refusing surgery for an open bite and crossbite

[Anna5]

Hello,

I am almost 40 years old and I have an open bite, unilateral crossbite and misaligned teeth/ jaw (from thumbsucking when I was younger). I consulted an orthodontist and he advised SARPE and upper jaw surgery for me. However, I declined these surgeries because they sound far too scary for me. Moreover, my problems are mainly cosmetic, I don't have any functional problems at the moment. Therefore, after another consultatation, the ortho and I decided I would just get fixed braces for about 9 months to make some esthetic improvements. I hope this will succeed! What do you think of this? Do you think my ortho will be able to fix my bite to some extent? Or would you definitely have the surgeries if you were me? I 'd love to share experiences with you. Are there more among you who were advised surgery, but refused and just got braces and were happy with this choice?

[quentin]

Hi there!

I had a deep underbite and TMJ issues, and during one consultation, I was told that I might need corrective jaw surgery (in addition to 4 extractions of perfectly healthy teeth). Surgery was definitely out of the question for me due to 1) cost; 2) I definitely did not want something so invasive.

The ortho I finally went with uses only Damon system (self-ligating braces), and generally he does not advocate surgery and/or extractions unless absolutely necessary in a small percentage of cases. He reviewed my case and decided that I did not need surgery. It's crazy, but after 2 weeks in braces, my underbite has already seen correction, and I get much less popping in my jaw.

I would say you get a second (or third or fourth) opinion on the matter. You are absolutely right to question this suggested treatment, and should only go with what you are comfortable with. Good luck!

[Anna5]

Hello Quentin,

Thanks for your supportive message! It is good to hear that you also choose for a non surgical route. You are right that surgery is very costly and invasive. I am happy to hear that you already see some progress after only two weeks, that is very quick! And encouraging!

I already had a second consultation and that ortho also said I might need jaw surgery to correct my crossbite. This really scared me. A third ortho (who advised me online, after only seeing a picture of my teeth) wrote that he thinks my smile can be made beautiful with only braces. Or at least, that it is the most logical route to first straighten my teeth with braces and then evaluate the result, instead of immediately resorting to invasive jaw surgery for a, in his opinion, not too bad open bite.

I wish you good luck on your journey of fixing your underbite!

Greetings from Anna

[bmueller]

that can definitely be fixed without sugery, but make sure you wear your retainer after you're done otherwise its likely to go back to the way it was. I have an open bite and was told it is difficult to treat and a high rate of relapse without proper retention.

[Anna5]

Hello!

Thanks for your encouraging reply. I will definitely make sure to wear my retainer after my treatment has been done!

Greetings from Anna

[Smiles10]

Sounds like its small enough to treat without surgery

[Anna5]

Thanks... I definitely hope it can be fixed, at least to some extent, without surgery....
Do you all here on this board really think this it the case? Or do some of you recommend me jaw surgery? (like my orthodontist did).
I think my teeth/ jawline are pretty bad and doubt whether braces alone can do the work, but for now I find surgery a bit too invasive and scary, for something that is mainly cosmetic for me....
I am in braces now and I hope to see some improvement in the coming months. And if I am not satisfied with the result in about a year, I may always opt for surgery in the future.

[bmueller]

I'd ask your ortho what are the advantages/disadvantages of not going the surgery route. Personally, I see no reason why your teeth cant turn out great without surgery. Some orthodontists can do amazing things without surgery and I looked into that extensively. i chose surgery because of long face syndrome more than my openbite.

make sure you feel 100% comfortable with your decision. You dont want to do it again!

[bbsadmin]

At age 40 it might be difficult to fix a crossbite without SARPE. See how things go, and if necessary, try the SARPE and more treatment with braces. I had an open bite (but no crossbite) and I didn't get any surgery, and although I needed a few extractions due to crowding, my teeth turned out OK!

[Smiles10]

With your crossbite , are your top molars biting inside your bottom molars?

[Anna5]

Thanks for your replies! Yes, on one side of my mouth my top molars bite inside my bottom molars, on the other side it is ok.
Personally, I don't mind my crossbite so much, it is my open bite that disturbs me the most. So I think I don't want SARPE, at least for now. I think I will just see how the braces work out.
Bbsadmin, I saw the tranformation of your teeth, that is really astonishing and gives me very good hope!

[Anna5]

Still some remarks: how great that they managed to close your open bite without surgery, bbsadmin. You have gone through a long road of orthodontic work, but the result is really astonishing! It gives me very good hope.
And, bmueller, I don't think your open bite looked bad, would it have been possible to close your open bite without surgery? I can understand that you chose the surgical route because of the long face syndrome. I hope you are happy with the results now!

[ktr78]

I think you'd be surprised by what braces can accomplish, by a competent ortho, if you make clear that surgery is not an option to you. Personally, considering you have lived almost 40 years with your situation, and you have stated that it doesn't bother you functionally, and not even all that much cosmetically, I would NOT do the surgery. Being almost 40, you will not recover like a 20-something would. I think after being in braces for a few months and seeing the improvements, you may be happy and not want to proceed with a surgery that, for you, would be purely cosmetic (AKA not medically necessary). Just my opinion...

[Anna5]

Dear ktr78,

Thanks for your wise reply. I think you are right that it is better for me just to do the braces and see what improvements will be accomplished first. For me, it is indeed purely cosmetic, and I think this reason won't justify such major surgery (or even 2 surgeries as the ortho suggested). My teeth don't need to get perfect, just some improvements would be great! I also feel like I can't decide for surgery, the thought of it alone already scares me very much, it is so invasive. And some other reasons to choose the nonsurgical route (at least for now) are that I have a small child to care for (not nice if mummy can't care for you for weeks after surgery for something mainly cosmetic....) and my pregnancy wish in the near future, if life would give it to me....

Greetings from Anna

[bmueller]

Just wanted to caution you that the surgical and non-surgical orthodontic plans may do different things to your teeth. It may not be as easy as just saying one day that you're switching to surgery. It may result in additional time in braces since the teeth they move for surgical and non surgical treatment may be different.

I originally planned to do a non surgical correction of my open bite and when I switched to surgery, the ortho had to call the company (wires were all computer bent) and all order new wires to match the new plan. Non-surgical treatment involved intruding the molars to reduce the openbite and the surgical treatment involved arranging the teeth as is in the jaw (actually making my openbite worse) so the jaws could be realigned correctly.