Overjet and overbite, what to do? (pics included)

[classII]

I was told by another doctor in September (professor of orthodontics) that my problem could have been corrected with surgery and braces alone. Had I known that at the time I would have run out the door the moment my former ortho mentioned extractions. I wish I would have gone to him first. I may need surgery anyways, but if it makes me better than I am now I say bring it on. I have such a TINY chin that it needs to be advanced. Plus my TMJ is far worse now than ever.

20 years ago my professor said that as well. fortunitley i didn't heed his advice.

they seek and preach perfection, when there is actually a grey area.

It looks great and fits great versus it great and fits accoding to spec. minus loss of nerves in your lips and cheeks.

Think botox looks wonderful (yeah right) must feel like a frozen freak.

[trigger1901]

Thanks so much everyone for posting your thoughts and experiences, I am
at work right now so I'll reply more in depth when
I get home.

[trigger1901]

The only thing about not having jaw surgery is that your chin is not brought forward. Aesthetically, the jaw appearance can be improved only with surgery, but if you're only concerned with your smile, surgery may not be necessary. The braces alone can fix the lip protusion too.

Your overbite would be easily corrected with the braces, so that's not an issue of needing surgery or not. It's the overjet that is the primary concern.

First of I have to say, I took a look at your braces story and I must say your teeth look amazing after bracer treatment.
If an orthodontist can make sure my upper front teeth are tilted backwards so they look more straight like my lower teeth, and pull my upper canines forward so they are in a straight row with my front teeth, then I'd be perfectly happy with my smile and I probably wouldn't notice my overjet that much anymore. I'm just hoping this is possible without too much consequences from leaving an overjet untreated, but I'll probably have to get a consult from a surgeon to be sure about that.

I went through a similar thing. Got braces on when I was 15 but due to a lot of other bad things going on in my life at the time I couldn't handle it and had them removed after two days. I got them back on in june 2008 at 21 and im so happy i did. I had a very bad overbite along with a huge gap between my top front teeth. I was told I would need jaw surgury because my jaw was back so far and kind of crooked but i refused to have surgury ( no health insurance and already had to take a loan out to get the braces). My ortho understood and has done everything he can to correct my problems without surgury. Now 18 months later i don't have an overbite, my jaw isn't crooked, and i love my teeth. And my jaw was really far back but now it's not. And i had a hard time finding an ortho because i'm not too trusting, i actually drive an hour and a half now to see him.
Estimated treatment time 18 to 24 months.

I'm really glad to hear you did not need jaw surgery to correct your teeth, its great to hear about people who have been in similar situations. Everyone in my environment either seems to have perfect teeth and think I'm strange for wanting to correct my teeth, however I'm getting so uncomfortable by my smile especially after comparing them to other people that I easily get insecure and try to hide my teeth resulting in even weirder facial expressions.

[drrick]

I do think that wisdom teeth can shift everything. I had perfectly straight teeth in high school. My dentist seriously thought I had braces because I had a "perfect bite".

Three years later my wisdom teeth came in and my front teeth on the bottom became crowded and crossed in front of each other.

I would definitely see another Ortho. You have to be completely confident in who you let rearrange your facial structure.

That is an old wives tale about the wisdomw teeth. Your teeth naturally migrate forward (and withthe tightening of your facial tissues over time also inwards) Thewy have done studies comparing those with wisdom teeth and those who wer congenitally missing them and the amount of movement was the same.

[trigger1901]

I have a classII Div 2, non extraction non surgical underway, 2 years +3 months and not nearly finished yet.

What I can tell you is that after 2 years of root moving' I'm only now getting to the bite stage, and from what i'm experiencing is what I think I see what is wrong with yours

right now the only teeth that touch (unless forced and moved) are the canines. That's by design right now as they need to be detorqued. As with your's they're tipped back.

The big queston is , is when you close your mouth, do you find them to be the two teeth that touch, and if so, when you clench, do you find or feel, your lower jaw sliding backwards (very subtle), untill all your teeth touch?

I'm VERY surprised by the fact that you managed to describe my situation perfectly! When I close my jaw I only my molars and my canines touch, but the funny thing is it wasn't this bad about a year ago, when my wisdom teeth or whatever they're called didn't come through all the way yet. I was then still able to touch the upper part of my upper teeth with my lower teeth, but now I can only touch the tops because I have to get my canines to slide over eachother. Its kinda hard to describe but I feel like I'm trapped in my own mouth because of my canines touching each other so much.

The clue is if you have a perfect upper arch and perfect lower arch and you still have an overjet, you quite clearly need surgery.

I believe I will still have an overjet even if they make my upper front teeth more straight, but I honestly wouldn't mind unless this makes things worse in the future. I'll still have to do that consult with a surgeon or something though before I can write that off.

[trigger1901]

That is an old wives tale about the wisdomw teeth. Your teeth naturally migrate forward (and withthe tightening of your facial tissues over time also inwards) Thewy have done studies comparing those with wisdom teeth and those who wer congenitally missing them and the amount of movement was the same.

My dentist indeed said that its a topic which is still being discussed a lot by researchers and the like. I did notice that when my wisdom teeth came through my teeth started moving more rapidly than before. But I guess it might be coincidence, I wonder if having the wisdom teeth removed may or may not help in my situation.

[trigger1901]

I too had braces as a teenager--but they think I went through a late growth spurt and my upper jaw grew and my lower jaw didn't......resulting in an overjet. I was told at around 22-23years old, braces and BSSO due to the underdeveloped lower jaw......I said no way....it doesn't bother me cosmetically, I'm not doing anything about it..............WELL------15years later, the overjet is significantly worse..if yours is 10mm, mine was more...it was clearly worsening over time..if I compare smile pics of myself from 10-15years ago and now....so at 38 I finally got the braces and will be having the BSSO at some point. I could really care less how my profile looks, and if I could opt out of the surgery I would...but neither the OD or the OS think my upper teeth can be pulled back enough and without the BSSO my overjet would return

My advice, you are still young, fix it all now...don't wait--it will get worse!!I would personally only go nonsurgical if the OD could guarantee without a doubt that the overjet won't return. I also had no extractions. I currently have a TPA in place as he is pulling my canines back--then the rest of those babies get pulled back--I can't wait!!!!!

good luck, any questions let me know!

Yeah I guess its best to fix everything while I'm still young, however there's so much conflicting feelings in me right now. I've had a really complicated youth and at the age of 22 I only just started to get the feeling like I'm in the prime time of my life.

I've missed out on a lot of stuff in my youth and I'm afraid that having to wear braces combined with a jaw surgery and a recovery period included with that will seriously hamper my ehr.. social development, if you know what I mean. I know these thoughts must be lies but they're still there.

I'm sure that if I leave everything untreated though I'll probably have the same thing happen with me, it will only get worse and I'll have to get it treated eventually. But I hope that there's a second option to improve my teeth a bit and maybe combine that with wearing a retainer so it will prevent things from getting worse.

[theKurp]

I believe I will still have an overjet even if they make my upper front teeth more straight, but I honestly wouldn't mind unless this makes things worse in the future. I'll still have to do that consult with a surgeon or something though before I can write that off.

What you don't seem to grasp is that straightening your teeth, without fixing the malocclusion, will be a temporary fix at best. In other words, you'll be right back here in a few years posting about the same problems - and perhaps worse - with regrets.

Your overjet and overbite are related. As I mentioned before, you have upper and lower over extruded teeth because there is little contact with opposing teeth. The longer you leave the overjet untreated the worse the overbite will get because your lower incisors will continue to extrude.

If I seem to know a little about your specific case it's because your case and mine are mirror images. The difference is, I let the overjet go untreated for so long that my lower incisors over extruded to the point of making contact with the roof of my mouth behind my upper front teeth.

Here are pictures of me prior to getting braces:




Notice in the first picture that my lower incisors have over extruded to the point of resulting in a 100% overbite. My overjet is measured at 8mm. Also notice that my upper canine, like yours, is tilted inward and is also over extruded (my other canine is part of a bridge so it doesn't match the other upper canine).

Here is a picture taken a month ago after 1 year in braces.


I am scheduled for lower jaw advancement on January 11th. The other treatment options provided to me simply did not appeal to me because they would negatively affect my profile and facial symmetry. Youth is very forgiving on profile and facial aesthetic imperfections, but become increasingly exagerated as one ages.

As some other posters have suggested, the best advice is to not take shortcuts. If at all possible you should choose the treatment that will not only last the rest of your life, but provide you with the best outcome. Think not only of your teeth and their appearance, but of your occlusion, profile, and facial symmetry.

Good luck to you.

[trigger1901]

I believe I will still have an overjet even if they make my upper front teeth more straight, but I honestly wouldn't mind unless this makes things worse in the future. I'll still have to do that consult with a surgeon or something though before I can write that off.

What you don't seem to grasp is that straightening your teeth, without fixing the malocclusion, will be a temporary fix at best. In other words, you'll be right back here in a few years posting about the same problems - and perhaps worse - with regrets.

Your overjet and overbite are related. As I mentioned before, you have upper and lower over extruded teeth because there is little contact with opposing teeth. The longer you leave the overjet untreated the worse the overbite will get because your lower incisors will continue to extrude.

If I seem to know a little about your specific case it's because your case and mine are mirror images. The difference is, I let the overjet go untreated for so long that my lower incisors over extruded to the point of making contact with the roof of my mouth behind my upper front teeth.

Here are pictures of me prior to getting braces:

Notice in the first picture that my lower incisors have over extruded to the point of resulting in a 100% overbite. My overjet is measured at 8mm. Also notice that my upper canine, like yours, is tilted inward and is also over extruded (my other canine is part of a bridge so it doesn't match the other upper canine).

Here is a picture taken a month ago after 1 year in braces.

I am scheduled for lower jaw advancement on January 11th. The other treatment options provided to me simply did not appeal to me because they would negatively affect my profile and facial symmetry. Youth is very forgiving on profile and facial aesthetic imperfections, but become increasingly exagerated as one ages.

As some other posters have suggested, the best advice is to not take shortcuts. If at all possible you should choose the treatment that will not only last the rest of your life, but provide you with the best outcome. Think not only of your teeth and their appearance, but of your occlusion, profile, and facial symmetry.

Good luck to you.

Hey TheKurp,

Thanks for your detailed post and the pictures, its great that you took pictures from before you started treatment. I notice similarities with your teeth, the lower teeth in one of the first pictures are arched upwards which you can clearly see in my case, not to the point that they are really touching the roof in my mouth but I guess it will only be a matter of time for this to be an issue.

You've apparently noticed how I am really trying to avoid the topic of surgery, its really just a scary thought for me that my jaw will be broken in two and moved forward, I can't grasp how that can be good for any person but I guess there's plenty of people who benefit from it.

Still though, looking at your teeth after 1 year of braces I'm amazed by how great they look, and I'm really excited of the thought that I can get the same result in perhaps a year if I don't neglect it. By this point though, is it really not possible to use a retainer or something else to keep the teeth in that position? Or are you teeth moved in such a way that you can't achieve a good bite until you have had your jaw surgery?

The thing I'm wondering if if the treatment WITH or WITHOUT surgery is really different up to the point where you would have the jaw surgery? If its the same bracer treatment beforehand, that means I don't have to make the decision before starting the whole treatment and taking the step to start it all will be much easier. Then again if I am that far ahead already, I guess taking a risk and feeling like crap for a couple of weeks is worth it since I'll benefit from it for the whole long life I plan to still have ahead of me.

[trigger1901]

Also, after having jaw surgery, how long does your orthodontist you still have to wear your braces? The one I had a consult from told me its 1 year braces, then surgery, then another year of braces, I wonder if its the same with your situation.

[theKurp]

Still though, looking at your teeth after 1 year of braces I'm amazed by how great they look, and I'm really excited of the thought that I can get the same result in perhaps a year if I don't neglect it. By this point though, is it really not possible to use a retainer or something else to keep the teeth in that position? Or are you teeth moved in such a way that you can't achieve a good bite until you have had your jaw surgery?

I can't answer your first question. But would you really want to commit to having to wear a retainer for the rest of your life? As for your second question, yes, my teeth are positioned at the moment in anticipation of surgery. My upper arch has been expanded to the point where my upper and lowers no longer "mesh". However, molds recently taken show that a good bite will be achieved after the surgery.

The thing I'm wondering if if the treatment WITH or WITHOUT surgery is really different up to the point where you would have the jaw surgery? If its the same bracer treatment beforehand, that means I don't have to make the decision before starting the whole treatment and taking the step to start it all will be much easier. Then again if I am that far ahead already, I guess taking a risk and feeling like crap for a couple of weeks is worth it since I'll benefit from it for the whole long life I plan to still have ahead of me.

Unless you are fortunate and money is no object, I strongly suggest that you have insurance pay for your surgery, if that is the option you choose. That said, I know Aetna warns that they may refuse coverage if you begin orthodontic treatment prior to submitting paperwork for pre-approval for surgery. I'm not sure about other insurance companies, but I would perform some due diligence to ensure that you dot your "i"'s and cross your "t"'s prior to beginning any treatment with respect to filling out and submitting all the required forms - in the RIGHT timeframe.

Also, after having jaw surgery, how long does your orthodontist you still have to wear your braces? The one I had a consult from told me its 1 year braces, then surgery, then another year of braces, I wonder if its the same with your situation.

I was told in the beginning that it would be another 6 to 8 months in braces after surgery. However, my dentist, who is working closely with my orthodontist, is a bit more optimistic.

[I love my teeth]

Trigger-

I totally get avoiding surgery!! I was 22 and the dentist and OD both said braces and lower jaw surgery (wired shut--it was the early 1990's!!) I said no way!! I was getting married--then I was too busy--then we were buying a house--then we were having a kid-----then another----everytime I switched dentists I heard the same thing, I said no, no, no!! Then last year we moved to Vancouver BC (we are from the US)--I am no longer working and my youngest was turning 5--so I said OK, I 'll go have it looked at again.....and here I am 7months in braces and awaiting the surgery---not one thing changed from when I was 22, except the time frame in braces is longer because my teeth are worse!!

So, I get you, I really do--hindsight is 20/20--I wish I did it at 22--It would have been done before I got married and I wouldn't be here today! But you need to do what is right for you----cosmetically it didn't bother me then---and didn't now. but I could see it was getting worse, and I feared for myself at 50 and 60, ect.....so, I really decided to do it for functional reasons, as opposed to cosmetic.........if you arehaving some self esteem issues now, and aren't happy with your appearance, just do it now, get it over with and by the time you are 25 you will have forgotten all about it! And then then you are 35 it will totally be a thing of your past!!

good luck!

[trigger1901]

I can't answer your first question. But would you really want to commit to having to wear a retainer for the rest of your life?

After some thinking I decided its not worth it to have to wear a retainer for life, should that option be presented. I find it very daunting to consider wearing bracers for 2 years and having jaw surgery in between, but I'm sure that after wearing my bracers for a year I'll be used to them, and I won't mind wearing them for another year too much if that means I'll benefit from it for my whole lifetime.

Trigger-

I totally get avoiding surgery!! I was 22 and the dentist and OD both said braces and lower jaw surgery (wired shut--it was the early 1990's!!) I said no way!! I was getting married--then I was too busy--then we were buying a house--then we were having a kid-----then another----everytime I switched dentists I heard the same thing, I said no, no, no!! Then last year we moved to Vancouver BC (we are from the US)--I am no longer working and my youngest was turning 5--so I said OK, I 'll go have it looked at again.....and here I am 7months in braces and awaiting the surgery---not one thing changed from when I was 22, except the time frame in braces is longer because my teeth are worse!!

So, I get you, I really do--hindsight is 20/20--I wish I did it at 22--It would have been done before I got married and I wouldn't be here today! But you need to do what is right for you----cosmetically it didn't bother me then---and didn't now. but I could see it was getting worse, and I feared for myself at 50 and 60, ect.....so, I really decided to do it for functional reasons, as opposed to cosmetic.........if you arehaving some self esteem issues now, and aren't happy with your appearance, just do it now, get it over with and by the time you are 25 you will have forgotten all about it! And then then you are 35 it will totally be a thing of your past!!

good luck!

I guess I should be glad that I'm really bothered by my teeth right now, and not 10/15 years from now when things could get considerably worse. I would still opt out of surgery if there's a way to prevent my overjet comes back but after hearing what theKurp had to say about the subject I think I really need the jaw surgery just so my teeth can hold eachother in place instead of overlapping all the time.
I'm terribly excited for my second consult and I really can't wait to get the process started as soon as possible, this stuff is on my mind way too much lately.
By the way is there any estimation on when you will need to do jaw surgery or do you still have to wait to see how things progress?

[I love my teeth]

Yes, I was told multiple times without the surgery my overjet will come back......it was considerably worse than yours---I did start a story on here but haven't added to it in months "I Love my teeth's braces story" If you want to see before pics..........

My OD told me 12-15months after braces it will be time for surgery, then for me a total of 24-30months in braces...........my consults done 15years ago, was 18-24 months in braces, so time does matter! they straighten the teeth, fix everything as much as they can with the wires, powerchains ect, then surgery fixes the rest........I assume they want to advance the lower jaw as little as possible, but I don't know! I have resigned myself to surgery, as I am NOT going through all this for nothing----I want to lovely, functional bite/smile until the day I die!!

[queenofoverbite]

Hey. Your issues sound pretty similar to mine.

The ortho says I have my "real" bite and my "trained bite".

In my case, I have to have orthognathic surgery. Pretty common as I understand. It would be smart to have a consultation with your orthodontist to fix these issues.

A confusing bite will eventually lead to some big issues.