refusing surgery for an open bite and crossbite

[Anna5]

Thanks for your comments, bmueller. I think it is true what you are saying and that is indeed something to consider.... It makes the decision harder knowing that it may not be so easy to switch..... But at the moment I don't feel up to surgery, so I think I had better go for the nonsurgical route (9 months in braces) and see how it works out.
How much time longer have you been in braces because of your switch to surgery? And what made you switch to surgery, after first having tried the nonsurgical route? Would it have been possible to close your open bite without surgery?

[bmueller]

I switched before I actually got the braces on. There was a 2 month wait to get them (lingual) as they are custom made to each tooth. I had gone in for a consultation about TADS to intrude my molars (as the non surgical approach) and basically freaked out at the idea of screws and hooks hanging from the roof of my mouth for 2 years for a lot of money, vs getting the real problem fixed with jaw surgery for just a bit more money and insurance covers it.

At the time I was just hellbent on not having surgery. Truthfully, my problem was skeletal in origin and had I not fixed it with surgery, I really wouldn't see much benefit. Yes, the openbite would be fixed but I still had other issues. I couldn't close my mouth at rest and showed all of my upper teeth without even smiling. They impacted my upper jaw 7 mm and now my mouth is closed at rest. I also consulted my ENT and he said it was best to go with the surgery because my face shape and airway were classic sleep apnea. I did A LOT of research before making up my mind. Lots of hours worrying about the surgery, but for me it turned out great and I would do it again! I hope to have a blog up soon to share my experience. I'll let you know and maybe it can help in your decision.

Original non surgical plan was 24 months.
Surgical plan: never got a definitive answer but probably 18 months max. (I'm at 13 months with very little left)

I had read someone's blog, not sure who, who started an openbite case non-surgical and then switched and it added like 6 months because instead of pulling the front teeth down, the ortho had to make the openbite worse to align the jaws correctly.

You seem pretty secure in not doing surgery and that's fine but I did hear a bit of indecison in your post. Just wanted to make sure you're not disappointed if you do decide to change in the future.

[Anna5]

Thanks for your good and long reply! You are right that although I seem pretty secure about not having surgery, in fact, I feel quite some indecision as well.... It is so hard to make a good decision! The problem is that I don't know yet how my teeth will look after 9 months, when I am finished with braces alone... How satisfied will I be then? I simply don't know yet. Most people (like you also posted before in your messages) think my problem can be fixed with braces alone, at least to a great extent, and don't think I definitely need surgery. And the thought of surgery scares me very much, it is so invasive for something just cosmetic ..... My husband and all of my relatives and friends being against surgery (they even don't think I need braces), a small child to care for, my wish to get pregnant within not too long a time, also wouldn't make it easier to chose the surgical route. Therefore I think it may be best for me to try the nonsurgical route first for the next 9 months ( I am already in braces for one week now) and just see how things are going. But is remains a hard decision.....
I am glad to hear that the surgical route turned out very well for you. It surely was the best decision you could make in your case. I am looking forward to reading your blog!

[someguy]

Hi Anna,

I read through your posts here, and it was nice to see someone with similar thinking to me. I think that if your bite really doesn't cause you any pain or unbearable functional issues, and the people around you don't even seem to notice anything cosmetically, your only reason for going with the much more invasive surgical route would be to avoid possible repercussions in the future. Have you spoken with orthos about possible long term consequences of the open/crossbite? I know for me at least the only reason I would go with the full surgical plan is if I'm told otherwise I will have a lot more pain/discomfort down the line.

I'm interested to see how the braces work out for you. Good luck with everything.

[Anna5]

Hello Someguy,

Thanks for your post and good advise. And yes, I asked my ortho about the longterm consequences of my open bite/ crossbite. They are not too bad he thinks, because my teeth are healthy and don't show any sign of wear yet. My jaw is clicking on one side when I open my mouth wide, but as long as I have no pain this is not a great worry either. My ortho said he thinks I can become 101 years of age with this bite without too much problems. So I am not afraid of the health consequences. And even if there would be possible health consequences, I still wouldn't be sure if that would justify such major surgery. I think I'd rather have some consequences of my bad bite, like a bit of extra wear and clicking, than major jaw surgery....But maybe that is bad reasoning, because TMJ can be very bad (fortunately I don't suffer from this)
For now, I am happy to have chosen the non surgical route. Surgery would be too invasive for me and I don't think I can handle that at the moment/ that this is the good time of my life to go for surgery (small child to care for, pregnancy wish).
I am looking forward to seeing how the braces work out for me. If they can achieve a pretty good result I would be happy. I defininitely keep you updated!
I also wish you very good luck with your upcoming journey to get your teeth fixed.

Greetings from Anna

[futurefbi07]

Anna5,

I am going through the process of trying to get my open bite closed. I have opted out of surgery and extractions(I don't want to lose healthy teeth). I'm always concerned about losing teeth due to old age and then I'd be left with even less teeth. In terms of surgery, I can live without it, so I don't want to spend the money or take the risk.

I would love to take the journey with you. My journey began on March 25, 2013

[Anna5]

Dear Futurefbi07,

Thanks for your message. I am happy to hear that you have also started your journey to get your open bite closed with braces alone.
Your journey has just begun like mine (I have been in braces for 4 weeks now). How are you doing now?
Do you have a big open bite or just minor? Does your ortho think he can fix it with braces alone? Like you, I would love to share our stories, as our issues are more or less similar and we both opted for the non surgical route. I am looking forward to hearing how you are doing and wish you very good luck with your braces journey!

Greetings from Anna

[futurefbi07]

Anna5--I think my open bite is bad. But it may not be that bad to others. Also, I feel like my bite got worse after having the spacers in. I also feel like it may have gotten worse after having braces. As for treatment, my Ortho said he can't make any guarantees that my open bite will close without surgery. He also said that I will have to wear a lot of rubber bands in the future. He hasn't mentioned anyhing about extractions, but he has mentioned IPR (filing teeth). When I say he mentioned it, I really mean he checked a box that said "selective reduction of permanent teeth necessary to complete treatment". I didn't notice this until a week into treatment, otherwise I would have asked about this. When I go in for my next appointment on May 6th, I'm going to speak with him about this. I really hate the idea of having anything done to my permanent teeth except movement. My ortho is probably going to hate me. I'm hoping that he will be understanding though. I will put up pictures when I am permitted. I tried to look at your pictures, bit I wasn't allowed. I'm assuming it's because I'm a newbie.

[Anna5]

Hello!

Here is a picture of my progress after 6 weeks.... I admit, I still doubt whether braces alone can improve my open bite enough, or that I had better have surgery because my jaw aligment is definitely not correct.... I am quite of obsessing over this recently, which is not good. I feel not happy with myself.
My jaw is also clicking often when I eat or open my mouth wide, it has become worse over the past week. I am not sure whether this is mainly because of my bite, or just stress related....
I feel so scared about having 2 surgeries, the long traject, my husband and friends totally disagreeing and thus not supporting....
What would you do if you were me, honestly? Do you think my bite is serious enough to go for surgery?
So I still hope that braces can do the tric, at least to some extent....
I will definitely talk with my ortho next time I go in (in 3 weeks).

Greetings from Anna

[sirwired]

It's really up to you if you want the surgery. We can't tell from two photos if you have a canted open bite because of mis-alignment, or a canted open bite because your upper jawbone is crooked. (That's what x-rays and orthodontists/surgeons that know how to read them are for.)

I think the braces will do a decent job getting you a nice straight arch, but they are going to be of limited use in closing an open bite unless the open bite is due to a correctable alignment problem.

Whatever you do, you need to make a decision soon... the longer you are in non-surgical braces, the longer it'll take to prep you for surgery if you choose to go that route. Pre-surgical braces put your teeth into the alignment they need to be in AFTER the surgeon moves your bones around; this is VERY different from the alignment teeth need to be in without surgery. For instance, if you had a narrow upper jaw and normal lower, and no surgery, proper alignment will cant the upper teeth inwards to "point" the biting surfaces towards the lower teeth. With surgery, the teeth are put exactly like they'd sit in a normal jaw, even though it makes for a poorly-functioning pre-surgical bite. Then, during the surgery, all the surgeon has to do is slide the pieces into whatever position puts you into the "natural" bite the ortho has prepared you for.

(I'm in pre-surgical ortho, and my bite is currently worse than it was before I went in, but I now have a nice, regular, archform, and surgery will then fix the bite.)

[bmueller]

I agree with Sirwired. I think I've mentioned it before, that you probably can get good results without surgery, but you do need to decide soon because there are different alignment techniques.

[Anna5]

Thanks for your comments, Sirwired and Bmueller. I think it is true that I have to decide soon. But for now, I remember my ortho saying that the treatment is still the same (surgical and non surgical), but this will surely change soon.
My jaws are definitely out of aligment. The question is to what extent this can be dentally compensated and whether I will be satisfied with the result.
I have already planned a consultation with my ortho in three weeks to talk about this. I keep you updated!

[sarahxgx]

I know id never be happy unless i got my underbite fixed!

[ajs604]

Hi,

I am having braces & TAD's to improve my opne bite which is far worse than you!! I decided against surgery as the procedure is barbaric in my opinion. It will be interesting to see how it all pans out. Best of luck to you!

[Anna5]

Thanks for your messages!

I am very happy that you got your underbite fixed, sarahxgx. I saw your pictures in another thread and you look amazing now!

And ajs604, I will follow your story with great interest. I agree that surgery is quite barbaric, on the other side it may sometimes be the best solution. My upper jaw is canted, so I am not sure whether this can be fixed with braces alone. I think not. The question is whether I will be happy with a less than perfect result, I hope so! I will have a talk with my ortho about it next Thursday. How are you doing now? Do you already see some improvement with the TAD's? I wish you very good luck with your treatment!!!