I'm wondering, how closely does an orthodontist and maxillofacial surgeon work in the case of orthognathic surgery? Is it usually a smooth process, meaning each knows exactly what to do to make the outcome as good as possible? Oh, and if I'm concerned about cost, can I elect to have the jaw work done somewhere else, like Canada, and the orthodontics in my home country? (The USA)
Also:
1)I'm a fully grown male who has dealt with jaw issues on and off, and I'm thinking about going back to braces/surgery. I do have clicking in the joints of my jaw as well. I also believe my facial height may have actually changed for the worse. I believe that in light of the fact that my looks maybe weren't a problem before (I can explain this more, the change in "before and after" pics, etc), something must have changed in my face that throws it off balance. The only thing I can come up with is that the vertical dimensions changed. I'm wondering if this could be due to an occlusal splint I've been wearing at night for about 4 years.
2) I have gum recession, but I'm wondering if that is more from the teeth erupting because of the splint. I understand this can happen. For the record, my splint is a full-coverage night guard/bite plate. I believe it's acrylic, and it's not too terribly thick. From what I gather, my mandible could have changed position, therefore increasing an already fairly long facial height.
If someone can let me know about this stuff that'd be great, as I'm a little lost and can't see a surgeon until a few months from now. I'm thinking of a maxillary impaction. Another concern is whether the surgeon will plan enough of a change, taking into account that braces can increase facial height even more. And since I've already gone through them once, that worries me. Of course correcting my slightly weak chin and overbite wouldn't be a bad thing either.
Also, when back teeth erupt more than they should, maybe by 1-2 mm, how is this corrected? Intrusion of molars would fix the problem, but I don't believe this is something US doctors do - I've only seen that it's done in Korea. I don't know if they'd treat me there. So if only the back teeth, meaning first and second molars, actually make contact and the others overlap a bit but don't actually touch, is this just handled by having the orthodontist bring the other teeth down and then the jaw surgeon doing the impaction, so that everything is even? I don't have an open bite in front, but my upper front teeth are very long. On the side, you can see very small spaces because my teeth don't interlock the way they should, but I don't know if this is an "open bite." I've had 2 maxillary premolar extractions.
Thanks for any help! I tried not to make it too long or detailed, but a lot's been on my mind about this recently.
Braces and surgery - How they work together? My situation...
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BachGuitar
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BachGuitar
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Just an example, whether it would or not I'm not sure. Well, without being insured that probably wouldn't work. I've also heard it's done in India. Not sure about the quality there.Audra wrote:Why do you think it would be cheaper to have your surgery done here in Canada?
It all depends on what I'd need, I guess. It's not just the cost but the quality that I'm concerned about.
I also don't know if I should see a surgeon for an evaluation. I don't know how this works with insurance. I have an insurance company with a TMJ benefit for surgery, but I don't plan on affording the surgery until a couple years from now.
I don't know how to answer all your questions. But I do know that my orthodontist and surgeon do work together and transfer records between them. My orthodontist's job was to make sure my arches and teeth were in perfect alignment so when the surgeon moved my jaws everything would fit perfectly. Any tweaks afterward were done with elastics.
As far as the process in the U.S. regarding insurance, I can't help you there as I live in Canada (and happy about that with regards to this surgery).
You would not be able to come to Canada to get your surgery done though. While our surgery is seen as "free" to other countries, it really is not. We pay for our universal health care through our high taxes. In my province there is no "private" option for those who want to pay to have a reduced wait list. Here the wait list for this surgery is 2 years.
As far as the process in the U.S. regarding insurance, I can't help you there as I live in Canada (and happy about that with regards to this surgery).
You would not be able to come to Canada to get your surgery done though. While our surgery is seen as "free" to other countries, it really is not. We pay for our universal health care through our high taxes. In my province there is no "private" option for those who want to pay to have a reduced wait list. Here the wait list for this surgery is 2 years.
I didn't wait an "extra" 2 years. I got put on the list at the beginning of my braces treatment. But yeah, it sucked. I'd rather wait than pay through the butt for the surgery though - or start treatment and get denied by insurance. I showed up at the hospital, they did the surgery, I got everything I needed, could have stayed an extra night or two if I felt I needed it, and I went home. No hospital billing, nothing. Although there was an "extra billing" from the surgeon of $3000 which I paid upfront, but that was it.
The orthodontist/surgeon relationship is of vital importance!
It's a team effort so they must discuss it and be in agreement in advance, then work together throughout the whole process. The orthodontist takes the dominant role as it is he who moves the teeth, which is the deciding factor in how much movement the jaw requires - the surgeon after all can only move the jaw to the where the bite meets correctly - however the skill of the surgeon determines how successful the result is no matter what orthodontics take place. So it's a bit like discussing a racing driver and his pit team!
Basically you need them to get on. I've read horror stories on here about people who's orthos and surgeons have disagreed on the best course of action AFTER they'd begun the process, I can't think of anything worse! This is why I chose a surgeon first then asked him to send me to the ortho he worked best with, and the three of us ended up sat in a room whilst THE PLAN was put together. So if you want the smoothest process I'd advise making sure they both like working with eachother.
It's a team effort so they must discuss it and be in agreement in advance, then work together throughout the whole process. The orthodontist takes the dominant role as it is he who moves the teeth, which is the deciding factor in how much movement the jaw requires - the surgeon after all can only move the jaw to the where the bite meets correctly - however the skill of the surgeon determines how successful the result is no matter what orthodontics take place. So it's a bit like discussing a racing driver and his pit team!
Basically you need them to get on. I've read horror stories on here about people who's orthos and surgeons have disagreed on the best course of action AFTER they'd begun the process, I can't think of anything worse! This is why I chose a surgeon first then asked him to send me to the ortho he worked best with, and the three of us ended up sat in a room whilst THE PLAN was put together. So if you want the smoothest process I'd advise making sure they both like working with eachother.
