<p>Hi all-
My son’s lower jaw grew faster than his upper one. He is 19 and at this moment when he bites down his bottom and top teeth meet edge to edge (no overlap of the top teeth over the bottom teeth like a normal bite). Apparently leaving this bite untreated will lead to the gradual wearing down of the teeth as they constantly are hitting together when eating, etc. Also I guess there can be problems with jaw pain, etc. (Cosmetically he doesn’t appear affected, and is a handsome devil if I do say so myself :))</p>
<p>Surgery means taking out a section of the bone in the lower jaw on each side and then forcing the lower jaw backwards, and securing it with screws. It sounds like mid-evil torture to me, but apparently it’s done quite frequently.</p>
<p>Also, they don’t like to do it on boys until they’re absolutely positive they’re done growing, so this won’t be happening for him until 18 months-2.5 years from now.</p>
<p>Still, I’m looking for feedback now:</p>
<p>Does anybody have experience with this surgery? </p>
<p>Also is there the equivalent of a “Mao Clinic” for this type of surgery, ie: The BEST place to go for jaw surgery, where they do a lot of them and they’re the best at it?</p>
<p>We have local oral surgeons in my area, but they don’t do a whole lot of them, and I was wondering if there’s a widely-known, highly successful practice in an area with more population density than where we live.</p>
<p>Or if it’s not “rocket surgery” (haha), and any oral surgeon will do, I’d love to hear those opinions too. </p>
<p>Thanks for reading! PM me if you have specific names or clinics</p>
<p>Just yesterday, we had a consultation about the same thing. My head is still spinning.</p>
<p>What’s complicated the situation is that ds is in braces, and the oral surgeon said the braces shouldn’t have been put on without the surgery first – or at least a consultation about the surgery so that we would have understood the time frame involved. It’s all complicated now because ds is in college 1,000 miles away and, of course, has limited time availabilities.</p>
<p>Something else we were told: He needs to have his wisdom teeth out before the surgery. And the oral surgeon requires that there be at least four months between the time of the wisdom-teeth removal and the jaw surgery. This may not be your ds’s case, but it is in ours. Our ds has an underbite, plus his midline is out of whack, plus he has a deviated septum. The oral surgeon would do both the jaw surgery and deviated septum at the same time. Funny how until he got braces I never noticed how out of whack his handsome face really is!</p>
<p>Our oral surgeon said he wants to see ds every week, I think, for eight weeks afterward, so I’m not sure that doing a surgery too far from your house would be advisable. This guy isn’t covered by our insurance, though we did get an out-of-network deficiency approval for him. We were all really impressed with his care. I’ll PM you his web address.</p>
<p>Anyway, now we’re left wondering how much or any of this stuff to do. It’s expensive, and the time frames make it burdensome. We could just do the deviated septum with our ENT and finish the braces and let ds do the surgrey on his own down the road. I suspect that’s what we’ll do, especially if it ends up being really expensive.</p>
<p>My husband had this surgery. Not easy but the alternatives (losing teeth in the future and super TMJ) is worse. Basically his jaw was cut and moved.
His orthodontist insisted on the best surgeon and did research for him. His ortho had the surgery years before. The procedure can damage nerves which can leave numbness in the chin and lip area (like having novocaine at the dentist). My husband has a very small area left numb that doesn’t affect him but can be irritating I’m sure at times. His orthodontist had been left with half a lip numb which makes it difficult to drink (hence his insistence on the best). The surgeon he ended up with does a ton of these procedures on a very regular basis. You will want someone very experienced.
My H was in the hospital for a couple days. Pain but there are pills for that.
Afterwards his teeth were wired shut for 8-10 weeks (can’t remember). I will say that didn’t seem to slow down my H much. Couldn’t talk well at first but didn’t take that long to speak clearly even with jaw wired (he ate pretty well too! Mush maybe but it didn’t slow him down). I will say he looks and breathes a lot better (stopped snoring almost altogether).</p>
<p>NJ, orthodontics can make minor adjustments and aid, somewhat, with appearance, but it can only do so much. Here’s an example of a severe underbite (middle example) that no amount of orthodonture will correct:</p>
<p>Nothing to add, but posting to keep tabs on this. My oldest has been suggested for this surgery as well and he’s trying to postpone it, possibly forever.</p>
<p>My son had a different bite problem (front teeth meet for chewing but not molars) and his dentist recommended surgery. However, we went and got three other opinions. The others said you could do it, but it wasn’t necessary. If he was comfortable as is, no surgery was an option. We decided not to do surgery. I’m not suggesting this is right for your problem, but a couple of other opinions can’t hurt.</p>
<p>OP,
We went through this with D but for an overbite. I agree with your impression of the surgery description (medieval torture!) I couldn’t bring myself to put D through it, especially because, like you, we thought she looked beautiful as she was. We decided to leave the decision to her to make when she is older.</p>
<p>Regarding future complications from not correcting the problem, I want to add that from my life experience, there are so many things that can be done to repair teeth nowadays, that if the biggest concern is wearing down the teeth over time, it seems like this would not be too difficult to address if and when it occurs, with veneers or something like that.</p>
<p>I think that if the problem were severe enough that my D’s appearance was significantly impacted and she was unhappy about it, I would probably have gone forward with it. This was not the case for her, fortunately.</p>
<p>"Something else we were told: He needs to have his wisdom teeth out before the surgery. And the oral surgeon requires that there be at least four months between the time of the wisdom-teeth removal and the jaw surgery. "</p>
<p>I would have this first step done as soon as possible, since his wisdom teeth may still be small and removing them now would prevent his lower jaw from growing even larger to accommodate full mature wisdom teeth.</p>
<p>When S2 was about 13 the orthodontist said that his chin was too small, and that we had 2 options, the first option (which was the orthodontist’s preffered option) was to do orthodontia a certain way and then when he was fully grown he would have jaw surgery to I guess move it forward, or do orthodontia another way and hope for the best. But the big thing was that we had to decide before we started orthodontia because if she would do things differently depending on whether or not he was going to have surgery. We decided against surgery. It sounded like medievel torture. She said another option was to have a chin implant (or something like that) at some point. To me, he is quite handsome, I guess maybe he has a small chin, but it isn’t anything I think anyone would notice. In addition he had two teeth that were growing horizontal rather than vertical so he had to have oral surgery to expose them and then they attached a chain to bring them down. That was successful. But he was in braces for a very long time (I think 3 or 4 years).</p>
<p>tx5, having seen your ds in pictures, I concur that he is quite handsome and has a fine chin! I’m not sure why an ortho would think that he/she would know an outcome when at 13 there’s a lot of growing left to do. I think you made the right call. :)</p>
<p>Thanks to all of you for your responses, and also to those who PM’ed me. </p>
<p>To address a couple of things from above:
He did have braces already (when he was 13/14) and when they came off his bite was beautiful. The problem was he still kept growing and that prominent jaw just kept on moving forward throughout high school. I think when he got his braces off he was about 5’6" and now he’s 6’. Apparently (says my ex-orthodontist who I’m not thrilled with at the moment…) this just happens to about 5-8% of kids, it’s genetic and there’s nothing he could do about it (mmmhmmmm…I wonder if we hadn’t been rushed into braces if some of this could have been avoided?).</p>
<p>2) He had his wisdom teeth out last summer, so we’re good there. </p>
<p>3) We’ve had a consult with a new orthodontist who actually had this surgery done when he was in dental school so he knows first hand about it. Some of the long recovery issues and jaw wiring have been minimized with new techniques and procedures and it sounds like as someone said above, the run up to the surgery is actually the biggest pain, with a new set of braces, etc.</p>
<p>It sounds like I should be looking for an office that does a lot of these surgeries. I would not be at all averse to traveling to a very reputable surgeon and staying in a local hotel for a week. Please continue to suggest if you have ideas.</p>
<p>You might consider setting up a consult with your state dental school. S2’s orthodontist was really pushing us to do the surgery for an overbite when he turned 18. It would require braces (a second round) for about 8 months prior to the surgery and than the surgery itself. We were concerned about it and our regular dentist suggested that we do a consult with our state dental school. They were great. They confirmed that he would need the braces, but they could do them at about half the cost of the orthodontist. They than noted that these braces would need to be adjusted at least monthely, so when they found out that S2 was headed to school out of state, they set up a consult at the dental school where he was headed. (The head of our dental school had trained with the head of the dental school there.) So the day before freshman move-in we did that appointment. They agreed about the need for braces, talked a lot about the logistics of a freshman in a new place, adapting to a new enviornment keeping up with the schedule of appointments, etc. They then did a family medical history – and when we said that both H and S1 had grown almost 3 inches between the ages of 18 and 21 they strongly recommended that we wait until he is older and more settled to even consider the surgery. If we had just followed the orthodontist’s advice and started right away we would have been in a mess. The two dental schools really gave us good advice – and both places it was free. If we decide to go ahead with the procedures we are strongly inclined to go through the dental school for at least the orthodontia portion of the procedure.</p>
<p>My d had this surgery. Getting any coverage from Insurance was a battle. We went out of network to get the best doc we could find. It was a 6 hour surgery and required braces for a year and removing four wisdom teeth. Her jaw was banded shut and she drank pureed food for a month. She was in braces twice before we saw an orthodontist who told us she never should have had braces before arranging surgery. Her lower jaw did not grow properly. Our doctor was the best, the outcome is great and everything went well. Our out of pocket for the orthodontist, the wisdom tooth removal, the surgery with anesth. and hospital would buy a luxury automobile. That is why I’m driving a 2003 Toyota today but I have no regrets.</p>
<p>My husband had this surgery back in the 80’s when he was in his late 20’s. (I am sure techniques have progressed since then) First few days after the surgery were difficult and he hurt, alot. Then it was really just waiting for wires to come off. I ended up pureeing pretty much everything he would eat before surgery, including steak, yuck. He did have an issue with the pin/wire (can’t remember) that held the jaws together after surgery and had to have a second surgery, but it was minor. Insurance paid for pretty much everything. Perhaps if there is an issue with insurance paying, you might want to wait a year, if possible and use your FSA to the max.</p>
<p>I don’t know where you live, yalemom15, but S had his broken jaw repaired this past summer by someone who is considered one of the best maxo guys around. Not sure if he does the type of surgery you are considering, although I don’t know why he wouldn’t, but PM me if you want his name, etc., and you can check him out yourself if he is close enough for you to qualify.</p>
<p>My daughter had this surgery as an 11th grader. They say the lower jaw is one of the last bones to grow, hers just sprouted forward in one year. I’ve heard boys can experience that during college! The xrays showed her lower teeth hitting in front of her upper teeth, which was not the case during the year earlier. </p>
<p>The process was- 1. remove wisdom teeth as the excision of the jaw is done where the wisdom teeth used to be. 2. Have braces for a period of time, then they remove the wires for the surgery. 3. Surgery which meant one night in the hospital, but the head nurse said it used to be outpatient in some places. (the first night the wall suction was super helpful for drainage, it would have been tough at home) </p>
<p>Her face was so swollen she couldn’t even put on a t shirt. It also is pretty bruised. She was on pain meds for almost a month to some extent. She only had a week before school started, it wasn’t enough time. She couldn’t talk, eat, or play the violin. Another week would have been nice. They called her Ham Ham (the anime overweight hamster) The little plate stays in, but the Dr. said people can get a small fish bone caught in it sometimes and get an infection. (very rare) He said the plate can be removed by any oral surgeon anywhere in the world if that happens. </p>
<p>Creating the correct bite during surgery is kind of an art, she had two oral surgeons working together. She is thrilled with the result, it smoothed out her profile even though only 7 mm was removed. I wouldn’t have the surgery unless someone can be home with you the first week at least. We are really happy with the results, but it was expensive. My friend who’s a dentist says it’s the most impressive cosmetic surgery as the results are so worthwhile.
I can recommend a practice in the Seattle area.</p>