Your thoughts

[SingleJawMelb]

Thanks guys v much for your replies and sorry for my lack of response till now. It was a pleasant surprise to see the replies I've only just realised there were some comments posted here.

So currently I've been back to the orthodontists. They are aware of my concerns about numbness after jaw surgery and have suggested a compromise which they saw would "camouflage" the bite. I think its Metal train tracks on top at first , and then on bottom. 2 miniscrews and chains (I think) on bottom teeth at the front, to pull the teeth down that are out of line. I think they are saying around 2 years for treatment. Possibly extracting one tooth on the bottom which I'm not massively keen on.

The treatment would be free but this means no ceramic braces. If surgery was really needed this could be again presented as an option during treatment, and they have assured me that any treatment will definitely improve things rather than make things worse. However I have heard in the past from other orthos that without going full on with treatment combined with jaw surgery, it might be better to leave alone. I feel like I trust what I'm being told by the current orthodontists I've seen recently, particularly as I am not paying for treatment. I've even asked them if I'm a "guinea pig" in terms of their suggested treatment and they have assured me I'm not on this too!

I've started to tell people about what I'm thinking of having done. Mostly the response is "why bother? Your bottom teeth are hidden anyway" or "Are your teeth bad? I hadnt noticed", I think the vibe is generally why put yourself through this? So anyway I'm still not sure if I want to go through with it, the time to treat, work issues and just feel a bit like I'm being vain. However I do need this nagging feeling that has affected my confidence to go away! A few of my mates are already warning that they will definitely laugh when they first see me, fair enough if I can put a smile on someones face!

Also my wife is having a baby next week (probably!) and then the braces appointment is 1 week after that if I do it, great timing!
I'm going to be a bit busy! Wont get any sympathy if im in pain understandably!

You may only need single jaw surgey when you have surgery.... that's what happened to me when I had my final consult, but he may have quoted me double just incase.

What did your surgeon say about the numbness. Search for numbness on this forum.

You've got your braces on now? Tell ortho you may not get surgery, ask for guidance as to what the ortho will do etc. I would tell my ortho Im not 100% going to go through with surgey, but still want to go to the consult with the surgeon when you are "ready" for surgey.

Everyone has bad teeth in the England. Surgery, even for non
Cosmetic reasons isn't common. Plus friends don't notice imperfections. Your profile also looks fine, plus you have a wife and kid, so you can't look that bad.

[dannyc77]

Braces if I go for it would go on in 10 days time
They already are looking at the moment for
avoiding surgery but if needed could still go for it with
the current treatment plan
In terms of numbness I think there is a high chance in
the region around the lower lip. Seen the x ray
and there's a nerve going right through where
a wisdom tooth would need to be removed
and surgery carried out
The surgeon said at my age about 20% chance of permanent ( I'd be 41). I think that's pretty high
So at the moment if anything would prefer without
surgery. They do have a good programme where u meet with previous patients and even meet a osycihologist prior to going for it which I was impressed with. But
at the moment don't think the surgery at least is worth it

[SingleJawMelb]

If you go for it?

[dannyc77]

Yes as per my original post, and recent post a few days ago

[SingleJawMelb]

No I haven't read anywhere that you weren't considering getting braces. Concerns about surgery but not braces.

FYI to get your braces put on, takes up a lot of the orthos time. You cancelling at this late stage is bad manners and very inconsiderate for other patients in the q and the public purse. I assume it's due to the baby? You really need to tell the ortho office so they can reschedule you asap.

You would be absolutely stupid not to get braces. Your teeth are very bad aesthetically and from a non cosmetic standpoint it looks bad, im not an specialist but you've spoken about an underbite/chipping etc.

I can understand your concern about surgery but the NHS only treats adult teeth that are extremely bad. You should be taking this opportunity with both hands, the vast majority of people are paying for surgery directly, you aren't. I was also not able to get braces on the NHS when I was living there.

Also the NHS isn't "free" your wages and all the rest of the population pay for the NHS through NI contributions, income taxe and tax on items. The NHS doesn't make a profit, it's a public service. It just doesn't cost the patient money at the point of service. Doesn't mean your surgeon isn't incompetent, you are getting more work than necessary or the most cost effective treatment.

There are no guarantees in life, just get your braces put on, stop thinking you know better than your team who are highly qualified and make the decision.

[SingleJawMelb]

Hi,

I am 29 and I am about to get braces next week, because I am having jaw surgery the whole process is being done on the NHS. So far I have had my wisdom teeth out, I get braces on for 18 months and then double jaw surgery and genioplasty (I have a weak chin profile too) then braces for a further 6 months.

It's never too late to have the treatment, I am so excited and can't wait. Like you I thought I wasn't depressed about it, it doesn't hold me back but subconsciously, for me, it does make me more shy and introverted, I hate smiling in public.

I have an overbite of 10mm, over crowding and incompetent lips which for some reason amused me when I read the letter.

I have a big annoyance with the NHS cause I was told by dentist to wait until I was 16 for braces, when I was 16 I was "too old". So I took myself to a new dentist, referred to hospital dentist and was told I could have the "painful" jaw surgey for my open bite but not braces, because they are "cosmetic".

If I was older and wiser I would have fought more. I'm so angry over my experience 14 years ago.

[SingleJawMelb]

Thanks for your reply iob and sorry for my lack of reply till now. I am seeing the orthodontics team at Eastman dental school in London in a couple of weeks. In the meantime I have met with my local dentist who I have seen for years who thinks I would b crazy to go for the orthognathic procedure. I got him to numb my bottom lip to see what it would be like. To be honest I wouldn't want to risk my lip having permanent numbness like I experienced for just a few hours , so I can't see me going through with jaw surgery: my age (40) makes it more likely that permanent numbness especially in lower jaw would happen, having seen the position of lower jaw nerve on my X Ray's

Your general dentist is an idiot and should keep his option to himself. A professional dentist would tell you to speak to your surgeon about your concerns and also your ortho. Your team have a far greater understanding and experience of jaw surgey and ortho than your general dentist. As you've said before you aren't paying for it, so it's not like they are trying to bill you a large amount.

[ditsy]

Unfortunately I cant help about the surgery side of things but if your teeth stop you from smiling then go for it! My hubby is 40 and he has a gorgeous smile but he never smiles properly because he's always worried about his teeth. So many people envy the opportunity to be able to afford or have their teeth fixed, I garentee you're friends will probably joke around at first but they will eventually own up that they wish they could sort theirs out too. Good luck with what you choose with the surgery stuff but deffo go for the brace x

[dannyc77]

Thanks for your reply iob and sorry for my lack of reply till now. I am seeing the orthodontics team at Eastman dental school in London in a couple of weeks. In the meantime I have met with my local dentist who I have seen for years who thinks I would b crazy to go for the orthognathic procedure. I got him to numb my bottom lip to see what it would be like. To be honest I wouldn't want to risk my lip having permanent numbness like I experienced for just a few hours , so I can't see me going through with jaw surgery: my age (40) makes it more likely that permanent numbness especially in lower jaw would happen, having seen the position of lower jaw nerve on my X Ray's

Your general dentist is an idiot and should keep his option to himself. A professional dentist would tell you to speak to your surgeon about your concerns and also your ortho. Your team have a far greater understanding and experience of jaw surgey and ortho than your general dentist. As you've said before you aren't paying for it, so it's not like they are trying to bill you a large amount.

Thanks for your reply. My dentist is most certainly not an idiot. Knowing my family for 30 years he knows that surgery is a big thing to undertake. I have not been told that I must have surgery. I have just been told it would result in the best outcome in terms of bite and straight teeth. But it comes with risks. So they have suggested a compromise which I have described. Thank you to all those who have replied, I find generally this forum is full of helpful and positive comments.

[dannyc77]

No I haven't read anywhere that you weren't considering getting braces. Concerns about surgery but not braces.

FYI to get your braces put on, takes up a lot of the orthos time. You cancelling at this late stage is bad manners and very inconsiderate for other patients in the q and the public purse. I assume it's due to the baby? You really need to tell the ortho office so they can reschedule you asap.

You would be absolutely stupid not to get braces. Your teeth are very bad aesthetically and from a non cosmetic standpoint it looks bad, im not an specialist but you've spoken about an underbite/chipping etc.

I can understand your concern about surgery but the NHS only treats adult teeth that are extremely bad. You should be taking this opportunity with both hands, the vast majority of people are paying for surgery directly, you aren't. I was also not able to get braces on the NHS when I was living there.

Also the NHS isn't "free" your wages and all the rest of the population pay for the NHS through NI contributions, income taxe and tax on items. The NHS doesn't make a profit, it's a public service. It just doesn't cost the patient money at the point of service. Doesn't mean your surgeon isn't incompetent, you are getting more work than necessary or the most cost effective treatment.

There are no guarantees in life, just get your braces put on, stop thinking you know better than your team who are highly qualified and make the decision.

I am aware of how the NHS is funded. I didnt ever suggest that my surgeon (that I paid to meet privately) was incompetent. I also never suggested I know better than my "team". Thanks for your reply.

[SingleJawMelb]

Thanks for your reply iob and sorry for my lack of reply till now. I am seeing the orthodontics team at Eastman dental school in London in a couple of weeks. In the meantime I have met with my local dentist who I have seen for years who thinks I would b crazy to go for the orthognathic procedure. I got him to numb my bottom lip to see what it would be like. To be honest I wouldn't want to risk my lip having permanent numbness like I experienced for just a few hours , so I can't see me going through with jaw surgery: my age (40) makes it more likely that permanent numbness especially in lower jaw would happen, having seen the position of lower jaw nerve on my X Ray's

Your general dentist is an idiot and should keep his option to himself. A professional dentist would tell you to speak to your surgeon about your concerns and also your ortho. Your team have a far greater understanding and experience of jaw surgey and ortho than your general dentist. As you've said before you aren't paying for it, so it's not like they are trying to bill you a large amount.

Thanks for your reply. My dentist is most certainly not an idiot. Knowing my family for 30 years he knows that surgery is a big thing to undertake. I have not been told that I must have surgery. I have just been told it would result in the best outcome in terms of bite and straight teeth. But it comes with risks. So they have suggested a compromise which I have described. Thank you to all those who have replied, I find generally this forum is full of helpful and positive comments.

Your general dentist is an idiot to suggest for you to go through with surgey isn't a wise move. You aren't doing the treatment for cosmetic reasons, you have a medical need for the procedure. For the best results you should consider surgey and he should be telling you this. Teeth won't be worn away as fast and you can chew properly.

With regards to numbness, I don't think it's that much of an issue. Not sure exactly how your lip was numbed but it's probably not the same sensation felt after jaw surgey. After surgey I was really numb from ananestic but that worn of and my numbness isn't an issue. The patient gets used to it.

I don't think the risks are high but I'm post surgery so easy enough for me to say. 20% chance in surgey isn't high. You are significantly likely not to have perm numbness. All surgey carries risk and if you are in that percentage it sucks for you.

I found it a lot harder to get used to speaking after surgey and my new bite. Plus a slight face change.

You said you had one wisdom tooth removed, why not both?

[SingleJawMelb]

No I haven't read anywhere that you weren't considering getting braces. Concerns about surgery but not braces.

FYI to get your braces put on, takes up a lot of the orthos time. You cancelling at this late stage is bad manners and very inconsiderate for other patients in the q and the public purse. I assume it's due to the baby? You really need to tell the ortho office so they can reschedule you asap.

You would be absolutely stupid not to get braces. Your teeth are very bad aesthetically and from a non cosmetic standpoint it looks bad, im not an specialist but you've spoken about an underbite/chipping etc.

I can understand your concern about surgery but the NHS only treats adult teeth that are extremely bad. You should be taking this opportunity with both hands, the vast majority of people are paying for surgery directly, you aren't. I was also not able to get braces on the NHS when I was living there.

Also the NHS isn't "free" your wages and all the rest of the population pay for the NHS through NI contributions, income taxe and tax on items. The NHS doesn't make a profit, it's a public service. It just doesn't cost the patient money at the point of service. Doesn't mean your surgeon isn't incompetent, you are getting more work than necessary or the most cost effective treatment.

There are no guarantees in life, just get your braces put on, stop thinking you know better than your team who are highly qualified and make the decision.

I am aware of how the NHS is funded. I didnt ever suggest that my surgeon (that I paid to meet privately) was incompetent. I also never suggested I know better than my "team". Thanks for your reply.

So you are aware of how the NHS is funded and you decided to make an appointment to get the braces put on, but still undecided. Still showing little regard to the orthos time and cost to the NHS.

I'm not saying your surgeon is incompetent, I'm saying it's always best to question the surgeon and his treatment plan. Just because you aren't "paying" for it, doesn't mean you aren't getting more work than needed due to the surgeons training/opinion/incompetence etc. So yes it's always good to question the treatment plan on this forum etc.

Interested to know how you booked an appointment with a the surgeon? Just because when I go back and I need more work doing I want to know.

[mmkay]

A general dentist (or medical general practitioner) can provide a useful 'sanity check' given their personal knowledge of you. They can also bring their own biases and give really poor advice on things they know little about and/or fail to refer you onwards. Be careful about paying too much attention to what they think on a specialist issue such as this.

[shortcircuit]

It's ironic that so many people here (USA) spend so much time, money, and effort to get a "perfect smile," after which virtually no one pays any attention to it because it's so common. I've heard about the stereotypical "British teeth" thing, there are people here who have the same but particularly for the under-30 crowd, it's definitely a rarity unless there have been significant financial or other health issues (chemo, bulimia, etc).

As far as whether or not to have surgery, again, IMO if you can reach a good, stable compromise without it, I wouldn't even hesitate to move forward. If it turns out that your choices are either get the surgery or wear your mouth as is, then you have to decide which is the lesser of two evils. Are there risks? Of course, but that's true of anything we do, and only you can decide whether or not the reward justifies the risk.

You can find any number of very vocal people online who had jaw surgery and wish they never did, but you have to realize that the proportion you see online isn't necessary the true proportion of satisfied vs. dissatisfied patients. The thing is, most of what I see people unhappy about (numbness, misalignments requiring revision, tooth loss, bone loss, infected screws/plates, dissatisfaction with facial changes, etc.) are mentioned in the informed consent form that they had to sign prior to surgery...that's the risk you take and all of the consent forms I looked at take great pains to state that the outcome is not guaranteed. Most of the satisfied ones probably never mention it again or go on forums like these unless specifically asked, it's a finished chapter in their books and they've moved on to other things.

However, I see the other side of the coin, especially the side that John Q. Public sees. A few of your teeth are out of place, so you're going to go in and have them bust your jaws with a hammer and chisel.....it does seem like an extreme solution and way overkill unless you're the one with the issues and have had time to come to terms with it. In your particular case, if you're not carrying the expectation that everything has to be absolutely perfect in the end, then there's nowhere to go but up and any improvement is better than now.

[SingleJawMelb]

Did you get the braces? How is it going ?