Class III Underbite

[pricklypear]

I have a severe class III underbite and am looking to get it fixed through surgery. The orthodontist I went to said that due to the crowding of teeth in my upper jaw, said that I need to take out 4 teeth (including 2 wisdom teeth) before I can proceed with putting braces on and getting the surgery.

I'm no professional but I really do not like the idea of pulling out 2 perfectly good teeth to create space for my crowded canine.

My concern is whether I should be seeking opinion from other orthodontists. (Is it possible to get different opinions from orthodontists for this?)

I also have a couple of general questions regarding the underbite surgery.

- I've just begun to look into getting my bite fixed and am pretty clueless as to where to start in terms of gathering information.

- Are there any long-term effects I should be worried about with respect to the surgery? (risks of screws coming loose, risk of jaw recession, being able to play sports? e.g. tae kwon do?)

- What is the recovery period after the surgery? (To completely heal enough to be able to play sports and live a regular life?)

- How long do the braces need to be put on before surgery?

- Are there any limits on physical activity with braces?

- How would I be able to judge the competence of orthodontists and surgeons? If two surgeons were to give me two different opinions on something, how should I make a decision?

Thanks

[Zoso]

Wow. A lot of questions there.

Especially since extractions and surgery are being proposed, you should definitely consider seeking a second opinion.

Now, how an underbite is treated depends entirely on what is causing it. It might be that your lower jaw is overdeveloped (prognathic) but it could also be that the upper jaw is underdeveloped. (Or it could be a bit of both). I've seen some underbite cases where the best approach has been expansion of the upper jaw, then either upper jaw surgery, lower jaw surgery, or bimax (both jaws). It all depends on the case.

You may want to consider consulting with an experienced OMS (oral and maxillofacial surgeon) before moving forward, as sometimes they will have a different idea of the best way to address a skeletal discrepancy than did the referring orthodontist. And you can't pick just any OMS - you would want one who is very experienced in this type of surgery; your orthodontist should be able to make some recommendations.

The type of side-effects associated with the surgery would depend on which surgical procedure(s) were necessary. Swelling, and bruising, and temporary numbness are the norm. But beyond that it varies. Once you know what procedures you're looking at, we can give you a better idea. The screws and plates do occasionally cause problems, usually due to infection developing, and this can happen anything from days to years post-op. But it is fairly uncommon. Contact sports (or any activities that risk a blow to the face) are usually prohibited for around three months post-op (sometimes a bit less) but can be resumed after that.

How long you would need to be in braces pre-op depends on what needs to be achieved, and how well your teeth respond to treatment. And no, there are no physical activities that are off limits when you have braces.

As to deciding between options, all you can do is ask questions and make the most informed decision you can. If Dr. A. suggests treatment a and Dr. B. suggests treatment b, then by all means ask Dr. A. why he does not favour approach b, and vice versa. Ask about side-effects. Ask about pros and cons. Ask about the quality and the stability of the predicted results.

[pricklypear]

thanks for your response. Also, does anyone know of any reputable orthodontists in Toronto? The orthodontist I went to has given me a quote for $7800 (for installing braces, monthly checkups until end of treatment of approximately 2 and half years). This I think is too much because the average treatment is around $5000.

[Zoso]

Can't help you there.

Will say though that surgical cases are usually a bit more costly, since there is extra work involved for the ortho.

[mikeg]

thanks for your response. Also, does anyone know of any reputable orthodontists in Toronto? The orthodontist I went to has given me a quote for $7800 (for installing braces, monthly checkups until end of treatment of approximately 2 and half years). This I think is too much because the average treatment is around $5000.

You may want to make a seperate post in the General Braces forum...