worried about the outcome of treatment plan

[mel2012]

hi everyone. (treatment is delayed at the moment due to a new cavity/money problems . I have a severe overjet (12mm) , i refused jaw surgery and im having a hard time trying to get an orthodontist is the uk to use an appliance on me.This is a summary of my last consultation :

* there is a size difference between the jaws
*the top teeth protrude 12mm (the average is 2mm) and the bite is deep
*the upper and lower teeth are mildly crowded.The upper right lateral incisor (adjacent to the front tooth) is missing.The upper right baby canine tooth is retained and is situated behind the upper right adult canine.Theupper right central incisor is darker than the other teeth.This tooth responds to an electric pulp test but less so than the upper left central incisor.This suggests the tooth may be dying and if so will require a root canal in the future.


Treatment :
* a limited treatment to reduce the protrusion of the upper teeth as much as possible.To achieve this you will need to have 2 teeth removed (upper right baby canine and upper left first premolar) and upper & lower braces fitted. two orthodontic mini screws may be needed to help control the tooth movements. The space on the upper right would be closed leaving the upper right canine next to the central incisor.although im confident a considerable improvement can be achieved,full correction may not be possible.

does this sound like a decent alternative plan? I really don't like the idea of having teeth removed as i have read that 'extraction and retraction' techniques can make the profile look worse ( i really hate the shape of my face already,i have a very small chin with hardly any definition) and that it can lead to problems such as sleep apnea
please give some advice on what you would do in my situation. thanks - Mel

[Tobilei]

I can't really tell you if it's an appropriate treatment plan for your issues, however not all people who have extractions regret their decision (we just tend to hear about the one's who do). How many ortho's have you consulted who are willing to treat you without surgery? I would get more than one opinion before going ahead with it, you seem to have quite a complex case.

[bmueller]

Extractions can work to fix the right problem.

If your upper jaw sticks out too much but your lower jaw is normal. This will work great.

If your upper jaw is normal but your lower jaw is too small, you run the risk of making your face look flat and sleep apnea etc etc.

I read the article below to get an idea of what my face was. Turns out my lower jaw was way too small and when they did extractions, it just made my face look flat and recessed.

http://www.facialbeauty.org/article/ske ... beauty.pdf

Decision is always up to you. I think with a 12 mm overjet and no surgery, I'd be happy with just making the teeth straight and seeing what elastics can do to reduce the overjet.

Best of luck!

[mel2012]

thanks for the replies. The orthodontist said that my lower jaw is too small, half of my overjet is due to my jaw and the other half is my teeth. obviously i don't want to end up with a flat profile/sleep apnea but im terrified of surgery :-/

[bmueller]

Maybe the best is to see how far he can fix it without surgery and without extractions. I've seen some pretty amazing results on the forum here of people using just elastics for a really long time. Maybe TADs can help. I'd look into that too!