went in for reg ortho, now thinking about surgery ???

[r2ndc]

I went in for regular orthodontic treatment to treat by overbite, misaligned teeth. Now that I'm like one or two office visits away from getting them removed I'm seriously thinking about possibility for surgery. I was made aware of the option, when the orthodontist first consultation in the beginning. But I decided to go the non-surgery route hoping this would be enough. Now, my orthodontist tells me, that I don't need surgery when I asked him about it in my last visit. Why my sudden change in thoughts? I'm having jaw pain and I feel my bite is not right (i feel my back teeth tough, but only on the outer edge). I did express my concerns about the jaw pain past few months, but the way he responded... I felt he was just trying to calm me down. He says my jaw pain is due to stress and/or possible clenching while I'm sleeping (which I for some reason I can't buy into 1) no where in my ortho tx I experience this 2) i'm not a clench, in fact i try to relax my jaw when I sleep - sleeping helps the pain).

So I made an appointment with a maxiofacial surgeon, who, after seeing my panoramic x-ray, said that there's a little bit of wear on my jaw joints (not a lot but she saw it rt away when she looked at the xray), and I told her that my lower jaw is under-developed (plus born missing a lower tooth). She also noticed my open-bite was hasn't been completely dealt with my treatment and mentioned if ortho doesn't do it, surgery would. I also mentioned to her that I can't find my bite.
** I've had jaw problems/pain since young, which I learned is due to a not fully grown lower jaw (so eating touch/hard pieces in bite sizes)

Would surgery help with this? And can you do surgery after or practically near the end of an ortho treatment (and after having 2 pre-molars removed)? Or is this something like physical therapy can help with (which the maxiofacial surgeon also mentioned)

Thanks for reading... am really at a loss to do... Get a second ortho opinion? Get more oral surgery consults???

[bmueller]

Maybe it's time for a second opinion, just to help you decide how to proceed. Best of luck!

[katsface]

You already consulted with a surgeon who said surgery would help, right? Your ortho probably has an incentive to tell you that you don't need surgery, because if you did need surgery that would mean she wasn't able to fix your bite and he/she may not be willing to admit that.

It seems like you may already have your answer. The orthodontist is giving explanations for pain that don't make sense to you. Your open bite is not resolved. You can't find your bite. You can tell that your teeth are not meeting properly.

The wear on your jaw joints will probably be from years of having a bad bite, and won't tell you if your treatment has been successful, but if you don't really have a successful treatment the wear could continue.

I think you have reason to question the success of the treatment you've gotten so far. I would get more consultations from orthodontists, and surgeons. I would probably also take this information back to your orthodontist and let them know that you don't feel like your treatment is finished yet. Talk to them about what the surgeon said. Let them know that you would like to continue treatment, even if it means surgery, until you have a perfect bite. If they don't agree, and you still feel like you need more work, it might be time to find a new orthodontist.

[sirwired]

If you elect for surgery now, expect probably another year or more of orthodontics prior to the surgery. Pre-surgery orthodontics are VERY different from non-surgical orthodontics. Pre-surgery orthodontics involves putting the teeth into a neat, straight arch, with all the teeth in ideal positions, even if your two arches don't meet when this is done; the surgeon then cuts the bone loose, shifts things around for a proper bite, and screws your jaw into the new position. Non-surgical orthodontics involves fashioning an improved bite within the arch you have, even if it means some of the teeth are tilted or shifted from their ideal.

Doing pre-surgical work now will mean undoing much of what you've already had done. You'll have to pay accordingly.

[BracketBaring]

It sounds like if it wasn't for your jaw pain, then you wouldn't be considering surgery. So I would exhaust all other options first. A bite guard and physical therapy are certainly worth a try, with basically no risk or potential consequences (unlike surgery). A lot of TMJ/jaw pain is caused by stress, and sometimes even poor posture and neck problems.

[r2ndc]

Thanks everyone for reading through this, and with all the typos (still a newbie on the board so I don't have an edit function).

[quote]If you elect for surgery now, expect probably another year or more of orthodontics prior to the surgery. Pre-surgery orthodontics are VERY different from non-surgical orthodontics. Pre-surgery orthodontics involves putting the teeth into a neat, straight arch, with all the teeth in ideal positions, even if your two arches don't meet when this is done; the surgeon then cuts the bone loose, shifts things around for a proper bite, and screws your jaw into the new position. Non-surgical orthodontics involves fashioning an improved bite within the arch you have, even if it means some of the teeth are tilted or shifted from their ideal.

Doing pre-surgical work now will mean undoing much of what you've already had done. You'll have to pay accordingly.[/quote]

^ and that was why I was so getting a little nervous... this is already my second time with braces (first time when I was back in middle school) - and 2nd time around of all that time and money(!)... and I'm like omg... what did I get myself into, did I not do enough research (when at the time I thought I did)?
And yeah - if it weren't for the jaw pain now and the difficulty eating (right now on soft foods, and using rt back teeth to chew a little, and tongue and roof of mouth to chew)... i wouldn't even have second guessed my treatment plan.