Metal Mouth Message Board

After consultations with a couple different orthodontists, I've been told best case scenario to close my anterior open bite would be oral surgery. Where I'm located there is no surgeon and I'd have to travel hundreds of miles.

Anyway, the ortho I've chosen mentioned that TADs (temorary anchorage devices) have shown some promising results in recent years and it could be an option for me if I didnt want to have surgery.

Thinking about oral surgery gives me anxiety and while I know everyone on this board has gone thru it or is gong to do it, I'd like to know if this was an option to you (for open bite) and why you chose not to do it(or to do it if you did.

My orthodontist recommended I have surgery to correct my fairly severe anterior open bite, but because of a blood clotting disorder I have, surgery is not a good option for me. He said he could try to fix the bite with TADS, but that he would not rule out surgery altogether. That was about two years ago. I've been in braces for about 18 months (after wearing a splint for six months) and had the TADS implanted about 3 months ago. The results to date have been absolutely astonishing. My bite has corrected far more than my doctor thought it would and he now thinks that we will be able to "perfect" my bite. The TADS were infinitely less invasive than surgery, and far less expensive. I would recommend anyone having the option available try the TADS method.

Hey, I really appreciate your response. I have done a little research and seen some really great things done with TADs for open bite. I know on these boards there were some not so great stories but if this is an option for me I think I will go for it. Do you have any pics you can post of your progress?

I've got a before picture (not with me today) but I'll see if I can get my husband to take one as I look now. It's truly been life-changing. For the first time ever I can bite through food with my front teeth. I don't think anyone can know what that's like unless they've been through it. I have always used my tongue against my front teeth to bite stuff like spaghetti (which, of course, only exacerbated the open bite). The weird thing is I never even knew I had an open bite until a couple of years ago. I just never gave it any thought. Now I look at pictures and think "how did I not notice that there's a gaping hole in my smile?" Anyway, my orthodontist rocks - he's a teaching doctor, and he's very excited about my case since, as you know, the technology is fairly new. FYI - they were originally going to implant the TADs on the top and bottom, but at the last minute my doc told me that the research was showing a large percentage of failures on the lower TADs (screws coming out), so he opted to only do the top, and we're still having great success. You might mention that to your ortho if he's thinking of using top & bottom. I'll try to get the pics posted in the next day or so. Keep up the good spirits!

Okay, I'm going to try to post the photos, but I'm not sure I'm doing this right. If they don't show up here, you can e-mail me and I'll send them to you (mlh71_2000@yahoo.com). (I likewise apologize if they're super-huge . . .)

This one should be the photo of me before treatment (I'm biting down all the way in the photo - this is as close as my front teeth got to each other before treatment):



This one is the way my mouth looks right now (I took the elastics out for the photo):


And, this one's hard to see, but it's a picture of the screws implanted in the roof of my mouth. I have two screws in my upper palate, and two on the outer gums opposite the screws in the roof of my mouth. They're connected by a powerchain that applies pressure to the molars and the wires, causing the molars to intrude into my jaw, which lets my bite close more.


Keep in mind that i've only had the TADs since Thanksgiving, so I've still got a lot of moving to do. And there's blue glue on my teeth that you can see in the last photo which prevents me from biting down all the way (the glue keeps the chain from slipping in between the molars and rubbing on the gum which is really painful).

Having the screws implanted was not painful at all - much easier than getting a wire changed, but for the next 4-5 days after that my mouth was super painful. I had swelling around the screws, and I had to wait for the calluses to develop on the insides of my cheeks to accommodate the outer screws. However, once that was done, the rest of it was a cakewalk. Now I get new powerchains every two weeks, and every visit the entire orthodontist staff oohs and aahs at my amazing progress. I'm so thrilled I went this route. Hopefully you will have a similar story.

Misty! Your results are amazing! All that progress is just from November? I am really encouraged by reading your story. My bite looks very similar to how yours was. I plan on posting pictures once I get braced. I have an appointment in a couple weeks to set a date to put on the braces (I feel like this whole process is moving so slow). I plan on telling him that I want to go with the TADs rather than surgery. Did you have a tongue thrust or know what caused your open bite?

I totally understand using your tongue to help with biting. It's something I consider normal which is crazy to everyone else.
congratulations on your progress!

Yes, I had (have?) a tongue thrust habit. Isn't it funny how you can have such a strange habit your whole life and never even know it? I used to deal with stress by not only clenching my teeth, but I would actually push on the back of my top front teeth with my tongue. I can't tell you how many times I've woken up with loose front teeth from pushing on them all night long. I've been seeing an orofacial myologist for two years now to try to "retrain" my tongue. I've had to learn to eat and drink differently, and how to cope with stress a little differently. I think my bite started to correct a little with just the braces, but once they put the TADs in, things really got going. I'm really pleased with the progress. Now, unfortunately, I'm getting really anxious to be done. I think I probably have several months left in braces, but I also know that the end is getting closer every day. How exciting for you, though, that you have this great alternative to surgery. I hope it works as well for you as it has for me. I know not every case goes great, but I'll keep my fingers crossed for you.

I had the bolllard type bone anchors (similar to Clo's on this site) implanted on Feb 4 and they were loaded yesterday during my ortho visit. They have been seeing great results with the TADs as well with one patient's bite closing completely within a month! They said that typically they can see up to 1mm movement in the rear which equals 2mm up front each month that force is applied. Instead of elastics I have wires attaching the anchors to my braces. Since it is a teaching hospital they are experimenting with different ways of attachment. I am very excited to see how my open bite changes and will try to report on my progress.

Yeah, my next appointment is next week and I am hoping that my otrho is as excited for TADs as I have become.

luckeesmom: good luck on your treatmeant! I look forward to seeing your and Misty71s progress. I hope to start my pictures next week...

Hey, Milliondollar - how did your last appointment go? Is your doctor going to recommend TADS or surgery?

I'm kind of in a holding pattern right now. My midline is off and is being very stubborn, so we'll see how long that takes to correct. Grrrr.

Hey Misty,

My last appt went well. I've been really stressed out about everything but he said we can go with the TADs. I actually just had my wisdoms and 4 other teeth pulled today and I'm home recovering. Once this heals up the process will get started. The Dr. wants me to be in braces for at least 6 months before he puts in the TADs. How far into treatment did you get yours?

I just read you were in braces for about 15 months before you had yours in. I should re-read posts before I write hehe

I am 6 months into my TAD treatment for anterior open bite. My upper molars have intruded all the way up to the TAD itself but my bite is horrible right now. My open bite is signficantly worse and the occlusion is pretty far off at this point. My orthodontist thinks he may need to place TADS on the lower jaw to intrude those molars also. Any of you experience this during treatment???

Braced 6/2008, TAD's 2/2009 and they were loaded in 3/09. I've had a lot of movement and good results and hope to finish up this coming spring/summer. My upper back teeth (7's) have not intruded as much as needed but my ortho believes that is due to the anti-tip device being only attached at the 6's. Next time I go they will put a new one in that hooks to both the 6's and 7's and that should close the bite completely.

I am very happy with the results and the TAD's have been relatively painless although it has been a bit of a trial and error to get the right intrusion because the TAD's can only be fit where there is bone density to support them. This means that my ortho has had to find creative ways to attach to them to get the force directed in a way that creates the movement they need and the constant force required.

Wow luckeeesmom...your case sounds a lot like mine! My 7s aren't intruding as much but also the bicuspids had started flaring so they put buttons on the linguals of the 6s and 7s and 4s and attached coils up to the palatal TADS to bring them back in. I also don't have much more room to move the TADS up so they are moving brackets and doing other creative things to continue the intrusion. The flaring is what has mainly caused my bite to be so off...which is making my bite much more open right now. I've only had lower braces for 3 months and uppers for 7. Sounds like you had braces for a while before TADS. My were placed 10 months ago and loaded immediately. Have had 2 replaced also. Hoping the molars align soon!