Wednesday, December 16, 2009


The dentist recommended two orthodontists for Andrew. He told us that he wasn't sure whether Andrew would need palate surgery too, or if the braces would be enough. Today we got our first opinion. Second opinion is in 3 weeks.

Wow. Andrew's bite is misaligned in one direction on the left side, and misaligned in the other direction on the other side. Around the canines, the upper teeth fit inside the bottom teeth. The front teeth cannot touch each other. The roof of his mouth is not wide enough. Oh, and by the way, the wisdom teeth need to be removed too. These are not matters of appearance; this is about the likelihood of teeth becoming worn out at far too young an age, as well as the near-certainty that the problem will cause pain in his jaw, back, neck, and headaches a couple decades down the line.

If the dentist where we used to live had pointed these things out, they could have changed his palate through orthodontia instead of waiting until his bones were harder and the joint fused so that it needs surgery.

They need x-rays to see how to remedy this. The orthodontist said that her first look at his mouth indicates that we'd probably need to have him in braces which will actually worsen his situation. It will take a year or so to get the teeth in the right position for where they'll be after they do the surgery to rearrange his palate. After a couple of months to heal from surgery, they will continue with the braces to get all the teeth in the right place as best as they can. I asked about what would happen if, for some reason, we started on this program and it was interrupted. Wouldn't we be leaving Andrew in worse shape than where he is now? The orthodontist said that there isn't much worse than what he's got now.


We talked briefly about the benefits and risks of a proper fix, as well as the benefits that might be achieved through a "compromise fix." These are going to be some hard decisions.


  1. Oh tough decisions is right!

    Our Abby has already been a customer of the orthodontist for about a year due to her misalignment. Her upper jaw sat to the right so that the bite was not correct. The orthodontist said normally he never does enything with kids her age (she was 7 at the time) but this is the only case because left undone, her jaw would grow permanently that way and cause problems. She had to wear an appliance in her mouth for awhile which pushed her upper jaw out (he even overcorrected a bit for insurance as she grows), now she wears a retainer at night and just goes in periodically so he can make sure everything stays in the right spot. He was also very adamant with us that this didn't mean she wouldn't ever need braces in the future that this was simply correcting a very bad, misaligned jaw and bite.

    Good luck with the decision, do what you can and try (sounds so lame to type it) not to worry about what you can't.

  2. When I was a kid I had a severe open bite. None of my teeth touched at all except the molars. Jaw surgery (basically breaking and resetting the jaw bone) was recommended, but my parents declined because it seemed like such a sever measure. I spent about four years in braces and ended up with a pretty decent bite. But in the last 25 years my bite has slowly started opening back up (even though I still wear my retainer). I recently saw an orthodontist to see about going back in to braces for a few years. She said that it wasn't a viable option for me--that the reason I have exposed roots right now is because the orthodontia that was done without the jaw surgery basically just hyper-extended my teeth. To get braces again would cause even more root to be exposed. She said the only permanent fix would be jaw surgery, which is a rather radical step I really don't want to take at this stage of my life. I found some online pictures of people who have had it done and the process and the recovery do not look at all fun.

    Difficult decisions indeed. I'm sorry Andrew is having to contend with this problem and pray that you are able to arrive at a decision you can feel at peace with.

  3. Glenda, your story makes me think maybe I should get Maggie in, just to be checked. In case.

    Chery, thanks for pointing out the downside of extensive work through braces. Given the two different sets of dental problems that Andrew's parents & grandparents have, adding extensive orthodontia (in lieu of surgery) would just worsen the problem with exposed roots. Doctors don't usually tell you about side effects that you'll face several decades down the road.

  4. Susan, I do not know about Andrew's issues, but there is a new option I found called The Damon System. Even if your kid has cross-bite, it can be solved without key turning by the usual way. Anyway, the link

    This guy showed me bad situations like the one you described and I am just saying there may be hope! I was turned off by the flashy nature, but from a physics standpoint, this seemed logical.

    There is even a video on youtube. We have been to 2 consults with regular orthodontists and a damon one and I am sold. They are even cheaper and the technology made more sense to me.
    Joe already had an appliance about 3-4 years ago to fix a bad problem with a tooth coming in in the wrong place and twisted. I would have continued on that path but our guy retired.

    Hope you find what you need!

  5. I had braces twice. The first time, in middle school, treatment was not managed well AT ALL. The second time, begun as an adult because my teeth were starting to fall out from the damage of misalignment, I had both braces and the surgery that Cheryl describes, involving both jaws. Both the surgeon and orthodontist I had are in your area, Susan. Not only that, my surgeon was able to convince my insurance company that the surgery was NECCESSARY (not cosmetic) to me being able to continue eating and keeping my teeth, and they paid. Whew!

    Money spent now for Andrew is *completely* worth it. If my care had been managed properly the first time around I likely would never had needed the surgery and second round of braces.

    AND WEAR YOUR RETAINER, PEOPLE. FOR THE REST OF YOUR LIFE. Or your teeth WILL undo themselves of all that expensive work. And you will be sorry.

  6. "Yes" about the retainer. I probably wore mine for 6-8 years, much longer than they told me I needed to. It got to where it was not fitting right any more. I should have gotten another one made, but I quit wearing it. It took quite a few years before my teeth started moving again, but they did. I wish I'd gotten another retainer.