Open bite. Surgery or an extraction that *might* work?

[waytooold]

I am 38 and a mother to 2 very small children. I currently have braces, upper and lower in prep for surgery to correct an open bite.

At the start of the process 2 orthodontists and a surgeon told me that I needed surgery to correct my issue. Only my back teeth actually touched and because they were doing all the work were getting cracked and damaged. I have trouble chewing food and have jaw spasms. Visually, I look fine and while my teeth weren’t straight they looked OK. My lower jaw and chin are only slightly receding.

9 months in and my bite has changed significantly and now my teeth are aligned on one side but strike on the other and I still have an open bite in the front.

My ortho has now told me she thinks she might be able to correct my bite without surgery. Which sounds great but I would have to have 2 healthy upper pre-molars teeth removed, it would add another 9 to 12 months of braces and most importantly she can’t guarantee it will work and won’t know until we have started the process. She thinks that extracting the teeth will help with the alignment and close my bite but I don’t understand how if my jaw wouldn’t shut when only the back teeth touched.

So here is my dilemma. If I go ahead with the tooth extraction I could find my self 9 to 12 months down the track needing surgery anyway and I will have lost 2 healthy teeth, which could also compromise the look of my smile and the projection of my top jaw. I will still have the appearance of a receding jaw and chin.

If I go ahead with surgery there are all the risks of surgery and the recovery time. I will need to get help in to look after my children while I’m in hospital and for at least the first or two week or so after I get home. I know that it could be months and months before I have fully recovered.

I know people here have experienced both extractions and surgery and I’m interested in your opinions and experiences. Am I crazy for still leaning towards surgery? I have 2 weeks to make a decision.

[keeponsmiling]

That's really tough that you've been left to make the decision! Can't the ortho make more moulds based on how your teeth are now that might help determine whether extractions would work? Also, have you had any advice on the long-term stability? If you go for extractions and it works, will the result last or will your teeth simply revert to their old position once the braces are removed? I'm pretty sure someone told me early on in the process that surgery was the better option in the long run to maintain a good tooth position. As for children, I'm 33 and have two in infant school. It's going to be a hard time and I'm lucky that I can pack them off to my mums for a fortnight. Do you have much of a support network to help you through? For what it's worth, extractions are a minor irritant on the grand scheme of things and I doubt anyone would be able to tell you had teeth missing once the others have filled the gap.

[annafaith]

Hi waytooold,

Tough decision, but thought I'd share what happened to me, as I've gone down the braces and finally surgery route. At around 10 years old I started my first round of braces with an old school orthodontist who was on his way to retiring. After about 4 years of treatment I achieved straight teeth, and my front teeth actually met together. Although I clearly had an overbite, surgery was never suggested to me, and I thought braces had solved my teeth issues. However! At about 16 I had to get 4 healthy molars removed due to crowding as my arches were all the wrong shape again, and the spaces were left to fill in by themselves. I had a bad habit of sucking my thumb and developed an open bite, and my wisdom teeth came through; one was impacted which restricted my bite even further. Like you, only my back molars touched in a couple of places. Basically, all those original years of braces meant nothing, because my teeth shifted back to their natural position due to the underlying jaw issue.

I went to a new orthodontist, who I have now, who trained in one of the top medical schools, so was a bit more in the loop than my old ortho! I too only wanted to have braces, and wasn't even aware of orthognathic surgery. He gave me both options, but put forward very strongly that his professional advice would be to get surgery. I was told that, when your jaws and bite are 'off' your teeth will always have a tendency to drift back to their natural position. I took this to mean that surgery SOLVES the underlying issues, whereas braces alone straighten the teeth superficially, but don't fix the underlying issues. For this reason, if I had gone for just braces, I was told that in a few years my teeth would just drift back to where they wanted to be, so I'd always have to wear some kind of brace to stop it from happening.

My advice would be to weigh up the LONG TERM implications of each option. The surgery would solve your jaw issues, I'm not sure just removing teeth would do that if you do have a receding jaw?

[zena]

I am 38 and a mother to 2 very small children. I currently have braces, upper and lower in prep for surgery to correct an open bite.

At the start of the process 2 orthodontists and a surgeon told me that I needed surgery to correct my issue. Only my back teeth actually touched and because they were doing all the work were getting cracked and damaged. I have trouble chewing food and have jaw spasms. Visually, I look fine and while my teeth weren’t straight they looked OK. My lower jaw and chin are only slightly receding.

9 months in and my bite has changed significantly and now my teeth are aligned on one side but strike on the other and I still have an open bite in the front.

My ortho has now told me she thinks she might be able to correct my bite without surgery. Which sounds great but I would have to have 2 healthy upper pre-molars teeth removed, it would add another 9 to 12 months of braces and most importantly she can’t guarantee it will work and won’t know until we have started the process. She thinks that extracting the teeth will help with the alignment and close my bite but I don’t understand how if my jaw wouldn’t shut when only the back teeth touched.

So here is my dilemma. If I go ahead with the tooth extraction I could find my self 9 to 12 months down the track needing surgery anyway and I will have lost 2 healthy teeth, which could also compromise the look of my smile and the projection of my top jaw. I will still have the appearance of a receding jaw and chin.

If I go ahead with surgery there are all the risks of surgery and the recovery time. I will need to get help in to look after my children while I’m in hospital and for at least the first or two week or so after I get home. I know that it could be months and months before I have fully recovered.

I know people here have experienced both extractions and surgery and I’m interested in your opinions and experiences. Am I crazy for still leaning towards surgery? I have 2 weeks to make a decision.

the same happened to me.they like extractions because it is easier for them. don't do the extractions. yes you are removing healty tooth for no reason. It happened to at the end I needed surgery anyway. so removing teeth was experimental for the orthodontist.