I’m 27 and live in Northern Ireland – if you want to be totally baffled, that’s the bit of Ireland in the UK. I had braces for a long time when I was a teen but didn’t attend my check-ups regularly – it was a long journey to the orthodontist and I was a bit of a wayward kid. The braces kept coming lose (wire releasing from train tracks) and I eventually got them taken off before the treatment was complete.
Probably a number of factors meant that I ended my teens with a considerably more imbalanced jaw relationship and bite than I had in my childhood. For that matter my teeth probably aren’t all that catastrophic now, my problems seem to be more with my jaws. I’m not sure, but I think a number of things may have contributed to this: bad swallowing/breathing habits; possibly having a slack jaw through a lot of my childhood; and prolonged orthodontics involving train tracks and teeth extraction which surely can’t be good for jaw development when you’re growing.
Anyway, my suspicions are that my maxilla is too small – or at least narrow – and maybe because of this, or the things that lead to it, I sort of have an anterior open bite and possibly an underbite. I’ve just had a dentist’s appointment about this and she holds the view that, yeah, my upper arch is narrow, there’s the open bite and a class 3 malocclusion. She then arranged an appointment with the consultant NHS orthodontist in the area.
I should add that I have these concerns about the growth of my maxilla as this centres around my main reason for doing all this – tongue function. I’ve ended up talking with my tongue sort of underneath my side teeth and my tongue gets badly rubbed by my molars and pre-molars. My upper arch seems to be too small for my tongue to fit up into. From some reading I’ve done I’m now wondering if through bad oral habits I failed to use my tongue properly to encourage the spread of my palate. It seems this lack of growth may have been reinforced by the extraction of a molar and pre-molar and a lengthy spell in braces in my teenage years.
My dentist advised me to give the consultant orthodontist a ring before my referral so that I could clarify a few things. I was in for a shock. The consultant was adamant that palate expansions simply aren’t carried out in adults – they’re supposedly unstable or something. I tried to mention the surgical element and how common a procedure it seems to be on this forum but to no avail. Her view was that I’d have to wear a retainer indefinitely or the teeth would move back in – that made me wonder if she hadn’t considered the surgical element and was thinking in terms of teeth tipping only. She said there wouldn’t be anyone in Northern Ireland who would carry out such an operation and advised me not to consider it if I did find someone offering the procedure elsewhere. All I could hope for in this part of the world was the moving of my top or lower jaws forward or back – so one of my key aims in seeking the surgery would remain unaddressed.
Interestingly, I’ve since phoned around some clinics in England and sure enough they offer a palate expansion as a standard procedure. I then contacted St. James oral and maxillo-facial clinic in Dublin (in the other part of Ireland if you want to be really confused) and the very helpful nurse there explained that they can do SARPEs, le forts, etc. Indeed, she said they were all standard and very common procedures. So I’m now left utterly bewildered about the orthodontics situation in my area.
Here are some pics (if I look like I’m grimacing in some shots it’s because I’m trying to pull my lips back to show my teeth):
Profile (with dark towel over door to provide contrast, err)…
Bite from the front…
A bit round to the side…
And the other side…
Close ups of teeth from each side…
From above…
Below…
Should add that it was difficult to correctly position my head vertically here while also balancing the camera… it was more difficult than I imagined. So I’m just not sure whether or not I’ve aligned my head in such a way that you get a good idea of my features in relation to the sagittal plane… if, even, that’s the right term.
This pic hopefully shows the narrowness (or at least the straightish sides) of my upper arch…
My teeth just seem to disappear after my cuspids on the upper arch. My molars and pre-molars on my lower arch lean in to accommodate the lack of width behind my cuspids above – this is even with having two molars on my lower arch removed. Despite this inward tilt of my lower teeth my upper molars just seem to sit on top of their counterparts below and not half a tooth width out. On the left side of my mouth I very nearly have a cross bite. The exceptions are the molars right at the back of my superior arch that, interestingly, were never connected to the brace when I was growing. This lack of width further back gives me a narrow smile, in terms of teeth, with what seems like empty space towards each corner of my mouth.
Bottom pre-molars and molars leaning inwards…
