Accept compromise? Ortho says won't fix open bite....

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#1 Post by **vctorascrt** » Tue Jul 18, 2006 9:49 pm

I just got my spacers today and am set to be braced next Tuesday. It will only cost me $2100, but I've chosen to accept a compromise. I have a maloclussion 1, with an open bite and crossbite. If I don't get teeth pulled or have jaw surgery, he said that my teeth will be straightened but my top teeth will not be pulled back (no room) and my crossbite may or may not be fixed. He is very vague about the whole process. I've had 6 consults, and they ranged from one not touching me without jaw surgery, one wanting to use a palate expander, one wanting to use "lots of rubberbands", and this guy who says I can accept the compromise. I really just want my front two teeth to have that "rounded" look, right now they go the opposite direction, and my bottom teeth have mild crowding. I also have crowns on two bottom teeth and am told that if I don't fix my crossbite, I may need to continue getting crowns on them in the upcoming years. What do ya'll think, is it smart to accept the compromise and go for straight teeth but still have my top teeth quite a bit forward of my bottom teeth? I can certainly change my mind and do jaw surgery later on, so I guess it's just a waiting game at this point. Has anybody else been in this situation?
Vicki

#2 Post by **nvcarissa** » Tue Jul 18, 2006 9:55 pm

My ortho wouldn't touch me without jaw surgery, and I can see why. Why go for half measures? Orthodontia isn't merely about a cosmetic fix, it should make your bite healthier and correct. The compromise doesn't seem to fit that bill. But ultimately, the decision is yours.

#3 Post by **ShinySmile** » Wed Jul 19, 2006 4:41 am

I've had an expander for three weeks to correct a crossbite/open bite...so far, it has worked beautifully. My ortho at first wanted to just do braces, but after looking at x-rays/records decided an expander and braces combo would make my bite perfect once the teeth were straightened.

If you think you'll be happy with the compromise, then go ahead and stick with your plan! I don't think this is the option for the ideal bite that you should have after orthodontics though... Good luck in deciding!

#4 Post by **JoeMama** » Wed Jul 19, 2006 10:13 am

I'm in a similar spot too. and I went with the compromise treatment. Without surgery, my teeth will only be 70-80% better (with Damon braces) than they were before, and I'm OK with that. Regular braces would have done even less. Surgery meant bone removal, titanium screws in my head forever, and a six week recovery. Maybe I'm a little old fashion, but it seems like that would be more traumatic than living with imperfect teeth. And I have never-ever, for one second, questioned my decision. But that's just me. You have to decide what will work for you. Good luck!

#5 Post by **JoeMama** » Wed Jul 19, 2006 11:51 am

But it does concern me a bit when partially misleading information is given to the person trying to make the decision.

Six weeks was what I was told to expect, by more than one ortho. It may depend on what you're having done, but that's what I was told and I don't appreciate being told that I'm misleading anyone. If you have/had a shorter expectation, that's super!

#6 Post by **vctorascrt** » Wed Jul 19, 2006 11:56 am

Thank you all for your support and experience. I went with this ortho because he could get the teeth straightened for half the cost of the others, not the $5000 everyone else had quoted. My teeth aren't that crooked, I just hate how my front teeth stick out. My dentist did also have positive things to say about him and he is accredited. He also did give me a heads up that if in a few months I am not happy with how things are going, surgery may still be an option. He won't do expanders on adults, but maybe I can talk him into it.

Or I may have to switch to the other ortho who will do expanders, that seems to be the best option. I really don't want to put up with that awful contraption, but I do have a narrow upper jaw and it makes sense to have to widen it out for that "rounded" look, so I guess I'll probably know a lot more a few months into braces and may have to look at other avenues at that point.

#7 Post by **hippyhippo** » Wed Jul 19, 2006 4:51 pm

6 week recovery??? Even the people I know who've had double jaw surgery were only out 4, and I'm back half days on week 2.

From what I've read and from my what ortho consults have told me, you should plan to take 2-3 weeks off work, and not to be surprized if recovery back to 100% normal take months. But it's very individual. Some will heal very quickly, others will take longer.

As someone who recently had lapriscopic surgery (obviously unrelated to my teeth!), I can say it took me a full 3 weeks just to get over the general anesethic. I did work half days that 3rd week, but I could barely drive home I was so exhausted. I needed something ridiculous like 12-14 hours of sleep a day!

So I understand why someone would be hesitant to have surgery. I'm pretty sure I'm going to end up getting jaw surgery with my treatment, but I'm not thrilled with it. Surgery sucks, but sometimes the benefits just outweigh the risks. Only you, with advice from your ortho (and maybe an oral surgeon), can determine if it is right for you.

#8 Post by **JoeMama** » Wed Jul 19, 2006 5:58 pm

KK (and others) - I'm not an orthodontist so I can't answer that question about how, exactly. I'm just sharing my experience, which is what this message board is all about. I was told 6 weeks... I was told Damons can help widen an arch more effectively than regular braces. .... By more than one person.... I've never had regular braces, but the Damons are doing an awesome job. I wonder why some of you seem so negative about the Damon brackets? KK - you are very objective, but I find that your posts about Damons are almost always on the dismissive side. There are those of us that REALLY like our Damon braces and we have the right to voice that opinion. If a friend were to ask me my opinion about Damons, I would recommend them. This message board is not any different. I'm sure you're right about the archwire and ortho skill being huge factors. But Damons rock (for me), that's my opinion and I'm offering it up to those who ask.

PS - and no - I don't work for the company!

#9 Post by **jcdamon3** » Wed Jul 19, 2006 6:19 pm

I just look at the logic of it. If you want to move something by pushing on it would you rather push against rubber or metal? What would be more effective? Everytime I think about that the logic tells me that pushing against something that doesn't give as easily would work better. So damons work better at moving the arch out because they have something firmer to push against. And maybe they don't work better, but logic tells me that they would at the very minimum work faster.

Now I will duck and let the stuff fly!

#10 Post by **jcdamon3** » Wed Jul 19, 2006 6:56 pm

Okay I stand correct. Replace damon in my post for "self ligating". I am talking about leverage.

#11 Post by **vctorascrt** » Wed Jul 19, 2006 8:13 pm

So the upper arch can be widened with just braces alone? Without surgery, or an RPE? I thought the the braces only straightened, without pulling teeth, how do they widen with nowhere to go?
My open bite isn't horrible, and I was told it's not a true open bite, somewhat of a mix between an overbite and an openbite. I would guess that my teeth stick out 4mm past my bottom teeth, much less severe than many of the cases I've seen on here, so if they are just rounded back instead of forward, I will be satisfied. Honestly, the idea of an RPE (even without surgery) scares the crap out of me. Braces will be tough enough (and my sentence is only a year), I don't think I could handle months of not being able to speak correctly and spitting on people. My current ortho will not do one on adults, but another ortho that I really liked says he does RPEs all the time on adults (I'm 29) and it's never been an issue.

#12 Post by **hippyhippo** » Wed Jul 19, 2006 9:33 pm

As to not being thrilled with the idea - no argument. You have to weigh benefits vs risks and inconveniences, as you say. But the weights going onto the scale should be as accurate as possible.

Absolutely! I probably sounded far too anti-surgery in my post, which I apologize for. I just didn't want the original poster to feel like their concerns about surgery were completely unfounded. There ARE risks involved. But again, for many people (likely myself included) it is the best way to achieve a healthy bite.

#13 Post by **vctorascrt** » Wed Jul 19, 2006 10:05 pm

I think you're right, the anticipation is the worst part of it. Right now I have 10, yes count them, 10 spacers! I started seeing different orthos back in May and am finally taking the plunge. Chewing any sort of real food is out, but my teeth don't really hurt, they are just sort of numb. The ortho says that because my teeth don't touch at all, I can do ceramics top and bottom, and he won't charge me extra for them. He said he does have a white wire, but hasn't used them in such a long time and that they don't work as well, but will try it if I'd like to. I probably won't go for the white wire if it's going to extend my time and probably just rub off anyway, but it may definitely be something I'll consider when I go in on Tues. I will try and take some pictures if I can figure out how to upload them, so everyone can see my pretty spacers.

My open bite is nothing like the picture shown, like I said, it's a cross between an open bite and an overbite. I also have a crossbite to be fixed, especially on the left side. The front teeth slightly cover the lower teeth, so if they're moved back with a more rounded upper arch, they should be at least closer to matching up. I had retainers as a kid , but never a consultant with an ortho, so this is all new to me. Anyway, I'm hoping I'll be completely happy with my "compromise" and if I have to change direction in a few months or 6m, so be it. Thanks, all!

#14 Post by **nvcarissa** » Wed Jul 19, 2006 11:05 pm

So the upper arch can be widened with just braces alone?

Yes, mine was. And in fact, my ortho is very conservative, just uses regular old brackets. I had no extractions and my bite rounded out quite nicely. When I had my surgery, the OS was very, very pleased with the work my ortho had done and said he had never seen an upper and lower teeth match up the way mine did.

I saw my ortho today for the first time since my surgery (today was 4 weeks exactly) and I think I finally figured out that he is a perfectionist and cautious. Looking at my very well lined up bite with, as far as I can tell, just a few more things to tweak he said, "That's about as good as can be expected at this point." At first I thought he had misgivings, but I realized that he is happy and can't wait to get back to doing his part on my mouth. He knows that he can't touch me until my OS gives the okay (though I did get new ligs today). A lot of his staff have been his patients and they all have excellent results, so I am sure he just wants to keep it going for me. At the end of the visit he asked me, "How does it feel to have all your teeth meet?" "Thrilled!!" I answered and he flashed me a very big smile. This from my quiet, conservative ortho. I am feeling pretty good about my treatment and am very happy that I decided to get my surgery.

With regards to six week recovery time...about the only thing that is affecting me now after four weeks is some jaw stiffness and the fact that my OS still has me on a no-chew diet. Other than that I was back to work full-time after two weeks. Maybe the six weeks is worst case scenario? My OS did make me sign the consent form that said I would be wired for one week, but that I MIGHT have to be wired for six. The best thing I heard from my OS in the hospital was that my wires would be removed after a week. Whew!! It used to be standard procedure to wire the jaw for six weeks, but with fixation, that is no longer necessary and gets the patient on the road to recovery much faster.

#15 Post by **hippyhippo** » Thu Jul 20, 2006 4:49 pm

With regards to six week recovery time...about the only thing that is affecting me now after four weeks is some jaw stiffness and the fact that my OS still has me on a no-chew diet. Other than that I was back to work full-time after two weeks.

Since you're going through this right now, at 4 weeks have you been given the all clear to resume all sorts of activities?

I'm a very active person, so I go to the gym and play sports several times a week. I was assuming that if/when I go through my surgery I wouldn't be able to resume these activities (especially any sort of sport that could involve contact, however incidental) for months. I hope you will prove my assumption wrong here, because that would be a huge relief!