Newbie with Underbite (Class III)

[gene]

Hi guys,

I'm a 25-year-old guy living in the USA, looking for comments and advice.

I am "fortunate" to have the bite that is the most difficult to correct: an underbite. (a.k.a. Class III)

Below is a picture of what my teeth look like now (sorry for the grainy photo, I did my best):



You can see that the upper teeth are behind the lower ones, but I also want to draw your attention to the following:

1) There is a gap between the upper front teeth
2) The upper front teeth do not line up with the bottom pair. Instead, they line up with a single left-front tooth
3) You can't see it but there is less of an overjet on the right, than on the left. On the left-hand side, the underbite is probably 2mm worse.
4) Of course, Mother Nature tried to compensate by tilting my front teeth in certain directions.

So... given this info, please share your comments. Anybody who had their underbite corrected, please share what you went through, was it worth it, etc.

I also want to tell you that I don't have any pain or any functional impairments, I've chewed/eaten/talked just fine all my life, so if I were to go through with treatment, this would mainly be cosmetic, and maybe to also prevent some future conditions, which sounds like a dicey proposition to me (after all everyone's teeth deteriorate with time).

But even the "cosmetic" argument shouldn't be brushed aside too easily. It's just that I'm terrified of surgery.

Your guidance and comments much appreciated, thanks.
Oh and one more thing: I have an appt. with an orthodontist this Thursday.

[MemphisTiff]

Hi Gene,

I also have an underbite with asymmetry and off-midline, though mine didn't look nearly as bad before I got braces as they do now...the result of putting my teeth where they actually should be on my jaw, heh.

I'm actually going in for surgery 2 weeks from tomorrow (yikes!) and I am very excited and at the same time a little apprehensive, of course. Even though my braces were put on in January, I've been considering this surgery (lightly, then more seriously) for the past 10 years. Well, now the past 8 months have just flown and I can't believe I'm about to have it done!

Anyway, mine is both functional and cosmetic. I'm starting to get a little TMJ problem (I'm 28, it started about 2 years ago for me) and I get occasional popping and cracking in my joints. So I do want to prevent further problems. I also have lip incompetence (long face so my lips don't close naturally) and am a mouth breather, though I've taught myself to stick my tongue between my teeth and breathe through my nose, haha. Not necessarily the most attractive traits.

But I'd be lying if I said that I wasn't most into this for the cosmetic reasons. I'm told that I'm attractive, but I've been self-conscious of my jaw for 10 years now, and usually wear my hair to hide the asymmetry, I always pose sideways to the camera, etc. I really hope to come out of this with a lot more confidence.

So I am actually going to meet with the surgeon in just a couple of hours to find out all the details of what he plans to do and get prepped (mentally) for surgery. In just a few weeks I'll be able to tell you how the surgery went and all that.

Just based on your pictures, I would say that orthodontics alone could get rid of your upper gap, but your underbite and off-midline would probably need to be fixed through surgery.

Personally, I hate my underbite so much and am so self-conscious of it that taking a chance on surgery is totally worth it to me, without question. The pain that's starting egged me on to actually start the process, but I still would have done it for cosmetic reasons alone as long as my insurance covered it.

So really it depends on you (of course). If you are comfortable with your mouth, then it's up to you whether or not you want to do it for preventive reasons or take a chance that nothing will ever start hurting and not do surgery. If you are unhappy with your looks though, that combined with the potential of future problems is a good reason to at least see a surgeon and see what they say.

I too am pretty scared about the surgery, deep down. Actually, I'm really only afraid of the anesthesia, because I have a heart murmur and I'm afraid I'll die on the table, lol! Everyone assures me that is the least thing to worry about, and that recovery and complications are the worry. But I've actually read so much about the surgery and the recovery process that I feel fully prepared for what I'll be going through post-op. It doesn't sound fun, but I have confidence I can get through it. I just want to make it to post-op, hehe.

If you haven't already browsed the messages on the Yahoo group, I highly recommend going over there and just reading through some of the folks' recovery issues and concerns, as well as their great outcomes. It is a really good source of information and a font of experience to learn from. They are super nice and supportive, though it's much busier there (100+ messages a day sometimes) so you may have to dive in and be assertive to get questions answered during busy times.

The link is: http://health.groups.yahoo.com/group/or ... rysupport/

Sorry for such a long-winded post, lol. I've just been in surgery-mode lately, and no one in my family really knows that much about all this, so I get talkative when I'm in that element.

Best of luck with your OD appointment!

~ Tiffany

[gene]

Wow, Tiffany, thanks a lot for your reply!

I'm sure you'll be fine and with the modern technology everything should go smoothly, especially the anesthesia. And indeed, in your case surgery is a necessity, since you're experiencing discomfort/pain (and the good looks will be an added bonus )

BTW, will they be operating on BOTH jaws or just the lower one?

In my case... it's not as clear-cut (pardon the pun )
i'm gonna report on the results of my appointment tomorrow

[gene]

Today had an appointment with an orthodontist.

He looked me over and advised against surgery. He said I don't look that bad, and plus, a strong lower jaw is a "masculine trait."

He explained to me that because my facial balance looks fine now, the surgeon would have to re-position BOTH jaws, to achieve a similarly good balance in the nose/lip dimension. Otherwise, just shortening the lower jaw will result in a "double chin" and make me look even worse.

While the lower jaw is pretty easy to detach and can be changed within 1.5 hrs, the upper jaw is very difficult because it's attached to the skull and will take more than twice as long.

Most patients who do this are women, he confirmed, because they're more concerned about their looks. But also, women with an underbite in particular feel bad because it's a masculine trait. Me being a guy, it's not that bad.

As for the gap b/w the teeth -- yes, very easy to fix, and he suggested braces, with the small caveat that they will make my bite just a tiny bit worse (b/c the teeth will be angled appropriately). An alternative is bonding, where they just put filler material in the gap, BUT he said it would make my teeth look wider than normal, and he wasn't wild about that idea.

He WAS very enthusiastic about braces for fixing that gap, though. The underbite worsening would be negligible, according to him.

Overall I was impressed, he seemed like an honest and objective guy who spoke his mind and told me what NOT to do.

[MemphisTiff]

BTW, will they be operating on BOTH jaws or just the lower one?

In my case... it's not as clear-cut (pardon the pun )
i'm gonna report on the results of my appointment tomorrow

The final decision has been to operate on both jaws. In order to balance my face, the upper jaw needs to be brought forward and moved up a little; the bottom jaw rotated to center and pulled back. He also said they'll be fixing my asymmetry by removing some bone from one side and possibly grafting it to the other side.

I left a big description of what he said over on the Yahoo group, so I won't waste space here with all that.

I'll be interested to hear what the OD tells you.

~ Tiffany

[gene]

I'll be interested to hear what the OD tells you.

~ Tiffany

That's pretty much my situation, too.
I just made a post right above yours about my OD visit, you probably missed it

[MemphisTiff]

Lol, yeah, don't mind me. I'm on antibiotics and tired and kinda out of it. Somewhere my brain thought your last post was from a different person, hehe.

I wish I had some good pix of my bite to post, but I usually try to hide it so it's minimized in photos. I'll get some befores and afters though from this surgery.

So sounds like your mind is made up...no surgery? Are you going to do the orthodontics to correct the gap? Or just leave well enough alone?

[nahky]

Hi gene. I have an an underbite also. An asymetric alignment (half a tooth on one side and whole tooth on the other). My pictures are in 'nakhy's' story in the braces story segment.

The first Ortho i was evaluated by said that surgery was not required for me and tha he would remove two bottom teeth and make them lean inwards to tuck in under my tops.

I could have done this, but my bite would still be assymetric. The second ortho i saw strongly suggested i get jaw surgery. This would mean i wouldnt not have to remove perfect healthy teeth and my bite would be perfect. He said that if i went with the first ortho's plan of attack, i would be left with an assymetric jaw. I didnt want a shonky job/jaw, its my face we're talkin about here. I might as well do a good job on it.

Are you sure the ortho isnt trying to perform heroics just with braces here? What has your maxillofacial surgeon said about this?

Im sure you won't be left short faced after the surgery, they calculate and measure and show you a computer generated image of a prediction of your face after the surgery.

Personally, my underbite doesnt make me look anymore masculine. Its actually given me a slight ape-ish appearance (not the best way to describe it) It makes my mouth look awkward. for me, its 50% functionality and 50% cosmetics. But im just thinking of it as a medical precedure that must be performed. I will definately be having my lower jaw reduced. The doc isnt sure about the tops just yet. fingers crossed its just the bottom, will be cheaper that way.

Goodluck with your decision.

[gene]

for me, its 50% functionality and 50% cosmetics.

Could you elaborate on what the functional problems are?

[MemphisTiff]

Are you sure the ortho isnt trying to perform heroics just with braces here? What has your maxillofacial surgeon said about this?

Good point. Not all OD's are created equal, hehe. I'm sure there are some that love a good challenge and will not necessarily give the best advice if they are biased (and want your money). But that said, if you are just borderline, it's just so hard to say.

Im sure you won't be left short faced after the surgery, they calculate and measure and show you a computer generated image of a prediction of your face after the surgery.

Mine actually doesn't do this...bummer. He measured, but didn't have the computer stuff. My OD has the software and sorta showed me what I might look like afterwards, but he was doing it based on teeth movement and not what the surgeon will do exactly.

Personally, my underbite doesnt make me look anymore masculine. Its actually given me a slight ape-ish appearance (not the best way to describe it) It makes my mouth look awkward.

I'm glad you said that. My thinking on this is that underbites can be kind of neanderthal-ish, or bulldog-ish. I had a guy friend who had a slight underbite, and it took me a long time to figure out what it was about him that looked a little off, but I finally did and it was that. He always looked as though he was straining a little to push his jaw out (which is how I feel I look) even though he wasn't. It wasn't a bad underbite, but I probably noticed it more due to my own. But I always thought he could benefit from the surgery. He was a cute guy, but he would have been just that much better looking if he had his jaw fixed. And he really never dated much, so I always wondered if girls who didn't know him and how fun he was were turned off by that neanderthal kind of look. It wasn't so noticeable from the front, but from his profile for sure.

...fingers crossed its just the bottom, will be cheaper that way.

Is your insurance not covering the surgery for you?

[gene]

by that neanderthal kind of look. It wasn't so noticeable from the front, but from his profile for sure.

Just want to point out that the "neanderthal look" is when BOTH jaws are too prominent in the face, not the lower one. Do you really think all neanderthals had underbites? Even monkeys have correct bites. But as I said their whole mouths stick out a lot compared to humans.

BTW regarding your friend. If you noticed this deformity and it was visible "for sure" than chances are somebody has said something to him about it. There are some people who don't fit in society because their defect is too visible.

[MemphisTiff]

Just want to point out that the "neanderthal look" is when BOTH jaws are too prominent in the face, not the lower one. Do you really think all neanderthals had underbites?

Well of course not, and typically I would say that the neanderthal look is a lot of forehead too...I always think Matt Dillon had that kind of forehead. But that's just what I think of when I see guys with noticeable underbites usually. If you don't like "neanderthal", then "bulldog" is the same kind of mental picture for me. And I don't mean it offensively of course, it's just a way to describe the look that other people can relate to. I think my jaw looks like I'm shoving it forward forcefully, but I'm not. Not a look I like.

BTW regarding your friend. If you noticed this deformity and it was visible "for sure" than chances are somebody has said something to him about it. There are some people who don't fit in society because their defect is too visible.

I'm sure probably no one has said anything to him about it. He's not ugly at all by any means. And people just don't do that anyway, in my experience. No one has ever once said anything to me about my jaw, and when I point it out to them, half of them say they don't notice. Or if they do, it's a sincere "Oh yeah...I see what you mean." But most people are polite and wouldn't say anything even if they did notice it before.

Lots of people still ask me why I'm having this surgery done. It's just perspective. I see it when I look in the mirror. They don't see it. Plus once you start looking at all these pics of other people and see what can be corrected, you're more likely to notice these things. I could tell you at least five people I know who could benefit cosmetically from jaw surgery, but I'm certainly not going to tell them that unless they bring it up and I can say it very nicely without sounding like I'm putting them down.

By the way, here's a few pix of me, if you want to see why I'm having this done. Part of my issue is that my jaw/chin stuff is much more noticeable on film in 2D than it is in the flesh. I never really knew I had this issue til I started college 10 years ago and saw my student ID picture (straight-on headshot). I hated it and actually started looking into the surgery then. I wish I'd done it then, because now 10 years later I wouldn't have the pain starting and I wouldn't have hidden from the camera so much over the years. Ah well.

http://gspence.smugmug.com/photos/23777204-M.jpg - If you look you can see how the left side of my face is very rounded and kind of prominent, while the right side is a straight line. I turned my head to the side a little to hide it, but I think it's still pretty obvious. This was taken in March, and I'd had my lower braces on for just over a month.

http://gspence.smugmug.com/photos/35534146-M.jpg - I think I hid it better in this pic. But you can see that the top of my smile is just a hint "gummy" and I just have a long face in general. (Wish the OS could shorten my forehead, hehe). This was taken last week.

http://gspence.smugmug.com/photos/23741485-M.jpg - Crooked face, lol. Not one of my fave wedding pics, but luckily my dad took it, not the professional. This was June 2001.

http://gspence.smugmug.com/photos/23720493-M.jpg - There's a side view of the long chin, or Jay Leno chin.

http://gspence.smugmug.com/photos/23454145-M.jpg - Agh! This one is hideous...see the asymmetry? 2001 again.

http://gspence.smugmug.com/photos/23454154-M.jpg - But then this one isn't so bad, taken the same night.

Anyway, I could analyze my photos all day, lol. I'm really hoping to see some good results cosmetically from this, but the pain and popping is definitely an issue as well, and also my bite being way off and not being able to tear things with my front teeth.

I've never felt like an outcast in society, but then when people look at me I'm always afraid they're doing that "There's something weird about her face but I'm not sure what" thing, hehe.

[gene]

Judging by your wedding photos, the underbite didn't deter your husband/BF from being attracted to you

[MemphisTiff]

Judging by your wedding photos, the underbite didn't deter your husband/BF from being attracted to you

No. And I do get flirted with by plenty of guys (he wasn't my only choice, hehe), but then again some guys will flirt with anyone.

Not that I think I'm Miss America material by any means, but I'm definitely not the ugliest person I've seen. I can't wait to get this done and get healed so I can take new pictures and see how different I look. I just hope I like the "new me" or else I'll cry, lol.

[nahky]

My function problems - generally i can talk/eat normally. But because my teeth dont meet, its impossible to eat the smaller items which require your teeth to meet. Like corn on the cob, and other examples i cannot think of now.
My top and bottom molars and other teeth (expect my front teeth) hit each other straight on. I find myself grinding away at times.
I find it straining to close my mouth. During the day, when im with people, i have to think about closing my mouth, by the end of the day, the muscles in my mouth feel so tired from just trying to close my mouth and also camouflage my underbite.
My underbite was causing my top teeth to moving in a forward angled position because it was trying to compensate for the underbite so the teeth could meet. (hence my neaderthal-ish appearance)
Im a big drooler when in bed (dont look at the pillow cover, its a scary site) I cannot close my mouth when im asleep
Its just a general uncomfortable feeling all-round.

MemphisTiff:
My insurance is covering for th hospital stay. thats it. So i have to pay the surgeons out of pocket. If doing only the bottom jaw, it will save me 1-2 aussie grand dollars.

My underbite is not overly noticeable. Some poeple notice it and some dont (or they problem have that thought "somethings not quite right") I know im decent looking from the fornt view, but when it comes to a profile view, i shudder at the thought. Although the braces have helps a great deal, theres this little part of me thats always saying "are they looking at my weird mouth?" my underbite is not blantenly obvious because both jaw are prominent, so if someone did know about underbites, it would still be difficult for them to be fully sure that i ahve an underbite, most would probably think "hes mouth sticks out" . Its a very self conscious feeling. The cosmetic benefits will be a mega MEGA bonus.
Im quite a confident person, but when someone is able to view me from a side view, my insecurities set in.

Since i have an symmetric jaw, my face is not even. I used photoshop and cut my face in half from a front on shot (hope you understand this bit) I copied one side of the face to the other, i mirrored it. I did this with both sides of my face. They look so different. I know rarely anyone is symmetrical (because i'vedid this with other people's faces, but generally both faces look similar) With me, it was looking at two different people, two extremes. One of them was a straight slanted face, the other was a broad faced. Hope the jaw surgery will even out both of these extreme to give me a balanced and even face.

Hope i didnt bore you with all this info, like memphis... this is the only place where i can truly discuss my issues about my current situation.
Im 17 now and soon to head into university. Im aiming to get into a marketing course and i know that this course requires confidence, with this surgery happening next year, i need all i can get. So i can leave it all behind me and be truly happy with who i am.