Should I confront my Ortho about this??? (pics now up...eww)

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jonathon003
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Should I confront my Ortho about this??? (pics now up...eww)

#1 Post by jonathon003 »

Basically, I'm 23 years old, and going back to have braces for the 2nd time around (1st time was when I was 13-15). I did NOT wear the retainer religiously, and assumed everything was my fault etc.

However, I've learned MANY things in the last few weeks. I've always known my jaw and bite, and just mouth overall had to be messed up, but just brushed it off as genetics. For instance, I have a slight receding chin, my mouth doesn't close comfortably (NEVER HAS tho, even after braces!), and my jaw is just misaligned (under bite). Anyway my concern is this: not wearing my retainer I can understand would affect my teeth shifting, but I have this feeling that my ortho NEVER did anything to help the growth of my jaw and overall mouth. I mean why have I always felt uncomfortable closing my mouth?? That's not normal I wouldnt think. This in effect has always made me a mouth breather, also pretty certain I have a deviated septum which makes airflow through the nose strenuous at times. Anyway my point is, it seems he never addressed any "jaw issues" after the first go around. Why is my side profile currently so messed up?? My upper jaw is too forward, and my lower jaw seems too far back. Can not wearing a retainer at age 15+ really massively affect jaw alignment to the point I need surgery now??

I have a feeling this was an issue he just never confronted because I KNOW for a fact I was never spoken to about my jaw or mouth in terms of how it closed, etc. I feel like asking him what happened as to why my jaw is so misaligned, I thought he was either supposed to correct that the first time, OR prevent future events such as what I'm going through?

Can anyone with some knowledge on this help me out?? I have an appointment next week. My braces will be going on very soon, probably in December. But anyway am I right for thinking that part of my current problems can or should be pinned on him??
Last edited by jonathon003 on Mon Dec 01, 2008 10:42 am, edited 1 time in total.

suetemi
Posts: 234
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#2 Post by suetemi »

Hard to say without more info. I went through exactly what you're going through now, except I never went to any orthodontist as a kid. I'm also a mouthbreather who slipped through the cracks and am somewhat resentful about the whole deal (resent at parents for not taking me to the ortho as a kid, at the countless dentists who never mentioned anything about my dysfunctional bite or the eroded molars it caused). I guess the point is that it happened and you can't do anything about it anyway. Even if you do pin it on him, what would it change?

If you had treatment at 13-15 yrs. old, that's phase II -- from my understanding your bones would have already been "set" by then and what your ortho could have done to prevent this from happening probably would have been limited. I dunno... Perhaps all he could have been able to do is to tell you that in the future you might need jaw surgery. When I was consulting with orthos, I asked if there was anything that could have been done to prevent this, and they all said "Yeah, if you came to see me when you were 6 or 7 yrs old." So believe me, I know how frustrating hindsight can be.

Is your appointment with the same ortho? if so, if you're unhappy with his service, why not find another one?
Last edited by suetemi on Thu Nov 27, 2008 3:30 pm, edited 1 time in total.

jonathon003
Posts: 103
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#3 Post by jonathon003 »

suetemi wrote:Hard to say without more info. I went through exactly what you're going through now, except I never went to any orthodontist as a kid. I'm also a mouthbreather who slipped through the cracks and am somewhat resentful about the whole deal (resent at parents for not taking me to the ortho as a kid, at the countless dentists who never mentioned anything about my dysfunctional bite or the eroded molars it caused). I guess the point is that it happened and you can't do anything about it anyway. Even if you do pin it on him, what would it change?

If you had treatment at 13-15 yrs. old, that's phase II -- from my understanding your bones would have already been "set" by then and what your ortho could have done to prevent this from happening probably would have been limited. I dunno... Perhaps all he could have been able to do is to tell you that in the future you might need jaw surgery. When I was consulting with orthos, I asked if there was anything that could have been done to prevent this, and they all said "Yeah, if you came to see me when you were 6 or 7 yrs old." So believe me, I know how frustrating hindsight can be.

Is your appointment with the same ortho? if so, if you're unhappy with his service, why not find another one?
hey suetemi, the response is greatly appreciated. Someone else actually PM'd me and had the same sentiment (not the reason for the PM, but did mention it) that you should not cry over spilt milk sort of thing. That's my fault b/c I didn't address the reason in my initial post as to why I care.

1) Maybe my ortho isn't as qualified as I think. I'm currently about to pay him ANOTHER 5 grand and want to make sure he knows what he's doing. Oh and it was my dentist who told me I had a class 3 occlusion and could benefit from orthognathic surgery, not even him. I'm going to meet with him next week. To give him the benefit of the doubt, I just took a bunch of x-rays and pics at his office last visit so maybe he was about to give me all this info coming up.

2) I'm a student and 5 grand is really not feasable. I'm having to borrow from my parents and I feel extremely terrible. It's just something I basically had to plead to them and how it's affecting my life. It gives me great anxiety blah blah blah (won't go into detail). Anyway i know it's a long shot, but what if it IS his fault he didn't correct it the first time, MAYBE he offers to reduce the cost?? lol i highly doubt it, but proper business ehtics would suggest I get a discount or compensation if the product I bought initially was flawed or didn't come close to expectations. I almost feel cheated and and now i'm giving him 5 grand for a problem mainly revolves around my jaw/bite alignment, and not even my teeth shifting.

so I hope that clears up a little as to my purpose for finding this out. Thanks again for the feedback.

jonathon003
Posts: 103
Joined: Thu Nov 20, 2008 2:01 pm

#4 Post by jonathon003 »

jonathon003 wrote:
suetemi wrote:Hard to say without more info. I went through exactly what you're going through now, except I never went to any orthodontist as a kid. I'm also a mouthbreather who slipped through the cracks and am somewhat resentful about the whole deal (resent at parents for not taking me to the ortho as a kid, at the countless dentists who never mentioned anything about my dysfunctional bite or the eroded molars it caused). I guess the point is that it happened and you can't do anything about it anyway. Even if you do pin it on him, what would it change?

If you had treatment at 13-15 yrs. old, that's phase II -- from my understanding your bones would have already been "set" by then and what your ortho could have done to prevent this from happening probably would have been limited. I dunno... Perhaps all he could have been able to do is to tell you that in the future you might need jaw surgery. When I was consulting with orthos, I asked if there was anything that could have been done to prevent this, and they all said "Yeah, if you came to see me when you were 6 or 7 yrs old." So believe me, I know how frustrating hindsight can be.

Is your appointment with the same ortho? if so, if you're unhappy with his service, why not find another one?
hey suetemi, the response is greatly appreciated. Someone else actually PM'd me and had the same sentiment (not the reason for the PM, but did mention it) that you should not cry over spilt milk sort of thing. That's my fault b/c I didn't address the reason in my initial post as to why I care.

1) Maybe my ortho isn't as qualified as I think. I'm currently about to pay him ANOTHER 5 grand and want to make sure he knows what he's doing. Oh and it was my dentist who told me I had a class 3 occlusion and could benefit from orthognathic surgery, not even him. I'm going to meet with him next week. To give him the benefit of the doubt, I just took a bunch of x-rays and pics at his office last visit so maybe he was about to give me all this info coming up.

2) I'm a student and 5 grand is really not feasable. I'm having to borrow from my parents and I feel extremely terrible. It's just something I basically had to plead to them and how it's affecting my life. It gives me great anxiety blah blah blah (won't go into detail). Anyway i know it's a long shot, but what if it IS his fault he didn't correct it the first time, MAYBE he offers to reduce the cost?? lol i highly doubt it, but proper business ehtics would suggest I get a discount or compensation if the product I bought initially was flawed or didn't come close to expectations. I almost feel cheated and and now i'm giving him 5 grand for a problem mainly revolves around my jaw/bite alignment, and not even my teeth shifting.

so I hope that clears up a little as to my purpose for finding this out. Thanks again for the feedback.
edit: oh and sorry you also could be bang on about the age thing. maybe it was too late by that age to do anything. but i wish he would have at least suggested or warned me about future problems? I dont know I had no idea it was "normal" to be able to close your mouth comfortably. It's really weird. I even have asked my parents many times, questions such as "are your teeth clenced when ur mouth is close?" etc etc etc trying to LEARN how to do it. They always kind of just gave me the classic nothing is wrong with u answers; but now i'm realizing there were/are real problems and i've been living in anguish for no reason...for problems that can be corrected. oh well.

jonathon003
Posts: 103
Joined: Thu Nov 20, 2008 2:01 pm

#5 Post by jonathon003 »

Meryaten wrote:How was your profile and the relationship between your jaws when you got your braces off at 15? Particularly since you're a bloke, it's possible that the current situation is something that arose, at least in part after you were done with your first round of ortho; and you're right in your assumption that even diligent retainer wear would not have prevented that.

I don't know. Maybe your ortho should have done more work to modify your jaw growth. But also maybe he did everything right. What's more to the point is what can and should be done now.

I'd urge you to seek consultations with a couple of orthodontists. Discuss your goals and priorities for any treatment, and see what they suggest.
thanks for the feedback as well. Yeah depending on the answers I get from him in my next visit, after he's analyzed the new pictures, and x-rays, I will seek other options if I'm not satisfied. Basically I'm just looking for acknowledgement that my jaw and mouth is very messed up (as my dentist has already told me) and that he will fix all of my problems, and stresses/insecurities about my mouth. Also maybe as to WHY the original treatment didn't prevent or fix this from happening.

on a side note: if anyone would also care to offer their opinion....I told him in my first consultation of how i find it hard for my lips to touch and close my mouth comfortably...and I said I feel like all my teeth are pushed out too much, and crowded. Anyway he said he could extract 4 of the teeth. I happily said sure, thinking that would solve a lot of my insecurities. I'm not thinking MAYBE it's just my jaw problems that are the reason for such. And another thread FREAKED me out about your face caving in when teeth are extracted. Anyway I guess it would be really impossible for someone to help me without looking at pics or inspecting my mouth, so I'm not sure what I'm looking for. Hopefully my next visit goes well and he answers all of my questionsa nd concerns and feels confident he can fix everything.

suetemi
Posts: 234
Joined: Sun Jul 23, 2006 10:06 am
Location: Chicago

#6 Post by suetemi »

jonathon003 wrote: I dont know I had no idea it was "normal" to be able to close your mouth comfortably. It's really weird.
Same here. I didn't know it was normal to breath through the nose or that I shouldn't be able to stick my tongue out a little when my teeth were down all the way, since my deformity was all I ever knew so it became normal to me.

There should be more dentists like yours! Maybe you can ask *him* for a recommendation for an orthodontist? As for your ortho, I don't see why you shouldn't bring up your concerns with him, although I'd suggest doing in a tactful way as to not come off bitter. It's worth a shot. If anything, perhaps it will make him more aware of the issue generally, whether it's better communication with patients or more diligence in informing patients about such problems and prospective solutions, etc.

jonathon003
Posts: 103
Joined: Thu Nov 20, 2008 2:01 pm

#7 Post by jonathon003 »

suetemi you're right I would NOT want to approach it in any kind of negative way. I realize that I really don't have great knowledge on the subject and don't want to come off as if I know more than the guy or something. I mean for all I know he did nothing wrong. But yeah I'll just outline my issues and se what he has to say. As for having a "great dentist" i hardly think so, as you'd think she would have mentioned something a LOOONG time ago about my bite and alignment problems etc. Granted it sounds like an ortho's field, but she no doubt knows a little about it as she does invisalign herself, and also had no problem detecting my various problems all of a sudden.

Meryaten wrote:Eh? I am totally confused. You say your dentist told you you have a Class III and you speak also about having an underbite. Yet you say that your upper jaw is too forward, and your lower jaw too far back, with a recessed chin. That's Class II and would give you an overjet not an underbite (more correctly referred to as a negative overjet). So I am not sure whether your dentist is giving you any useful information at all.
Okay I'm real sorry it's kind of complicated. I personally feel myself, and know this from just looking at my side profile...that my lower jaw is pushed back and needs to be aligned with the upper jaw. Now, whether that means bringing the upper jaw BACK, or simply pusshing the lower jaw OUT, or both, I have no idea. It seems though to my eye that the upper jaw is a little too close to my nose tip; wait that seems hard to picture. Basically, which actually I heard is an effect of mouthbreathing, my nose doesn't point out all that much so maybe thats why my upper jaw looks like it needs to be pushed back. I'm sorry if that doesnt make sense, it's hard to explain. when my mouth is closed though, it looks like my upper jaw or lip, is too far out and should be recessed.

As for the class 3. I have no idea what that means really. I tried reading about it but wasn't making sense of much of it. Visually my lower front teeth are actually touching my upper fronts, which is a slight UNDER bite. However it seems as if my permanent retainer on the lowers, have actually SHIFTED them out on an angle this way. they are not perpendicular sticking upright but angled shifting out of my mouth. I'm quite certainmy permanent retainer/wire has done this as I never used to notice them slanted outwards.

Now as for the lower jaw...it seems way recessed when I clench my teeth or close my mouth. I try to force my lower jaw outwards ALL THE TIME to compensate and b/c it really eats at me. So when I'm aligning my jaw to the position I THINK it should be...out where my upper is and not recessed...my front bottom teeth are WAAAAAAAY in front of my upper fronts which makes sense since they're touching even in normal bite position.

hope that made ANY sense as to whats going on with my mouth. As for the class 3 again, i'm not sure if she was accurate in that assessment or what. I just no visually and physically whats wrong from my own eye.

again thanks a TON guys you've both been real helpful and I applaud you for taking your time to help someone out.

I still say that you should seek another ortho's opinion, and discuss your history when you do. (Don't ask outright if your old ortho got it wrong, but you may be able to glean useful info by careful questions). I think you'd benefit from hearing what another professional has to say. I also think that it's possible (as he's never mentioned it) that your current ortho is not one who is accustomed to working with surgical cases, so if yours is indeed one that would best be treated that way, then you'd be better off by far working with an orthodontist who is used to such cases, and has experience with such cases. And last, but by no means least, I think that you lack confidence in your current ortho, and for that reason alone, you may be better off having your treatment done by another doc - otherwise, I wonder if you'd not spend the duration of your treatment time second-guessing everything, and worrying yourself silly!

With respect to getting a discount because the first go-around didn't give you a great bite and profile today: good luck, but don't bank on it. I don't mean to sound harsh, but I just think that you'd have a tough time proving any mis-management of your case - even if there was any such mis-management.[/quote]

FuzzyPants
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Location: Vancouver, BC

#8 Post by FuzzyPants »

It would help to see photos of your profile. Regardless, I would seek the opinions of a couple of different orthodontists.

I had a class II bite, but would hold my jaw forward so my teeth were edge to edge (well, as edge to edge as crooked teeth can be).

Did your original orthodontist talk to your parents about the jaw issues during your first treatment? After all, you were a minor at the time so you may not have been included in those conversations.
Braced October 17, 2007
BSSO and Lefort August 13, 2008
De-braced November 24, 2008

indecisive1
Posts: 43
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#9 Post by indecisive1 »

Hi Jonathon. If it's any consolation I think most of us have been through the same thing. Granted I am older than you and I had braces as a teenager (back in the 80's), I too was never told by my first orthodontist (the one I saw as a teenager) that there was anything wrong with my jaw. I have a very narrow upper palate, an open bite and receding chin. I too am unable to close my mouth without straining. My orthodontic experience as a teenager was quite traumatic. My orthodontist tried to close my bite by filing my back teeth, and pulling my central,lateral incisors and canines in a desperate attempt to close my bite. The actual trauma lead to 2 root canals soon after. My current orthodontist and maxillofacial surgeon summed it up perfectly. For me upper and lower jaw surgery was not really heard of back in the 80's..today it's much more common. My orthodontist actually said to me that if I was a teenager today and had come to him for treatment, he would not even attempt to rectify my open bite without surgery...it would not even be an option. I guess what I am trying to say is that you could forever dwell on the past and think "what if", but at the end of the day it would solve nothing. Stay positive and best of luck!

indecisive1
Posts: 43
Joined: Wed Aug 13, 2008 4:11 am

#10 Post by indecisive1 »

I forgot to add, I too believe u should get a second opinion and I know that money is an issue, but I would rather pay more and go to someone reputable and who is experienced in treating patients who require surgical intervention, rather than hope for a discount from someone you're not too sure about. This is surgery...you're spending sooooo much money, you'd want to get it right this time! Get a second opinion and ask around if anyone has had any experience with this orthodontist! When I started this journey (as an adult) in May, the first orthodontist I saw seemed a bit apprehensive...this site has been amazing...and the knowledge people have is exceptional! A member from this site referred me to another orthodontist (mind u I live in Australia and this person was from America) and I haven't looked back since!!! Again best of luck..I hope all goes well for you!

jonathon003
Posts: 103
Joined: Thu Nov 20, 2008 2:01 pm

#11 Post by jonathon003 »

alright guys i've learned a lot in here!! this is such a wicked site.

ok what i think i'm going to try and do is take some pics of my profile and teeth, etc etc etc. Might take me a while as I'm not really computer savy (or in particular posting up pics on forums, never have) and also kind of busy with school. But i should have them up today or tmrw. Appreciate all the helps and responses...seems like it really would be wise to see some other ortho's. man it sucks tho cuz i just really wanted this process in motion by now and already dropped 325 bucks for xrays and photos at my ortho. but obv i know whats right and how big of a decision this is so $325 and a month or two extr really means nothing. it's just harder for me being young and short-minded just wanting to get fixed ASAP!! lol.

edit: i will definetly look into his case about the deviated septum and orthognathic in 1. thats pretty crazy! i'm not even 100% sure but my doc a few months ago when i was complaining for the 39273828th time about congestion and nasal breathing problems which he never seems to take seriously (just gives me some nasal sprays that never do anything longer than 30 min of freedom), anyway he told me that it looked like my septum might be deviated and it was shifted to one side. he asked if i had an injury or something, and i did actually fracture my jaw once when i was 16 or so (wasn't that serious and doubt it was related to my current jaw problems) so maybe that impact shifted everything who knows. but yeah i'll try to get more info on my septum and if in fact it is serious enough to be corrected surgically.


ah man i dream of days where i can close my mouth with comfort, and be able to walk around in society without looking like a complete idiot/goof/mouth breather, with 2 front teeth showing etc. and i dream of my side profile actually looking normal damnit! these are things 80% of ppl it seems always experienced their whole lives...what a raw deal! esp when it messes with ur psychy (sp?) and gives u anxiety. ah well.

suetemi
Posts: 234
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Location: Chicago

#12 Post by suetemi »

I would find out first if your bite problem is skeletal or not. If it is, you would need surgery to fix it. In that case, the ortho you choose would be following specific instructions of the oral surgeon in how to move your teeth (if that makes you feel any better if you decide to stick with the current ortho). So it becomes more of an issue of finding a good oral surgeon...I mean, ideally you want both a good ortho and oral surgeon, of course...Maybe Im getting way ahead of myself.

Do you have insurance in case you do end up needing surgery? I am a student too and my surgery is being covered by my schools student health insurance...

jonathon003
Posts: 103
Joined: Thu Nov 20, 2008 2:01 pm

#13 Post by jonathon003 »

suetemi wrote:I would find out first if your bite problem is skeletal or not. If it is, you would need surgery to fix it. In that case, the ortho you choose would be following specific instructions of the oral surgeon in how to move your teeth (if that makes you feel any better if you decide to stick with the current ortho). So it becomes more of an issue of finding a good oral surgeon...I mean, ideally you want both a good ortho and oral surgeon, of course...Maybe Im getting way ahead of myself.

Do you have insurance in case you do end up needing surgery? I am a student too and my surgery is being covered by my schools student health insurance...
oh yeah? I didn't quite know how that happened assumed the ortho would recommend or refer a surgeon if need be, but anyway I'm just gonna have a long chat with him next week and then I'll go from there. I mean if he sounds sincere and agrees that there are many issues going on in my mouth and feels confident he can meet MY expectations, than I'll feel happy about him. I may have come off like I didn't like the guy or somethin, but I actually do. Obviously that has nothing to do with his work, but he's a great guy. One time I remember with braces when I was biting into a hot dog, my wiring at the back was moved and piercing my mouth. My mom called him at his house phone (this was after business hours) and he didn't hesitate to go into the office and give me a private/emergency appointment to fix it. So he's definetly a stand up guy, just was worried maybe he might be out of touch with jaw alignment procedures or WAS the first time around.

As for the insurance, I'm pretty sure I've heard OHIP which is our health care here in Toronto, covers Orthognathic surgery, or at least most of it. But wow your school covers it?? Maybe I can get additional coverage if OHIP doesnt cover everything. I'll check with my school to see.


One question before I take pics...and this will sound pretty stupid: When someone is in relaxed closed-mouth position just going about their business...are your teeth together in a bite form? Or are they seperated? lol I literally have NOOO idea considering I've never felt relaxed with my mouth closed. :( thanks in advance.

jonathon003
Posts: 103
Joined: Thu Nov 20, 2008 2:01 pm

#14 Post by jonathon003 »

here is a test to see if i can post images okay.

Image

Image

jonathon003
Posts: 103
Joined: Thu Nov 20, 2008 2:01 pm

#15 Post by jonathon003 »

ok i will post some more...gimme a few seconds.


and lol disregard the DISGUSTING state of whats left of my chin strap. it looks nice and neat when fresh! and wow these pics are disgusting. i swear my front profile actually looks great (minus the crooked teeth). i can barely look at these. also notice in general the immaturity of my whole mouth/jaw region for a 23 yold. (yet I do have quite a baby face in general, and a fairly small frame, ie. bones).

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