How should I pursue this?

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#1 Post by **Schnapple** » Thu Apr 01, 2010 3:48 am

I have a misaligned jaw and an open bite. My face is very assymmetrical as one side if flatter with hardly any cheek. When I put two fingers into my ears and my thumbs on the corner of my jaw, the flatter side of my face I presume is the jaw that is approx 1 inch longer.
Basically I have had TMJ problems since I was 9, and further related problems in the following years such as neck, shoulder, rib and back pain. I am now 22.

I had braces for 1 year when I was 14 and by 17, the problems became noticeable and become worse. At 18, I received a splint which did nothing. I went back to my orthodontist last year and was told that due to growth, my bite had become worse. It has now been just over a year and the orthodontist has stated that he has done all that he can do (which is aligned the teeth), but the bite is still very off. He stated that in order to refer me to a jaw specialist at another clinic, I will need to have the braces off? (Is this correct and the right way to go about it?) I thought that even pre-surgery, they will wire the braces together so why would I need them removed?

I am also wondering, pre-surgery how long should you have your braces on for?

Can somebody tell me when I do finally see the jaw specialist, what will the procedure be/what will happen?

The orthodontist has described that I have not grown in a 'favourable' way and this is rather depressing.

#2 Post by **Schnapple** » Thu Apr 01, 2010 3:56 am

Basically, because I was past age 18 I had to pay for my orthodontic treatement the 2nd time around with my savings.

It just breaks my heart that once the braces are taken off, I will be back at square 1. During the time I had the braces put on approximately 1 year ago, I was very optimistic that things were finally changing and I was getting somewhere. But now, the thought of having my braces off 18 months to 2 years and then being referred to a jaw specialist scares me as I do not know what the next stages will be?

I guess I am worried the jaw specialist will make me live with the misaligned jaw and bad bite/facial appearance, and say that there is nothing he can do so live with it.

The one thing I really want is jaw surgery to correct the health problems/pain and appearance issues. Is this what I should be pushing for from day 1 with the jaw specialist? What will happen in the first appointment with the jaw specialist? By then, the orthondontist will have take my braces off and fitted retainers for me instead.

#3 Post by **revolutionary** » Fri Apr 02, 2010 12:16 am

Hey lady -

Don't stress it too hard. I would see the jaw specialist as soon as possible, and if you can, make an appointment with another one as well so you can get a second (well, third) opinion. I would make the appointment BEFORE you get the braces off.

I never had an orthodontist (I didn't have braces before my surgery, and my surgeon is doing all my post-op orthodontic work), but it seems to me like a lot of people really go through the wringer with them. It seems I just got lucky, and that the norm is about 1-2 years of braces before surgery, but it REALLY really depends on your situation, and again I strongly urge you to see a jaw specialist *before* you get the braces removed. A good oral surgeon with know about BOTH orthodontics and jaw surgery, and generally speaking, oral surgeons are more experienced and qualified than orthodontists.

I highly doubt your case is hopeless and that you'd be turned away by a good surgeon, and I think that you should definitely make it a point to bring up the pain as well as aesthetic problems. I'm sure they'd be able to do something more. Orthodontists just aren't really qualified to prep you for surgery without actually consulting with a surgeon - just, as you said, to align your teeth properly, and then, *WITH the surgeon's guidance*, align your teeth for surgery.

#4 Post by **suzyscientist** » Fri Apr 02, 2010 1:02 pm

Hi Schapple,

First - I notice you're in the UK. Do you have an NHS dentist? If so, ask him/her to refer you to an NHS orthodontist because of your bite. You could try your GP too. They will arrange a consultation with a surgeon and an orthodontist. I'm over 18 too (28) but got referred because of my bite, not my appearance or teeth straightness or anything. And, my bite doesn't sound half as bad as yours!

I haven't dealt with private orthos before so I don't know what the rules are about taking braces off, but it doesn't make sense to me, especially if the surgeon will work with the ortho to do treat you. Ditto what Revolutionary said - I would try and see a jaw specialist asap while you're still wearing your braces. They will be very experienced in this kind of thing.

It sounds like you are really troubled with this so you really have to push it with your dentist/ GP. There's no reason to suffer.

Good luck and keep your spirits up!

Suzy

#5 Post by **dvdrdiscs** » Fri Apr 02, 2010 6:41 pm

Sounds like you're describing my asymmetry. That was one of the issues I brought up with the surgeon when I first saw him, whether the jaw being unleveled will be fixed. He basically said no because the way they make the compound fracture, it's not going to change the levels of the jaw. Typically the surgeon will make a vertical fracture behind your last molar and shift the jaw accordingly. You can kind of picture how this would not solve the leveling issue.