Question About What Ortho said???

[altesse7]

Got braces on, last Monday. Ortho let me know, since I never had a tooth, (as an adult or child) on my bottom 4 incisor, there would be an overjet. Or I could get an implant. I really don't want to go the implant route, so it the overjet going to be horrible?

Also, I have TMJ, but had it my whole life. Ortho, said if it had never bugged me, not to worry about it. Since I got the braces on, the left side of my jaw is getting stuck, when I eat, it is very painful, clicking big time, and not acting it's self. I can't keep my teeth closed, because so much pain. Should I tell ortho? Any help would be much appreciated! ~Beck

[JumpTheDitch]

Yes you should tell your ortho! I did tell my ortho when my clicky-but-never-painful/problematic jaw started to cause issues mid-treatment (my jaw always clicked on one side, but never hurt or got 'stuck', etc until partway through the retraction phase following bicuspid extractions for overjet). I continued to wear elastics & the remaining gaps were retracted as planned. Fast forward 7 or 8 years, & im now in the (very expensive) process of reversing the retraction. I discovered I had TMJD & a retracted mandible, with both TMJ discs 'slipped'. The only relief I got from the symptoms were from wearing a mandibular repositioing splint, which held my lower jaw forward, similar to my pre-orthodontic bite.

Tell your ortho, & if they dont look closely at your jaw-to-jaw functional relationship, get a second opinion. Functional orthodontists & neuromuscular dentists follow a holistic approach, considering the function of the joints & the impact of one part of the body on another part. Ie: the effect of your teeth positioning along the jaw bone and how it affects your jaw-to-jaw relationship/patent airway/neck posture/etc and the impact on your overall health.

Hopefully I will be able to reverse the ill-effects of the retracted mandible, & with any luck most, if not all, of the symptoms will be eliminated, but the bone degeneration in my TMJs can never be reversed. I really wish I'd understood what was happening when the clicking started playing up, & had the courage to get a second opinion. I could have saved myself a lot of pain, damage & time, not to mention money. If you have concerns, raise them first with your ortho. I would advise getting a second opinion, regardless. It's your health, look after it.

I dont mean to be alarming, I just hate to hear people mentioning TMJ issues appearing during treatment. I wish I'd known back then what I know now. Your TMJs are important, make sure your orthodontic treatment supports them.

All the best!

[JumpTheDitch]

By the way, rereading your post I notice you mention clicking on your left. My dentist says TMJ symptoms are almost always worse on the left side. Mine are. Weird, huh!

[bmueller]

I don't quite understand how missing an incisor will give you an overjet. I would ask if you can have a bridge made to fill in the space where the tooth would have been. One thing I think you probably would have without that tooth (or a replacement) is a midline that would be off, but not an overjet. Hmmmm. I would ask for clarification before you get too far in and are unhappy with the way things are turning out.

About the TMJ... not good... definitely bring that up, especially if you never had it before braces. Sounds like something's off and you don't want to do permanent damage to your jaw joint.

[Slack]

I don't quite understand how missing an incisor will give you an overjet.

I'm not sure, but with one less tooth the arch must "retract" to close the gap. Could that be it?

[bmueller]

I don't quite understand how missing an incisor will give you an overjet.

I'm not sure, but with one less tooth the arch must "retract" to close the gap. Could that be it?

But on the bottom jaw? Seems like there's only so much room to retract. I am missing a premolar on the bottom and the molars/premolars still there were brought forward not the incisors brought back to close the space.

Maybe they can build up the sides of the other incisors so the total width of the three would equal having a fourth tooth there? Just throwing out ideas...

[altesse7]

With the over jet issue..... He said he was going to close the spaces, with braces, he isn't going to bring my molars forward, because my molars are perfect and he doesn't want to disrupt them.
So, since I have a tooth missing on the bottom and none on the top, it won't be, as it should, since, there is a tooth gone on the bottom. I could get an implant or a crown, to make space, so there is no over jet. I really don't want to.

About the TMJ issue. I got braces, as a young teen. I had the clicking, then. My orth, then wasn't concerned, either. I wasn't in pain. It was just clicking. I went to have a second opinion, already.. The other ortho said that sometimes, braces correct TMJ. Since mine wasn't so bad, no one was concerned. I am concerned, just because I am a week into having my braces on, and I am having pain, from my teeth shifting. But, also realizing, I can't close my jaw, all the way. And, when I do, it kills, with my teeth shifting.
I am definitely going to bring it up with him,in two days, when I get my spacers removed.

[bmueller]

The good news is that your molars line up correctly so you have a good bite. Whatever overjet you do end up with probably won't be a big deal.

With my missing tooth, my bite did not line up at all and made it difficult to chew, made my tmj worse etc.

Good luck with everything. Keep us posted on your progress!

[altesse7]

I will! I am blogging and blogging. I am going to to link it all, when I have more posts, and get it all situated.

[eyetech]

I was also told that due to the fact that I'm also missing an incisor on the bottom (not sure what happened there-was never mentioned in the past-but a dentist did pull both my upper incisors on the top when I was a child) that I would have a slight overbite remaining at the end of my treatment since I have an equal number of teeth on the top and an odd number on the bottom. He will reduce it a lot though-prior to my braces, my front teeth completely covered my bottom teeth when I bit down. He also told me that I wouldn't have a proper midline as he would line the space between the two front teeth to be centered on the middle of the remaining three incisors on the bottom.

[sirwired]

I'd say you definitely want that TMJ looked at... it it will go away as treatment progresses, fine. But you don't want to do long-term damage to that joint.