Will OHIP cover an open cross bite? Anyone from Ontario

[trossi]

Hi!
So I've had braces about 8 years ago and my orthodontist told me I couldn't correct my bite without surgery. I don't know how to post an image but basically I have an open bite all the way across except for my very back teeth, the farthest molar and my wisdom teeth do touch. I have noticed that over the years my jaws are no longer aligned. I don't know if i've done this from all the scraping of my teeth trying to get them to close. I am going to speak with my dentist next week as my orthodontist has retired.

I was wondering before I start the whole dental journey again, what is OHIP willing to cover in terms of jaw issues. This seems more functional to me since I have both trouble pronouncing words because of all the spaces, as well as jaw pain from trying to close my jaw. I have read about other functional problems that I had basically thought were normal since I've never had a normal bite.

Considering I'm in school it would be a huge help to have OHIP cover most of the surgery as I see most people have had, but I am worried about what is considered functional surgery to ohip. I have neither an overbite or an underbite, basically my teeth and flat above each other with spaces in between. I actually have images on my blog so I'll post the link.
replace the word dot with an actual period vvvvvv
http://blondeinthebrain.blogspot(dot)com/2011/02/my-very-special-jaw-issues.html

Anyone who has had similar issues and has had it covered by OHIP, it would be a huge help if you could share your experience.

Thanks

[Laundraholic]

I'm also in Ontario and scheduled for double-jaw surgery in March to fix a Class 3.

The entire operation (the actual surgery, the hospital stay, the anesthesiologist, etc etc) is covered by OHIP, but what is NOT covered is the surgeon's "extra" fees (which ranges from what I've seen from about $1500 to $5000, depending on single or double jaw, the surgeon, etc etc).
These fees are for case planning and etc, but not for the actual surgery.

These extra fees can then be submitted to your private health insurance if you have any.

As far as I know, there was never anything about the surgeon or orthodontist having to submit anything to OHIP to prove that it was required from a functional standpoint vs. aesthetics.
The surgery is covered, period.

[trossi]

[quote="Laundraholic"]I'm also in Ontario and scheduled for double-jaw surgery in March to fix a Class 3.

The entire operation (the actual surgery, the hospital stay, the anesthesiologist, etc etc) is covered by OHIP, but what is NOT covered is the surgeon's "extra" fees (which ranges from what I've seen from about $1500 to $5000, depending on single or double jaw, the surgeon, etc etc).
These fees are for case planning and etc, but not for the actual surgery.

These extra fees can then be submitted to your private health insurance if you have any.

As far as I know, there was never anything about the surgeon or orthodontist having to submit anything to OHIP to prove that it was required from a functional standpoint vs. aesthetics.
The surgery is covered, period.[/quote]

Thank you so much!! It has been impossible to find anyone from Ontario who has undergone this process for some reason. This is a big help. How long did it take you to go through the whole process? From braces to where you are now? I've heard so many different things about waiting times to get a surgery date. I'm in Toronto so I'm not really sure if that means surgeons are busy with many patients or if there are more surgeons so wait times aren't 2 years. Also, has your bite issue caused any pain in your jaw?
Thank you so much !
I've only been able to talk to people from other provinces, some of them said they couldn't get surgery covered so that was a concern for me, but its very reassuring hearing it from someone who lives in Ontario.

[Laundraholic]

Just do a search for "Ontario" or "OHIP" in this forum and a lot of threads should come up, especially about the costs.

My oral surgeon only has hospital rights one day a month, so I was told there could have been a delay from when I was "surgery-ready" to when surgery was available.
The orthodontist and surgeon have worked together several times, and my ortho knew to send me back to the surgeon to book a surgery date about 6 months from when he thought I was ready. So I booked at the end of September 2010 for surgery this March.

I was also told when this started that if I needed the surgery in the summer months, I would have to book a LOT earlier as that many people having this type of surgery are students.

I was SUPPOSED to have this done when I was 18 (when my jaw stopped growing), but my parents decided against it at the time as they thought it was unnecessary (and I was still a child living under their roof, under their insurance, and they were paying for my post-secondary, so it's not like I could have done it on my own at the time).
They said that I could decide for myself once I was a self-sufficent adult, and although the dentist would bring it up every 6 months when I had an appointment, I didn't seriously start considering it for myself until I was 32, married and with 2 kids.

I too was really worried about the cost, as most information out there is U.S - based and their costs are WAY more than ours. As it was, when I had my initial consult with the oral surgeon prior to being braced, hearing $3500 for double-jaw I almost cried with relief.


I was braced in May 2008, and originally told it would be about 18 months in braces, and then the surgery, and then about 6 months of braces post-surgery.

BUT since I'm older (I'm 35) and my bones are harder, it's taken a LONG time for the teeth to move and the gaps to close before I was deemed surgery ready. So it'll be just under 3 years of braces by the time I finally get the surgery.

[trossi]

[quote="Laundraholic"]Just do a search for "Ontario" or "OHIP" in this forum and a lot of threads should come up, especially about the costs.

My oral surgeon only has hospital rights one day a month, so I was told there could have been a delay from when I was "surgery-ready" to when surgery was available.
The orthodontist and surgeon have worked together several times, and my ortho knew to send me back to the surgeon to book a surgery date about 6 months from when he thought I was ready. So I booked at the end of September 2010 for surgery this March.

I was also told when this started that if I needed the surgery in the summer months, I would have to book a LOT earlier as that many people having this type of surgery are students.

I was SUPPOSED to have this done when I was 18 (when my jaw stopped growing), but my parents decided against it at the time as they thought it was unnecessary (and I was still a child living under their roof, under their insurance, and they were paying for my post-secondary, so it's not like I could have done it on my own at the time).
They said that I could decide for myself once I was a self-sufficent adult, and although the dentist would bring it up every 6 months when I had an appointment, I didn't seriously start considering it for myself until I was 32, married and with 2 kids.

I too was really worried about the cost, as most information out there is U.S - based and their costs are WAY more than ours. As it was, when I had my initial consult with the oral surgeon prior to being braced, hearing $3500 for double-jaw I almost cried with relief.


I was braced in May 2008, and originally told it would be about 18 months in braces, and then the surgery, and then about 6 months of braces post-surgery.

BUT since I'm older (I'm 35) and my bones are harder, it's taken a LONG time for the teeth to move and the gaps to close before I was deemed surgery ready. So it'll be just under 3 years of braces by the time I finally get the surgery.[/quote]

Wow thats a long time to have to wear braces. I had braces when I was 15 for about a year, and they worked surprisingly fast. At the time my orthodontist was retiring and didn't really seem too aware of anything. He did say that braces would never fix my jaw problems and that they were for cosmetic purposes. My parents sort of ignored the fact that not having my jaw fixed would cause any problems in the future. I'm 24 now and I'm a full time student so it will be hard to get the time to do surgery other than during the summer.

I don't really know much about the surgery or what exactly needs to be done to my jaw other than what is obvious to me from having an open bite. I've also just gotten a new dentist and now I need to be referred to a new orthodontist. Hopefully this one can see how bad my bite really is.

It was really scary seeing people pay around 20K and up for this surgery so its a huge relieve even if I have to pay a few thousand out of my pocket, much better than paying the full cost.
I have been bad for avoiding the dentist, which is probably why my bite has shifted into a cross-bite without me knowing. Next week I do have my first dentist appointment with my new dentist so I'm hoping it all goes well from there. I also have 4 wisdom teeth that I have been avoiding, they all need to be removed, so I'm sure that will set everything back while those heal.

Thank you so much for your help! I'll also try searching for ontario or OHIP to see what other information I can find. Its very reassuring hearing the opinion of someone who is from Ontario

[trossi]

Hi!
So I've had braces about 8 years ago and my orthodontist told me I couldn't correct my bite without surgery. I don't know how to post an image but basically I have an open bite all the way across except for my very back teeth, the farthest molar and my wisdom teeth do touch. I have noticed that over the years my jaws are no longer aligned. I don't know if i've done this from all the scraping of my teeth trying to get them to close. I am going to speak with my dentist next week as my orthodontist has retired.

I was wondering before I start the whole dental journey again, what is OHIP willing to cover in terms of jaw issues. This seems more functional to me since I have both trouble pronouncing words because of all the spaces, as well as jaw pain from trying to close my jaw. I have read about other functional problems that I had basically thought were normal since I've never had a normal bite.

Considering I'm in school it would be a huge help to have OHIP cover most of the surgery as I see most people have had, but I am worried about what is considered functional surgery to ohip. I have neither an overbite or an underbite, basically my teeth and flat above each other with spaces in between. I actually have images on my blog so I'll post the link.
replace the word dot with an actual period vvvvvv
http://blondeinthebrain.blogspot(dot)com/2011/02/my-very-special-jaw-issues.html

Anyone who has had similar issues and has had it covered by OHIP, it would be a huge help if you could share your experience.

Thanks

BTW this is my bite closed, so this is as closed as I can get my teeth

[tomato2010]

Laundraholic - Are surgeries covered for severe cases only or are all jaw surgeries covered with OHIP?

Trossi - Sorry I can't be of help since I'm also in the process of gathering info, but good luck and I hope you get it covered with OHIP!

[Laundraholic]

Laundraholic - Are surgeries covered for severe cases only or are all jaw surgeries covered with OHIP?

I don't want to give any wrong information... so make sure you still do your own research.

And there is actually a lot of information on this board if you do a search using "ontario" or "OHIP".

THIS IS SPAM PLEASE REPORT IT TO THE ADMINISTRATOR. THIS IS SPAM PLEASE REPORT IT TO THE ADMINISTRATOR. THIS IS SPAM PLEASE REPORT IT TO THE ADMINISTRATOR. THIS IS SPAM PLEASE REPORT IT TO THE ADMINISTRATOR., I'm not anywhere near a severe case and there was never any question about having to get it "assessed for severity" or anything like that at all. The maxillofacial surgeon gave me a cost of "his fees", and that's it.
Everything else is covered by OHIP.
I'm covered by my employer benefits to stay in a semi-private ward, but am electing to stay in a private room, so will have to pay the difference between the semi-private and private cost (around $50). My husband is going to ask to stay overnight with me, and I'm assuming that he'll want TV and so will have to pay that charge as well.

But even if you don't have any employer benefits, OHIP covers your stay in a general ward (4 ppl in the room).


It's not considered plastic surgery (and therefore not done by a plastic surgeon), so I'm assuming that's why it's covered by OHIP.

[trossi]

Laundraholic - Are surgeries covered for severe cases only or are all jaw surgeries covered with OHIP?

I don't want to give any wrong information... so make sure you still do your own research.

And there is actually a lot of information on this board if you do a search using "ontario" or "OHIP".

THIS IS SPAM PLEASE REPORT IT TO THE ADMINISTRATOR. THIS IS SPAM PLEASE REPORT IT TO THE ADMINISTRATOR. THIS IS SPAM PLEASE REPORT IT TO THE ADMINISTRATOR. THIS IS SPAM PLEASE REPORT IT TO THE ADMINISTRATOR., I'm not anywhere near a severe case and there was never any question about having to get it "assessed for severity" or anything like that at all. The maxillofacial surgeon gave me a cost of "his fees", and that's it.
Everything else is covered by OHIP.
I'm covered by my employer benefits to stay in a semi-private ward, but am electing to stay in a private room, so will have to pay the difference between the semi-private and private cost (around $50). My husband is going to ask to stay overnight with me, and I'm assuming that he'll want TV and so will have to pay that charge as well.

But even if you don't have any employer benefits, OHIP covers your stay in a general ward (4 ppl in the room).


It's not considered plastic surgery (and therefore not done by a plastic surgeon), so I'm assuming that's why it's covered by OHIP.

Thank you so much!
It was confusing hearing so many cases in the states so I initially thought it must not be covered. Because of school its hard to get appointments as soon as I may want them so the information part is taking a while. I have done a search and it seems like everyone in Ontario who is undergoing this surgery is covered. Thank you so much though, this has been the only place on the internet where I have managed to gather information regarding surgery in Ontario.

[trossi]

Laundraholic - Are surgeries covered for severe cases only or are all jaw surgeries covered with OHIP?

Trossi - Sorry I can't be of help since I'm also in the process of gathering info, but good luck and I hope you get it covered with OHIP!

Goodluck! I hope everything goes well. How long have you been gathering info?

[tomato2010]

Thank you for the information as well! For some reason I was under the impression that OHIP covered hospital stays and anesthesia, but that the surgeon fees would need to be paid by the patient for those that have a less severe case. Maybe I've confused this with those trying to get insurance to pay for it (maybe in the US)... And the cost of it that I read online ranged from a few thousand to tens of thousand. I have a cousin who needs surgery to correct his bite as its severe and he can't chew properly and my aunt tells me all that's covered, including the surgeon fees BUT he's not going for the surgery anyway and I'm being advised not to by my aunt, but I digress.

I'm a Canadian but am overseas at the moment and have been going for consultations here (since I'm here anyway) to different surgeons, thinking the costs would be similar. But now I see that it might be cheaper in Canada. Here, I've been quoted $13,000 ~ 15,000 for double jaw surgery (including stays at the surgeons practice where they have recovery rooms and such - rather than going to a hospital room that the surgeon reserves) and then there's paying for braces (~$6,000 ceramic ones) and additional fees added for cutting edges of jaws and chin or whatnot to make it more aesthetically pleasing (this is optional).

If you don't mind, could you share the names of your surgeons or surgeons you know who are good? I've never met a surgeon in Canada and am not sure if they accept consultations over email / phone.... but I'm thinking of emailing several places just in case and then if it's all good, I'll fly back to Canada and have it done there. I have a lot of sites bookmarked and will start reading those for a better idea too. And as it was suggested here, will do a search on this forum too.

Trossi - I have been gathering info for over a year. It's kind of a long story, but basically I didn't even know these surgeries were even available or possible and being overseas and not speaking the language that fluently, no one really told me what I needed to get done. So for the past few years I've been, in a way, treating the symptoms without addressing the real problem. Don't know if that makes any sense And now that I've gone for consultations here with surgeons, I have a better idea - although they have VERY different ideas of how they'd like to treat the problem, so that's confusing too.

My post is getting way too long, so I'll end it here. Good luck everyone!!

[Laundraholic]

Thank you for the information as well! For some reason I was under the impression that OHIP covered hospital stays and anesthesia, but that the surgeon fees would need to be paid by the patient for those that have a less severe case.

I DO have to pay the surgeon's fees ($3500 for double jaw; from what I've read depending on the surgeon and what type of surgery, the surgeon's fees range from about $1500 to $5000).
The actual surgery is covered by OHIP (including hospital stay and anaesthesia), but the surgeon's fee is for case planning and other stuff.

This will have to be paid out of pocket.

You can then try to have these reiumbursed if you have employer or private benefits.

What you also have to pay for out of pocket is the cost of the braces. If you have employer or private benefits on top of OHIP, this may be covered (usually 50% up to a maximum amount, depending on what type of coverage you have).

[tomato2010]

Laundraholic - thank you so much for clearing that up and for providing so much information. You've been really helpful and I really appreciate it...