Metal Mouth Message Board

Hi, I'm a 17 year old male, and I have a problem (as do most people on this forum ).

Anyways, I never had braces or any orthodontic work really, but recently I looked into the mirror and noticed a few things:

- My lower teeth are starting to become crowded and are turning+twisting slowly
- My upper front teeth are slanted and pushed out
- Recessed lower jaw
- My lower lip covers my upper teeth (think about it, it's really weird )
- Extremely narrow face
- Flat cheeks
- Overjet


When I was younger, my orthodontist said I might need braces but my teeth aren't that bad so I probably don't need them. She never gave me them. After looking in the mirror I did some research.

I figured out I have something called "long face syndrome." The symptoms I described describe exactly that.

Also, these are other things I have, which I found associated with long face syndrome:

- I feel like I don't have enough room for my tongue so it pushes my upper front teeth out
- I find it harder to breathe through my nose so I've been a mouth breather my whole life
- Bruxism (this is a pain in the ***)

I figured out the main cause of my long face syndrome was mouth breathing. So recently, I've tried breathing through my nose more often, especially when I sleep; however, I usually wake up with a sore throat and obvious signs that I've been breathing through my mouth again (which is probably why I snore and might be developing sleep apnea just like my father).

When I was younger my jaw used to click a lot, but over time the clicking disappeared. I guess TMJ was another sign of Long Face Syndrome, but I learned that over time the joints become like "plastic" and may stop clicking, even though TMJ is still there. I don't know if this is true or not.

So after learning about these problems, I took another look at myself.

I have narrow upper and lower jaws, which may explain why my teeth are crowding.
My upper jaw is very long, and pushes down very far enough to push my lower jaw back, to a point where I feel like it might be obstructing my airway, which also explains why my lower lip covers my upper teeth.
The angle of my Jaw causes my Bruxism and tongue thrusting.

So after figuring all this out, I look at treatment options. It said online that I need to do these things:

1) Get braces to get my teeth ready for surgery.
2) Get SARPE and RME procedures because my palates already closed and can't be expanded through functional orthotics.
3) Wear braces and expanders while getting ready for Orthognathic Surgery.
4) Get Orthognatic Surgery - something called LeFort and sliding my jaw or something. I have no idea what it's called.
5) Braces again.


Now I've scheduled an appointment with my Orthodontist in a month and I have a few questions.

1) How do I explain to her what I have? Should I say "long face syndrome" or what? I don't wanna sound like an idiot, but I don't wanna sound like a smart*** either. I want my orthodontist to know everything and not think I'm doing this for cosmetic reasons.

2) What's the best way to present all this information without sounding like I'm doing this for cosmetic reasons?

3) According to what I wrote, would you say my case is bad enough to be covered by insurance for medical reasons? I'm 17, and I'd really like to get this fixed at a young age.

4) Is surgery the best option? I think I have Medicaid. Will orthognatic surgery be covered?

5) Would you recommend me going to a Maxillofacial Specialist or just wait until I go to my ortho?


I'm gonna have to get this fixed sooner or later, because I heard the long term consequences of Long Face Syndrome are worse.

Thanks for bearing with me. If I forgot to add anything, I'll either edit this post or discuss it later.

Usually LFS patients have either an open bite or overjet( or both). I dont understand how your upper teeth would be covered by your lower lip in that case.

If anything it sounds like whatever the opposite of long face syndrome is. Are your lips naturally closed at rest?

It would be easier to help with a pic.

My upper teeth are covered by my lower lip because my upper jaw grew too far downward, pushing my lower jaw back. I might have explained it wrong. If i close my bite, my teeth meet a bit below my lower lip (I can bite the inside of my lower lip).

I have an overjet and a slight open bite, and at rest, my lips are open. I usually leave them open until I realize that they're open, and then close them (and then the cycle repeats).
Sorry about the pics. I'll try to get some later.

Hi!

Just noticed you posted this in April-- any update with the orthodontist?

I JUST met with an ortho today-- I think I have some similar symptoms with you, but I have a bad open bite. I've never heard of Long Face Syndrome but it seems I have that, too!

Like you, I thought my tongue pushed out my teeth (cause I don't suck my thumb), but the ortho suggested it could just be the jaw growth.
Basically, he said my upper jaw is too long, pushed down on my lower jaw, and a whole bunch of scary and depressing things.

He suggested that I get jaw surgery which I honestly am terrified by (for the procedure itself and the cost!).

Any updates you have would be greatly appreciated!!

My ortho didn't care and sent me off, telling me to buy a night guard for my teeth. I went to my family physician and mentioned how my jaw cracks and she sent me to get a MRI. The MRI proved mild dislocation and now I have an appointment with an oral surgeon. I'm hoping for surgery to help fix this problem for good though.

Sorry for the late reply. I was on vacation.

i have long face syndrome and my lower lip covers my upper teeth (even though I have an over jet). This is common in LFS patients as you mentioned, the upper jaw becomes underdeveloped through mouth breathing etc and is too far back (obstructing the airway, constricting the tongue etc).
My surgeon is planning to move my upper jaw up and forwards, allowing my lower jaw to close more and my airway to open wider, He will also set my lower jaw back a bit.
If your ortho or facial surgeon isn't helpful, keep pushing. Don't take no for answer! Try another dentist if you have to, It's your life. A lot of dentists don't know much about surgery and dismiss the idea. You need to find professionals that have worked with surgeons before and who understand the diagnostics behind choosing surgery. It sounds like anyone who 'gets' it will recommend you for surgery.
Good luck! Keep us posted!!

Thanks beetle!

Well I visited the Oral Surgeon and he stated that with mild displacement of my jaw joint, it isn't anything serious and I should go on a "liquid diet" for a week and see how it feels, and if it doesn't help, he'll prescribe me a plastic splint... Just a splint.

After taking another X-Ray, the Oral Surgeon said that my teeth were fairly aligned, but also pointed out problems with my wisdom teeth: the top wisdom teeth do not have room to grow in whatsoever, and I also noticed it because I can feel them jabbing behind the space where my gum ends; and my lower wisdom teeth are coming in sideways, pushing into my other teeth. He told me to get those removed first, and then my Orthodontist has to give me braces.

What really threw me off was the fact that my Orthodontist attempted to give me braces, even after taking an X-Ray of my teeth. Certainly, she whould've realized that my wisdom teeth weren't coming in properly, and should've planned to remove them before attempting to give me braces, which she also brutally told me that the braces will not be covered by insurance...

Anyways, all of that is a whole separate problem. What I am wondering now is after removing my wisdom teeth, and getting braces, my teeth will probably become misaligned again due to my tongue thrusting. When my mouth is at rest, my tongue puts this odd pressure on my front teeth and it's really annoying. My bite also feels uncomfortable, and I feel like my jaw it constricting my airway by being angled backwards into my throat.

What totally sucks so far is that both my Orthodontist and Oral Surgeon are being oblivious to the problem. I'm planning to consult with a new Orthodontist about my wisdom teeth surgery after a terrible experience with my old one, and I plan to consult these problems with them as well. Hopefully they're understanding and have knowledge of this situation.

Any tips or other information will be appreciated!

you're in the US, right?

if so, consult with more surgeons. if you live in large states like california/florida/texas/new york you have a lot of options, smaller states not so sure. almost 250 surgeons in 100 mile radius where i live, but that's california lol. also, your orthodontist sounds incredibly pushy and doesn't seem to have your interests at heart.

you can use this to help you find surgeons:

http://www.aaoms.org/findoms.php