Severe overbite! Surgery?

[loveyoutothemoonandtosaturn]

Took my 12 year old to the dentist today for a check up. He still has quite a few baby teeth so isn't ready for braces yet however his teeth do stick out quite a bit which he is self conscious about. Dentist took an X-ray and told me he has a very severe overbite that will need to be treated sooner rather than later. He has referred me to the orthodontist but there's a 12 month waiting list so told me if he was in my shoes he would pay private to get this sorted! Otherwise he could need surgery down the line? I'm so shocked as to be honest I've never even noticed his teeth to be that bad.. has anyone any experience of this? Can they even do anything while he still has so many baby teeth?

My DS has similar issues but with an underbite. He's only 10, but the dentist first mentioned it a couple of years ago, and in total contradiction to your dentist, said they'd need to wait until he's 18 and fully grown, and then they'll deal with it?! But then we saw her this week, and she is seeing him every three months now, so that she can get him on the orthodontist list, as soon as all his baby teeth are out. 😵‍💫 I think I need to get a second opinion really as I am fairly confused with what we should actually be doing!

A years waiting list would be worth it surely? If they can't start until all the tetth are there that might be a whole anyway. Is he drumming up business?

It gets silly when it's 4 years...

My DD had a severe overbite. She was referred to the hospital orthodontic team and it was fixed with a variety of braces. One was designed to train her lower jaw forward before she got the next brace that realigned her teeth.

Your DS won't have a teeth realigning brace until he has all his adult teeth, but I assume they could potentially start moving the jaw (not 100% sure of that tho). Once the jaw is realigned and the teeth straightened, your DS will have to wear a retainer at night as an ongoing thing to prevent the teeth moving again.

I had bilateral split surgery on my lower jaw when I was 20 ( I am 29 now) I had a crossbite and underbite. I wore braces for 3 years to make my teeth "worse" for when I had the surgery so that it would line up. I was told they couldn't preform surgery until I was 18 anyway. I wouldnt bother going private as there will be nothing they can do yet anyway. 12 month will be worth the wait

BTW, the overbite/misaligned teeth have to be over a certain measurement for a child to qualify for free treatment. Sounds as though your DS qualifies but do get the orthodontist to talk it through with you so that you understand. I look at my DDs before and after X-rays now and it's shocking to realise just how bad they were.

My son had a severe overbite. He was referred by the dentist to the local hospital consultant orthodontist when he was about 13 but there was a delay in treatment due to the referral not being sent, a 2 year waiting list and then lockdown happening.

When he was seen by orthodontist she told us that the only mode of treatment was surgery. Although my son was self conscious about his teeth and smile he did not want surgery especially when she stated the risks.

We waited a year and he was seen again by the same orthodontist and he was asked if he wanted surgery again, and that there was no other option. My son said no.

I got a second opinion who prescribed a braces and retainer regime. We paid privately, it was £2,500 that I paid in instalments.

He now has lovely straight teeth and a great smile.

I had a bilateral osteotomy a number of years ago- was so tough during the recovery but I'm really glad I did it!

I'd be happy enough to wait a year if that's definitely all it's going to be! The way the dentist put it to me was that I'd be mad to wait and it'd be worth paying private as it's so severe.

My ds had a 14mm overbite sorted out with a functional appliance - some sort of brace that has blocks to encourage your jaws to sit better. If you combine this treatment with the growth spurt, it does get the bottom jaw better. I would definitely pay privately if I could. Both my dc have had extensive nhs orthodontic work - the hospital is an utter nightmare for appointments etc. You see a clinician, they say on the form that they need to see you again in 6 weeks. You go to reception, they say no appointments left in 6 weeks. You try to book a bit further out and they say the booking isn't open. As soon as it opens, all the appointments vanish. You eventually get a random letter with a ridiculously inconvenient appointment.

I presume you are talking about overjet , that is when the top front teeth stick out a lot over the lower teeth. The underlying problem in these cases is a discrepancy in the size of the top and lower jaws.

In order to avoid surgery the optimal time to start braces for this type of problem is before the pubertal growth spurt which starts around 13 in boys. Often this sort of problem is associated with a very narrow upper jaw and the brace can be used to guide growth and expand the upper jaw. If braces are started after the growth spurt then the only way to expand the jaw is to wait until they are early twenties and use surgery. In not so severe cases teeth can be moved around to improve the overjet.

Bear in mind if you have a private consultation that will not move your son up the waiting list and if he wants treatment he will still need to wait or you will have to pay privately. You will be looking at £2500 upwards for treatment , depending on complexity.

Although this is talking about early intervention , it is a good overview of functional appliances and references , explaining why treatment at pubertal growth spurt is important https://hendersonhousedentistry.co.uk/wp-content/uploads/Consent-to-early-functional-appliance-therapy-V1.pdf

@Lollygaggle what sort of braces would they be talking about? Just the usual train tracks with bands or halos?

I had surgery on my lower jaw and I can't imagine how non surgery would give the same look I have now? Like they lengthened my whole bottom jaw, can they "grow bone" without surgery? I now have a lovely side profile but I do worry for my 18 month daughter that I've passed on the genetic malformation, life is easier for good looking people, I know because I was unattractive to attractive with the work done solely on my teeth, I was treated differently

Twin blocks , quadrihelix , arch expanders etc very rarely headgear these days. Very different to normal train track braces. If you time it right you can guide the jaw growth avoiding surgery , but eg twin blocks are not easy to wear and important to start at right time eg 11 to 12 ish

Look here at what a functional (twin block) appliance can do to jaw relationship https://www.greaterspringfieldorthodontics.com.au/before-and-after-photos/

we had an overbite fixed with twin block braces which, as prev posters have said, need to be worn as you’re still growing - ideal as you’re heading into puberty growth spurt - as your body is growing a more defined larger jaw anyway at that point and the block braces force it to grow in the right way (sort of).

But if he still has baby teeth I don’t think they’d do block braces yet? Feels like it might be worth paying for another opinion with an orthodontist. Orthodontists are better able to say what’s possible and what the risks are, I think.

The retained baby teeth at 12 are not a particular issue in this case, they can be extracted by the high street dentist on direction from the Orthodontist.

Similar with my 12 year old - though it wasn’t a surprise, I’d been dragging him to the orthodontist from about aged 10 as it’s important to start as soon as you can. Treatment started just before 12th birthday with twin blocks, them moved onto braces. They were done in about 1.5 years - beautiful straight teeth and no overbite.

Thank you for all your answers. Really good information! Anyone who's kids had the twin blocks, how did they find it? I dread the thought of this big having to wear them, he's a disaster at most things. I can picture us needing them fixed constantly or him refusing to wear them if they interfere with football etc

The normal advice is to wear the blocks 22 hours a day and only take them out to clean them , if playing a sport or for difficult foods.

They are difficult to wear at first and require the child to be committed otherwise as soon as they get to school they go in a pocket , get damaged,lost etc.

They require excellent cleaning and will make speech difficult at first . The problem with braces is when parent and dentist are keen and child isn't . Not wearing braces as stipulated and not keeping them clean causes more problems than doing nothing.

My DD had twin blocks from age 11. It's not an easy ride, I'll be honest. It takes a lot of getting used to and they must be pretty uncomfortable, at least to begin with.

BUT, it made a massive difference to my DD's face and jaw. She's very glad she went through the process.

Twin blocks are hard and messy but so worth it. You’re supposed to eat with them as well but that was the one thing we did compromise on when at school.

We made for an initial consultation with private orthodontist (who is also consultant at the hospital). They said for our child’s overbite they can do a twin box brace - they have to have their Top D teeth out and try to pick the growth spurt time so that the bottom jaw can be prompted to grow quickly. If he waited until he was an adult, he would have had to have surgery and jaw implants put in. It’s just a year of wearing a twin box brace at 12/13. Depends on what is causing the overbite. It is a short bottom jaw for my son. His was quite severe around 15mm so the bottom teeth were crowding his tongue.
as the timing of the twin box brace was critical to hit this growth spurt, he was prioritised in the waiting queue. So I would pay for an initial private assessment if you can and make your decision then. It was around £100/£150 towards initial consult . The private cost to having twin box brace followed by train tracks was around £4000.

For our son, he has to take them out for food and sport but wear them the rest of the time. It was achy for 3 days and took him a week to get used to speaking with them in. They fitted them in the summer holidays to give him a chance to get used to them before school.

By top D teeth out, I meant baby Teeth out and adult upper 4 teeth grown in.

Yes they can grow bone up to a certain age. First the muscle extends, but it’s not comfortable, so the brain sends a signal to the body to grow more bone. Our bodies are amazing!