Overjet, surgery and braces - alternatives

I’ve read a lot on blogs and forums lately about people who are about to undergo surgery for their overjet. First and foremost I wonder why they didn’t get treatment earlier (around age seven) but that’s a topic for another blog post. Something that seems very common is to wear braces for overjet for a very long time, usually with rubber bands, after which the orthodontist gives up and says, “nope, this didn’t do anything, you’re going to need surgery”.

Functional orthodontists, however, claim that an overjet can’t be corrected with braces alone (and certainly not combined with tooth extractions) so according to them that would be a waste of time. In cases when traditional orthodontists believe they have solved the problem, they have instead created an illusion and an even worse functional problem has been produced.

You could die trying to move the teeth around in order to take care of an overjet but it’s not going to help since it’s a skeletal issue. The teeth are not to blame and should be taken out of the equation.

This is why I am an advocate for functional orthodontics. Read here what my guru Tooth975, a functional orthodontist who works for Yahoo Answers, says about this matter.

ALF, Crozat and Schwarz are all examples of functional appliances that are used to broaden the upper arch in both adults and children. They are sometimes also used to expand the upper jaw forward. The lower jaw can be brought forward by using a splint. Please note that these appliances don’t move the teeth but instead they focus on the jaws which is the right way to go! You might need braces afterwards but this final touch usually doesn’t take too long.

Go on to this post.

Here, Tooth975 explains how the lower jaw has to be guided forward by stretching the muscles. This may sound strange to somebody who hasn’t dealt with these problems themselves. The best way to explain this is that the lower jaw can sometimes “hang” too far back even though there is enough bone for a non surgical approach to work.

Furthermore, Tooth975 (I know, gotta love him, right?!) says that surgery should always be avoided if possible. Sometimes it’s necessary of course but in most cases the problem could also have been prevented if it had been dealt with at an early age.

It seems relevant to discuss if too many people are recommended to have surgery. If the only alternative presented is extraction/retraction orthodontics that only camouflages the problem and doesn’t solve it, this is a very serious matter. Recovery time after surgery is several months and there is always the risk of loss of sensation in the lower lip. Some patients lose a lot of weight because they can’t eat normally for a while. Not to mention the physical and emotional suffering involved. However, here in Sweden, this is what the county council and national health insurance are willing to cover.

From extractions/braces to jaw expansion - the transition

I just listened to an 8 minute long radio recording with Dr. William Hang who has lately become my guru. He is one of the few orthodontists out there who try to solve the cause behind crooked teeth by fixing the jaws first. I have to say I am completely taken by this interview! This is the first time I hear Dr. Hang talk and it is almost as if he has read all the different thoughts I’ve had for 17 years (that is, ever since I had my braces removed).

Dr. Hang explains how he “converted” from extraction/retraction orthodontics to what he does today (mainly expansion of jaws and bringing them forward). Even Dr. Hang was once “on of those who recommended that you had teeth pulled”. But today he doesn’t even want to look at these people, it makes him shudder. He didn’t realize back then how bad it really was and how much damage that kind of treatment can do.

In the middle of the transition he still had a couple of patients who were undergoing traditional treatment and of course he had to finish what he started. He tells us how his pulse started to accelerate as he saw their names on the schedule. He almost had anxiety attacks and it was all very difficult for him. I am so impressed that he had the courage to break lose, that he was so far ahead of the others and that he later on had the strength to admit to himself and the public that this was wrong.

He also talks about women he met who had teeth pulled and braces and who look back at the result and say, “I don’t like this, not even a little bit!” One of them even said, “My life was over at 13. When I had my braces removed and saw myself, my life was over.”

This almost brought tears to my eyes. For 17 years I thought I was crazy! I have never liked how my mouth turned out or felt and I have hated what the orthodontic treatment did to my face. But I have never heard of anybody who feels the same way. My experience was very vague and I didn’t understand what was wrong, I couldn’t explain it. This is what it must feel like to suffer from a disease that doesn’t have a name yet and is suddenly recognized one day. An awakening, an aha moment. It is an incredible relief! 

Teeth that are shifting

I've come across many forums where people complain about shifting of teeth after braces have been removed. Either they forgot to wear their retainer or the bonded retainer wire on the back of their teeth fell off. It surprises me that almost no-one asks why this happens. Are we just supposed to accept that this is how things work? I remember questioning this before I did my major research. I used to say to myself, "What's up with this, an unstable result? What have I let them do to my mouth?" I at least wish they would've explained things before treatment. Some people still don't get this information and it's upsetting to me. In my opinion having to wear a retainer for the rest of your life involves a big risk. Let's say I go on a trip where I travel for more than 24 hours and my sleep is irregular for a week or so due to jetlag. Or if I get a kid and forget to wear the retainer for  a couple of nights because of the chaos that occurs. Or if the bonded retainer falls off while you're on a trip (I had this happen recently).

Before I did my research I asked a dentist about shifting of teeth after the wire fell off and she told me the whole thing is one big experiment. Orthodontists ask themselves if the number of years you wear the retainer is related to whether they will shift or not. After reading a lot about the topic I found a whole bunch of American websites that stated that if you don't solve the jaw problems (that almost always seem to be the culprit to begin with) the amount of time that you wear the retainer will be of no importance and that life-long retention is the safest. I would rather solve the underlying problems! Such techniques exist too, and they have been available for decades. But instead they choose to aggravate the problem. Seeing it from that perspective, I don't blame the teeth for wanting to return to their original position! ;)
 

I found a blog written by a person who lost her retainer and her teeth started shifting right away. She went back to the orthodontist to consult them and they said they made a mistake by not removing teeth because of crowding. Like that was the reason for the shifting. Where did that statement come from, was it just a wild guess? From what I've heard risk of shifting increases if you have teeth pulled. This is because the dental arches are made smaller leading to decreased tongue space among other things.
 

How about at least providing the patient with some theories. Or are they trying to evade the fact that they ignored a big problem with the mouth that still remains?

Retainer forever? We'd prefer teeth that are not kept in place by a "bandaid"! 

Adult braces and pulling teeth

I get extremely upset when I think about the fact that the government paid for something that might have damaged more parts of my health than I can imagine. (For example, my weird blood pressure and heart palpitations could be related because that's what happens when you can't breathe properly at night.) This is probably going to cost me at least 15.000 dollars (possibly more) to fix. I want treatment immediately but I realize it's not possible. I must make up my mind first about what country I want to live in.

I have surfed around on some blogs written by people who wear braces. Most of them are teenagers and adults and a lot of them were adviced to have teeth pulled. It's sure is strange that extraction orthodontics is so big in Sweden when the side effects have been discussed in the USA since the 1980's. Anyway, I have commented on blogs written by people who didn't yet go through with the decision. When commenting I always try to be humble, saying stuff like, "it never hurts to be aware of the debate".

Maybe I should stop doing this though? It doesn't seem like I can get through to them. They trust their orthodontists completely. It is just very hard when you see pictures of very mild crowding and know that extractions were suggested even for those. I know all too well that my words might not matter to them. They so desperately want to believe that this simple offer of free orthodontics will solve the matter. I think it's wishful thinking that traditional braces with extractions will take care of everything and that there are no side effects whatsoever.

I can only speak for myself but I do due diligence before I have anything done. Google is my friend. When I had my orthodontics done there was no Internet to help me (well, it did exist but nobody was aware of it). One glance at Facefocused.com would have made me turn down treatment for sure.

Traditional braces - friend's glad she never wore them

I went to dinner at a friend's place last night and we started talking about how much her crooked teeth bothered her. I started talking about what I've read lately, that you shouldn't extract and/or retract teeth in orthodontics because it can damage the profile, the bite, the position of the tongue and the position of the jaw joint (TMJ) but that this is still done in many cases. She was shocked and said, "Are you SERIOUS?" I told her about Weston A. Price and how he found the reason for crooked teeth and that traditional orthodontics don't take care of the real problem and can make everything worse.

Then I told her that you will usually need bonded retainers on the back of the teeth for the rest of your life to keep them from shifting since the result is so unstable. "Are you SERIOUS?" she said again. She couldn't let the topic go. The more I told her the happier she was that she had never worn (traditional) braces.

Later we started talking about children and that they often wait until they are fully grown here in Sweden which is the wrong thing to do. She had relatives that had to wear braces and pull out an eye tooth (a canine tooth coming in in the roof of the mouth) and when I told her that kind of scenario can often be avoided if you guide the growth of the jaws at an early age she was really surprised that more people aren't aware of this.

We then started measuring each other's intercanine width and laughed like little girls. "Ok, let's measure yours, oh my, your upper jaw is too small!" "Are you supposed to have that big of a jaw, that's huge!" (The norm is 40 mm for both men and women.) We measured the distance between the nose and the front teeth (according to Dr. Hang and Orthotropics practitioners). Her distance was too big but mine was of course bigger. We laughed again. But then we got serious once more. We discussed how I'm going to reach out to people? I don't know if most people wouldn't care about their health to get straight teeth but that they might not disregard the fact that these retraction methods cause double chin, bigger nose, damaged profile and treatment relapse? I gave her some links for further research.

Imagine if this could have been avoided at an early stage. I'm sure this person would've been thrilled.

Overbite and upper jaw too far back

I can't help but look at friends who I know used to wear braces, some of who had teeth extracted, and give their teeth and jaws a quick glance. Those who didn't have teeth extracted have the broadest smile, no doubt about it. They don't all have an inwardly slanted upper lip but usually straight (convex is the ideal, like most fashion models). But of course I avoid staring, it would have been weird if I did. :)

I almost worked myself to death today. To be able to write articles about overbites and jaw surgery I have to try to figure out exactly what happened to me. I finally gathered enough strength to open an old photo album with pictures of myself. I could never stand looking at pictures of myself as a kid, a face that I was forced to have damaged to please my parents and the dentists. (At least, that's how I used to look at it, I know it's not entirely true.)

I found pictures of myself as an eight year old. What can I say? My upper jaw is too far... back. Can you imagine? You have a 10 mm overjet - how the heck are you supposed to be able to figure out that the upper jaw is too far back? (The dentists should tell you this because they should know, shouldn't they?) But this is often the case, or so I've read, and I could clearly see that this was the case with me. The teeth appeared to be protruding but that's a different story. The truth is that the position of the teeth is usually perfect only they have been pushed out because the upper jaw is too narrow. Therefore the jaw is to blame, not the teeth!

Next thing that happens is that the upper jaw stops the lower jaw from developing properly and you end up with a weak chin. It's said that these problems keep getting worse the older you get and that was something I could determine from looking at these pictures. The face grows longer and longer and the profile becomes more and more diagonal. It really is pretty scary. Traditional orthodontics that move teeth backwards guide the face to grow even more wrong. Basically, they do the opposite of what should've been done.

Furthermore, to not help an eight year old who has this kind of problem? No, you choose to wait until it's too late. That's bordering on evil in my opinion! From what I've come to understand, scientists have known for about a century that when the cranium, the jaws and the teeth start to grow in the wrong direction they will continue to do so and if anything, get worse.

I feel disfigured. After having read all this I wonder how anybody has ever been able to find me attractive or cute. I may look alright from the front? I wonder if my super fast metabolism has anything to do with this. The cranium didn't develop the way it should which makes you look sick. I look like a person who has melted and got smudged out.
Maybe I should stop working this late...