in the end, the only think what counts is how you feel about it.....
I wish you lots of strenght and good luck with your treatment!

[deathorglory]

I do want it fixed.


I dont mind if its regular braces or invisalign. Oddly the ortho didnt even bring up regular braces.

Is there anyway an overjet can be corrected partially without any movement of molars? For example- just move the front teeth back to reduce the overjet- maybe by rotating the lateral incisors?

I dont mind rubberbands etc. What I dont want is jaw surgery (dont think I need it) and dont want any headgear- I'm in a professional field and can't afford that.

Can invisaligns even correct overjet say by 2 mm?

I have no teeth gapping and have read online that invisaligns work best with some gap- so does this mean I cant get much out of it?

Any knowledge about how overjet can be corrected in adults besides removing a tooth?

Without room to move (ie extractions), I think it'll be hard to correct an overjet. Even if you rotate some teeth (which I don't think is easily done with Invisalign) there will only be so much room to move. I've had braces on for about 6 months now and even with my top teeth straightened and my smile widened, you'd think my overjet would've gotten better, right? Well...it hasn't changed. Still at 8mm.

With jaw surgery it's not like they're gonna make you go back to work right away, swollen and unable to talk. I'm in a professional field where I talk to people all day, but since I'll only be having lower jaw surgery, I'm gonna take 3 weeks off to make sure I'm at least at 80% then go back to work. From all the blogs that I see, the swelling isn't as noticeable at 3 weeks and I'd be able to speak pretty well. And there's no headgear involved for adults. That's usually something used on children since they're still growing and something like headgear could potentially stop an overgrowth of the upper jaw. As adults, our bones are already where they are, so headgear won't help anything anyway.

For Invisalign...one of my coworkers got it for a rotation of one tooth. She got the express treatment, so only 10 weeks, but from what she said, she felt that her tooth still isn't perfect, even after completing treatment. :T

[sirwired]

When you said "surgery" did you mean just extractions, or actual orthognathic surgery also?

If there's no room, you can't just "force" teeth backwards if there's nowhere for them to go. In addition, if you don't want headgear, what would supply the force? To move teeth backwards, you either need to push them (headgear), or pull them (anchorage to molars (with an available gap) or a TAD.) I don't think a TAD would work here, although I suppose it might possible (that's a question for an ortho.)

You cannot just move teeth willy-nilly around the mouth; if the final bite you end up with isn't healthy to match your new smile, it will either:
A) Not be well-integrated, giving you problems chewing, along with premature tooth wear.
B) Be unstable, leading to relapse
C) Be unhealthy, leading to TMJ, gum recession, etc.

Without being an orthodontist, it's hard to say exactly what you need. I will mention that for some situations, you just plain need either extractions and/or surgery. Speaking for myself, my aesthetic problems were nearly zero (I had a nice smile, if I do say so myself); like you, I was hoping to get away with Invisilign to correct my bite and go on my merry way. Seeing an ortho was an education; because of my particular problems, one ortho didn't even want to take my case, the 2nd said it was one of the most complex cases he had ever treated, and didn't even develop a treatment plan until he had a full set of formal records (x-rays, impressions, photos, etc.) to work with. It ended up being two years of braces followed by upper jaw surgery for a problem that only a dentist could spot to begin with. (Severe gingival recession triggered by a cross-bite caused by a narrow palate and right ramal hypoplasia. (Translation: Disappearing gums caused by a narrow upper palate, and a chin comically shifted to the right.))

Get a 2nd opinion, but if the 2nd one says you need extractions and/or surgery, that's probably what you need.

[jay123]

Well here's the thing.

I've talked to other orthodontists- but it was a few years ago.

He said- he could rotate one of my incisors and that would cause enough room to realign my upper overjet and allow them to move back. he said since my molars cant be moved- the movement i would see would be 1- 2 mm at best for my overjet. he said my smile would improve and that all this would also require rubberbands.

he said i could use invisalign or regular braces for this.

i didnt do it because i thought it was too expensive at the time. I have since moved from that place.

[deathorglory]

Since you're in a new place and you obviously want what the other guy said, you'd need an orthodontist willing to do that. But basically, if you say anything about it, they may just agree to do it whether it's good for you or not...

At any rate, you need to get a second opinion. Even in the last few years treatment options have changed. You never know what the next guy will tell you. My opinion is that rotating a tooth will probably make it fit your bite strangely - I'd much rather go the extraction or jaw surgery route. Obviously, since I'm to have jaw surgery in February...

[sean89]

As an alternative to extractions, ask your ortho if he can file down your upper premolars to create enough room to allow the upper arch to retract. It's an aggressive form of 'interproximal reduction' and will take off the enamel from your premolars and might even penetrate the dentin. This will make those same teeth sensitive if not sore. But it will give you about 1.5-2.5mm of room. As a consequence, the upper teeth should retract into the gap created and so the overjet will be reduced. The reason many people don't want extractions is because they believe the arch narrows if a tooth has been removed and there is less bone in the gum, but this will not be the case in this instance. For a 4mm overjet, extractions are overkill. The downside is that you might need the prepared premolars to be crowned.

If you speak to an ortho, please let me know his/her response to this suggestion because I am going to suggest it to the ortho I am consulting with.

[jay123]

my next appointment is not until september 17 i think. It will be a while. but I will look into it.

How much benefit can I get with invisalign to have my overjet reduced with minimal molar involvment. can we even get 1 mm movement?

[jay123]

looking at celebrity pictures- they ALL have NO or close to zero overjet. And their smiles look perfect.

How do they all achieve this? did they just have good dental work as kids?

Isnt there ANYTHING i can do besides surgery.

[deathorglory]

Dude. Ask the ortho. We're not licensed, so how could we possibly guess at that?

[sirwired]

looking at celebrity pictures- they ALL have NO or close to zero overjet. And their smiles look perfect.

How do they all achieve this? did they just have good dental work as kids?

Isnt there ANYTHING i can do besides surgery.

In your original post, you said the ortho wanted to extract. The only time you mentioned surgery was the subject line... what surgery was he proposing?

Every case is different; if your teeth are already at the limits imposed by your jaw structure, surgery may be the only option... (this is why we can't answer your questions with any certainty; we aren't orthodontists and don't have access to all your records.)