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I've had braces since April '14. In July I had my 4 premolars taken out to correct crowding as my teeth were fairly crowded. I also had a transposed tooth on the left hand side (which kind of was above another tooth and I looked like a vampire haha!). I also had an open bite - my lower jaw was overdeveloped, whereas my upper jaw was underdeveloped. Along with this, my midline was shifted off to the left...(which is why my open bite wasnt as noticeable through just looking at my profile). My orthodontist suggested I go through the jaw surgery route but at the time I refused straight away.
A few months after my braces, I started to notice that I was clenching my teeth a lot, had a bit of jaw pain and the occasional clicking noise while chewing. My lower jaw is better looking than originally (its not as protruding), but I feel like maybe jaw surgery would have been the better option to solve all this. I'm worried that my open bite may relapse after my braces etc.
Is it too late to reconsider jaw surgery now? I've gone through extractions and now have power chains and my gaps are closing. My orthodontist hasn't started working on closing my bite yet.
I know any kind of surgery is something nobody wants, but if jaw surgery was involved in my treatment id go with it (of course id dread everything about it until I was done healing and saw results, but thats besides the point), I can only hope that timing doesn't make a drastic change, but at the end of the day as adults getting orthodontic treatment for a better smile we should be prepared to do what's needed no matter how much we may hate certain things. I know I didn't really answer your question, but im unsure anybody here can really answer it.
Has your ortho suggested surgery when you were discussing a treatment plan? If so, I'd say you are probably still a surgical candidate, although your ortho may have to undo some of the work already done to line your teeth up for surgery. (Expect your bite to get worse... it's part of the pre-surgery process.)
Tyrantblade wrote:I know any kind of surgery is something nobody wants, but if jaw surgery was involved in my treatment id go with it (of course id dread everything about it until I was done healing and saw results, but thats besides the point), I can only hope that timing doesn't make a drastic change, but at the end of the day as adults getting orthodontic treatment for a better smile we should be prepared to do what's needed no matter how much we may hate certain things. I know I didn't really answer your question, but im unsure anybody here can really answer it.
Thanks for your input. I know it is kind of daunting..but thinking back on it, I was terrified of my extractions (hence why I was deciding on whether to get braces or not) but now I've gone through it, I realise it was needed! Very glad I got my braces.
sirwired wrote:Has your ortho suggested surgery when you were discussing a treatment plan? If so, I'd say you are probably still a surgical candidate, although your ortho may have to undo some of the work already done to line your teeth up for surgery. (Expect your bite to get worse... it's part of the pre-surgery process.)
Yes, when I was going for consultations, all 3 of the orthodontist's I went to mentioned surgery. The first one suggested that I needed more work done (not only braces) hence surgery. The second one was really pushing surgery and showed me a few cases he had worked on. And the one I'm with now also mentioned surgery and talking to an oral surgeon but he also said I could just go with the extractions alone (which he said would lead to a compromised result).
I had a (relatively mild) open bite and an off-centre midline on the top, and chose to go a non-surgical route.
There was always the chance that they wouldn't get my bite completely closed, but I preferred that to the thought of jaw surgery!
After 14 months, I'm basically done, which is a better result than either my ortho or I expected. My bite probably would have been a bit more perfect with surgery, but it was a lot of time, money and risk for a marginally better result, and I'm totally happy with how I've ended up.
It's worth a conversation with your ortho(s?) about what the likely results are without surgery, and how far they think they'll be able to take it.
With regards to the teeth clenching and clicking and things - I had plenty of that along the way through my treatment. (I clenched and ground my teeth before, and I know I'll end up having extra bits of plastic fitted to my retainers to prevent me damaging my teeth once my braces come off!) I think a bit of weirdness is normal as your teeth and bite change around, and you have to get used to your bite being in a completely different place and so on. Mine has all settled now, apart from the teeth clenching which I had before anyway...
My mum has recently had jaw surgery for disc problems (the discs in her jaw joints got basically crushed when she was hit on the chin by a see-saw as a child (really!) but only started causing problems 50+ years later when they degraded further with age), and her symptoms were SO much worse than my slight weirdness through my orthodontics - she couldn't find her bite at all, struggled to chew, couldn't hold her mouth closed etc etc. If it's real jaw trouble, I think it will most likely be a bit clearer.
Basically, I'd recommend another chat with your ortho about how they think your treatment is going so far, and how likely they think it is that they won't be able to close your bite all the way without surgery. Of course they won't really know in advance, but they should at least have a feeling for how responsive your teeth have been so far!
I will mention that the recovery from jaw surgery, while not fun, is more tedious than painful. I think I was off pain meds in two or three days from my upper jaw surgery, but it was two weeks before I went back to work, and two months to get back to my normal diet.
Word of warning, if you are at all squeamish, DO NOT look at YouTube videos of the surgery! While I found them fascinating, they make you very glad you are not awake during the process.
I paid $6500 for a functional orthodontist who could straighten my teeth and fix my 10mm overbite/overjet without extractions or jaw surgery, which I refuse to do. Considering how much more expensive jaw surgery is, it seems to be a wise move anyway. After two years with just braces and only one extraction, I find that when my jaw is at rest (not chewing or clenched), it seems to be -exactly- where it should be.
When I chew or bite down, it goes back to where it always was, but that isn't uncomfortable and I can chew just fine.
FOUR extractions?! I had very crowded jaws with a couple teeth in front of each other; that sounds like a lazy/unskilled orthodontist to me. Personally, I'd tell him to shove it - but what's done is done, and your future treatment will have to take that into account now.
Anywhoo, I'd recommend a second opinion - and although I don't know what your dental situation is, I definitely think that most jaw surgery cases could be resolved with functional appliances.
Everybody's case is different. It is not at all uncommon for an orthodontic case to require four extractions. One cannot intuit a treatment plan merely by measuring the amount of overjet. Without access to a patient's records (and the skill to interpret them) it's going a bit far to proclaim somebody's chosen orthodontist as likely to be "lazy" or "unskilled".
The ability to solve a case with appliances instead of surgery depends on the skeletal structure of a particular patient. If the jaw is simply the wrong shape, it's the wrong shape. Appliances can move jawbones, they can even pry them apart, but they can't make jawbones longer or shorter. Outside of the leeway allowed by the flexibility of the palate, and the mold-ability and range of motion of the TMJ, their use in jaw-limited cases is rather small.
sirwired wrote:Everybody's case is different. It is not at all uncommon for an orthodontic case to require four extractions. One cannot intuit a treatment plan merely by measuring the amount of overjet. Without access to a patient's records (and the skill to interpret them) it's going a bit far to proclaim somebody's chosen orthodontist as likely to be "lazy" or "unskilled".
The ability to solve a case with appliances instead of surgery depends on the skeletal structure of a particular patient. If the jaw is simply the wrong shape, it's the wrong shape. Appliances can move jawbones, they can even pry them apart, but they can't make jawbones longer or shorter. Outside of the leeway allowed by the flexibility of the palate, and the mold-ability and range of motion of the TMJ, their use in jaw-limited cases is rather small.
Well said.
Dan
Pain is inevitable. Suffering is optional. -- Buddist saying
Just wondering how you are getting on with your braces?
I am also reconsidering jaw surgery but already had my 2 pre molar extractions...and I am kinda afraid to talk to my orthodontist about it.
To start with I was always concerned about my teeth only. I blamed it all on my teeth and didn't realise anything about jaw joints etc.
I had 3 consultations. The first one said 3 extractions, 2 upper pre-molars to fix my 9mm overrate and 1 lower incisor to correct overcrowding. This consultation was a few years ago.
Then recently I had 2 further consultations and both said jaw surgery would be the ideal choice. Or 2 upper pre-molars extractions but no lower extractions were required to correct overcrowding on my lower jaw.
I outright refused jaw surgery, it just seemed too extreme. I guess i didn't research enough and didn't realise how common it is? and that the recovery isn't as bad as i thought. It also doesn't help coz at the time I had a wisdom tooth extracted and it hurt like hell for a week and that was like just one tooth so I freaked out about jaw surgery lol.
I dunno what to do at the moment. I keep feeling depressed about it on and off.
You really need to talk to your orthodontist about your options. Nobody here can tell you if surgery is still an option or not. Sorry if this isn't very helpful, but most of us here aren't orthodontists, and even if we were, we aren't your orthodontist, who is familiar with your case and has access to you and your records.
Hero878 wrote:Just wondering how you are getting on with your braces?
I am also reconsidering jaw surgery but already had my 2 pre molar extractions...and I am kinda afraid to talk to my orthodontist about it.
To start with I was always concerned about my teeth only. I blamed it all on my teeth and didn't realise anything about jaw joints etc.
I had 3 consultations. The first one said 3 extractions, 2 upper pre-molars to fix my 9mm overrate and 1 lower incisor to correct overcrowding. This consultation was a few years ago.
Then recently I had 2 further consultations and both said jaw surgery would be the ideal choice. Or 2 upper pre-molars extractions but no lower extractions were required to correct overcrowding on my lower jaw.
I outright refused jaw surgery, it just seemed too extreme. I guess i didn't research enough and didn't realise how common it is? and that the recovery isn't as bad as i thought. It also doesn't help coz at the time I had a wisdom tooth extracted and it hurt like hell for a week and that was like just one tooth so I freaked out about jaw surgery lol.
I dunno what to do at the moment. I keep feeling depressed about it on and off.
Hiya!
So I've been in my braces for a year now. Had 4 extractions last July and now the gaps are nearly closed. My face has thinned a bit but overall my facial profile is more even and people have commented that it looks much much better (as before my chin was protruding outwards a lot).
Although my chin is still a little bit on the protruding side, my gaps have not fully closed yet nor has my bite (as my ortho is trying to focus on closing the gaps first). I had been on power chains for 4 months or so. Last appointment he took off the power chains and replaced my bottom wire to a thicker one as one tooth is still rotating!
I think it's a matter of waiting. I'm very happy with how my profile is now compared to before and have seen a lot of progress so far. I had considered surgery as mentioned previously, but I think since my ortho had planned everything out before hand, I will continue and see how it goes. I did a bit of research on this matter - basically before jaw surgery they make your bite much worse than it was before. However, since my ortho has already spent months on making it better, changing to jaw surgery may mean that he would have to undo the months of orthodontic treatment and basically go down the opposite way.
Thanks for the update! I am so happy to hear that your treatment is going so well and the improvements to your profile.
I ended up talking to my orthodontist over the phone and he seemed very calm and cheerful when I asked about switching to surgery, like it was no big deal.
He said I may need bridges to fill in the gaps from my 2 upper pre-molars but that will be decided by the hospital based orthodontist. Who I have a consultation with tomorrow.
He also said like you mentioned...worsen the bite but extracted some lower pre-molars but then use lower jaw surgery to move my lower jaw forward. Unfortunately my orthodontist now thinks that I may also require upper jaw surgery to move my back teeth upwards...
I really dunno about upper jaw surgery as it seems way more invasive than lower.
Well I hope I get good news tomorrow from this hospital based orthodontist. Infant he's the same orthodontist who treated me when I was in school many many years ago and also the same one who I consulted with just a few years ago...but who at the time never mentioned surgery as an option.
