<p>Took 18yo ds college freshman to the ortho to talk about braces. His teeth are crooked, and he has an underbite. We hadn’t done braces earlier because he was a late teether and is just now getting his 12-year molars.</p>
<p>The ortho today says ds1 will need oral surgery to get the best result. We were totally caught off guard by this. Anyone have any experience with the surgery? The one positive is that the ortho said an oral surgeon could do both the jaw realignment and the deviated septum surgery we had planned for this June, but now both those procedures would need to take place next summer. We’re proceeding with the braces since that needs to be done anyway. I’m just not sure how all this is supposed to happen when he’s only home for weeks at a time. Ortho acted surprised no one has mentioned surgery before.</p>
<p>I’m not even sure what my question is. I guess I’m just looking for people’s experiences/advice.</p>
<p>We were also surprised with a suggestion of jaw surgery for our daughter. (we haven’t had it done yet) My advice would be to seek out a second and third opinion, asking questions about whether the surgery should wait until after all growth is done which may be still a while for a boy, and questions about recovery. Recovery wasn’t described as badly as I had envisioned it. Perhaps if necessary surgery could be done at the beginning of a summer.</p>
<p>After you have opinions from the orthos, it may be good to discuss them with your dentist and physician. Good luck.</p>
<p>I’m not a dental person, but it seems like it’d make more sense to get the jaw realignment done first, the braces after. That way the teeth can be aligned properly.</p>
<p>One of our kids was late in losing teeth. By age 13, had only lost six baby teeth. Ortho had ten or twelve teeth removed (by oral surgeon), four of which were unerupted perm teeth (way too crowded; amazing xrays). After a year, two teeth STILL hadn’t come down. Back to oral surgeon, did the ‘gold chain’ thing to drag them down. In the meantime, they put braces on the front teeth for a few months, just to help appearance. </p>
<p>But we never had to go through the jaw realignment procedure. A friend has one scheduled. Will be taking six weeks off from work. It’s pretty major, from what I hear.</p>
<p>I am not a dentist, but I have some observations.</p>
<p>Because of the major investment required, I would get at least several consultations from recommended orthodontists before deciding what to do.</p>
<p>Also, be sure to ask exactly what are the benefits of doing the surgery, and the risks of not. In many cases, jaw surgery is only necessary for cosmetic reasons, or the teeth can be aligned to accommodate the jaw misalignment. </p>
<p>It can seem orthodontists sometimes desire to plan for a “perfect” result, particularly when the financial cost to the patient is so high, to deliver anything less than perfect. But sometimes “perfect” is relative and the patient and the orthodontist may have differing opinions about the the benefits of surgery to correct minor malocclusions and the willingness of the patient to get a perfect result at all costs.</p>
<p>As my general dentist (not ortho) told me, humans have lived with dental malocclusions for hundreds of thousands of years. While there are some malocclusions that require orthodontic treatment for good dental health, there are other malocclusions that are minor or only cosmetic, and it is completely reasonable for a patient to decline treatment for those especially when that treatment is surgery.</p>
<p>Personally, I would not consider jaw surgery unless several orthodontists told me it was medically necessary for good oral health.</p>
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<p>Typically with jaw surgery the alignment of the jaw is carefully determined by both the orthodontist and the oral surgeon, and this can require braces before surgery, after, or (most likely) both.</p>
<p>Ah, I guess we were lucky. My D’s dentist referred her to an ortho when she was in 2nd grade for treatment of an underbite. He said she would likely require surgery if we waited until later to correct it. Can you imagine “activating” an oral torture device (turning the screw in an expander) in a 2nd grader every night? I’m almost crying now just thinking about it, but D’s underbite was corrected beautifully without surgery. Just wondering why more dentists don’t inform their young underbite patients that surgery might be necessary if they wait until they’re older to correct the problem?</p>
<p>I’d definitely get a second opinion if I were you, but my D’s ortho warned us about just such a scenario if she waited for treatment.</p>
<p>I agree with getting a second and third opinion. Be prepared for possibly having 2 complete different views. As our D did with an ortho situation. I agree with Jbusc, that the best scenario may be for perfection, but not all steps may be necessary.
If you decide on getting other professional opinions, just make sure you have copies of the panorex/xrays. It can be costly to have these things repeated.</p>
<p>Mapesy, my D was referred to ortho when she was in 2nd grade, because of narrow jaw and crowding was going to be an issues. He suggested a palette expander which is exactly as you said. Turning a screw every night with a key over a year or 2. I got 2 more opinions and they each were different suggesting some type of intervention needed at that time. Because of that, I summised that there was no one answer and that I should wait. When she was 15 she then got her braces with no incident, had an underbite and they put 2 special wiring on the problem teeth and the result was fantastic. A friend who is a dentist told me that most of these early ortho interventions are designed to get parents in the money loop sooner and many of these things can tipically wait til the child is older and more developed.</p>
<p>I don’t know much about that situation but I got braces when I was like 11 or so and I still had two “baby teeth”. They made me have them extracted before I could get braces on because they said they couldn’t put braces on those teeth because if they did fall out it would throw everything off when the new ones grew in. They probably want him to have the surgery first so that everything is ok and ready for the braces to do what they are supposed to do.</p>
<p>Thanks for the stories, everyone. I’m on my way out of town without internet access so want to quickly respond now.</p>
<p>I’m relieved to hear that other orthos might give other opinions. This makes me feel like I don’t have to make this decision now. I can’t anyway, as the ortho says the braces need to be on for at least a year. I don’t feel the luxury of getting other opinions from other orthos right now because ds is home on spring break, and we want to forge ahead. This is the same practice we’re using for ds2, who has had braces for a year and will get his off this summer. I’m happy enough with the practice, though halfway through dds2’s treatment, a new dentist was added who took over our office. I don’t care for him quite as much as the other guy.</p>
<p>The dentist told us that, ideally, he’d have braces for a year to get the teeth initially aligned/straigthened, then the oral surgery to correct the underbite and the crossbite, then six final months of braces for last-minute alignment issues, post-surgery. He said that we didn’t have to do the surgery at all, but that braces can’t correct ds’s bite issues. Of course, ds doesn’t think he has a bite problem at all, but I see them now that I’m really looking at his teeth. </p>
<p>I guess the reason that I was feeling a little anxious is because we had planned on the deviated septum surgery in June, before this came up. If we can get those done together a year from now, then OK, but if we opt against the oral surgery or just p ut it off indefinitely, I would like to get the septum surgery this June, as he has a 3.5-week time frame that would be perfect for the surgery recovery and follow-up before he jumps into this summer jobs.</p>