My Story - long and difficult

[Eurodude]

Can anybody relate to my story? As a teenager I had fixed brackets to straighten my teeth. 4 pre-molars were extracted beforehand and later on all 4 wisdom teeth. I freak now when I think I lost 8 good teeth.

No dental problems for a good 20 years but then I slowly started to notice a whole cascade of weird signs that something was not right. First my teeth started to become crooked again and some were rotated, then the tops of all the front teeth became really worn down and there were odd shiny surfaces on the sides of some other ones (wear facets as I know now). At the time I just though it was ageing and didn’t make any connection with grinding and bite issues. The one day the lower canine just started clipping away until there was just a stump. Before this happened there was a huge notch worn away at the gum line weakening the tooth. These ‘abfractions’ are yet another sign of grinding. I was also becoming a mouth breather and often woke up with an incredibly dry mouth. I couldn’t join the dots at this stage; a retracted mandible blocks the airway so nasal breathing can’t deliver sufficient air so you open your mouth as a compensation Often you only understand life looking backwards.

The second phase was worse. I started getting a pressure / pain in my left cheek which I though was sinus and would take anti-biotics. These symptoms would come and go but I eventually wound up with severe headaches as well as pain and clicking in my left TMJ so it was pretty clear what the problem was. My jaw also deviated on opening

Third phase was TMJ treatment in the US with an experienced specialist on the East Coast. Diagnostics showed that my TMJs had been damaged by the earlier orthodontic work. By removing the bicuspids all my front teeth were retracted to close the gaps. This set my mandible too far back and over-compressed the TMJ area. The condyles were actually bent, the dentist called them ‘shepherds crooks’ and the discs were both anteriorly displaced, the left side was non-reducing. I had to wear a pivot appliance to bring my jaw down and forward and while it did relieve the dizziness / brain fog it didn't help with the headaches. After 15 months I had another MRI and the discs were still out of position.

So in September 2009 I had disc plication surgery. Luckily the discs weren't perforated, only thinned but the ligaments were stretched beyond what a splint could fix. Now they are back in position. I have no clicking, no deviation and very good opening 52mm ( up from 44mm). I am wearing a repositioning appliance to give me the 8mm vertical I need and to bring my jaw into a correct edge to edge position while the TMJs are healing. They are now not so sore when I press down on them.

However I realise now my TMJs are back to normal but my teeth aren’t. My mandible is down and forward bringing the tongue with it and now it doesn’t fit on the roof of my mouth behind my front teeth.
I have the worse type of malocclusion as far as TMJ problems are concerned, class 2 division 2 so my treatment plan is to finish the case as a class 2. Widening both dental arches opening up the extraction sites and replacing the teeth which were taken out, splaying my upper incisors out to a 15 degree angle so as to free up the mandible and extruding the molars to give my bite the correct vertical dimension. Basically I am going to get the bite I should have had all along. Already I notice how my face has changed with the repositioning appliance, stronger chin, fuller lips, longer face

I know that extraction orthodontics are still performed and it makes me angry. It’s a time bomb that you will walk around with. What really upsets me it that there is an alternative which is widening the dental arches to solve the ‘overcrowding’ but the people advocating this approach are still in the minority and get rubbished by the status quo orthodontists.

[kittenmaisey]

I really can relate to your story.. totally. I had fixed braces in the uk. In the early 80's. When I was a Teenager.

Move forward 30 years. And I have all the symptoms you have mentioned. Including the rather unattractive 'dished in profile'.

Which often makes me look as if I have no teeth at times. Everything pushed back. Which most definately affects my breathing. Especially at night, when I'm lying down.

My new Partner keep commenting on my gasps for air!

I only wish my arches had been left crowded. At least there would now be
room for my tongue to live!. I am left with arches that are barely visable.

[BracedVeryLate]

euro and kitten,
I can relate to your story. At first I thought I was crazy, but I now know that even a few mm difference in the position of one's teeth can throw things off dramatically.
I have been looking into options for repairing the damage, and found a specialist in California. I plan to have the damage reversed as soon as possible. Luckily I realized this so quickly, and also will prevent my children from this mistake. I am sorry you have been suffering from this.