Metal Mouth Message Board

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I'm 24 years old and had braces for 3 years (got them off a couple years ago). I've been living with this open bite since then and it's starting to weigh on me in many ways (self-esteem and even just eating is a pain).

I absolutely do not want to get braces again. Is surgery my only option? How effective is it? What would it entail? Would I have to have my jaw wired shut for a year or is that old school thinking? I honestly don't know anything.

Thanks for any help.

Also, I live in Canada.

I hate to be the bearer of bad news, but I don't think you have much chance of getting this fixed without surgery, sorry. Did the orthodontist you worked with ever tell you that you wouldn't have a fully functional outcome without surgery? Your teeth look good within their own arches, however it looks to me like you have a significant underbite in addition to the open bite, to the degree that it is beyond the ability of braces alone to fix. Orthodontists can camouflage mismatches between your upper and lower jaws to a certain point, beyond that there is no way to produce a stable result without actually going in and addressing the mismatch directly.

Being wired shut after surgery doesn't happen as often anymore with the use of internal hardware to hold things together, however I have read accounts of people who were wired after surgery to be on the safe side when things didn't go quite as planned during the procedure. No one is wired shut for a whole year, it's typically going to be 6-8 weeks at the very most. The majority won't be wired, and instead will have heavy rubber bands to hold their jaws together for a period of time, and some don't even have much of that depending on what was done.

I would recommend reading through as many of the threads on here as you can, and also look at blogs where people have posted pictures. If you search "jaw surgery" on Reddit there are also a number of AMA's that people have done with before and after pictures.

You can also talk to some orthodontists (not the one you went to, I'm stunned that they would call your case finished without some good reason) and see what they say.

Question: when you had braces on, did they go all the way to the back of your mouth? In other words, were all your back teeth braced as well?

Also, it appears you have a cross bite. See an orthognathic surgeon for better Analysis.

@shortcircuit
Yes, my braces were on my back teeth as well.

Also, I don't think I actually have that much of an cross/overbite I was kind of protruding my jaw forward like in the picture to get a better shot of my teeth (if I just smile normally my bottom lip covers my bottom teeth entirely like this http://i.imgur.com/YOAZOVw.jpg ). The front of the top and bottom of my teeth seem to line up pretty well. If they actually touched it would be pretty flush.

And yeah I expected surgery was the only option. I'm just curious how effective it is and how much it will put my out of commission/limit my daily life.

And of course how much it would cost.

Also I just realised I meant to say open bite and not over bite in my original post. You probably got that by now though.

rific wrote:And of course how much it would cost.

Like shortcircuit said, there's a ton of info on this forum if you search it. Long explanations of costs and insurance concerns, as well as loads of info on what recovery is like, and discussions of cases where it was or wasn't effective. If you're serious about the surgery, put in the time to do your research and read up. If you just have a vague passing interest (hence why you're just asking this stuff here rather than searching the forum), here's your 5-cent answers: you'll probably have to get braces anyways as part of the surgery unless your bite is perfect; surgery might not be the only option, but it's probably the best option (consult an oral surgeon); it's generally effective but lots of people aren't happy with how they look afterwards; it entails sawing your jaws apart and then screwing them back together in a new position; you'll have elastics, not be wired shut unless you're getting a certain procedure specifically for underbites; you'd be able to walk around after about a day or 2 and you'll be able to return to work at minimum about 2 weeks after the surgery, but most people give it 3-4 weeks (you'll continue to have minor swelling for a year or so); it costs $25k-100k unless your insurance covers it, in which case the whole shebang should cost you less than $10k.

Was the open bite there when they took your braces off, or has it grown over time since then? From what I've read, open bites are one of the issues that are most prone to relapse after the braces come off. If this has developed over time since they took the hardware out, then there's your answer.

If you step back and take a long view of the surgery in general, what it boils down to is risk versus reward. These surgeries are not trivial procedures and do carry a fair amount of risk, permanent nerve damage is one of the most common side effects. Like snapdresser said, many also struggle emotionally with facial changes, because sometimes they don't recognize themselves in the mirror anymore and that can be very hard to accept.

Any time you undergo general anesthesia, there is a risk that you aren't going to wake up again, and if you search the literature and other sources (this forum as well), you can find cases where things have gone horribly wrong and the patients have been left much worse off than when they started. The question you must answer for yourself, and the answer is different for everyone because we all have different issues and expectations, is whether you want to risk exchanging your current set of problems for a different and potentially worse set. These aren't experimental procedures, so the potential side effects have been well documented and the risk is pretty small for most of them, but small doesn't mean zero. In other words: are things bad enough now that I am willing to risk bigger problems for the chance of getting things fixed and working as they should?

snapdresser wrote:

rific wrote:And of course how much it would cost.

Like shortcircuit said, there's a ton of info on this forum if you search it. Long explanations of costs and insurance concerns, as well as loads of info on what recovery is like, and discussions of cases where it was or wasn't effective. If you're serious about the surgery, put in the time to do your research and read up. If you just have a vague passing interest (hence why you're just asking this stuff here rather than searching the forum), here's your 5-cent answers: you'll probably have to get braces anyways as part of the surgery unless your bite is perfect; surgery might not be the only option, but it's probably the best option (consult an oral surgeon); it's generally effective but lots of people aren't happy with how they look afterwards; it entails sawing your jaws apart and then screwing them back together in a new position; you'll have elastics, not be wired shut unless you're getting a certain procedure specifically for underbites; you'd be able to walk around after about a day or 2 and you'll be able to return to work at minimum about 2 weeks after the surgery, but most people give it 3-4 weeks (you'll continue to have minor swelling for a year or so); it costs $25k-100k unless your insurance covers it, in which case the whole shebang should cost you less than $10k.

This is good advice except in Canada, public healthcare pays for the surgery.

jaime wrote:

snapdresser wrote:

rific wrote:And of course how much it would cost.

Like shortcircuit said, there's a ton of info on this forum if you search it. Long explanations of costs and insurance concerns, as well as loads of info on what recovery is like, and discussions of cases where it was or wasn't effective. If you're serious about the surgery, put in the time to do your research and read up. If you just have a vague passing interest (hence why you're just asking this stuff here rather than searching the forum), here's your 5-cent answers: you'll probably have to get braces anyways as part of the surgery unless your bite is perfect; surgery might not be the only option, but it's probably the best option (consult an oral surgeon); it's generally effective but lots of people aren't happy with how they look afterwards; it entails sawing your jaws apart and then screwing them back together in a new position; you'll have elastics, not be wired shut unless you're getting a certain procedure specifically for underbites; you'd be able to walk around after about a day or 2 and you'll be able to return to work at minimum about 2 weeks after the surgery, but most people give it 3-4 weeks (you'll continue to have minor swelling for a year or so); it costs $25k-100k unless your insurance covers it, in which case the whole shebang should cost you less than $10k.

This is good advice except in Canada, public healthcare pays for the surgery.

I thought you still had to pay out of pocket for the braces? Those are paid for by public healthcare too?

snapdresser wrote:

jaime wrote:

snapdresser wrote:
Like shortcircuit said, there's a ton of info on this forum if you search it. Long explanations of costs and insurance concerns, as well as loads of info on what recovery is like, and discussions of cases where it was or wasn't effective. If you're serious about the surgery, put in the time to do your research and read up. If you just have a vague passing interest (hence why you're just asking this stuff here rather than searching the forum), here's your 5-cent answers: you'll probably have to get braces anyways as part of the surgery unless your bite is perfect; surgery might not be the only option, but it's probably the best option (consult an oral surgeon); it's generally effective but lots of people aren't happy with how they look afterwards; it entails sawing your jaws apart and then screwing them back together in a new position; you'll have elastics, not be wired shut unless you're getting a certain procedure specifically for underbites; you'd be able to walk around after about a day or 2 and you'll be able to return to work at minimum about 2 weeks after the surgery, but most people give it 3-4 weeks (you'll continue to have minor swelling for a year or so); it costs $25k-100k unless your insurance covers it, in which case the whole shebang should cost you less than $10k.

This is good advice except in Canada, public healthcare pays for the surgery.

I thought you still had to pay out of pocket for the braces? Those are paid for by public healthcare too?

Oh sorry yeah, braces aren't covered, just surgery. Braces are anywhere from $5000-$8000CAD.

Okay, thanks for all the advice. I'll do further research here and maybe book an appointment with an ortho and check my options.