Braces and Surgery for a 12.5mm overjet - am undecided - any advice?

[Krystal]

Hello everyone

I'm a 36 year old female and have a Class II Division, increased overbite - increased over jet of 12.5mm. I've been privately to see an orthodontist and the only way he said to correct my problem is to wear fixed braces for approx a year then oral surgery. This would involve breaking the jaw and bringing the lower jaw forward etc.

He said I'd a strong chin point and therefore a possibility I may require a simultaneous reduction genioplasty to get the best possible result.

He talked about some people may have mild dumbness permanently or tingling/no feeling around the lip area following this type of surgery and wanted to make me aware of that as it could be permanent.

I'm undecided what to do but I know I'm depressed as I hate the way I look and if anyone has any advice for me that would be great. I think only for the risk of having no feeling/dumbness permanently I'd definitely go ahead.

Maybe someone has already been through this type of surgery or knows someone who has and any advice or help would be greately appreciated.

Thanks

Krystal

[Sunny]

Hi Krystal and welcome to this forum!

I've not had jaw surgery, but i work for three orthodontist's and we have patients who have surgery. It's important that each patient is well informed and this means making sure they know about all the risks. All surgery involves risks and then there's the risk that are peculiar jaw surgery. It's necessary for you to know all this before you agree to the surgery, as although many of the risks are minimal, it would be dreadful for something to happen and you weren't aware of the possibility.

From what i've observed, many patients have some numbness and tingling following surgery. Some areas may remain numb for many months, even a couple of years. It does seem that most feeling returns, although the numbness and tingling can be annoying. Most of our patients find the recovering phase to be challenging, but they as their bodies heal, they quickly forget the worst parts and most are open about being happy with their decision to have surgery to correct their bite.

Talk to your ortho and surgeon some more Krystal and hopefully they'll help you weigh up the positives and negatives.

Good luck with your decision!

[Kmeri]

Hi, I have never posted anything in my life before (don't even use facebook!) but felt compelled to answer your post. I am a 38 year old woman and when I was younger i had a 12mm over jet and it really sounds the same as you! I also have a "strong chin" like you described.
I had orthodontics and headgear when I was young and it did a reasonable job, then I went back last year after feeling like my teeth were getting worse again and found out that I still had a 9mm overjet. My orthodontist, who also offers surgery gave me the same diagnois as you describe and she said that because my chin was strong I would be better off accepting the jaw relationship and just having a set of braces to reduce the overjet. I have nearly finished those brace now and although I do still have an overjet I look fine really! I would really not recommend surgery without speaking to more orthodontists. All that surgery you describe will cost a fortune and it is a worry that the dentist is thinking about his/her bank balance before your well being. I know someone who had the same thing but she had a weak chin so it was better for her to have facial surgery. It cost her £19,000 initially but she has had loads of problems and had to have her jaw broken again recently (at extra cost).
Be glad that you have a strong chin and get those braces, you will look fine in the end even though your jaw relationship wont be perfect you will look good!
At the very least get a second opinion from someone you trust. If you contact me I can recommend mine.

[Krystal]

Thanks Sunny and Kmeri for the advice. I actually got a second opinion and was advised to go for braces only and he didn't recommend surgery. He said my problem wasn't severe enough for surgery. I asked would he need to do any extractions and he said no. He said my overjet was 12mm and that I needed upper and lower braces. Said my lower teeth sit back and said the braces will bring them forward. Also when I smile it just shows my top 4 teeth and said the braces will help bring out my other top teeth for a better smile.

Think I'm confused to be honest. The braces are several thousand pound and I want too be sure. I'm just abit worried incase I don't see much of a difference as the other Orthodontist said braces on there own wouldn't work as I needed surgery. The second Orthodontist didn't recommend surgery and said I'd see a great difference after the braces and possibily half the overjet (ie 6mm)

Anyone else experience anything like this? Would braces on their own help?

Thanks so much for any advice, I really appreciate any opinions.

[Bekster45]

Do you have an option of getting another opinionl. Since the two consultations you have had seem to be so far apart, it may help to have a third opinion and see what they recommend. It may give you more of an idea what to do, especially if that one is clearly on the side of one or the other of these.

[Sunny]

It's great you had another consult, but due to getting such a different treatment plan, I really think you should go for more consults.

Surgery is usually not related to severity ... but it's about jaw relationship. If a person's bite is out of alignment for dental reasons, then it should be fixed with orthodontics alone, whereas if it's out of alignment due to bone structure the only way it can be corrected for a person who's stopped growing is with orthodontics and surgery.

Hopefully having another one, two or three consults will help you make a decision.

Good luck!

[Kmeri]

Basically I think the choice is, go for the surgery and you will get a more "perfect" result however it's pretty traumatic and very expensive. Go for the braces and the result wont be as perfect but you wont have to go thorough the trauma of facial surgery. I still have an overjet but then if you look at people's teeth in general very few people have perfect teeth (except for celebrities!)
My daughter has inherited my teeth (unfortunately) and she is only 5 so she still looks ok but I know that when her adult teeth come through it's not going to be good! I will have to decide for her what to do and I am going to get lots of opinions before I decide.
It sounds great that he can do it without any extractions. I had four teeth taken out and even now I've had the second lot of braces you can still only see the 6 teeth at the front rather than the 8 teeth to make a beautiful wide smile. I have a friend who has quite an over jet but she has a beautiful wide smile and this is one of her best features!
Dont get too hung up on perfection and get some more advice!

[Krystal]

Thanks everyone for the help. Well I actually got another opinion (was lucky and got a cancellation) and he advised that I need oral surgery to bring my lower jaw surgery and said that braces wouldn't make any difference. Said the problem was with my jaw as I have a jaw discrepancy. He also gave me an option for veneers if I didn't want to go for surgery so will have to think about it. So that's 2 opinions now saying I need jaw surgery and one saying just braces.

Personally, I would have loved to have the braces but part of me was thinking I don't want to pay out that money and not notice much of a difference afterwards. So hard to know what too really, dont think I can afford a 4th consultation

[Krystal]

Sorry I forgot to say that my upper teeth sit on my lower lip and in the mornings it seems worse Think I'm concerned that my teeth will go back to where they were after the braces. I know he said I'd wear retainers at night time after the treatment. Is there a chance of teeth going back to their position?

Feeling down in the dumps about my teeth and I hate this look of where my teeth sit on lower lip. Confused to the point as how braces can help that as ortho said he wanted to bring out the teeth beside my four main teeth at the top for a more rounded smile. Then my lower teeth sit back and said lower braces will bring them forward.

Just thinking will braces help my problem as well seeing my upper teeth sit on my lower lip?

[Sunny]

Firstly your teeth will not have moved in the morning ... it is most likely related to how your jaw relaxes while you sleep.

There is always the risk that teeth will move back, but that's were your continued discipline with retainers and once yearly appointments with your ortho are important. Wearing retainers while you sleep will help your teeth to remain in the position they are moved to at the end of your orthodontic treatment.

Without surgery your jaw bones remain where they are now. What you have to think about, is how your teeth will look aligned in your current jaw bones. Maybe you need to see another ortho and ask more questions of the three you've already seen.

Surgery is not the only answer to correct an overbite like your's, but you need to discuss with your ortho's what your compromised results will be if you need surgery and don't have it. I think about 50% of our patients who are surgical cases, don't have surgery. Knowing what their results will be like without surgery, as opposed to having surgery, is a great start and it allows those patients choosing not to have surgery, to know what the differences are.

Surgery is not the only answer, but for some people it is necessary!

[Krystal]

Thanks Sunny. Yeah it's just hard to imagine what my teeth would look like after braces and in the same jaw structure as it remains the same.

I've attached some photo's so everyone can get a better idea of what my teeth are like. I'm sure you all agree my overjet is quite bad

[Krystal]

Hi, everyone, well I've actually spoke to the first orthodontist I went too and asked him would braces on their own help. He said fixed appliances would be used to align and coordinate the arches after which a mandibular advancement osteotomy would be required. Said I've a strong chin point and may require a simultaneous reduction genioplasty to get the best possible result. He said appliances would merely align my lower anterior teeth and would not have any effect on my overjet. The extraction of a premolar from either side of the upper arch and the subsequent retraction of the upper labial segment would reduce my overjet however this is likely to have a detrimental affect on my profile.

Forgot to say to everyone that with him I can pay for the braces or he'll put me under the NHS but there's a 2 year waiting list. So he said braces won't have any effect.

I then spoke to the other orthodontist I went too and he has said braces will help and my overjet will be about 6mm after treatment. Confirmed again that I didn't need surgery as he'd bring my lower teeth forward. Braces with him are a few thousand pound.

This decision is so so hard!

[Sunny]

Is the second ortho going to require you to have extractions from your upper jaw?

The extraction of a premolar from either side of the upper arch and the subsequent retraction of the upper labial segment would reduce my overjet however this is likely to have a detrimental affect on my profile.

What do you mean by this? Extractions can mean that an overjet is able to be corrected for dental cases, as usually this is the result of teeth being too large for the existing jaw and mouth.

[Kmeri]

Hiya, It is interesting seeing your photos as it really does look like your situation is similar to mine. If you can send me your private e-mail somehow I will send you my invisilgn graphics thing that shows exactly how my teeth have moved (I dont want to post it online tho!).
My "jaw relationship" as they say has not changed but my teeth have and while if I look carefully there is still an overbite and still my lower jaw is too far back etc but I actually look fine.
It's interesting you saying about your top teeth hitting your lower lip, I never even noticed this until my teeth started moving and now they don't - it's weird!
I really feel for you having to make this decision, it must be hard!

[Krystal]

Is the second ortho going to require you to have extractions from your upper jaw?
What do you mean by this? Extractions can mean that an overjet is able to be corrected for dental cases, as usually this is the result of teeth being too large for the existing jaw and mouth.

Hi Sunny, sorry maybe I didn't explain it too well. The ortho said he wouldn't do any extractions as it could change my profile. Said the problem wasn't my teeth it was the size and position of my jaw. Sorry again for any confusion.

[Krystal]

Hiya, It is interesting seeing your photos as it really does look like your situation is similar to mine. If you can send me your private e-mail somehow I will send you my invisilgn graphics thing that shows exactly how my teeth have moved (I dont want to post it online tho!).
My "jaw relationship" as they say has not changed but my teeth have and while if I look carefully there is still an overbite and still my lower jaw is too far back etc but I actually look fine.
It's interesting you saying about your top teeth hitting your lower lip, I never even noticed this until my teeth started moving and now they don't - it's weird!
I really feel for you having to make this decision, it must be hard!

Hi Kmeri, so I'm not alone then would be great to hear from you. That's great that you look fine now - my email is krystal23456 at g mail dot com

Yeah it's such a hard decision really, will hopefully get there.

[Krystal]

Hello everyone, well I'm disappointed and sad Have been to see my Dentist as he said before I'd get braces on he'd want to do X-rays. Well he say's he's not sure if braces is for me as I've had quite alot of work done on my teeth and some aren't very healthy at the roots and he's abit concerned. I have fillings as well and have crowns at the top and he said this can cause few problems. He wants me to see the ortho again and tell him that my Dentist is concerned. So not sure what to think now, I know I've had quite abit of work done on my teeth etc and he said some of the roots aren't very healthy and he's concerned about them. So disappointed to say the least don't know what to do as I was really looking forward to getting on my braces

[Sunny]

Krystal your ortho may still be able to treat your case. It's important to make sure your teeth are in premium health before undergoing orthodontic treatment, as it is tough on the roots of your teeth, your gums and general oral health.

If the roots of teeth aren't long enough and/or healthy enough, these people may not be suitable for treatment. Basically there's no point having ortho treatment and risking your teeth falling out.

Talk to your ortho and hopefully things will work out well for you! Good luck!

[Krystal]

Thanks Sunny for your help. I'll need to talk to my ortho again. Basically my dentist said a few of my teeth are heavily filled and I've had a few root canal treatments done at the top. Said my upper teeth were unstable and he'd be very concerned re moving them as it could jeopardize the health of them. Really worried now and disappointed as I was so looking forward to getting the braces on. I really don't want to look like this for the rest of my life and not sure what my options will be, if any. Unfortunatey I don't think there's anything I can do to reverse my problem ie damage already done to the roots Thanks again.

[Realeyesrealize]

Hi

I also have a Class II - 11 mm overjet and a strong chin. With my mouth closed I really don't mind my profile but can't stand my teeth when I open my mouth. I have been to four ortho's so far and 3 said surgery ( but also said I can do braces and extractions) one said not at all but extractions would be necessary. The last one told me I wouldnt be happy with just braces and will not like my profile ( which is good with my mouth closed) he said my nose will look bigger and I'll have a flat upper lip. He said without surgery no point of braces because it's a jaw issue not teeth. He was very honest with me and said he will not take me on without surgery because I won't be happy. I decided to go with surgery because it's will be the only thing that will actually help with my jaw. I have been unhappy with my face for so long I might as well do it right. I have yet to meet with the surgent and find out all the details but have looked into side effects such as numbing etc and I'm prepared to live with it. It's a very serious decision and do what feels right - I knew I did not want to waste time and effort into a maybe it'll work solution. Do the research meet with a sergeant and discuss your fears etc. i am getting my braces on in a month or so and can't wait to be done with the surgery next year . Good luck!!!!