refusing surgery for an open bite and crossbite

[Anna5]

Hello boodles8,

Thanks for your message. I am almost 40 years old. Jaw clicking has never been a problem (only when I opened my mouth very wide you could hear a click, but I never did this) for me, despite having this bite for over 20 years now. The jaw clicking started when I got braces last year.
My ortho referred me to a jaw fysiotherapist and that helped quite a bit. The fysiotherapist told me that that I didn't open my mouth symmetrically (shifting my lower jaw too much to the left and to the right when I open my mouth). Now that I try to take care of this, the jaw clicking has become less, but is is still there. He also told me to avoid 'playing' with my teeth and jaw (as I did a lot, and I heard that many people in braces do so), for example don't clicking my jaws on purpose, that makes things much worse.
So, I am not sure whether the jaw clicking is caused by my bite or whether it is a temporary problem caused by the braces. I hope the surgeon can find out. I am very worried about the clicking and I want to do everything to keep my jaw joints healthy and to avoid further, bigger, problems , even if it means surgery.....

How are you doing now? Does your jaw not click any more after surgery?

[boodles8]

By all means ask the surgeon if he thinks it's a permanent problem. Personally, I doubt whether he could possibly know for sure. I think only time would tell. But maybe they have more foresight than I give them credit for. They've certainly studied a lot.

I'm doing much better now. I no longer have clicking unless I move my jaw asymmetrically. Basically, it used to have no other option. I also don't have pain on a regular basis, though my joints will still act up. They will tolerate a lot more before they act up, though, and I'm still learning where my new limit is. At least it's a predictable limit, versus the unpredicatability of the pain before. I've been happily splintless for months now, ever since surgery--technically only since the surgery splint came out. I really think if I had done this back in college, I would have no limits now.

I wish you wisdom as you decide between these hard choices.

[Anna5]

Hello!

Good to hear that you are doing better!

I had an appointment with the surgeon today and he said I don't need surgery! He think my malformation/malloclusion is too small to talke the risk of surgery and he is confident that my ortho can give me a good bite with braces only. He also said that surgery not always takes away TMJ problems (as was common thought in the past), but may as well cause it.
He expects the jaw clicking to get better when my braces are getting off. Sometimes jaw clicking gets worse with braces (my case) and then it will get better as soon as they are off. Anyway, I will go back to the surgeon after my braces are off and then we will see if there is still something that needed to be done to protect my jaw joints, eg another referral to the jaw fysiotherapist to make sure that I open my mouth symmetrically.

[headbanggg]

It was good to hear that you don't need surgery. Im so happy for you How long are you expected to be in braces? Your teeth look pretty good already .

[Anna5]

Thank you, headbanggg. I know I should be happy, but I am still a bit worried whether I will get a good result without surgery... But I think I should trust my ortho now.
I am expected to be in braces for another 6 months (ortho), but I expect a bit longer.
How are you going with your treatment?

[impec]

[quote="playmaker7206"]First 3 orthos recommended surgery. They did not have much experience with TAD's, and doctors will do what makes them comfortable. The ortho I selected immediately went into his patient files at the initial consult and started pulling up photos of HIS patients he had treated with open bites. None of them had surgery, and all of them had full occlusion of their bite at the end of treatment. The photos were amazing, and the fact they were his patients made me feel very comfortable. This ortho explained that the use of TAD's was developed by the Koreans. This ortho was previously in the Air Force and chief of Orthodontics at Misawa Air Force Base in Japan. In Asia, some of the orthos can get up to 9mm of closure using Skeletal Anchorage Systems which is far more invasive than TADs, but less invasive of a LeForte.[/quote]



Wow... could you PM me the name of that ortho ? That's rxactly what I'm looking for.