Edge to edge bite

[Vincent]

Hello! I created a thread about my edge to edge bite some time ago, and I have now gotten a second opinion from both an orthodontist and a jaw specialist.

My bottom teeth are already leaning backwards into the mouth, so the only way to fix it with braces is to lean the front teeth forward. This will however give them a somewhat sharp angle (too sharp in my opinion), so I don't consider that an option.

Besides, my other big concern is my protruding jaw line, and braces will not fix that. If you look at my profile, it will absolutely look like I have a fairly large underbite, but (unfortunately) I only have a small underbite (edge to edge). I say unfortunately, because if it was large it would allow my jaw to be moved backwards, and most importantly, insurance would cover it. As it is now, there's no way the insurance will cover any of this, so I'm looking at funding it all by myself. At this point I'm willing to have it done anywhere in the world, as long as it's done by very best specialists out there (any recommendations?).

I don't really see why am I such a special case, because when I google for people with a similar problem to mine, they all seem to have been able to have it fixed by genioplasty and jaw surgery. I guess my real disadvantage here is that my bite is very functional apart from the edge to edge bite.

[Sunny]

Vincent surgery doesn't correct issues unless they're as a result of your skelaton forming incorrectly. Many underbites/overbites are dental and surgery would just be a waste of the patients money and hopefully no surgeon would operate on these people.

For those of us with underbites that are dental, we may never have the results that people who need surgeon get ... but we wouldn't with surgery either.

If your bite is functional and insurance won't cover your treatment ... why do you think you need surgery? Have you had a few consults with both orthodontist's and surgeons who confirm this ... and why?

Good luck learning to accept what is best for you.

[mikeg]

You could have a class 3 underbite, but results in an edge to edge rather than a true underbite where your bottoms over lap.

I had a similar bite and had braces/rubber bands to fix it the best they could without surgery.. I would get a few more opinions from orthos that really work with surgical cases and see what they think.

As far as insurance goes, it is becoming harder and harder to get things covered. If you look at the case studies at Orthognathic Surgery Jaw Correction you will see that some had to pay out of pocket and others had insurance cover it...

The way this heatlhcare system is going it is harder and harder to get certain surgeries that may be deemed cosmetic covered.

[Vincent]

My bite very functional in the sense that I do not have any chewing problems, and although I have an edge to edge bite, the rest of my bite is ideal according to the orthodontist (only one side is half a tooth off). I guess it should be possible to correct the edge to edge bite with braces, but that will not solve the problem of the protruding jaw (protruding chin).

I don't really understand how my profile can be so much off when my bite is supposely almost okay (it would be perfect if I moved the lower jaw back at most 5 mm) and changed the angle on the four lower front teeth to point more straight up. My lower lip is sticking out 5 mm compared to the upper lip whenever I open the mouth slightly. I have a flat mid-face, so it might simply be the case that my upper jaw isn't fully developed although I doubt it.

I don't understand why my lower jaw can't be moved while other people that also have a very slight underbite (also edge to edge) have had it done: Welcome to Merrimack Valley Oral Surgeons Inc.

[smylex]

The way this heatlhcare system is going it is harder and harder to get certain surgeries that may be deemed cosmetic covered.

Most health insurance policies were never intended to cover cosmetic surgeries. Health insurance is for medical necessity. This is stated in the contract you sign.

The very definition of insurance is "coverage by contract in which one party agrees to indemnify or reimburse another for loss that occurs under the terms of the contract;" and, "the act, system, or business of insuring property, life, one's person, etc., against loss or harm arising in specified contingencies, as fire, accident, death, disablement, or the like, in consideration of a payment proportionate to the risk involved." --Dictionary.com

Medical insurance was designed to be financial coverage for things that aren't pre-planned, i.e. accidents, injuries, birth defects or genetic anomalies that fall within the guidelines established for what would be considered far beyond purely cosmetic problems.

For instance, if someone has a crooked nose and the angle of the nose is causing interference in the patient's breathing that results in obstructive sleep apnea, this can be grounds for full coverage of plastic surgery. The medical need is too great to be ignored. However, if it's not interfering with breathing functions and the patient just doesn't like the shape of his or her nose, it's purely cosmetic and will not be covered.

The same goes for orthognathic surgery. If there are one or more symptoms present and the patient's health is compromised because of the skeletal deformity, the medical insurance will cover the surgery. If it's something that can easily be corrected with orthodontic appliances within a predetermined time period, it won't be covered.

[Sunny]

Well written Smylex!

In Australia this is the case with any standard policies, but if you chose to pay a load more, there are policies you can get that have loads of extras ... but ghee you pay for most of them in the long run.

Many people, like me, can't afford any medical insurance and fortunately in Australia we still have a system that is affordable by most and more public hospital and public hospital staff than private ones. This is changing, which is really sad, as I'm a firm believer in the government being the ones responsible for it's people health, welfare and education.

Vincent ... you may need to talk to someone other than an orthodontist, as if your bite is functional, your face issues may have nothing to do with your skelaton with regards to your jaw.

[mikeg]

well written indeed.. but if you have a class 3 underbite, I doubt you would consider it "cosmetic" by any means..... While your bite may be functional enough to live with it and eat, an underbite can lead to TMJ issues, speech issues, not chewing properly, grinding, etc.

Crossbite is also fairly common with underbites and biting your cheek and other negatives will alway exist...

I don't blame anyone for wanting to get it fixed early...

In an edge to edge case, vincent may not have a class 3 underbite and can benefit from braces alone.

[smylex]

I guess my real disadvantage here is that my bite is very functional apart from the edge to edge bite.

Vincent, from what you're describing, insurance companies usually don't consider cases like yours to be one of medical necessity. I don't know where you live, but this link is an example of what it is that the insurance companies are looking for in this situation. This is what my insurance covers, yours may differ.

SURG.00049 Mandibular/Maxillary (Orthognathic) Surgery

In my own case, I fall under the masticatory dysfunction or malocclusion section, as well as one or more of the symptoms shown underneath those reasons why the surgery would be covered. My physician believes this may also be contributing to OSA, as well as my temporomandibular joint dysfunction.