Surgery or no surgery

[clen3k]

Hi!

Small disclaimer - not a native speaker, so please pardon me if I use incorrect terminology. Just hope I get my questions across.

I'm 29 and deal with one of those horrid teeth situations where I have yellowish crooked, but really healthy teeth. So I actually haven't needed much dental work and from the times I did... Serious dentist fear.

I've wanted and needed braces since I was a teen, but my parents couldn't afford it. When I started making my own money, I asked my dentist and she said that all four my wisdom teeth had to come out, since I have a tiny mouth, my teeth lie saddle shaped, with my four upper and lower front teeth squished together basically like this.

//\\

All over each other.

Cue panic at having my teeth pulled. No more thoughts of braces.

Years later another dentist told me that it would be a ridiculous idea to have my wisdom teeth pulled as they're strong, healthy, straight, have nice straight roots, cause no problems etc.

Then the same dentist told me last year that it was time to seriously consider braces again. Mostly because with how overlayed my front teeth were getting, they were getting impossible to clean and keep healthy.

I finally made an orthodontist appointment. She did an xray, a mold of my mouth and teeth etc.

Went back for the consult and yep.

All four wisdom teeth plus one more from the front on my lower jaw. (First of all, doesn't an odd number like that through my teeth out of alignment or something? My ortho said no, but...)

The more horrible news was that apparently my lower front teeth right now come out at a 50 degree angle and my lower jaw needs to be brought forward at least a cm with surgery.

I got so freaked I almost walked out then and there.

Then we talked about it some more, and these are my main concerns:

A) general anesthesia. I have arythmia, I almost didn't come out of my appendicitis surgery as a teen. I know different drugs can be used, everything can be monitored, but still the idea terrifies me.

B) cost. I'm already set to take out a loan for the braces, with the surgery, I'm gonna be paying it back until retirement. We don't have dental insurance over here and I'm an elementary school teacher.

C) vanity. I already have a stronger jawline and chin than I'd like (think Keira Knightley) and with my jaw brought even more forward, I'm gonna look like an Easter Island statue.

But my ortho made it blunt - no surgery, no point to braces.

So. I made an appointment with another orthodontist. At first she said the same thing, but then reluctantly admitted that it could be made to work if I also wore rubber bands for two years to move my jaw less radically. But with that way, the results would be less stable.

Right now. I'm at the point where I have about two months to make up my mind in which direction I want to go.

There seems to be a lot against the surgery. But then again, both orthos say this is what they recommend.
On the other hand, me, my wallet and vanity would *greatly* prefer the less intrusive option. But here I'm scared that I'd be throwing away money and time since the orthodontist says I'm less likely to see results that way.

Overall, I kinda don't get why it's so important to have my upper and lower jaws align perfectly anyway? Why is an overbite that bad?

Of course after years of living with crooked teeth, I want a nice smile, but my main concern still is being able to take care of my front teeth and not have them overlap this badly. Right now, I see a dentist for a cleaning every three months, because they just can't be cleaned properly at home and I'm phobic of cavities.

Anyway. I'm definitely doing the braces. I already had the first of my wisdom teeth extracted last week under local anesthesia (a surprisingly easy and quick procedure with me back to eating and working and exercing normally the next day). The extractions are spaced two weeks apart to allow for recovery time in between (did not want to go the general anesthesia and all at once route for obvious reasons) and once the last one's healed it's braces time.

Right now, I'd just like some input from the people who've had to make the decision about lower jaw surgery. And especially those who decided not to have surgery after braces removed.

TIA!

[hidakat]

Hi there,

I was in a similar situation, as I should have had braces as a kid and my family couldn't afford it. I'm told if I had gotten them as a child, I wouldn't have needed surgery because children's jaws are not yet fully formed and can be manipulated. I did go through surgery and I'm 6 months into my recovery. The verdict is still out on whether it was the right choice for me. My breathing is improved, but it is also a very long, hard road to recovery. Not all of my feeling in my lower lip has returned yet, and it is a struggle getting used to the changes to your face, even if they aren't necessarily bad changes. I've read it usually takes about a year, physiologically, to come to terms with those changes.

I would check on the insurance thing, over here the surgery itself falls under medical insurance, not dental. If you have that, the surgery should be more affordable. Check with your insurance company on what costs you should expect, and check beforehand that:

1. your procedure is covered (the surgeon you plan to use should help you create a case for this)
2. your surgeon, hospital, and all associated anesthesia and radiology are also covered.

1cm is a lot, my overbite was only 7mm. I chose to have the surgery so I could close my mouth and breathe properly through my nose. If you don't have any problems with breathing, and your bite doesn't cause problems with chewing or talking it's probably not worth the ordeal. It's up to you to decide if the risks are worth the reward, it's different for everyone.

[hidakat]

*psychologically, not physiologically

[Alicia110613]

Hi,

I think you should consult with additional orthodontists (make sure they are reputable in your area) to understand the potential options. Ask whether it's possible for them to just straighten your teeth, which is your primary concern, the pros & cons of doing so without surgery. If you are not having a functional problem with your current bite, I don't see why the orthodontist can't just make your teeth a little straighter? (even though it may not be the ideal solution from your ortho/surgeon's point of view) Make sure to let them understand YOUR concern/needs, and see what can be done.

I initially chose to only have my teeth straightened because I was not mentally prepared for jaw surgery. A year after finishing my ortho treatment, I decided that I wanted it perfect and went for the surgery (at which point I had to get braces again).

[Poll]

If you do not sonar or don't have any breathing problems then moving your lower jaw forward may cause you breathing problems. Because moving jaw forward over 9 mm causes permanent change in your throat. In USA this operation is used to treat sleep apnea and only movement over 9 mm gives permanent positive effect. For people who do not have sleep apnea it may give negative effect.

My jaw was moved 11 mm forward and my throat hurts because it is too wide now and mucosal layer is too dray or secrete is too thick now. My breathing functioned perfectly and I could sleep well before the surgery. Now I cough when I speak and have to take medication which makes secrete runnier. I have problems with sleeping because my jaw opens when I sleep. Sometimes I woke up after few hours of sleep because the throat hurts or I have to take medications to make the conditions in throat more tolerable and to be able to sleep through the night. I wasn't nervous or had any fears before the treatment but now I don't trust doctors at all. But it's more like a legal issue than psychological.

My quality of life was very good before the surgery and is very bad after the surgery. My orthodontist looked only at the models and x-rays calculated how many mm my jaw is deviated from a normal position and didn't take into account how well I was functioning and how happy I was with my look. My orthodontist had a very bad care quality and she violated the most important rule - do not harm.

Intervening into perfectly functioning system surgically may effect unbelievably many functions negatively. It may effect breathing, sleeping, speaking, biting, chewing, swallowing, kissing, drinking, TMJ dynamics, your look, your IAN nerve, which sports you can't do anymore, etc.

There are lot of before and after surgery photos in the internet and some people do look normal before and like Frankestein after the surgery. But at least some of them had serious functional problems and having the surgery was worth for them I hope. If your only problem is how to keep teeth clean then the braces treatment would solve this.

I agree with Alicia110613. You should look for a second independent opinion. Don't tell to the second orthodontist anything the first one told. In your place of you I would look for a third opinion too. I am much wiser after the treatment and wish I had went for a consultation to a neighboring country too

If you are nervous I recommend you to record the consultations so you can listen them later and really weigh all the pros and cons.

Not a native speaker either. English is a second foreign language for me.