UK newbie seeking advice on possible jaw surgery

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#1 Post by **dentalguy** » Fri May 01, 2009 4:11 pm

Hi, first time post here.

Iâ€™m in the UK and am looking for some advice on getting something done with my jaws/teeth. To describe the state of my bite, Iâ€™d have to say that my upper dental arch seems to be too narrow towards the front while the lower seems too big in all directions. This means that my upper teeth at the front of my mouth sit on top of their counterparts below (I wonder if my lower jaw has grown downwards to accommodate this?!) To my mind this seems to contrast with whatâ€™s normal for other people where, at the front of the mouth, the top teeth come down over those below; the incisors of both arches overlap with those on the bottom being behind.

Iâ€™m not sure if Iâ€™ve got this right but isnâ€™t the upper dental arch meant to be bigger than the one on your bottom jaw? If thatâ€™s so, then my mouth seems to be at odds with this as my lower arch is about the same size as the one above. For that matter, if you look at where my teeth come out of their gums the bottom setâ€™s probably slightly bigger.

I donâ€™t know, but the orthodontic work I had done in my teens might have contributed to this. I had some top teeth extracted and wore train track braces in my mid to late teens. Prior to this, in childhood and early adolescence, I had a fairly average bite where my front teeth came down over those below. The NHS orthodontist treating me mentioned that this change in my bite couldnâ€™t really be corrected without doing something with my jaws. However, I didnâ€™t enquire further about this at the time as he gave the impression that it really wasnâ€™t something he would take forward. I should add too that I attended my orthodontic treatments poorly, my brace broke several times and I ended up getting it off without then using retainers. Needless to say my teeth arenâ€™t great.

Iâ€™ve taken some photos â€“ they arenâ€™t great â€“ of my teeth hopefully to give you a clearer idea than the waffle above does of my situation. I should point out that Iâ€™m not grimacing in some of them because of a facial tick or anything, itâ€™s just that I was trying to pull my lips back to reveal my bite. Oh, and Iâ€™ve blanked out my eyes as that seems to be required in the posting rules (or at least that you donâ€™t show your entire face).

Final point: if I bite my teeth together they do seem to meet towards the back but if I relax my lower jaw slips forward a bit. Iâ€™ve done this in some of the shots as Iâ€™m concerned that my â€˜clenchedâ€™ bite is a little strained and unnatural. Ps. darkening the room and using the flash to illuminate right into my mouth probably makes my teeth seem, er, yellower than they actually are, er... the rest of the horror show's authentic

#2 Post by **TinaAH** » Fri May 01, 2009 4:52 pm

Wow. Your teeth actually look eerily almost exactly like mine did pre-op. Coincidentally, I also had braces as a pre-teen and feel that they caused some weirdness later on (I'm 42 years old now and just had surgery 2 weeks ago).

I think braces and surgery would definitely sort a lot of that out for you. Its not something to enter into lightly though. It changes the appearance of your face and it is a somewhat major surgery. So, you'd obviously want to consider how important this is to you. For me, I had gone about 30 years being dreadfully embarrassed by my teeth and smile. I don't regret my decision and even with my post-op gap (which is to be corrected in a few weeks with braces again) - I am so glad I had it done.

--Tina

#3 Post by **Saffie** » Sat May 02, 2009 10:27 am

You might as well ask for a consultation. From what I've read here, NHS waiting times can be anything from a couple of months to two years to start treatment, so you'll have plenty of time to think it over, and getting an opinion doesn't necessarily mean you have to have the treatment. The advice I got from the orthodontist who said I should consider surgery was that unless the very thought of it made me want to run screaming in the opposite direction, then I should go to see the surgeon and get more information.

#4 Post by **dentalguy** » Sat May 02, 2009 3:27 pm

Hi Saffie. Who do you ask for a consultation anyway. Is it the nearest NHS orthodontist? Or do you have to be referred to them by your local dentist? I wonder what sort of treatment the NHS covers anyway.

Hi Tina. Wow, that is spooky... you having nearly the same teeth problems to begin with. I'm very interested to know what you had done as it might parallel what I'm looking ahead to. I take it you had jaw surgery but what form did it take?

#5 Post by **TinaAH** » Sat May 02, 2009 5:04 pm

Hi,

I've had braces since August 2008 (and also a botched attempt wayyy back in 1982-ish, when I was a kid). The recent braces focused on getting my teeth to lean "out" more and line up better.

I then had my top jaw widened 2 weeks ago and my front teeth realigned (not sure what the name of the surgery is), which has made a huge difference already. I have to keep on with my braces for another several months, once my jaw is healed (probably in about 6 weeks post-op) because the surgery makes your top jaw widened so they don't meet your bottom teeth anymore - and gives you a slight gap between your top front teeth. Its all part of the process...which will result in what I hope will be a most excellent smile!

--Tina

#6 Post by **TinaAH** » Sat May 02, 2009 5:08 pm

By the way...when you hear "top jaw surgery" it sounds way more traumatic and painful than it really is. Your top jaw actually heals faster than a lower jaw surgery because your top jaw doesn't get the pressure and hard work that your lower jaw does.

I can honestly say that the only real pain I've had was the day of the surgery, right after, the bridge of my nose hurt like a bad sinus headache. After that, Tylenol and prescription Vicodin (not at the same time!) took care of any pain I had.

--Tina

#7 Post by **dentalguy** » Fri May 08, 2009 12:58 pm

Tina, (sorry for taking a week to get back) when you have surgery to widen your top jaw does it affect any of the facial features just above the mouth? I'm asking because I saw this clip on youtube of a guy who had his palate enlarged and it seemed to cause his nose to widen. However, he was probably a severe case as he said there'd been a lot of movement.

Am I right in thinking that you went for an operation called a sarpe? Although it's probably fairly minor when you think of everything, one thing that's on my mind about the whole jaw surgery 'experience' is the amount of time it takes to heal - or at least until you're half way able to function again. I mean, how soon can you usually expect to get back to work - provided your day job doesn't involve opera singing or something - after undergoing palate work?

Sorry about all the questions but this is all new to me.

#8 Post by **crazybeautiful** » Fri May 08, 2009 1:16 pm

Hey dentalguy- I had SARPE too (or SARME, as I know it). One thing that changed was my nostrils- they got a little bit bigger. Though I expanded 10mm so it was quite a large expansion. They put in a certain type stitch below the nose to stop the area from noticeably widening, however. It has a name, but I really cannot remember it, sorry!

In terms of healing and eating, I was pretty much ok after a few days. Recovery varies, and some people don't feel they can eat normally for a while. For me, I was very swollen, but I was eating pretty much 100% normally after about 3 or 4 days. The anaesthesia and medication took it out of me the most, and in the end I took 3 weeks off. On the flip side, some people are fine after little more than a week. So let's say 2 weeks is the estimated recover time

#9 Post by **crazybeautiful** » Fri May 08, 2009 1:19 pm

* just to add, as there is no edit function:

From the look of your top jaw it doesn't seem so narrow as for major facial changes to occur. So don't worry too much about this aspect- any changes will look natural, and of course it's all for the better anyway.

Also, compared to what my teeth were like 17 months ago, your teeth look bloody great!

#10 Post by **dentalguy** » Fri May 08, 2009 1:26 pm

Hi, crazybeautiful. Yeah, I think that guy's - in the youtube clips - nostril widened noticeably because he had a huge amount of movement in his upper jaw. It seemed to be very much smaller than his lower jaw before he started the whole procedure.

Two weeks doesn't sound too bad for a recovery period. I suppose it's a good deal longer if you have work on the lower jaw.

Do you find you have more room for your tongue when you eat or talk now as a result of a wider palate?