Completely lost after several jaw operations

[davids20]

Hi there, I've been troubled with this for a long time and I feel helpless and not sure what to do.

I broke my jaw in June 2016 after getting punched in Spain, I had an operation over there a few days later to fix this. They said it was broken in 2 places, the left side (mandible i think?) and down by the front bottom teeth. I had plates put in both places it was broken. Before this my teeth were near perfect, I had braces when I was a child (I was 18 when I broke my jaw, now 20). Soon after I realised something was wrong and that the teeth on my left side weren't meeting but I had hoped it would correct itself. About 2 months later one side of my jaw swelled up badly and I went to a hospital near where I live (Ireland). I had surgery to remove the plates in November 2016 as my body was rejecting them.

My teeth weren't meeting at all on one side and I went back to the hospital, had another surgery in Feburary 2017 to try fix this (they rebroke the jaw on the side it was broken and tried put it back with plates). A few months went by and i was now able to make my teeth kind of touch on one side but i had to make my jaw move awkardly. Months went by and this became progessively worse, also had a root canal in this time due to a dead front bottom tooth because of lost nerves.

Ended up going back for another surgery in October 2017 in which they planned to break both sides and put it back together from the start, turned out the side that had been broken was infected again, so they could only take out the plates from that side and break the other side. After this surgery my teeth were wired shut for 6 weeks for the first time. My teeth now meet better than before but I still would have to move my jaw slightly to the right, and at that only one molar touches at the back on either side, and there is now a gap between my front top and lower teeth and at all times.

For the first time through all of this I have begun experiencing TMD problems about 2 months ago. It constantly feels that the left side of my jaw is more strained than my right, and i often feel pressure in my ears and get slight headaches. I also hear clicking and popping. Most of the time this is very slight, except if I ever go out drinking which it gets rather sore for a few days. I also realised through googling that an orthodontist is able to fix teeth not meeting on one side after my dentist telling me to just go see a surgeon.

I'm completely lost at what to do now. I would have another surgery if I thought this would help but I'm not sure what good a fourth surgery would be. The surgery would be free atleast as healthcare is very good in Ireland. My other option would be to see if an orthodontist could help but I would probably have to pay 3000/4000 and that is a very big cost at my age. I'm also very scared that if I do get my teeth sorted by an orthodonist, that the TMD problems would persist, and if I were to end up needing more jaw surgery after this my teeth would be out of place and I would be back where I started.

I feel like this is really holding me back in life. I'm now scared of having teeth cracking due to maccolusion or my jaw never being back to normal again, often even having dreams of having it broken again, having severe pain or looking in the mirror and having it all distorted. Anyone know what I should do?

[Seaunicorn]

I’m so sorry that you have to go trough all this trouble, I sounds awful! I think that you should go and see a surgeon and hear what he/she thinks would be best! If your teeth did meet/fit properly before all this the problem is obviously skeletal and moving only the teeth would mean moving them away from their proper places and that is usually not a good idea.

[EmilyTravels]

Man, I feel for you!

I can really only relate my own experience. I broke my jaw last April in a cycling accident. I fractured the bottom left mandible and both condyles. The CT scan I had in the ER did not reveal the fractures, so I was sent home and told my jaw was fine. Problem was, my teeth didn't meet up at all. I had a decent bite before, and now only one molar was touching on the left side, none on the right, when I bit down. I was hoping this was all from swelling and would rectify itself on its own -- but that was not to be.

Three weeks after the accident when my malocclusion had not resolved, I finally consulted with an oral surgeon (something I would have done much sooner if the ER doc had not missed the jaw fractures completely!) The OS took panoramic x-rays and informed me that my jaw was fractured in three places. He scheduled me for surgery the following week, so four weeks after my accident.

I didn't have any plates like you; really all he did was physically manipulate my condyles back into position and wire my jaw shut. He said that the lower mandible fracture would heal on its own. I was wired shut for only two weeks due to my age (56) -- too long and I might be left unable to open my jaw. After unwiring, I wore heavy elastics on my arch bars (where the wires had been) for three more weeks.

After this five weeks, my arch bars were removed, and the oral surgeon said that I would need orthodontics to finish the work. My bite was much better than before the wiring, but still not what it was before the accident. My midline was off and my teeth touched first on the left before the right when I bit down, plus I had more of an overjet than before the accident.

After a few weeks off, recommended by the oral surgeon, I consulted an orthodontist and got braces on my teeth, which I've now had for almost six months. I have been wearing elastics for the past two months. The elastics have helped my bite so much! The overjet has decreased, the midline is perfect, and my molars line up in back now, so chewing is much easier. The orthodontist did say that without further jaw surgery, I probably wouldn't have a "perfect" result, but he didn't recommend surgery -- probably due to my age, and the fact that he could improve things enough for a satisfactory result.

So, I am very happy with the orthodontia so far. I don't know if it would be enough for your case, and since you're so young, you might get different recommendations than I did from an orthodontist, but it would be worth your while to consult with a couple before you resign yourself to further surgery. It might turn out that orthodontia could improve things greatly for you.

I will also mention that I had clicking and weird sensations on my left side in the condyle/TMJ area after the jaw wiring and before I started orthodontia, but I have not had any since, nor any other TMJ pain or issues that I am aware of. My jaw opening is within normal range as well. I do have problems with teeth grinding and clenching that I never had prior to my accident, and I don't know if these will last forever or resolve in time.

I wish you all the best luck with this -- it is not an easy road to travel, and it's still hard for me to get my brain around how much just a moment in time resulting in jaw fractures can change your life forever.

[Seaunicorn]

Hi again! I just wanted to clarify that sometimes it's ok to move the teeth even though the problem is skeletal. It depends on how much they would have to be moved!

[davids20]

Thanks a lot for the replies, I have booked in to see my surgeon again in a few days and I think i'll book in with an orthodontist as well and go from there.

[davids20]

[quote=davids20 post_id=500511 time=1519253549 user_id=31450]
Hi there, I've been troubled with this for a long time and I feel helpless and not sure what to do.

I broke my jaw in June 2016 after getting punched in Spain, I had an operation over there a few days later to fix this. They said it was broken in 2 places, the left side (mandible i think?) and down by the front bottom teeth. I had plates put in both places it was broken. Before this my teeth were near perfect, I had braces when I was a child (I was 18 when I broke my jaw, now 20). Soon after I realised something was wrong and that the teeth on my left side weren't meeting but I had hoped it would correct itself. About 2 months later one side of my jaw swelled up badly and I went to a hospital near where I live (Ireland). I had surgery to remove the plates in November 2016 as my body was rejecting them.

My teeth weren't meeting at all on one side and I went back to the hospital, had another surgery in Feburary 2017 to try fix this (they rebroke the jaw on the side it was broken and tried put it back with plates). A few months went by and i was now able to make my teeth kind of touch on one side but i had to make my jaw move awkardly. Months went by and this became progessively worse, also had a root canal in this time due to a dead front bottom tooth because of lost nerves.

Ended up going back for another surgery in October 2017 in which they planned to break both sides and put it back together from the start, turned out the side that had been broken was infected again, so they could only take out the plates from that side and break the other side. After this surgery my teeth were wired shut for 6 weeks for the first time. My teeth now meet better than before but I still would have to move my jaw slightly to the right, and at that only one molar touches at the back on either side, and there is now a gap between my front top and lower teeth and at all times.

For the first time through all of this I have begun experiencing TMD problems about 2 months ago. It constantly feels that the left side of my jaw is more strained than my right, and i often feel pressure in my ears and get slight headaches. I also hear clicking and popping. Most of the time this is very slight, except if I ever go out drinking which it gets rather sore for a few days. I also realised through googling that an orthodontist is able to fix teeth not meeting on one side after my dentist telling me to just go see a surgeon.

I'm completely lost at what to do now. I would have another surgery if I thought this would help but I'm not sure what good a fourth surgery would be. The surgery would be free atleast as healthcare is very good in Ireland. My other option would be to see if an orthodontist could help but I would probably have to pay 3000/4000 and that is a very big cost at my age. I'm also very scared that if I do get my teeth sorted by an orthodonist, that the TMD problems would persist, and if I were to end up needing more jaw surgery after this my teeth would be out of place and I would be back where I started.

I feel like this is really holding me back in life. I'm now scared of having teeth cracking due to maccolusion or my jaw never being back to normal again, often even having dreams of having it broken again, having severe pain or looking in the mirror and having it all distorted. Anyone know what I should do?
[/quote]

[Clare1]

I really hope you can get your problem sorted. Must be awful when you had no problems before being punched. Sounds like a nightmare. Perhaps the surgeon can refer you to someone who specialises in this area of orthodontistry