Orthodontist suggests surgery, any advise would be appreciated.

[PrivatelyE5]

So this is my second crack at orthodontics, I had them iny late teens into early adulthood bit my teeth have shifted a fair bit and my overbite has returned, with a vengeance. I went to a consultation, different orthodontist as the clinic I went to closed after my Ortho passed away, and I was recommended surgery or don't bother.

I'm not thrilled at the idea of going u dear the knife so I'm getting a second opinion next week but have any of you heard of this or had this happen to you?

[djspeece]

I have no direct experience with oral surgery, but suggest that you might want to reach out to the member "sirwired" who is extremely knowledgeable and has undergone surgery. He has not been on this board for some time, but it's worth a shot. Also, you may not be able to send IMs until you have 7 (I think) posts so make sure you start replying! Best of luck to you.

[PrivatelyE5]

Thanks for the advice.

[djspeece]

Also, if you click on the "Braces Treatment Discussions" above, you'll see a listing of sub-forums that includes "Oral (orthognathic) Surgery" which might put you in touch with others contemplating surgery. Best of luck to you.

[PrivatelyE5]

Thing is I'm trying to avoid surgery, I'd rather not go under the knife if I can so I'm trying to cast a wider net.

[Meowmeowbeans2]

The first ortho I went to said I had to have surgery, so I got 2 other opinions. The other orthos said 12 and 16 months in braces is all I need since I don't have functional issues.

I had an edge-to-edge bite and crossbite, so I think the surgery would have been widening upper jaw and bringing lower jaw back. My mother had double jaw surgery in the 80's and calls it the greatest regret of her life because she lost all feeling in her lower face. She also feels she was pressured into it for perfection when perhaps just braces would be good enough.

So with that history lesson and 2/3 saying just braces would be fine, I went with the 16-month estimate. It was a more convenient location for me, and I'm actually ahead of schedule!

[PrivatelyE5]

That's the big thing I'm concerned about, they seem to understate the risks and I don't really like the idea of losing any sensation in my lower jaw in order to achieve someone else's definition of cosmetic perfection.

If these morbidities were things I had only read about that would be one thing but I have two close friends that have had lasting effects from their surgeries one person has had almost no feeling in her lower lip for a decade and sometimes it tingles almost painfully. Those aren't insubstantial side effects.

[assertives]

From what I gathered, if your malocclusion is due to a skeletal issue, then you'll likely need surgery to correct, as braces alone may either not fully correct your bite problems, or your result will not be stable. If it was a dental issue, then braces and elastics could be sufficient. If yours was a borderline case, a compromise could possibly work to give you a somewhat functional and hopefully stable bite. I'd say definitely get a couple more opinions to see what your options are.

[PrivatelyE5]

I've been told that my bite is basically right on the cusp. There are some underlying skeletal issues but my lower teeth are also just too far back. The question is if I relapsed after the first round of treatment were mistakes made or is surgery the only viable avenue.

I feel like there's a lot of pressure being applied on me suggesting that 1) no functional improvement can be made 2) the risks of side effects are insignificant which just isn't the case.

[assertives]

The question is if I relapsed after the first round of treatment were mistakes made or is surgery the only viable avenue.

I feel like there's a lot of pressure being applied on me suggesting that 1) no functional improvement can be made 2) the risks of side effects are insignificant which just isn't the case.

This is something only an ortho who has taken your xrays/scans and study moulds would be able to advise you. I would say though, that there is no such thing as a risk-free treatment. Every treatment comes with it it's inherent risks and side effects which also affects different people differently.

I think the "guiding principle" of choosing or recommending one treatment option over another is based in a risk vs benefits kind of assessment: would the benefits in getting treatment outweigh the risks and side-effects? Also, everyone's risk profile is different, so perhaps work out your own motivations and priorities in seeking treatment and then manage your expectations accordingly.

That said, pick an orthodontist that you are comfortable with, and whose treatment plan makes the most sense to you, based on your own personal risk profile. If you feel pressured to choose a treatment plan you don't agree with/not convinced/not willing to take the risks, or don't feel you can fully trust that particular ortho, pick another ortho.

Lastly, I also wanted to add that choosing not to seek treatment is also an option too.

[PrivatelyE5]

I'm getting my old records from last time and hopefully that'll give us a bigger picture.

[PrivatelyE5]

Update, I've lined up one more consult. I'm not always the most patient person and I'm trying to resist the urge to just get this show in the road so to speak. We'll see what the Orthodontist at this third clinic says.

[FoxieFoxxo]

I was supposed to have jaw surgery. I have a class II malocclusion and severe overbite. I decided against jaw surgery as the risk was far too great. Imagine when your hand goes to sleep, that sensation...only on your face. I wouldn't be able to do it. I also read horror stories of facial asymmetry and not being able to pronounce words correctly anymore. Also, your jaw can collapse etc. It was just far too scary. Anyways, with self-ligating braces for two years in the end the results in the functionality and aesthetic look of my mouth is quite great. The palates are widened considerably to the point when I smile there is no negative spaces at the corners of my mouth, I can chew normally, my crooked overbite is mostly straight and my cross-bite was completely corrected and no longer have severe headaches. Is it a perfect result that jaw surgery would have given me? No. But I do have a beautiful smile and functionality all the same. I hope you find an orthodontist willing to give you the best result based on what you're comfortable doing!

[PrivatelyE5]

I have gotten a lot of any results I get will not be stable... Which is a little annoying.

[assertives]

If your bite issues are due to skeletal discrepancies that are significant enough for several orthos to recommend surgery, sounds like you may be one of those who definitely need surgery. Especially since you've already experienced first hand a relapse after having gone through one round of treatment with just braces.