NHS UK surgery

[Schnapple]

Hello all,

I am just wondering whether anyone can clarify this situation for me and put my mind at ease.
Basically, I have been suffering with TMJ problems and associated functional symptoms for many years now. Orthodontics alone have not corrected this. I have been told that the possibility of my TMJ problems being solved may be unlikely and something that I have to live with, as many sufferers do. I will be having a better splint made for me soon when bracing is removed.
However, before orthodontic treatment I had an open bite which became worse over the years and interfered with eating, social situations, lack of mouth closing and sleeping was awkward. Orthodontic treatment has minimised the open bite through use of elastics but for the duration of 2 years in bracing, never once have I bited/chewed food through the front teeth in fear of making the open bite worse. (Always tore or cut food with a knife/fork e.g. sandwiches. Neither have I ever eaten chicken off a bone) I have been told that once bracing is removed soon, over time this open bite may gradually widen as it it facial bone structure and not teeth positioning that is causing it, and the only solution which is also long-term is surgery.

I have been told bracing is not a requirement before surgery as my teeth are already aligned after bracing of 2 years. Therefore, does anyone know if I did proceed ahead:

How long would the waiting time be before I get a surgery date? (Would I just be analysed/braced up/given surgery date?)
Is it worth it? (Judging from what is read above. I have heard that most of the time people have improvements from jaw surgery, rather than anything negative)
How much would the above case be related to functional/aesthetic in terms of weighting to be assessed for NHS surgery in the UK?

I am worried that I may be rejected due to a surgeon thinking that I am doing this purely for aesthetic reasons when it is interfering with my life. People have said comments such as, 'Why is your mouth always open?', 'Close your mouth', 'Why are you tearing/cutting such food?', 'Why can't you eat this?' and 'Your facial shape is long' etc. Obviously, these are comments coming from a third party and affecting me.

My mind if swaying towards surgery as after all that I have been through with 2 years of bracing, I cannot possibly live my life fearing that all the work will come undone due to bone structure, so the only long-term permanant solution would be forwards and to have this corrected.

Thanks all for your help

[Mart]

Hi Schnapple (are you german? just curious)
Giving what you have just said i think you would be perfectly eligible for NHS treatment, (i noticed you were form the uk) any malocclusion of a certain severity (whether it be open, under, or over bite) is available for free NHS surgery, giving the symptoms you described (difficulty eating etc) i think you would definitely be eligible for surgical intervening, any function correction will of-course hold a certain amount of aesthetic improvement, but this is perfectly fine, one improves the other, and they certainly wouldn't refuse treatment just because your intentions might be entirely, or partly, aesthetic. I'm in the process of treating an underbite, and although there are perfectly function reasons for the treatment, the biggest impingement of my concerns are the aesthetic results of my problem. (i don't think I'm alone on this)

The first person to contact should be your dentist. Only they have the power to refer you to an orthodontist. Strangely in the NHS system you are unable to refer yourself, so you must not skip this step. Go your dentist and tell them your concern, they will then refer you to the appropriate NHS orthodontic treatment centre where you will receive your brace and possibly surgical treatment for your overbite. I wish you all the best. Let me know how it goes!

Martin

edit: i just reread your post and realized that you have already received orthodontic treatment, i'd suggest that if this isn't improving your situation that you may need surgery. I'll leave this open for those who have received similar treatment, as i have a different problem as you and so will be of limited help.

[Emmauk]

Hi

Your orthodontist will know if you would qualify for sugery on the NHS if you are border line or he is un-sure he can refer you to a Maxillo facial surgeon who can talk more detail about the whys and what not, this would also be on the nhs unless your ortho outright says you wouldnt be eligable.

When i looked into this a couple of years ago i did find an article from the nhs online that gave measurement which enabled you to roughly work out how "serious" your problem is and therefore you can see if you would be entitled for treatment on the nhs.

I have an open bite which is severe, bracing alone will still leave me up to 12mm out which if i remember correctly put me in the worst case senario when i found this article.

If you are unsure if its the right thing to do try and go and see a surgeon who can put it into perspective for you and help you decide if you would get out of it what you need.

[crazybeautiful]

I just found the 'severity measurements' online:

http://www.bos.org.uk/orthodonticsandyo ... whatisiotn

Though don't just take this as is: the aesthetic concerns are just as important, and I imagine most surgeons/orthos do have enough wisdom to see this in patients who actually need the surgery.

And I can't tell you how worth it is

Consult your ortho, and good luck

BTW, may I ask what part of 'the north' you are from?

[canthandlethetooth]

Here's what I did for an overbite/recessive jaw

I paid for an appointment at Total Orthodontics. The orthodontist there measured me and referred me to the maxo department at a quite well renowed hospital and after a consult there I was put on the waiting list and have since had my surgery.

A couple of things you ought to know
Be prepared to wait for the NHS - they do things at their own speed but they do them well
Surgeons are NOT judgemental. If your measurements qualify for treatment a surgeon will not turn around and say that he won't treat you because there is an asthetic reason in your desire for surgery.

Good luck and all the best.

[Amanda6]

Hi Schnapple,

I also have TMJ dysfunction, and am currently having functional orthodontics in the UK to help correct it. Like you I also had extraction orthodontics as a child, which may be linked to the TMJ dysfunction which I now have. The functional orthodontics, which expands the upper arch using an ALF appliance, and also having a 24/7 lower splint for the duration of the orthodontics, is supposed to help correct the TMJ.
I'm concerned that you feel you need surgery to treat your problem, when functional orthodontics could help. Maybe your 2nd round of orthodontics wasn't functional orthodontics, so therefore hasn't addressed your TMJ.