New here: ?s -- Fees/Scottsdale/Dr. Arnett

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#1 Post by **Round2inAZ** » Mon May 26, 2008 12:46 am

Greetings all,

This is my first post here. I really appreciate the great info on this site and forum!

I'm 45 and have had braces TWICE, so if I go for round 3 my username will have to be changed!

Long story short: My problem is more cosmetic than functional (although I have minor TMJ click on one side and never close down on the back teeth when relaxed), so insurance will not cover it. Also, as a result of prior braces some of the occlusion is "textbook," although I have facial asymmetry, an overjet, and retrognathia.

I saw "the best" oral surgeon in Tucson, and he says that I need both jaws done. Also I will need a genioplasty. Since I work for the hospital where he is on staff (and get an employee discount) and he charges $4,000 per jaw, that is affordable for me. However, his practice is geared more toward functional correction so he won't be doing the surgery. He gave me three names in the Scottsdale area of surgeons who might do it, so I will be venturing there to consult them. I have no idea if they will do it or what their fees are.

Dr. Arnett in Santa Barbara does beautiful work, and both my probable future orthod and the OS rave about him. But, my OS says that Arnett's fees are $15,000 per jaw. YIKES!! Can anyone confirm this?

Also, is there any way that a patient like me (cosmetic and self pay) can get into some type of research study? Or find a surgeon who does work at reduced fees? How does one go about locating these a "pro bono" surgeon?

adTHANKSvance for your help!!

#2 Post by **Round2inAZ** » Mon May 26, 2008 1:42 am

Thanks for your reply. And for the warm welcome.

It's good to know that there are so many satisified patients here. Perhaps someone who had their surgery in the Scottsdale area can provide me with the name of their doc so I can add them to the list of prospective OSs; I'd particularly like to hear from those who had more of a cosmetic correction, as I will be having.

Thanks!

#3 Post by **Arvensis** » Mon May 26, 2008 8:07 am

Wait, did I miss something here?

Your problem is cosmetic, not functional, correct? That's where the facial assymetry/overjet/retrognathia come in right? And these were not considered functional issues enough for the guy in Tuscon so he's decided he would not be the one to do the surgery? I thought overjets were by default functional, how do you have a textbook occlusion with one? Am I correct in assuming that the surgeons who "might" do it are skeptical on performing surgery because the issue is cosmetic not functional? Am I the only one who gets a bit nervous on the "why" factor when doctors start refusing to do elective surgery procedures?

Keep in mind that the majority of us here had functional issues not cosmetic, also, and would never have considered something drastic like surgery if we'd been able to chew in advance. You live with a lot of changes and recovery time without complaint if you're doing it to be able to take bites out of sandwiches for the first time in your life instead of to improve the jaw line.

As for research studies, I doubt there are many for people without functional issues, as I've never heard of any for people with functional issues

#4 Post by **Arvensis** » Mon May 26, 2008 4:28 pm

Meryaten wrote:Well, I for one don't consider an overjet caused by retrognathia to be merely cosmetic. OK so he's the dental pro, not me, but ... odd chap, that OS.

Exactly my confusion!!

#5 Post by **fromjersey** » Mon May 26, 2008 5:43 pm

Me too-- confusion! I think overjet, TMJ click, malocclusion back teeth, retrognathia are all functional. And if form follows function, all those are more than cosmetic.
Helen

#6 Post by **Round2inAZ** » Mon May 26, 2008 9:09 pm

It seems that we have an interesting discussion going here. Thanks for your replies.

All I can tell you that he is the second oral surgeon to look at my situation and proclaim that it is "merely cosmetic." The first was "the guy" in Knoxville, TN -- a DMD at UT Medical Center-Knoxville. He said EXACTLY the same thing as this guy.

This is what one orthodontic consultation (not the one who will be treating) report says:

Facial Form

* Mandibular retrusion giving a convex facial profile
* Left/right asymmetry of the face
* Good facial balance in height (this is BS -- my facial height is imbalanced, with the upper 2/3 of my face fine but the lower 1/3 being too "short")
* Lips close comfortably without strain

Dental Relationships

* Permanent dentition
* Class II Division I malocclusion -- 6 mm
* Moderately Deep Overbite -- 60%
* Moderately increased Overjet -- 3-5 mm
* Adequate space for aligning the maxillary arch
* Moderate crowding of the mandibular arch
* Maxillary dental midline is displaced to the right ("1 to 2 mm")
* Left TMJ click

Unfortunately this is all I have right now. The only Cephalometric Analysis that I have is dated (1989), but I'm calling the prospective orthod to make an appointment for a current one.

Meanwhile, if the above "means anything" to you guys, I would appreciate some feeback. Thanks!

#7 Post by **Arvensis** » Mon May 26, 2008 9:46 pm

I wonder if this means that your bite could be corrected by just braces or something like that, hence why the jaw changes are cosmetic despite the asymmetry?

Meryeten, come on in with your big bad terminology self;)

#8 Post by **Round2inAZ** » Mon May 26, 2008 9:57 pm

Well my occlusion is actually pretty good. I should probably clarify that I an *able* to bite down on the back teeth, but I just never do. While in a normal, relaxed position I am biting in the front but not the back -- it's just not comfortable. This wasn't even noticed by me unitl the orthodontist said something about it during examination! He asked me to hold it, and after about 30 seconds it was just too tiring.

Looking at the report, some aspects are obviously cosmetic (e.g., "moderate crowding on the mandibular arch" [crooked/crowded front lowers], and "maxillary dental midline is displaced to the right" [midline is off-center] ), but if there is anyone here with any technical training and expertise please chime in here. We welcome your comments!

One thing that I found interesting is that my overjet is up to 5 mm, and I was just reading another poster's story who says that theirs is pretty bad and requires attention at 6 mm. ??

#9 Post by **Round2inAZ** » Mon May 26, 2008 11:17 pm

Hi Aventis,

Arvensis wrote: Keep in mind that the majority of us here had functional issues not cosmetic, also, and would never have considered something drastic like surgery if we'd been able to chew in advance. You live with a lot of changes and recovery time without complaint if you're doing it to be able to take bites out of sandwiches for the first time in your life instead of to improve the jaw line.

Yes, I have read quite a bit on here and am aware of that. I am also aware, however, that many patients undergo these procedures for the aesthetic results. Just last night I read a poll of orthognathic patients which indicated that 40% sought treatment for cosmetic reasons. Not only have I researched the procedures, I work in an acute care setting at a university teaching hospital -- so am fully aware of what is involved. In addition, I have undergone my own painful cosmetic surgical procedures in the past (three rhinoplasties, braces twice) so know the drill. No pain, no gain. But thanks for pointing it out.

As for research studies, I doubt there are many for people without functional issues, as I've never heard of any for people with functional issues

You're probably right there. That was my desperation talking -- insurance won't cover it, and this will be a huge expense. Then again, the Wolfords, Arnetts, and Posnicks of the world have to train on somebody.

Have a good night!